No Backtracking

No Backtracking principles

This is a plan for life. You will carefully reintroduce certain carbohydrates into your diet — and find the balance that maintains your weight and keeps you feeling trim. This crucial phase will allow you to:

• Establish the carbohydrate levels that you can eat in order to remain slim and supply your energy requirements
• Break totally with bad habits made in the past
• Never return to yo-yo dieting
• Find a healthy attitude to food and a viable eating plan for the rest of your life.

No Backtracking rules

During this phase you need to:

• Increase your daily carb intake by no more than 10g (1/3oz) each week

• Add new foods one at a time

• Eliminate a new food if it provokes weight gain; a return of physical symptoms lost during the Fast-Track Plan; increased appetite, cravings or water retention

• Drop back to the next-lowest level of carbohydrate intake if you gain weight

• Carry on eating adequate amounts of healthy fats and lean protein at every meal to ensure a balanced diet

• Continue to take vitamin and mineral supplements regularly, drink masses of water and, of course, exercise regularly.

Make this diet the one that works

Once you have reached your target weight, you can start on the No Backtracking plan. Increase your intake of carbohydrates by 5-10 grams per day until you reach your optimum level for weight management This will probably be around 40 per cent of your total daily calorific intake, but remember that everybody differs, especially when you consider activity levels.

If you have high insulin resistance, then you may have to Keep on Tracking and be careful about how many carbohydrates you consume on a daily basis. But if you're one of the lucky ones with low insulin resistance, you may be able to eat most vegetables (including starchy vegetables), fruit, pulses andwholegrains such as oats, barley, millet, wild rice, couscous and buckwheat. You can also begin to use recipes containing carbohydrate ingredients such as breadcrumbs; you may even be able to handle an occasional potato. But don't eat all these things in one day. You still have to monitor your carbohydrate intake to stay where you are - healthy and energized. Remember the eating habits that got you here in the first place. You should have successfully gauged your ideal carbohydrate level, and be maintaining a stable weight and energy levels, within 4-12 weeks of following the No Backtracking plan.

Stick to the basic weight management tips and try to be good 80 per cent of the time. We are all allowed the odd slip up - if you want a slab of chocolate cake from time to time, make sure it is the best you find and enjoy it. If you ever see the scales creeping up, cut back, even go back to the Fast Track plan for a few days until your weight is back to normal, and then gradually raise your carbohydrate levels once again.

A template for life

Two portions of higher GI carbohydrates are included per day on the suggested eating plan. Treat this as the template you ought to follow from now on. And try some of these tricks to keep your carbohydrates at a moderate, healthy level:

• Opt for rye bread, oatcakes and rye crackers instead of wheat-based bread. Even if you are not wheat-intolerant, it is worth considering this.

• Eat fruit 20 minutes before eating anything else, not afterwards. Fruit takes less time to digest, but if eaten on top of a heavy meal, can cause bloating.

• If you are going to drink alcohol, choose dry white wine or, even better, red, which contains flavonoids with antioxidant and anti-platelet properties thought to reduce deaths from coronary artery disease. If you have managed to kick the alcohol habit, opt for grape juice, which contains flavonoids similar to those in red wine.

• Mix sweet potato with cauliflower as a mash or purée to go with roast chicken. The aim is to mix a high GI vegetable with a low one, to reduce the total carbohydrate level.

• When making a rice dish such as risotto, reverse your ratio of vegetables to rice: add a little rice to a heap of vegetables. And try grating raw vegetables such as carrots and courgettes into the dish at the last moment - it adds texture and you get the benefit of all those raw phytonutrients.

• Don't give up on those whey-protein smoothies - they are still the most effective way of getting high-value biological protein.

Low-carb lifestyle guidelines

By now you should have a pretty clear idea of what you have to do to improve your diet and, with it, your entire lifestyle.

The general principles

Cut out all unhealthy refined carbohydrates.

• Curb your intake of high GI carbohydrates and focus on those from the low—medium GI range.

• Eat most of your fruit and vegetables raw to ensure a good level of phytonutrients and fibre.

• Eat more high-quality protein — organic if at all possible.

• Increase your intake of healthy omega-3 fatty acids by eating more oily fish, and use only natural unrefined oils in your cooking.

• Cut out tea, coffee, concentrated fruit juices and alcohol, and banish soft drinks of any kind, but drink at least eight glasses of water per day.

• Incorporate 30-45 minutes of aerobic exercise at least three times in to your weekly routine, and carry out resistance training at least three times per week.

