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If the test measured the ability to lose weight, the results would parallel the failure rates for Americans who are trying to reduce their girth. According to the 2011 Food & Health Survey conducted by the International Food Information Council Foundation, 77 percent of Americans are trying to lose weight or avoid gaining weight. Despite their efforts, nearly 70 percent of Americans are overweight or obese.
Given the inability of the majority of us to manage our weight, are we all just weak-willed slackers? Or are other factors operating to make failure the most likely outcome?
For the most part, the test takers do not blame others for their failure; they blame themselves. Desperate to succeed despite a history of dangerous scams and diet schemes, consumers continue their search for a magical solution to weight loss and willingly throw money at the problem. Growing at an annual rate of nearly 11 percent for the past five years, the market for weight-loss products (food, drugs, supplements, services, ingredients, devices, accessories and cosmetics) in 2014 is projected to reach $586 billion.
Designed to Eat
So why is it so difficult to lose weight? Obesity psychologist Jim Keller, Director of Behavioral Health at the WeightWise Bariatric Program in Oklahoma City, asserts that the human body and brain are designed to eat -- thus explaining why losing weight proves so challenging for so many.
Keller, who has conducted 14,000 psychological interviews of individuals considering bariatric surgery, says that the causes of obesity are complex. Obesity is not simply a function of laziness or an indication of emotional instability. In addition, genetic and biological factors do not act in isolation, but are constantly interacting with an array of environmental factors. Keller notes that both the availability and persuasive advertising of unhealthy food contribute to the obesity epidemic.
Why Is Changing Eating Habits So Difficult?
While external and genetic factors play a role, no one questions that individuals are in charge of their daily decisions about what and how much to eat. So once we make up our minds to change a habit, why do we find ourselves falling back into old ones? Why can't we simply make a decision and get on with it? What puzzles and frustrates many trying to lose weight is why changing one's eating habits is so darn hard.
According to Dr. Howard Rankin, an expert on behavioral change, a key part of the problem is that we believe we have more control over our behavior than we really do. Stress, anxiety and addiction can limit the conscious control we have over our choices. Dr. Rankin asserts:
What drives our behavior is not logic but brain biochemistry, habits and addiction, states of consciousness and what we see people around us doing. We are emotional beings with the ability to rationalize -- not rational beings with emotions. If we are stressed, depressed or addicted, no matter how good the advice we are given, chances are that we will not be able to act on it. The more primitive, emotional brain generally has precedence over the newer, more rational brain.
But even if we removed those individuals who are stressed, depressed or addicted from the test group, we still would be left with a large population of individuals who are unable to stick with their resolve to lose weight.
I speak from personal experience. I've started many a day resolved to eat healthfully for the rest of my life. But by late evening, a piece of chocolate cake with vanilla ice cream has somehow found its way into my stomach.
One possibility is that I have multiple personalities. Another is that resolve is not constant. According to Dr. Rankin, resolve ebbs and flows like the tide. One moment we can be fired up to be mindful of our eating, but in the next instant, our mood, our state of consciousness or the context has changed. Much to our chagrin, we find ourselves indulging in unhealthy treats.
Dr. Rankin also has a healthy respect for people's extraordinary ability to rationalize almost any behavior. We can persuade ourselves to do almost anything we want to do -- especially when the behaviors are ones that our brains are used to doing. But trying to persuade ourselves to do things that we don't really want to do -- behaviors our brain is not used to -- is not easy. We are very adept at making wonderful (and plausible) excuses as to why we can't do what we don't want to do.
Five Tips to Help You Lose Weight
The obstacles to losing weight, however, are not insurmountable. The National Weight Registry is tracking over 5,000 individuals who have lost an average of 66 pounds and kept the weight off for five years. Insights from their success stories are consistent with these five tips from Dr. Rankin:
1.) Focus on a change of heart, not a change of mind. Losing weight through changing what and how much you eat doesn't happen because you rationally decide to lose weight. You have to have a change of heart; that is, you must get in touch with your deepest, heartfelt desires.
Your motivation may not be positive. Indeed, it may stem from a fear of loss. For example, you may not want to get sick. Or you may not want to be ostracized. To get in touch with your motivation, think about the negative consequences of not changing as well as the positive ones. Getting fit must become a priority and your life must be organized accordingly. Nobody can change you but you, and once you've made the changes, you need to stay focused. Successful individuals keep their motivation in the forefront of their minds all the time.
