The RIGHT Way to Lose Weight

If you could step inside my doctor’s office for the next few minutes and be a fly on the wall, I think we could learn some things together. I invite you to observe a few patients who came seeking help for obesity.

Kelley

Kelley is roundly obese, in her early 60s, and works in a church. She is very social and articulate. She is really worried about her kidneys because she knows someone on dialysis. She has been overweight all her life. She has tried multiple diet programs. She has been on the medically-supervised fasting program, and more than one that sends meals to her home. She has come to me to get healthy. We evaluated Kelley’s hormone levels and metabolism. Turns out, she has borderline kidney function, high liver enzymes, and very high insulin levels. She states she is very motivated to make some permanent changes. However, after several months of treatment, our conversation went something like this:

Dr. S: How are you doing with the diet?

K: Great!

Dr. S: I see that your weight is unchanged, why do you think that is?

K: I don’t know. I’m doing everything right.

Dr. S: Then why aren’t you losing weight?

(Long pause) She looked up finally and sheepishly said, “I need it.”

Dr. S: What do you mean?

K: Because it protects me. Since I was a little girl, I have been able to keep people at a distance by being overweight. When I’m fat, I’m transparent, people don’t look at me. I don’t exist. I have a wall of protection as long as I’m obese.

Dr. S: Why do you want to keep people away?

(Another long pause, then tears…)

K: I was sexually molested as a child, and I just can’t stand the thought of anyone being close to me. I have never told anyone this, and have never understood why I couldn’t lose weight before.

We discussed this further and what was the right strategy for Kelley to lose weight. It wasn’t the course of treatment we were taking or those she tried for many years. She needed help with childhood trauma. She was suffering primarily from PTSD, and needed to address this need first. Then, she may be able to move forward with the physical illness. In the meantime, she continued taking her medications, and we added some nutrient supplements to help protect her kidneys and liver, as well as a yoga program to help her deal with stress.

Julie

A very nice-looking 40-year-old blonde woman came in to see me. She was a filmmaker and valued her looks. She had started on one of our programs and was seeing the nutritionist, acupuncturist, and health coach. She was overweight, but not obese, and didn’t have any health issues related to being heavy.

Dr. S: Describe what happened.

J: I started getting palpitations, and thought I was going to die. I had chest pain, like an elephant on my chest, and I couldn’t breathe. My friend took me to the ER and they told me it was a panic attack. Since then I have had several episodes. I always feel like I need to go to the hospital, but my friend talked me out of it.

Dr. S: Have you ever had this before?

J: No. It has only happened since I’ve been on the program. I had the first one after I noticed that I lost ten pounds. It wasn’t an “Oh boy!” experience for me, just a feeling of dread – and then I got a panic attack.

Dr. S: Oh, your positive results should have brought some rejoicing, but you had panic, is that right?

J: Yes, that’s what it seems.

Dr. S: Why would you panic?

J: I’m not sure. I want to say that I don’t want to be skinny.

Dr. S: Why not?

J: I think it’s because all my life I have been defined by how I look. Twenty years ago I was a Calvin Klein model, traveling all over the world, having pictures taken of me, walking down runways, and being ogled and lusted-after. It was all about my looks. Nobody cared about me. Nobody knew me. They didn’t want me, they just wanted my body. Now I have a good career. I love making movies, and I’m good at what I do. I don’t want to go back to being that skinny girl that everyone looks at. I want to be seen for who I am, for my talents and abilities…

Her voice trailed off as she looked up at me.

J: Well, I guess I really don’t need your help. Now that I know what the issue is, I can live with it, and I’m not going to lose weight.

Dawn

Dawn was only in her 30s and was very obese. We call it “morbidly obese” because this is something people die from. She was recently diagnosed with diabetes and was prescribed medications. But, the medications were making her sick. She was nauseated and had no energy. She would fatigue with only a little exertion. She hated the drugs and came to me to help her get off them.

For eight months we worked together, trying various things to lower her blood sugar. The different diets and supplements didn’t seem to be working. At this point, I walked in the room and asked, “How is it going?”

D: Fine.

Dr. S: I see your blood sugar is still high, and your weight has not changed?

D: I’m doing everything you said!

Dr. S: (heavy sigh, exasperated) …then why aren’t you losing weight?

D: (in a monotone) Because I don’t want to.

Dr. S: (shocked) Why not?

D: I came here to get off the medications that were causing me problems, I don’t want to lose weight.

Dr. S: if you don’t lose weight, we can’t get the blood sugar down. Why don’t you want to lose weight?

D: I saw a show about weight loss and there was this guy on it who had lost a hundred pounds. They showed his before and after pictures, and it was worse – he looked old. His face was saggy, his arms were saggy, and he had a bunch of skin hanging over his belt. It looked horrible! I don’t want to look like that!

We discussed that she may not be saggy and that her skin would contract around her body as she slowly lost weight. But Dawn decided instead to go back to her other doctor and see if she could get on some different medications.

Natasha

One of the most obese people I ever met was Natasha. We never knew exactly how much she weighed because our scales didn’t go over 400 LBS at the clinic.

