JAMA Research Breakthrough: Fat Helps Diabetes!

Previously posted on Diet.com!

The Journal of the American Medical Association reported that normal weight diabetics were twice as likely to die than overweight or obese diabetics! These findings involved over 2,500 diabetic patients in long term studies.

View THE NEW YORK TIMES article here!

As surprising as this sounds, the same effect has been previously documented in people with heart failure, hypertension and kidney disease.

Why is this surprising? Because we are constantly bombarded with messages proclaiming that thin is healthy and fat is disgusting. These messages come from industries making billions by training us to believe this. Scientists simply can't compete with their huge advertising and marketing budgets. Research makes headlines for a day and gets buried, while scientists quietly go about their work.

The "obesity paradox" is a term suggesting that people with certain chronic diseases tend to have lower mortality rates if they carry excess pounds. How much more evidence do we need, before we call it a blessing?

Researchers at Dallas' Cooper Institute studied 22,000 men for 8 years. They found that men who were overweight but fit were two times less likely to have died than those who were lean but unfit.

The Harvard Nurses' Health Study found that physically active people had lower death rates, regardless of weight, than thin people who exercised less than an hour per week.

Even our own government studies (NHANES) confirm that overweight people tend to outlive thin people.

How about we toss out the scale, and strive to live a healthy lifestyle? Eat more natural foods, listen to hunger and satiation, move your body and cope effectively. That's about the best we can do.

Dr. Abby Gets Personal

Dr. Abby Gets Personal

As a passionate observer of weight fluctuation, I became fascinated by my parents’ recent journey.

Mom was skinny for most of her life.   I remember Dad making malted milkshakes to fatten her up, when I was young.  (None for me, though!)  As she hit her 70’s, she spread into a size 16, but retained her bean pole legs.  She never really dieted, but went through brief periods of “watching her weight.” 

Her weight gain seemed normal to me as she aged, and I was happy that it would protect her bones.  This was gratifying, since the most exercise she ever does is pushing a fork or remote control.

Early in her 70’s, she became ill, and lost about 20 pounds.  She was finally diagnosed with” Cdiff.”  After a few months it was under control, and she regained all 20 pounds.   

Dad always looked normal to me, though he developed some weight around the belly, as he aged.  He often did “calisthenics” at home, and before my time, was a very fit soldier.  His love for tennis kept him in good shape, and still helps manage diabetes, at 83. 

Last year, Mom underwent surgery for colon cancer, which resulted in a shortened colon.  There were some complications and scary moments, but in the end, she was cancer free, and able to live her life.

She lost 30 pounds over 6 months during the ordeal, yet gained every single one back in the next 3 months.

Dad was loyal and caring throughout, and moved into her hospital room for the duration.  They snuck him hospital food every day, and after six weeks, he lost 15 pounds. Afterwards, he also regained all of those pounds, in half the time taken to lose them.

Did Mom and Dad pig out, during the recovery?  Hardly.  They ate normally, and had absolutely no control over their weight.  Their bodies simply reverted to homeostasis – their normal weights.  In fact, they actually eat less than ever!  Mom says they used to have a steak each, and now simply split one.  Their bodies manufactured more weight from less food.

There was one other notable weight-related event.  About 8 months ago, Dad fell on the tennis court, and sustained some injuries.  He had to stop playing for a few months.  During those months, he lost about 7 pounds!  What could explain that?  Exercise is supposed to help you lose weight, not gain!

Perhaps he lost muscle tone, which is heavy, and perhaps he inadvertently ate less, since his body required fewer calories.  Who knows, but when he started playing again, he regained the weight.

What’s the moral of the story?  Our biological set points are tough, sturdy markers, which operate to maintain our optimal body weight.  People naturally come in small, medium, and large sizes, and try as we may to permanently alter our weight, it may be a losing battle.

These observations certainly reinforced my belief to strive for “health at every size, naturally.” Live a healthy lifestyle, to become your personal best.

I also believe this experience offered my parents a new perspective on people of size.  Perhaps they no longer believe that all fat people are gluttons.  Gaining 30 pounds in 3 months was eye-opening, and helped them to become more compassionate and respectful of diversity.

Dessert for Breakfast!

Originally posted @ Diet.com

Here’s a headline to celebrate: “Dessert at Breakfast May Help Dieters!” I wanted to toast to it, with cookies instead of toast!