2.) Practice self-discipline. Self-control is a muscle that, like other muscles, needs exercise and strengthening. Change doesn't happen because you want it to happen. Each time you resist temptation, you are developing greater self-control. Success breeds success. Facing down temptations builds strength for future decision moments. Some of my clients throw away their favorite food as a symbolic act that shows they have control over the food and not the other way round.
Self-discipline is required for behavior change, but does that mean that the lack of self-discipline causes obesity? No. That would be like saying aspirin helps a headache go away, so headaches are caused by a lack of aspirin -- which is nonsense!
3.) Eliminate or reduce sugary, fat-laden foods. Such foods create physical changes at a cellular level that alter how our brains and bodies react. When analyzing your level of addiction, consider both physical dependence (changes at the cellular level) and psychological dependence (the habitual repetition of a behavior in an attempt to satisfy an emotional need). For example, how often do you use a sugary treat to lift your spirits?
What is often misunderstood is that these dependences exist on a continuum. You can be mildly, moderately or severely dependent, and the degree of dependence determines how difficult it will be to change.
4.) Make history your teacher, not your jailer. You can learn from your mistakes. Instead of [beating yourself up] when you fail to keep your promises to yourself, seek to gain self-knowledge so you won't repeat the error. No one is perfect. Be sure to acknowledge what you are doing right, not just what isn't working.
5.) Surround yourself with friends, family and colleagues who will support your effort. Getting fit and losing weight absolutely require others. Although you alone can make the changes you need to make, you can't make the changes alone. Not only in terms of eating, but in all areas of our lives, we are much more influenced by other people than we imagine. One of the most potent forces for positive change is the emotional support of the individuals who surround you.
You must, however, ask for the support you need. Don't assume that others know what would be most helpful to you. Similarly, you need to avoid those people who aren't on the same page as you. Social pressure can work for you or against you. Hang out with the right people.
Change is difficult, and whoever finds a way to bottle and market motivation and self-discipline will make a fortune. In the absence of such a product, however, the next best thing is helpful insights into the process of changing our behavior.
Dr. Rankin reminds us that, for better or worse, our core, emotional values will ultimately determine our choices. Once we identify our heartfelt desires, we can use them to create a healthy lifestyle that reflects our best self. Our deepest values can be summoned to keep us on track, especially when we are facing temptations and distractions. They can also serve as our compass when we go astray.
If we are willing to remain diligently committed to our emotional values, we can be confident that we will succeed in realizing our health and fitness goals. And when we do, maybe some of us will go one step further and give support to family and friends so that they can join us in becoming healthier and happier.
What is this enigmatic and exalted state called 'enlightenment'? Why is everyone so enamored by this word? Why is everyone so eager to attain it? Does anyone really understand the essence of it? Many speak of it as if they do, and while others use it to enhance their status. I have been in the presence of such people, and I am always astounded at the level of ignorance guiding their behavior. Such people are nowhere near awakened, let alone enlightened, and this includes both teacher and student. It is like the blind leading the blind. The irony is that the effort they expend on becoming enlightened only impedes the realization that they already are. Enlightenment is not something you do; it is about being.
This beingness seems to be the hardest lesson to master, for it involves a gradual, developmental and cumulative process of growth through steps and stages. It emerges as a natural consequence of allowing, rather than by any egoic effort to attain it, because it involves surrendering and the ultimate dissolution of the ego in order to realize it. You can read the world's greatest mystical and spiritual literature, become very knowledgeable on techniques, rites and rituals, and yet remain completely unchanged. Accumulation of knowledge is not enlightenment, and neither is the prowess of mystical vocabulary the proof.
What we need is a new definition of what enlightenment means within the context of modern existence. The popular version is depicted as a sudden state of rapture and ecstasy, accompanied by luminous light and visions, an end of suffering and the dawning of bliss, thus permanently enlightening the aspirant. All this may very well be true, but does this depiction really explain what enlightenment is?
This state of beingness is easy to attain or maintain in an ashram, monastery or somewhere up in the mountains far removed from the challenges of modern life. There's nothing wrong with pursuing a monastic life or dedicating your life to simplicity and seclusion; this has its time and value on the journey. But how much of that pursuit is authentic, versus escaping the demands of the world? When you live in seclusion, you bet it's easier to maintain a consciousness of love and compassion.
