Sustainable Weight Loss provides a road map to long-term weight loss that is simple and offers easy-to-understand principles. Gain the personal control needed to break the shackles that inhibit the ability to achieve weight loss goals. Some diet experts advocate counting calories each time we prepare to eat. This kind of complexity is one of the reasons many people fail with diets. One-size-fits-all approaches are only a small part of the overall diet problem. These concepts are of vital importance to weight loss success: - Weight Control = Good Health-Weight control and good health go hand-in-hand. - Goal Setting-The importance of good goal setting and sound implementation of your plan cannot be overstated. - Lifestyle Changes-Good weight management cannot be accomplished without some basic lifestyle changes. - Caloric Balancing-The hallmark of good weight management is a balance between calories consumed and calories burned. - Reasonable vs. Perfect Body-We must take an honest look at ourselves, and our own personal traits to determine what body size and shape is reasonable for us. Come to grips with the basic requirements of weight control and find ways to apply them in your own life. Lose the weight you want to lose, and sustain that weight loss-for good.

Sustainable Weight Loss

The Definitive Guide to Maintaining a Healthy Body WeightBy D. Lee Waller

iUniverse, Inc.

Copyright © 2011 D. Lee Waller, JD, ND
All right reserved.
ISBN: 978-1-4620-0160-6

Contents

Dedication....................................................vAcknowledgements..............................................viiAbout the Author..............................................ixForeword......................................................xviiPreface.......................................................xixIntroduction..................................................xxvWarning / Disclaimer..........................................xxxvPart One Understanding the Basics.............................11 An Overview of the Human Body...............................32 The Role of Genetics........................................13Part Two Consider Your Options................................233 The Importance of Food Choices..............................254 The Power of Exercise.......................................695 Psychological Aspects of Weight Loss........................1056 The Role of Hormones........................................153Part Three How to Make a Difference...........................1757 The Driving Force Within....................................1778 Lesser-Known Weight Loss Considerations.....................2199 The Last Resort - A Hidden Trap Awaits......................24510 Summary - What Action to Take Now..........................263Appendix How to Find Help.....................................285Index.........................................................289

Chapter One

An Overview of the Human Body

The human body is a marvelous creation intended to operate flawlessly for decades, by adapting to its surroundings in order to serve its changing needs. While the plant kingdom is tethered to the earth the animal kingdom is intended to move freely and independently of its surroundings. The existence of physical objects, plants, animals and others, appears at first blush like they should last for long periods, but existence on earth is not quite that simple. There is one rule of the physical universe that interferes with that idea. It is called entropy.

Understanding Entropy

Entropy is "the tendency of any system to move toward randomness or disorder." More entropy equates to greater disorder of the system. "In general most systems within the physical universe tend toward increasing positive entropy and towards more disorder over time, (i.e. things tend to fall apart)." If we look at the things around us, for example a car, a refrigerator, a TV, etc., we see entropy at work. Through use all of these items deteriorate over time. Ah, but there is good news for all of us mortals! There is an exception to the entropic rule of the physical universe and it is this.

The plant and animal kingdoms actually experience negative entropy. Both plants and animals move toward decreasing disorder of their systems. The bodies of plants and animals continuously try to correct themselves. If the body is damaged or contracts an illness it works tirelessly to heal itself. For example when the human body experiences a laceration, abrasion or bruise or when it contracts a cold or the flu, if left alone it will heal itself. The one and only time negative entropy doesn't work for the human body is when the body is too weak or run down to be able to wage the appropriate fight, at which point the organism experiences a steady decline in health, resulting in death.

By applying this fact to the condition of excess body weight it is easy to understand the body works diligently, around the clock to maintain a stable and homeostatic weight. In reality your body is not only constantly fighting for your survival it is also trying to optimize your weight, what ever that weight might be.

Having identified negative entropy, it must be understood no matter how much the body fights on behalf of us, it is still possible to override its propensity for perfection. In the context of obesity there have arisen two interesting theories that support this idea. The first theory is called the Absence of Protection Model, which believes obesity is the result of living in an obese causing or obese promoting environment. The second theory is called the Central Resistance Model, which believes under normal circumstances the body's energy balance system provides an effective defense against weight gain and/or weight loss and obesity involves genetic or acquired defects, impairing the function of this system. There will be more as to how this might work in the chapters on genetics and the role of hormones.

How Cells Produce Energy

The science of Cellular Physiology is the study of cells, including their internal structure and function. While it is not the goal of this book to turn you into an expert on this subject, it will be necessary for you to have at least an elementary understanding of a few basic concepts of how a cell produces energy. Let's take a closer look at some aspects of the internal functioning of a cell.

"Cells are the fundamental structural and functional units of living organisms." Cells are the building blocks for tissue, organs and bones within the body. It has been said we live and die at the cellular level.