I hungrily continued reading about this extraordinary study. Researchers divided 144 obese subjects, into a low carb breakfast group (LC), and a high carb plus protein-and-dessert breakfast group (D). Dessert eaters could choose from cookies, chocolate, cake or ice cream. Daily calories remained the same for both groups, but the LC breakfast contained 300 calories, while the D group enjoyed 600 calories for breakfast. Everyone ate the same lunch, but dinner consisted of 600 calories for the LC’s and 300 calories for the D’s.

At the end of 16 weeks, both groups lost about 32 pounds. However, after another 16 weeks, the dessert group lost an additional 13 pounds, while the others regained all but 3.5 pounds! Isn’t this the best news ever?

Here’s the science: Those on the dessert regimen maintained lower levels of ghrelin, which is the hormone responsible for hunger. As a result, they reported being more satisfied, with significantly reduced hunger and cravings than the LC breakfast group. The LC breakfast group experienced increased cravings for sweets, fats, carbohydrates/starches and fast foods! 

But here’s the piece de resistance...

Both groups had similar insulin and glucose levels before the study, and both groups improved at week 16. However, by the end of follow-up, the dessert group enjoyed even better levels, while levels became much worse for the LC breakfast group!

The same thing happened with cholesterol and triglycerides. Both groups were similar, but by the end, total cholesterol, triglycerides and LDL (bad cholesterol) were significantly lower for the dessert-eaters, than the low carb breakfast group! In fact, the good cholesterol (HDL) was significantly higher! Yahooooo!!!!!!!!!!!

It looks like dessert-eaters were so satisfied at breakfast that they were able to continue their diet into the end zone. The joy of eating dessert at breakfast, combined with reduced ghrelin, is a winning combination that can probably be sustained forever. Would you complain if I prescribed that for you? The low carbers could not continue adhering to their regimen, and regained most of their weight.

I have often suggested that my patients eat treats for breakfast, such as a whole grain waffle, with natural ice cream, and a drizzle of chocolate syrup. Those who comply, never binge on ice cream later. It seems better to have preferred foods when there is more control, such as in the morning, which seems to get it out of their system.

Having treats for breakfast also eliminates the “forbidden food” syndrome, by lowering its reward value. If you know you can have cake for breakfast, there is less desire for it at other times. We call it “prescribing the symptom.”

Bottom Line: Eating a high carbohydrate, high protein breakfast including dessert, can help people to maintain a healthy weight management plan.

"The Fat Trap"

The Health editor of the NY Times admitted that she is approximately 60 pounds overweight; the result of yo-yo dieting.  She then proceeded to review research to shed light on why this happens.  To date there are approximately 900 postings; it generated tremendous interest.  Many posts were about not giving up on weight loss despite the futility, and others were about how they lost weight.  Here is the link to “The Fat Trap”  http://well.blogs.nytimes.com/2011/12/28/why-lost-pounds-come-back/  What follows are my responses, followed by attacks from my detractors.

“Why might our biology fight so hard to regain lost weight?  Because losing weight is not in your best interest?  Why, in the face of scientific and anecdotal evidence do people think that losing weight is still a healthy and admirable goal?  Yo-yo dieting has been proven to be harmful, and people who have kept weight off generally meet the criteria for eating disorders, and obsessive-compulsive neurosis!

People are obviously meant to come in a variety of shapes and sizes.  The process of living healthfully, not the outcome of weight loss counts most, and the “evils” of obesity can be easily managed with modern medicine and healthy lifestyles.  Furthermore, insulin resistance, hypertension, and lousy cholesterol have also been found to result from yo-you dieting.  They also occur in thin people.

There is no research suggesting that people who lose weight live longer.  The NY Times recently reported that New Yorkers are living longer than ever before, despite increased obesity! (This was also found by the CDC for all of America.) 

The “obesity crisis” seems like a scam to sell diet products and make discrimination against people of size acceptable.

Let’s strive to live a relatively healthy lifestyle, and accept our resultant size with grace and dignity. No more putting ourselves or others down; discrimination begins with us.”

Thank you.

Abby Aronowitz, Ph.D.

Expert psychologist for Diet.com

www.YourFinalDiet.com

“A Ph.D. working as an expert psychologist for Diet.com believes the "obesity crisis" is a "scam." Really? Diabetes, heart disease, loss of mobility, loss of sexual attractiveness, social disapprobation--all are figments of our imagination, implanted in our minds by the folks who sell diet products? If people are "meant to come in all shapes and sizes" what explains the phenomenon of the dominant shape and size changing very significantly over the last 50 years. "Meant" by whom? I am suspicious of any post which ends with a link to a for-profit website designed to sell the poster's book. ($12.99 shipping and handling). Does not this make the poster a person who "sells diet products" herself?”