DIETARY MYTHS

Myth: skipping meals is a good way to lose weight.

Fact: your body needs a regular supply of nutrients each day in order to work properly. If you skip meals, you will be more likely to make up for it by snacking or eating more at the next meal. Studies show that people who skip breakfast tend to be heavier than those who eat a nutritious breakfast. A healthier way to lose weight is to eat many small meals throughout the day.

Myth: eating after 8 pm causes weight gain

Fact: it doesn't matter at what time of day you eat; if you are eating too much of the wrong type of food and not getting any exercise, that will make you fat.

Are you all fired up?

You should be, because you are going to get back in control. You now know what you are doing, understand your body and should look on this as an important project that will bring untold benefits. Now that you understand how your body metabolizes the food that you eat, you can start to view food as a vital fuel that helps your body function at optimum levels. This should be a turning point. It should change your attitude from one of 'Oh no, I'm on a diet' to a more positive 'I'm doing this for me, to make myself healthier, fitter, stronger, leaner'.

Pretty soon you are going to be feeling and looking better. Think of that boost of self-confidence that you are going to experience. So get ready to roll and flex that determination. Whether you have 3kg (71b) to lose or 30kg (701b), this regime is only going to work if you are committed to changing your eating and exercise habits for life.

The rest of this section offers advice on weight, and on setting goals for (and managing) weight loss; suggests how to cope with the cravings and snack attacks that may arise when you are on a diet; and gives tips on taking supplements and sticking to a healthy diet, even when you lead a busy lifestyle. It is followed by the three-step programme and nutritious recipes that form theMainstay. Plus, there is also a section on adapting the plans to suit a vegetarian diet, which includes some delicious low-carb vegetarian recipes.

DIETARY MYTH

Myth: low-fat or non-fat means no calories. Fact: many low-fat and non-fat foods still contain a lot of calories. Often these foods also contain extra sugar, flour or starch thickeners to make them taste better. These ingredients all represent extra carbohydrates. As we have seen, you need to eat healthy fats to lose extra fat.

Essential fats

If you have been doggedly avoiding fat in an attempt to lose weight — this approach is WRONG. You need fats in your diet. Your brain consists mostly of fat, and your intelligence, heartbeat and muscular movements all depend on it. The only way in which your body can send electrical messages through living tissue is via your nerve cells and their connectors, which again are made of fat.

The fact is that some fats (known as lipids) are essential. They act as the second energy reserve behind glycogen, providing most of their energy at around 70 per cent of maximum heart rate. Endurance athletes utilize fat as an energy source more than other sports people and this is why they tend to be lean.

Fats are not just for energy, though. Their many other functions include insulating important organs, carrying fat-soluble vitamins and regulating hormone levels. If you're a female athlete and you experience a loss of your periods, this may be due to extremely low body fat, for this plays a vital role in the activation of the female hormone oestrogen.

Fats also contribute to health in many other ways — provided they are of the right kind. In an attempt to warn people about the risk of consuming toomuch fat, certain groups have created the impression that all fats are bad, but this simply is not true.

Are you eating the wrong fats?

Many people in the Western world are getting 45 per cent of their calorific intake from fats, but these are junk fats that the body cannot use, so these people are just as fat-deficient as those on extremely low-fat regimes.

THERE ARE TWO MAIN TYPES OF NATURAL FATS:

1. Saturated fats come primarily from animal sources such as meat and dairy products, and from coconut and palm-kernel oil; they are solid at room temperature. They provide the body with a stored form of energy in fat cells.

2. Unsaturated fats are found in vegetables, nuts, grains and seeds, and in fish and game; they are liquid at room temperature. They contain two fatty acids that are essential to life and, more importantly, that the body cannot produce itself. These are linoleic acid (omega-6) and linolenic acid (omega-3) From these two 'essential fatty acids' your body can make all the other fatty acids it needs.

Is it just a case of cutting out saturated fat?

Saturated fat gets a bad press, and a diet too heavy in it has been closely linked to cardiovascular disease. However, there is another fat with an equal capacity to harm: hydrogenated fat.

Hydrogenated fat is solid or semi-solid at room temperature (the best example being margarine). It is created when a liquid oil (such as corn oil) has hydrogen added to it, changing its chemical structure. This in turn can interfere with the metabolism of some essential fatty acids. Research has shown that the trans fats in hydrogenated fats can increase LDL (poor) cholesterol,decrease HDL (good) cholesterol and thus raise the risk of coronary heart disease. Hydrogenated fat is found in almost all processed foods, plus frozen convenience foods and deep-fried fast food. This is another good reason to say goodbye to junk food and hello to fresh produce.