N: I eat a perfect diet, it makes no sense that I’m so overweight. I think it’s genetic. My father was over 500 Lbs. but he ate like a pig!

Dr. S: Let’s have you just write down everything you eat for a week. Write it down immediately so you get everything. Don’t wait until the end of the day and try to remember what you eat. All I need is the date, time, what you eat, and how much.

(A week later)

Dr. S: Did you keep a record of what you eat?

N: (eyes as big as saucers) YOU WOULD NOT BELIEVE WHAT I EAT!!!

Dr. S: (smiling) Try me!

She showed me the list, and one evening looked like this:

• Time: 6pm
• Food: Lasagna
• Amount: 1 pan

Dr. S: One pan? How big is the pan?

N: Oh, you know, one of those large frozen lasagna pans.

Dr. S: You ate the whole thing at one sitting?

N: No, I just took one small piece at a time over a couple of hours.

Dr. S: Then you got hungry again?

N: Well, I got hungry after an hour and went out for a hamburger.

Diet record (same date):

• Time: 9pm
• Food: hamburger
• Amount: 6

Dr. S: Then you ate 6 hamburgers? How big were they?

N: Just the regular hamburgers from McDonald’s.

Dr. S: Oh… What do you want to do?

N: Uhhh. (Looking down at the floor) I guess I don’t need you anymore. I know what I gotta do.

Asking the Right Questions

Part of the reason for me sharing these stories is to say that not everybody wants to be skinny. We have this idea in our world that, “You can never be too thin or too rich.” But this is not everyone’s ideal.

But mostly I want to point out that the most important part of starting a weight loss program is to begin with the question of “why?” If you are overweight, it is of primary importance to know why. Consider just some of the possibilities:

• High insulin causes carb cravings.
• High cortisol (stress hormones) cause insulin resistance and weight gain.
• Low thyroid is a rare bird – everyone wants to blame their thyroid, but it’s usually a secondary issue.
• Changes in other hormones can cause changes in weight. (Progesterone increases appetite)
• Some people just like to eat.
• Being unaware of what you eat can cause overeating.
• Some have not grown out of the “oral phase” of development.
• People often substitute food for other desires: sex, thirst, connection, and so forth.
• Depression can cause people to eat.
• Anxiety may lead to food addictions.

Note that there are hormonal, chemical, developmental, and psychological causes of obesity. Everyone is different. Two people who live together and eat exactly the same food may not be the same weight. However, getting to the root of the cause before treating the symptoms is essential. As in the four cases above, just treating the symptoms isn’t useful. I have had many people who try for many years to lose weight because they don’t know what’s going on in their own bodies. Both Kelley and Julie didn’t know why they needed to be fat – their own subconscious brain was hindering them. It was only after another problem came up, and many failures that they were willing to look at why.

Most overweight people don’t know why they eat. I have seen many who tell me they are on the perfect diet, and cannot understand why they aren’t normal weight. After a few weeks with a diet record, they see, like Natasha. Also, going from diet to diet may not be helpful if you have a hormone imbalance.

Finding the Cause

You can do this! Try the following simple ways to start:

Keep a diet record.

DO NOT put any spin or judgment. In other words, don’t leave things out because “It was just one,” or “It doesn’t count.” Also, don’t beat yourself up if you find yourself with a different written record than a mental record. Our brains do not record everything we eat, that’s normal. In fact, most of the things we do automatically are NOT recorded in the brain. You don’t remember how many steps you took, or how many breaths. Without a written record you would not know. So, just write it all down.

Write how you feel in a journal.

While keeping a list of the foods you eat can be helpful for part of your issues, it may not be the bottom-line. You may need to keep a journal daily of how you feel. How the food makes you feel. How it feels when you don’t eat. Writing is a great way to organize your thoughts and keep you on task. Writing your feelings will bring out any subconscious blocks to your weight loss program.

Some people have chronic stomach issues that make them feel hungry all the time, even though they have already eaten. When you are writing in a journal, as yourself about being hungry. If the reason you’re eating is due to stomach issues, it may be useful to take a digestive aid. Licorice root and Apple Cider Vinegar are generally helpful, you can find these here. This supplement calms the stomach and adds fiber so you don’t feel empty.

It often helps to have someone you trust ask you why.

Your brain will lie to you, but is more likely to answer another person truthfully. They must keep asking. The answer “I’m hungry all the time” is not the bottom line, it’s just a stopping point. There is another, “why?” underneath. See if you can get all the way to the bottom. It may take some time, and attention. In the cases above, I condensed months of visits into a few lines so it isn’t like it all just came out on the first visit.

Most of the time, you will find your “WHY?” answers by using these methods. If you don’t, there are several places to turn to look for root causes.

• A good counselor that can ask the right questions can be very helpful.
• A good doctor who can order the right tests of hormones to look at balance and ratios, as well as metabolic markers can guide you through the process.

Your why is going to be different than anyone else’s. Don’t take another person’s why as your own – unless it is your own. Once you know why, the rest is easy. Your “why” will tell you exactly “what” to do, and “how.” This is the light at the end of the tunnel. Anything is easy when you know how.

DIET RECORD

DATE           TIME                                             FOOD                                                     AMOUNT