Comment:

“Why, in the face of scientific and anecdotal evidence do people think that losing weight is still a healthy and admirable goal?"

Apparently, you haven't read the conclusive epidemiological evidence that obesity, (BMI >30), doubles one's risk of cardiovascular disease and cancer. Moreover, type 2 diabetes, a disease exclusive to obesity, is not only the primary cause of blindness, renal failure and amputations, but typically shortens one's lifespan by a decade or more. Obesity can further affect one's quality of life, increasing the risk of asthma, arthritis and other autoimmune diseases. The scam of the obesity crisis is that the obese are not made to pay the significantly higher medical costs they impose on the rest of us.”

Here’s my next post:

“Keeping weight off is damn near impossible for the average mortal, But living a healthy lifestyle regardless of the scale, is a more achievable goal for many.  Thin people should live healthfully too, but many believe that because they are thin, they can eat crap and sit on the couch…

The focus on “fat” per se, does everyone a disservice.  Healthful living should be everyone’s goal, but many fat people have learned to hate their bodies, because they’re considered ugly, unattractive and worthless.  This absolutely demolishes self-esteem, and represents the malignancy of discrimination.

We take better care of that which we love, than that which we hate, so a cultural and personal attitude adjustment is in order.

Here is a link for a free download of my book,” Your Final Diet.” 

http://www.yourfinaldiet.com/book-promo.html 

It offers a path to healthful living by making peace with food and body image, while accepting the resulting size with grace and dignity.

 It was endorsed by Hillary Clinton, because it’s particularly empowering to girls and women.   Hey, it’s worth it, just for the chapter on self-acceptance!

BTW, I am an expert psychologist for Diet .com, writing a “Health At Every Size, Naturally” column, entitled “Where Science Meets Sin!”.  I am very grateful to my editor be being so open-minded.”

Here is another detractor:

"Keeping weight off is damn near impossible for the average mortal ..."

Not a great attitude, Dr. Abby. I also am tired or reading about supposedly fit fat people and broken down thin people all of whom are eating badly when most unfit people are fat.

The reason the focus is on extreme overweight and obesity is because they are associated or cause many obvious, serious problems. Yes, everyone should eat well and exercise, in our economy, good luck with that. But the costs of the obesity epidemic prompt the most attention.”

My final post:

“Our bodies are programmed for survival – at least living long enough to have and raise children.  So why won’t our bodies help us to maintain weight loss, if it’s so healthy??? Why does it fight like the dickens to put weight back on?  And why does every population study around the world find highest survival rates for overweight people?  (Our own government found 86,000 FEWER deaths in the overweight range,and 33,000 more deaths in the thin range.) Are we living longer than ever before despite our increase in weight or because of it?   Fat stores energy, which aids survival during illness, but researchers are also investigating the role fat plays within the immune system.  Can anyone cite research finding that weight loss extends life? All I’ve seen is that most biological improvements are quickly reversed with weight gain and yo-yo dieting - which happens in nearly 100% of cases.  The “obesity crisis” correlates with an increase in DIETING!

Many thanks for the overwhelming requests for the free download of my book, in a previous post.  If anyone else would like to learn how to finally make peace with food and body image, and learn what a healthy lifestyle means – regardless of weight loss, I will reprint the offer here.  Once we stop hating our fat, and loving ourselves, we can find a relaxed, enjoyable truce with food and movement, as opposed to the obsessions reported by those in the Weight Registry.”   http://www.yourfinaldiet.com/book-promo.html

Thank you.

Dr. Abby!

Longevity Linked To Fat?

Originally posted @diet.com

According to the Centers for Disease Control and Prevention, U.S. life expectancy just hit another all-time high. Is this despite increasing weights of Americans, or because of it?

Data recently reviewed from 2009 found 36,547 fewer deaths than the year before. The newly estimated age of 78 years, 2 months for a baby born in 2009 compares to 75.4 years in 1990. In approximately 20 years, nearly 3 years were added to our lives!

The average American male gained 17.1 pounds and the average American female added 15.4 pounds in the last 20 years. That's 70 days of life added for every woman's extra pound of fat! Why didn't this make headlines??? If life expectancy was down, everyone would be blaming the "obesity crisis."

Fat bias is pervasive and acceptable. It skews interpretation of research, and interferes with dissemination of true methods for obtaining optimal health. When fat is always blamed for ill health, it obscures more important determinants, such as genetics and lifestyle.