If you usually ingest high amounts of processed fats and use commercially altered oils for cooking, then you are certainly not getting the balance of fats that your body needs.

Why don't food manufacturers use healthier oils?

Even though the food industry uses vegetable oils that contain a reasonable amount of omega-6 fatty acids, they avoid omega-3s because these are more susceptible to oxidization — in other words, they go rancid quickly and don't have a long shelf life.

Ironic, isn't it? Food manufacturers quite happily promote food under the guise of lowering cholesterol and reducing heart disease, but they are ignoring one of the fats essential to health. So unless you are eating high amounts of fish, fish oils, leafy vegetables, nuts, unrefined olive oil, tofu or flaxseed oil, your ratio of omega-6 to omega-3 fats is probably screwed up, and this in turn will be screwing up your health.

The current Western diet is much higher in omega-6 fatty acids than omega-3's. Remember those healthy Palaeolithic people we were discussing earlier? They were eating equal amounts of both.

How is this relevant to body weight?

If you are eating a diet with a good balance of omega-6 and omega-3 fatty acids, this will affect your body in beneficial fat-burning ways:

• Your metabolic rate will be increased, as will the metabolism of fats, so more stored fat will be burned for energy
• Your cells' sensitivity to insulin will be increased, so that it regulates blood- sugar levels more effectively
• The ratio of insulin to glucagons will improve, which will unlock the fat- storage banks and again allow fat to be burned as energy
• Natural appetite suppressants will kick in.

So if you want to improve your chances of losing weight, you need to up your intake of omega-3 and other healthy fats.

Essential fats Q&A

Q. How often should I eat oily fish per week if I want to consume enough omega-3 fatty acids?

A. You should aim to eat oily fish a minimum of 2-3 times per week, or ensure you use flaxseed oil regularly on salads to raise your levels. Try to eat fish from as safe a source as possible as many coldwater fish are contaminated with heavy metals and pesticides.

Q. How can I avoid hydrogenated fat?

A. Cut out processed food and only use cold-pressed un-refined oils such as olive oil, or coconut oil for cooking. Don't eat fast food that has been deep-fried and avoid butter type spreads. If you did this, then you should be able to avoid consuming dangerous trans fatty acids.

Making the most of meat

Meat only poses two possible threats, namely its visible fat and the fact that too much of any good thing is .... well, not much good. Eating too much meat means you are eating too much saturated fat, absorbing too many unwanted fat kilojoules and pushing your protein intake through the roof.

Enjoyed in moderation though, lean red meat (with all visible fat removed) is quite a bright star in the nutrient skies. It is rich in potassium, B vitamins, zinc and iron and an excellent source of protein. Served in small, lean portions with the addition of dietary fibre, red meat will enhance your health rather than harm it.

Fibre, as found in grains, dried beans and vegetables, helps to fight heart disease, digestive disorders and certain types of cancer. These foods, when served with meat, will assist your body in coping with the hidden fats in the meat. Fibre-rich foods will also help you feel satisfied faster and for longer - an excellent way in which to help you control your meat intake and so too, those unwanted fat kilojoules.

You can make some clever cuts in your meat consumption, and I am not referring to cutting it out. I mean buying and eating cuts that contain less of the hidden fats (often called the marble fat) and cholesterol-causing saturated fat. Be 'pound' wise and buy clever cuts. Those are the hind-quarter cuts such as fillet, rump, topside and leg of lamb. They contain the least hidden fats. However, even after the visible fat has been removed, you'd be surprised to know how much fat is hidden in what you deem 'pure' meat.

The cooking method also dictates how much fat you will eventually consume. Red meat actually loses weight during cooking or grilling on a rack, and depending on the period of time for which the meat is exposed to the heat, between 7 and 23% of the fat could drip away. That is provided of course you don't consume the pan drippings! With stews and casseroles, in which the fat becomes part of the sauce, no dripping away of fat takes place and it seeps into the cooking liquids. Those you end up eating by way of the gravy or a sauce. And needless to say, frying meat in fat or oil obviously adds even more fat (and unwanted) kilojoules to your unsuspecting body - rather a stupid thing to do if you want to be lean and healthy. So consider your cut and its cooking method with great care if you care about your weight.