Cells are comprised of a vast array of component parts. One that is critical to our understanding is the mitochondria (mye-toh-KON-dree-ah). All cells in the human body contain one or more mitochondria. The "mitochondria could be called the power plant of the cell because it is here that energy from nutrients is converted into a form that is usable by the cell." The end product of this nutrient conversion process is adenosine triphosphate (ATP). ATP is the source of energy the cell uses to function.

There are two ways the mitochondria produce ATP. They are:

• Aerobic Metabolism - The word aerobic means in the presence of oxygen. This process occurs when either fatty acids or glucose are taken from the bloodstream into the mitochondria and combined with oxygen to produce ATP, water and carbon dioxide.

• Anaerobic Metabolism - The word anaerobic means in the absence of oxygen. This process occurs when glucose is taken from the bloodstream into the mitochondria and is involved in a fermentation process called lactate fermentation, where it is combined with creatine phosphate, resulting in the production of ATP and lactic acid.

There will be a more detailed discussion of this process in the chapter on exercise.

Good Health and Weight Control are Inseparable

For more than 100 years there has been substantial support for the idea that a homeostatic system exists in the body that adjusts energy intake and energy expenditure to promote the stability of body fat. To support this hypothesis data cited in the chapter on the role of hormones demonstrates there are in fact hormones that perform this task precisely (e.g. ghrelin, leptin). This concept supports the previously mentioned rule of negative entropy. The controversy that remains is that if our bodies are truly homeostatic systems then why has the condition of obesity grown so rapidly in recent years. While this question lingers, research has already proven that our modern lifestyle is causing defects in the homeostatic system. There are also some additional facts that we know relative to health and obesity.

It is virtually impossible for an obese person [usually defined as a person with a Body Mass Index (BMI) greater than 30], to return to a normal body weight (a BMI of 18.5-25), and not experience measurable health improvement. In both Finland, and the United States, it has been shown that a reduction of five percent of body weight can reduce the risk of developing type 2 diabetes, in high-risk individuals. Minimal weight loss can reduce: (1) systolic blood pressure during rest, (2) systolic blood pressure and pulse rate after mental stress, during the recovery period, and (3) the time it takes for the body to reach a resting systolic blood pressure level. A decrease of five to ten, percent of body weight is also known to improve triglycerides and HDL cholesterol, in addition to blood pressure.

I believe there are six critical factors contributing to optimal health. They are shown on the Wheel of Health and will be considered in detail in later chapters. The Wheel of Health suggests the percentage contribution each factor makes to our health and identifies several important considerations, that may help control those factors. The factors are:

• Genetics (10 percent),

• Stress (10 percent),

• Rest (10 percent),

• Environmental considerations (20 percent),

• Exercise (20 percent),

• What we put in our bodies (30 percent).

The Set Point Theory

In 1982 a couple of researchers named Bennett and Gurin proposed what they called the Set Point Theory, where they explained how the human body resists changes in body weight from its own natural state of equilibrium. Their theory holds that, "when body weight is reduced below a given a set point, the body makes a series of internal adjustments to resist weight change and conserve fat stores." The body's main control mechanism is believed to be the brain's hypothalamus, which plays a key role in maintaining the body's homeostasis. When dieting begins the metabolism slows down in order to conserve the calories it already has, and as a result of "this innate biological response, dieting becomes progressively less effective, and ... a plateau is reached at which further weight loss seems all but impossible." This situation is especially troubling for people attempting to lose weight by dieting, because as soon as normal eating is resumed the body returns to its previous weight.

A few years later Harris suggested the state of equilibrium characterized by the set point may also regulate a number of other parameters, "including nutrient balance, energy balance, and physical aspects of adipose tissue, such as fat cell number and size." Over the years the set point theory has been extended, and it has been shown the body's set point can be changed. Factors shown to lower the set point are: (1) dietary changes (e.g. lowered fat consumption), (2) exercise levels (e.g. increased aerobic activity), (3) drugs (e.g. fenfluramine), and (4) hormone changes (e.g. ghrelin).

I didn't mentioned the set point theory, to give you something more to think about but if it comes up in conversation with others, you will have heard of it and understand what it's all about. If you proceed forward with the recommendations from other chapters regarding proper dietary practices, exercise programs, hormone evaluation, etc. you will lose the weight you want to and will keep it off, without having to concern yourself about your set point.

Body Type

In the 1940's an American psychologist named William Sheldon while studying the association of body types and human temperaments, proposed that human body types be classified into three somatotypes, which he named, ectomorphic, mesomorphic and endomorphic. Here's how these three body types are characterized:

• Ectomorphic - The person with a light bone structure, long, thin muscles and limbs, low fat storage, who tends to be slender (perhaps underweight) and finds gaining weight difficult.

• Mesomorphic - The lean athletic person with a medium bone structure, who gains muscle easily with minimal fat gain, and is often described as muscular or wellbuilt.

• Endomorphic - The large bone structure person who gains weight easily, with predominately more fat than muscle and often battles a weight problem throughout life.