News stories linked increased life expectancy to a range of causes, including less heart disease, fewer homicides, better medical treatment, increased vaccinations, and decreases in smoking. Nowhere was the correlation between Americans' expanding lives linked to their expanding weights.

Research continues to explore why increased weights are linked to increased life expectancy, since this is actually old news. Every population study around the world found longest survival rates in the overweight range, despite pervasive beliefs that thin is the healthiest range. In fact the NIH found 86,000 fewer deaths in the overweight range when compared to the normal weight range, and 33,000 more deaths in the thin range. Why didn't they revise weight recommendations after their own research confirmed this???

There is some evidence suggesting that fat is part of the immune system, and keeps us healthier. Of course fat provides stored energy reserves to aid survival in times of illness. Additionally, fat secretes estrogen, which can compensate for ovaries shutting down in menopause. Estrogen is typically considered the fountain of youth, so perhaps this contributes to increased life expectancy in women. Females will tend to die at 80.6 yrs, whereas males will kick the bucket at an average of 75.7 years.

I also believe there may be an evolutionary reason for this. One guy can impregnate many women, whereas most women give birth to only a few children. There is more of a need for women to hang around to nurture them, whereas if a bunch of men died off early, the species can survive with only a few studmuffins.

My advice is to live a relatively healthy lifestyle, enjoy life, and don’t worry about your weight. Becoming your personal best is a great goal, since not everyone was meant to be thin.

Dr. Abby Bashes "The Bead Diet"

Originally posted @diet.com

Have you heard of “The Bead Diet?” According to their website, www.accuweight.com, people lose 15 pounds a month, with most people losing more.

This three part program includes applying pressure to tiny beads behind the ear (acupressure), performing “Chi Gong Breathing,” and a crazy food plan.

Acupressure is designed to trick the body into feeling full, by creating balance through the hypothalamus. This part of the brain governs fullness and the amount of food eaten.

“Chi Gong Breathing” is supposed to harness the life force, “chi,” to improve health and longevity, and increase feelings of peace and harmony. They also claim that it enhances energy levels, attention, concentration, and mental alertness.

Next comes the food. There is no specific information on the site, but I’ve been told that for two days you eat milk products, and for two days fruits and veggies. The site promotes lots of artificial sweetener.

The nutritional balance of the food, along with acupressure, supposedly tricks the body to ignore the reduction of calories. This prevents starvation mode. The body uses stored fat for energy, resulting in weight loss and amazing medical results. If you exercise and feel faint, they suggest a bit of honey in water, and a sugar-free electrolyte drink if necessary.

They encourage eating between noon and 6PM because the body needs nutrition during those hours. Eating outside those hours might cause the body “to cannibalize itself using not only fat, but muscle, organ mass and negatively affect your metabolism.” YOWZA!

Finally, after losing all the weight you want, they promise maintenance within 3-5 pounds of goal, apparently your new set point.

Does this sound too good to be true? Even if everything goes according to plan, the claim of maintaining that level of success sounds preposterous. It would be more believable if they provided some decent research confirming this. After all, they have been operating for 11+ years, yet there is not a single follow-up study on their website.

The only study cited followed 16 subjects on the plan for 13 weeks. They lost an average of 46 pounds. Since when is sixteen subjects considered strong science, especially without any follow-up???

We all know that most people can lose weight on any fad diet, but few people can keep it off without developing an eating disorder; ie. preoccupation with food and weight. I believe the two part system of dieting to lose weight, and then trying to maintain the loss, is what has failed. There needs to be one way of living, which strives towards health and fitness.

"Dr. Abby's Diet Resolutions"

Originally posted @diet.com

New Years, New Years Resolutions,

Time for cleansing absolutions.


Diets, diets, everywhere,

Wash the fat from way down there!


Fat from cakes and nog and such,

Such a glutton, ate so much!


Why oh why am I so fat?

“Cuz on my ass I simply sat.


Gimme this and gimme that,

More o’ this, and more o’ that.


But is it time for deprivation?

Oh no, please, such aggravation.


Time to try out something new,

Something easy, here’s a clue.


Compensation, compensation!

Beats that ugly deprivation.


Health at every size is great!

Be your best, with no self hate.


Tweak your choices,

Mouth rejoices.


Dark chocolate bits

For antioxidant hits!


Eat when hungry, stop when enuf,

And exercise to make you buff!


Take my advice,

To deal with the vice.


Dr. Abby’s Diet Revolution

Is certainly the best solution!