Best of all course, is to go wild. it you enjoy red meat, 'have venison often. A very large serving of grilled game steak (300 g) will only add a humble 9,6 g of fat to your intake, whereas a similar serving of grilled beef steak (rump, fat removed) could add as much as 30 g of fat.

Similarly, if you enjoy poultry, be game for game. Ostrich, pheasant and quail are ultra-lean and 300 g of roast game will only provide you with about 10,5 g of fat. On the other hand, if you roasted (with the skin intact) and consumed its domesticated counterpart the chicken, the exact same size of serving will happily lay in the region of 39 g of fat on your body.

Be cautioned, though; game and venison tend to be dry - as a result of their low fat content - so don't defeat the whole object by adding buffer, oil, bacon, lard or cream to the dish. Use wine, fruit and stocks instead to moisten the meat. As for a sauce or gravy, the stock of game or venison is delightfully robust in flavour. Reduce your cooking liquid by boiling it rapidly with garlic, aromatic peppercorns and herbs until richly brown and thickened to your liking. A wiser, leaner and more nourishing bet than a creamy sauce, for sure.

Don't inhibit your^- nutrients

There is no point in trying to follow a healthy diet if you are not aware of the fact that the absorption of certain nutrients can be inhibited. In other words, their assimilation and uptake by the body can be hindered by some or other bad food combination with nutrient inhibitors.

The nutrients most at risk are calcium and iron. Thus, try not to consume calcium-rich foods with alcohol, high-fibre cereals or red meats - they restrict the absorption of calcium. This means for example, that it is not wise to combine cheese and wine or cereal and milk. Serve wine with low-fat meat, chicken, fish, fruit and vegetable snacks and your cereal with fruit juice instead of milk. Vitamin D, however, aids the absorption of calcium. As sunlight is an excellent way to improve your vitamin D levels, serve lean, fruity milkshakes around your pool instead of fruit juices. That way your body will benefit fully from your clever combinations.

The absorption of iron is hampered by the simultaneous intake of tea, red wine and high-fibre cereals, so don't serve, say, iron-rich liver with whole wheat bread or brown rice, Rather serve it with potatoes or white rice. On the other hand, foods rich in vitamin C assist in the absorption of non-heam iron (iron derived from vegetables), so combine those foods for optimum nutrition. For instance, a salad made from iron-rich spinach, vitamin C-rich tomatoes and sweet peppers would be an excellent choice for super-A nutrient absorption without any threat of inhibitors.

On dining out

American-style food has become the norm in our lives: burgers, sticky ribs, fried chicken, coleslaw, chips, fried onion rings, sodas and sundaes.

Do your body a favour and favour ethnic foods more than once in a while. Most countries' indigenous recipes conform to the food pyramid: high fibre, high carbohydrates, including vegetables, moderate protein and humble amounts of fat. Here are some examples for when next you eat out, or feel like entertaining at home:

Indian: Choose breads (naan and purl) and pulses (dhal), vegetarian curries and biryani (rice and a little meat). Avoid fatty lamb curries and coconut-milk desserts. Chinese: Choose soup, stir fry vegetables, steamed rice, cooked noodles, chow- mein, chop suey. Avoid deep fried sweet & sour dishes and bow ties.

Thai and Indonesian: Choose vegetables and seafood in broth, steamed vegetables and fish. Avoid deep fried dishes and curries made with coconut milk. Japanese: Choose sushi, sashimi (raw fish) and steamed or broth-cooked dishes. Avoid tempura and deep-fried ice cream. (True!)

Italian: Choose lightly dressed salads, minestrone, pasta with vegetable sauces, grilled veal with lemon, pizza breads and pizza with less cheese and salami, grilled fish and vegetables and sorbet and fruit for dessert. Beware of the antipasti tables - those delicacies are often swimming in oil: select from them with your head rather than with your heart. Avoid creamy sauces, cheesy pizzas and Italian ice cream.

The carbo consideration

As you know, certain slimming clinics and some diet doctors have vilified carbohydrates for decades. They claim that a low-carbo diet, rich in protein, will

Or improve your metabolism by forcing your body to release more growth hormones. This - the intake of mainly proteins - will ostensibly build more muscle tissue and in that way improve your metabolism forever. Forget it; its only a half-truth. The whole truth is that, in the absence of the energy the carbos are supposed to provide, your body will use up all the protein you eat as energy and after that, when more energy is required, which is invariably the case, it goes on to use some of its own protein as well. Remember those lean muscle cells? Those lovely little protein-filled cells that cause your metabolism to be energetic, vibrant and efficient. If you didn't have them, you would get fatter and fatter with each passing day. The bottom line? If you do not eat sufficient carbos for energy, it will promote chronic weight gain in the long run through the permanent loss of lean muscle tissue and very little, if any, real body fat will be lost.