So what is enlightenment? How about coming down from that mountain and putting your unity consciousness to the test amidst mortgage payments and credit card debt, divorce lawyers and aging parents, nasty bosses and health problems, wars and poverty? Such conditions, as the alchemist knows, burns away the dross to reveal who we are not. Yes, in the midst of the madness we awaken, grow comfortable with our dualistic nature and develop mystical stamina so that we can handle our sobriety. Illusions are like drugs and enlightenment is like rehab.
An enlightened person neither seeks the light, nor remains inactive in the darkness. Their goal is not enlightenment, but of conduct toward self, life and others. When you're in the presence of such a person, no verbal exchange is necessary to know who you are dealing with. Such people can serve in monasteries or stock markets, run corporations or run for office, walk the desert or walk to work. They have the ability to see things as they really are, to accept what is and remain open to all of life. This is done not out of naiveté or denial, but out of profound understanding of how life really works.
'After enlightenment, the laundry.' -- a Zen proverb "
7 Tips to Fix Your Cholesterol Without Medication: "The singular focus on treating cholesterol as a means to prevent heart attacks is leading to the deaths of millions of people because the real underlying cause of the majority of heart disease is not being diagnosed or treated by most physicians.
For example, I recently saw a patient named Jim who had 'normal' cholesterol levels yet was taking the most powerful statin on the market, Crestor. Despite this aggressive pharmaceutical treatment, this man was headed for a serious heart attack. Jim's doctors had missed his real disease risks by focusing on and treating his cholesterol levels. All the while they were ignoring the most important condition that put him at dramatically higher risk of heart attacks, diabetes, cancer and dementia. In a moment I will explain what this condition is and what you can do about it.
This craze for treating cholesterol has lead to an onslaught of pharmaceuticals designed to 'lower cholesterol.' Statins are now the number one selling class of drugs in the nation and new cholesterol medications are produced every day. The latest in a new class of 'super' cholesterol drugs, CETP inhibitors, now in the drug approval pipeline from Merck (anacetrapib) burst into the news recently with exclamations from typically restrained scientists. Data on this new drug was recently published in the New England Journal of Medicine and presented at the American Heart Association conference in Chicago.
The study found a 39.8 percent reduction in LDL (or bad cholesterol) and a 138 percent increase in HDL or good cholesterol.(i) Sure, the medications lowered cholesterol. However, the study was not large enough or long enough to answer the most important question: Did the drug result in fewer heart attacks and deaths? Despite this glaring omission, the scientists reporting on these results used words such as 'spectacular,' 'giddy,' 'enormous,' 'most excited in decades' to describe their enthusiasm over the medication. Of course, the researchers (as I described in a recent post 'Dangerous Spin Doctors') were on the payroll of Merck who funded the study.
Why Lowering Cholesterol May Not Lower the Risk of Death
Unfortunately, these scientists seemed to have short-term memory loss. Just three short years ago in 2007, another new 'wonder' drug from Pfizer (torcetrapib) which worked on the same mechanism that anacetrapib does, was found to dramatically lower LDL and raise HDL cholesterol, just like this new drug from Merck. There was only one small problem -- in those taking the drug, deaths from heart attacks increased 25 percent, deaths from heart disease increased 40 percent and overall deaths increased 200 percent.(ii) After spending $800 million in development Pfizer had to walk away from the drug. Oops. How can a drug that does all the right things (dramatically lowering bad cholesterol and raise good cholesterol) actually cause more heart disease and deaths?
The answer is simple. Drugs don't treat the underlying causes of chronic illness. It is not our genes which haven't changed much in 20,000 years, although they may predispose us to environmental and lifestyle triggers of illness. The causes of chronic disease are rooted in what we eat, how much we move, how we face stress, how connected we are to our communities and toxic chemicals and metals in our environment.
A wry editorial in the New England Journal of Medicine many years ago remarked that doctors should use new drugs as soon as they come on the market before side effects develop. Perhaps that's what the authors of this study are proposing we do with anacetrapib.
At best this new 'super cholesterol' drug will lower cholesterol numbers without killing too many people while increasing health care costs by billions of dollars as millions of new prescriptions are written for this new 'super cholesterol drug.' Worse it may end up in the same garbage dump Pfizer's drug from three years ago did. Even worse scenarios exist and the reason is startling simple.