It is possible for any of us to have characteristics of more than one somatotype. After looking closely at ourselves and at others it should be easy to see how different people tend to fall into one of these body types. Although many experts have attempted to discredit the somatotype criteria as being outdated, I think you will find this to be very useful as you progress forward with weight loss. I have focused on this distinction, not to make you believe your somatotype locks you into a particular body for life, quite the contrary. It is true you cannot change your bone structure, one of the basics of your somatotype, but you certainly can change your body composition. So what is body composition?

Body Composition

The body is composed of five distinct parts. They are fat, muscles, organs, bones and everything else. Since the topic of this book is weight loss and the goal is weight reduction, coupled with weight maintenance, the main thing we want to get rid of is body fat. During weight loss it is important to know where the lost weight is coming from, (e.g. fat, muscle, water), because you certainly don't want the loss to come from lean muscle mass. What is important to know is how much fat your body contains, usually defined as a percentage of total body weight. Below we will look at three of the most popular measurement techniques.

Body Mass Index (BMI)

Body mass index (BMI), became popular in the 1980's, as rates of obesity climbed sharply. BMI is often mistakenly used as a measure of body composition, while it is really a measure of relative heaviness. BMI is referenced extensively in the research data discussed in later chapters. It is noteworthy that BMI tends to increase with age, then plateau or even decline slightly. A person's BMI is the result of a numerical calculation using their height and weight. It is not important to be able to calculate BMI since BMI data tables and calculators have been developed to give you that information. Should you need your exact BMI, go online and Google BMI calculator and follow the directions. What is important to understand is the BMI number is a gauge, often used to determine whether a person is underweight, proper weight, overweight or obese. Once a person's BMI has been determined, the following table is used to identify the body condition. Body Mass Index Comparison Chart

The major problem with the BMI calculation is it uses total body weight rather than estimates of fat and lean body mass separately, therefore it does not discriminate between the overly fat individual and the athletic more muscular body type. Since BMI calculations frequently favor body weight only, while the makeup of the individual is really a combination of genetic and environmental factors, BMI frequently fails to accurately reflect the actual body composition.26 I feel this is enough of a problem to deem the BMI almost worthless, even though researchers cannot seem to give it up.

Waist to Hip Ratio (WHR)

The waist to hip ratio (WHR) may be the most widely used body composition technique. Since abdominal obesity is known to increase health risks, WHR is one quick means of determining body fat distribution. It is calculated by dividing the waist measurement by the hip measurement. The American College of sports medicine interprets WHR measurements outside the following ranges to indicate a high level of health risk:

Waist Circumference (WC)

The waist circumference (WC) is used frequently because it is a convenient measurement of fat tissue. It is nothing more than a waist measurement or more simply, your current pant size. I believe using the waist of your pants, as a fat monitoring tool, is much simpler than having to take a physical measurement, like you do with WC. Instead of using a tape measure, simply apply my Belt Hole Rule and monitor the belt you normally wear to hold your pants up. Whenever you put your belt on take a close look at which hole you are using. If you are running out of holes you are gaining weight and if you are seeing extra holes you are losing weight. This technique usually works well for men since the waist is the first place weight is gained and the last place it is lost. Since women tend to gain first in the hips and thighs the Belt Hole Rule may work better if combined with a visual observation of those areas.

Fat Free Mass (FFM)

The most reliable body composition technique and a good method of determining an overweight condition or obesity is to determine fat free mass (FFM), which is also frequently referred to as lean body mass or lean muscle mass. FFM is expressed as a percentage of total body weight. There are a number of methods used to determine fat-free mass. Among the most popular are skin fold measurements, bioelectric impedance and hydrostatic weighing. These three techniques require skills and equipment beyond the scope of this book; therefore, they will be left for you to explore with a personal trainer or other health professional, should you wish to do so. Below is a table showing estimated fitness levels as they relate to percent of body fat. If you are serious about measuring your FFM, you can find inexpensive fat loss monitors on the Internet. I personally have a battery operated, Omron model HBF-306F that can be purchased for less than $35.00.

Metabolism - Friend or Foe

"Metabolism is the aggregate of all the chemical reactions that take place in the body." Metabolism "involves a complex network of hormones and enzymes that not only convert food into fuel but also affect how efficiently you burn that fuel." The speed and efficiency of our metabolic processes are what is called our metabolic rate. The majority of our metabolic rate is determined by our gender, age, amount of lean muscle mass, and by the amount of exercise we do. Our basal metabolic rate (BMR), which is also known as resting metabolic rate (RMR), "is the amount of energy that is necessary to maintain life and to keep the body functioning at a minimal level," and about 60 to 75 percent of the our daily energy use is for basal metabolism. The reason this is important for you to know is because the remaining 25 to 40 percent of daily metabolism is something you have control over.

(Continues...)

Excerpted from Sustainable Weight Lossby D. Lee Waller Copyright © 2011 by D. Lee Waller, JD, ND. Excerpted by permission of iUniverse, Inc.. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
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