Here's what you should consider when it comes to your carbo intake, so that in future you can manipulate it in such a manner that they actually work for you.

Simple carbohydrates are sugars like cane sugar, honey, fructose and glucose, Complex carbohydrates are starches like bread, pasta, dried beans and cereals.

• The only differences between sugar and starch are their taste, nutrient values and rate of absorption by the body.Once ingested, the body converts all carbohydrates to glucose.

• Complex carbohydrates with a low Glycaemic Index (GI) protect your body's muscle reserves by supplying the body with energy while promoting the burning of fat for extra energy. (See How low should you go?)

• Try to consume 60 to 65% of your daily kilojoules from complex carbohydrates, preferably those with a low GI. The eating plan conforms to this principle. Simply follow it and you won't need to do any calculations! Eventually, this kind of eating pattern will become a habit, and your preferred way of life,

• If you follow an eating plan rich in complex carbohydrates with a low GI, coupled with a low fat intake (around 33 g in total per day) your blood sugar levels will remain stable. You will enjoy a more naturally controlled appetite and greater emotional stability. The eating plan referred to is designed specifically with those factors in mind. Within days you will experience the full benefits of this way of eating. Your excess fat will start disappearing and you will have more energy than you ever thought possible, fewer mood swings, anxiety attacks, hunger pangs, sugar or starch cravings and you will start feeling optimistic and full of life.

• Be aware that the digestion of carbohydrates begins with the first bite. If you don't chew your complex carbohydrates well, efficient digestion will not take place, which can impede your body's fat burning mechanism.

Do fat people live dangerously?

Generally speaking, most people who worry about being overweight do so not out of concern for their health but because of the cosmetic and social disadvantages of being fat.

This is ironic considering the growing body of scientific evidence that points to the harmful medical and psychological consequences of overweight and obesity. The following risks and conditions have been associated with the problem:

• hypertension
• high blood cholesterol levels
• increased risk of cardiovascular heart disease and diabetes mellitus
• impaired lung function
• gall-bladder disease
• cancer
• osteoarthritis
• reproductive system abnormalities
• psychological disturbances

Quite a list with which to burden yourself! So it's not surprising that experts maintain that the obese tend to have shorter lifespans than people who manage to keep their weight at low-risk levels.

Researchers have also established that it is not only the amount of excess fat you carry, but where you carry it that can put you at risk of developing certain illnesses and conditions. Some people's extra weight settles around their middles (referred to in medical terms as `android fat distribution'), giving them what is commonly referred to as an 'apple' figure. Others carry the weight around their hips (gynoid fat distribution or 'pear' figure). Apple figures occur more often in men (although they are found in women too); pear figures are far more common in women than in men.

For several reasons relating to metabolism, the 'apples' are at higher risk for the development of cardiovascular heart disease and diabetes mellitus than the 'pears'. So anyone who is overweight and has an android fat distribution should be even more concerned about his or her weight.

What makes fat people fat?

After a great deal of research in this field, the experts finally agree that people become fat because of an imbalance in the following simple equation:

energy in = energy out + energy stored

This imbalance can be brought about by various factors which could increase energy intake and/or decrease energy expenditure.

Scientists agree that overweight or obesity is rarely caused by a single factor. In order to come to grips with a personal overweight problem, however, it is necessary to realise that the over-riding cause is an energy intake which is higher than energy expenditure.

Energy expenditure is something which varies considerably from person to person. These variations are part of the reason why some people appear to be able to eat more than others but gain less weight. The three, main factors which influence energy expenditure are:

• Metabolic rate, which contributes approximately 73% to total expenditure and is influenced by factors such as age, sex, fat free (muscle) mass, body surface, hormonal secretions, etc.
• Physical activity, which contributes between 12 and 30% to total energy expenditure.
• Thermogenesis (see below) which contributes approximately 15% to total energy expenditure.

This last component has recently been the focus of a lot of obesity research. The term refers to heat produced in the body in response to cold, or to excessive food intake, especially carbohydrates. Theoretically, thermogenesis enables a person to eat as much as he or she likes without gaining weight, because excessive energy is 'wasted'in the form of heat. In the early 1920s this phenomenon was described as 'luxusconsumption'. An inability to 'waste' energy in this way could ultimately cause obesity, implying that obesity is the result of a metabolic 'fault'.