These drugs do not address the fundamental underlying cause of heart disease. Heart disease is not a Lipitor or Crestor or even an 'anacetrapib' deficiency. It is a complex end result of multiple factors driven by our diet, fitness level, stress and other lifestyle factors such as smoking, social connections, and, increasingly, environmental toxins. Taking a pill won't fix these problems that push our biology steadily along the trajectory of disease. The idea of putting statins at the check out counter of McDonald's is the epitome of reductionist thinking. The problem isn't cholesterol -- it's all the stuff we are putting in our mouths!
Jim, my patient, is a perfect example of how doctors treat the symptoms, not the cause of disease. As I have written about in a previous blog, most doctors focus on the wrong target for preventing and treating heart disease. Abnormal cholesterol levels are just a downstream problem that is mostly a result of 'diabesity' or the continuum of blood sugar and insulin imbalances that range from pre-diabetes to full-blown end stage diabetes. Taking a statin or a CETP inhibitor cannot reverse this change in our biology. We cannot use a drug to correct what happens to our biology because of a high sugar and refined flour, low fiber, processed diet, a sedentary lifestyle, excessive stress, lack of sleep or the harmful effects of pollution.
Let's take a closer look at Jim. On 10 mg of Crestor, the most powerful statin on the market, his total cholesterol was a beautiful 173, and his LDL was a respectable 101. But the good news ended there. His triglycerides were 176 (normal is less than 100), and his HDL was 37 (normal is greater than 50).
Jim's number belie a deeper truth about cholesterol that most conventional doctors are ignoring today: Given the current state of scientific understanding, the cholesterol numbers doctors measure today are increasingly irrelevant.
The Real Cause of Heart Disease
Instead of looking just at the cholesterol numbers, we need to look at the cholesterol particle size. The real question is: Do you have small or large HDL or LDL particles. Small, dense particles are more atherogenic (more likely to cause the plaque in the arteries that leads to heart attacks), than large buoyant, fluffy cholesterol particles. Small particles are associated with pre-diabetes (or metabolic syndrome) and diabetes and are caused by insulin resistance. Recent research (see my 'Do Statins Cause Diabetes and Heart Disease' blog) indicates that statins may actually increase diabetes.
While measuring cholesterol particle size is a simple blood test that can be done at Labcorp, most doctors do not look at it, even though it is the only meaningful way to evaluate cholesterol numbers. You can have a LDL cholesterol that looks normal, like Jim did at 101, but you may have over 1000 small LDL particles which are very dangerous. On the other hand, you can have the same LDL number of 101, and it may be made up of only 400 large particles which cause no real health risk. Your health risk has less to do with your cholesterol numbers than it does the quantity and size of your cholesterol particles.
Again, we can take Jim as an example. His cholesterol particles were all small and dense because he had severe pre-diabetes. This is also not hard to diagnose. Jim was obese at 285 pounds with a BMI (body mass index) of 36. You are considered obese if your BMI is greater than 30. His waist-to-hip ratio was 1.04 (normal is less than 0.9 for men). He had very high insulin and blood sugar levels after we gave him a test drink of glucose (sugar). All this added up to tell us he had severe pre-diabetes or metabolic syndrome. As I mentioned before, he also had high triglycerides and low HDL -- another clue that he had metabolic syndrome. We also found he had very low testosterone and growth hormone, further symptoms of pre-diabetes or metabolic syndrome.
Jim reported that despite working with a trainer he kept losing muscle and he was always hungry. This is why.
Let me reiterate: These are measurements and tests that can be done in any doctor's office, but are rarely done. These are not esoteric or expensive labs that can only be done at specialty clinics.
The condition that Jim suffered from, metabolic syndrome, is the most common medical condition in America, but the most rarely diagnosed. It affects over half the population. It is the major cause of heart disease, diabetes, and aging, and it is one of the major causes of dementia and cancer, not to mention infertility and sexual dysfunction. Yet, it is mostly ignored by doctors. Why? The answer is simple and tragic: There are no drugs to treat it effectively, and doctors tend to focus on what they can treat with medications, even if it is the wrong target. This is one of the reasons statins are so popular in America despite the vast research against them.
Seven Tips to Fix Your Cholesterol (and Reverse Metabolic Syndrome Without Medication)
Luckily, this doesn't mean you are doomed, even if you are already suffering from metabolic syndrome and heart problems. High cholesterol and pre-diabetes or metabolic syndrome can be successfully diagnosed and treated. I have reviewed this in previous blogs, but here are seven tips to help you get big large fluffy cholesterol particles and reverse metabolic syndrome.
1. Get the right cholesterol tests. Check NMR particle sizes for cholesterol by asking your doctor for this test at Labcorp or LipoScience. You want to know if you have safe light and fluffy cholesterol particles, or small dense, artery damaging cholesterol particles. A regular cholesterol test won't tell you this.
2. Check for Metabolic Syndrome.
• Do you have a fat belly? Measure you waist at the belly button and your hips at the widest point -- if your waist/hip is greater than 0.8 if you are a woman or 0.9 if you are man, then you have a problem
• If you have small LDL and HDL particles, you have metabolic syndrome.
• If your triglycerides are greater than 100 and your HDL is less than 50, or the ratio of triglycerides to HDL is greater than four, then you have metabolic syndrome.
• Do a glucose insulin challenge test. This is very important and most physicians do not test for insulin and glucose. To read more about how to do the right type of testing for metabolic syndrome or pre-diabetes please see www.drhyman.com for my information.
• Check your hemoglobin A1c, which measures blood sugar over the last six weeks. If it is greater than 5.5, you may have metabolic syndrome
3. Eat a Healthy Diet. Eat a diet with a low glycemic load, high in fiber, and phytonutrient and omega-3 rich. It should be plant based, and you should consume plenty of good quality protein such as beans, nuts, seeds, and lean animal protein (ideally organic or grass fed). I have described specific diets that abide by these parameters in my books 'UltraMetabolism' and 'The Diabesity Prescription.'
4. Exercise. Enough Said.
5. Get Good Quality Sleep. Sleep is essential for healing your body, maintaining balanced blood sugar, and your overall health.
6. Use Supplements to Support Healthy Cholesterol Particle Size. These include:
• A multivitamin including at least 500 mcg of chromium, 2 mg of biotin and 400 mg of lipoic acid. For most you will take three capsules twice a day.
• 1000 mg of omega-3 fats (EPA/DHA) twice a day.
• 2000 IU of vitamin D3 a day at maximum. (Some people recommend less -- consult your doctor.)
• 1200 mg of red rice yeast twice a day.
• 2-4 capsules of glucomannan 15 minutes before meals with a glass of water.
• Broad-range, balanced concentration of plant sterols. You will usually take one capsule with each meal.
7. Consider Using High Dose Niacin or Vitamin B3. This can only be done with a doctor's prescription. It is useful to help raise HDL cholesterol, lower LDL cholesterol and triglycerides, and increase particle size.
8. Use Low-Dose Statins ONLY If You Have Had Heart Disease or are a male with multiple risk factors, while carefully monitoring for muscle and liver damage.
For the vast majority of people this approach is better than simply taking a cholesterol medication. To reduce your risk of heart disease you need to address metabolic syndrome, and that can ONLY be done effectively with a comprehensive diet and lifestyle approach like the one outlined above.
For more information on metabolic syndrome, heart disease, cholesterol, and other essential health topics, please visit www.drhyman.com.
Now I'd like to hear from you ...
Have you taken statins, what has been the effect and do you have muscle pain or any neurologic side effects?
Do you think metabolic syndrome is an important factor to address to reduce the risk of heart disease? Why or why not? Has your doctor ever said, your sugar is a little high and we will watch it? What for what -- until it is so bad you are eligible to take diabetes medication?
What do you think of conventional medicine's tendency to prescribe medications over dietary and lifestyle change for chronic health conditions?
I would love to hear your thoughts. Share them by leaving a comment below.
To your good health,
Mark Hyman, MD
(i) Cannon, C.P., Shah, S., Dansky, H.M. et al. 2010. Safety of anacetrapib in patients with or at high risk for voronary heart disease. N Engl J Med. 363(25): 2406-2415.
(ii) Barter, P.J., Caulfield, M., Eriksson, M. et al. 2007. Effects of torcetrapib in patients at high risk for coronary events. N Engl J Med. 357(21):2109-2122.
Mark Hyman, M.D. is a practicing physician, founder of The UltraWellness Center, a four-time New York Times bestselling author, and an international leader in the field of Functional Medicine. You can follow him on Twitter, connect with him on LinkedIn, watch his videos on YouTube, become a fan on Facebook, and subscribe to his newsletter.