In an attempt to explain this possible energy-wasting system, various hypotheses have been suggested, ranging from the existence of specialized brown fat tissue which is able to waste energy as heat, to metabolic enzyme cycles - also known as 'futile cycles' - which waste energy. However, no conclusive evidence has been produced to point the 'obesity finger' at any particular mechanism. Even if it could be proved, some people simply have to accept that they need less energy than others to maintain their weight.

Factors that help to make you fat

• Irregular eating habits (skipping of meals, over-eating at other times, over-consumption of specific foods).
• A tendency to resort to food for comfort or in order to deal with other emotions and situations such as frustration, boredom, loneliness, stress, lack of confidence, low self-image.
• Compulsive eating and obsessional thoughts about food and eating.
• Pressure by friends to 'join in and eat' when you are trying to decrease or balance your food intake.
• A tendency to eat not because you are hungry but rather in response to certain external stimuli, such as time of day, the smell and taste of food, the sight of other people eating, the availability of food, the sight of a restaurant or cafe.
• Inability to recognise when you are really hungry and/or when you have had enough.
• A habit of eating fast without really tasting your food.
• A hectic (but not necessarily physically active) lifestyle which includes lots of snacking in place of regular meals.
• Having to attend social, business or other activities associated with eating on a regular basis.
• Frequent, unsuccessful attempts at dieting.
• A sedentary lifestyle with little or no regular exercise.
• Inadequate knowledge of energy needs, balanced eating habits, the difference between good and bad weight reduction programmes, and a healthy lifestyle in general.
• A family history of overweight.

Underweight — the other side of the coin continue…

Causes and treatments

A full discussion of the causes and treatment of these serious eating disorders have filled books of their own.

A team consisting of a psychologist and/or a psychiatrist, a dietitian and a medical doctor should be involved in the treatment of a patient with an eating disorder. It is also important to bear in mind that treatment could stretch over many months before it has any significant effect and that even then the results are not always positive.

Generally speaking, the outlook for both anorexia nervosa and bulimia is not encouraging. In the case of the former, the outcome may vary from sudden recovery with little or no treatment, to death. Someone may be a victim of it for a few months or for a lifetime and it appears that only 40-60% of significantly ill patients make a good physical and psychosocial recovery. The mortality rate is estimated at between 5% and 18%, with the most frequent causes of death being suicide and the effects of starvation. Although not much literature has been published on bulimia, it is estimated that only 40-50% of treated bulimics can eventually be regarded as cured. Some are cured with relatively little effort, while others seem to return to normal eating habits and discontinue their purging behaviour after intensive treatment, only to relapse during periods of stress.

Serious medical complications - including death - are more likely to occur in bulimics and prugers, due to excessive losses of essential body fluids and electrolytes (such as potassium and sodium).

The risk of suicide is also believed to be higher, possibly because bulimia is often associated with depression.

Preventing the preventable

Because these eating disorders so often have a negative outcome, it is vital to either prevent their development or at least take action as soon as warning signals appear. You can help to guard against the development of anorexia nervosa and bulimia in a young person by following these guidelines:

1. Make a practice of discouraging restrictive dieting, meal-skipping and fasting.
2. Avoid unnecessary emphasis on and talk about figures, being fat and food which is 'fattening'.
3. Carefully phrase any weight-related recommendations or comments.
4. Try to correct misconceptions about nutrition, normal body weight and encourage a healthy approach to weight loss.
5. Place the 'ideal' female portrayed by the media into perspective.
6. Provide information about the normal physical changes which occur during puberty.
7. Refer an adolescent who appears to have a problem - or is at risk of developing one - to a physician, a mental health professional (psychologist/psychiatrist) or a dietitian skilled in working with patients who have eating disorders.

Reading the signs

Clearly, it is very important to identify someone who is at risk of developing - or already suffering from - an eating disorder in good time, so that treatment can be effective. But how would you know if your daughter or an acquaintance was in clanger of becoming a victim? The possible warning signals for anorexia nervosa and bulimia are summarised in the table

In conclusion, it must be said that in man the control of food intake is a very complex and delicate process. Unfortunately, the primitive reflexes which control our need for food - and thus our hunger - have become buried under so many layers of conditioning and social factors that we are hardly aware of them anymore. Perhaps the time has come for modern man to realise once more that the primary reason for food intake is to support life and encourage good health. All the other reasons - whether to do with the emotions, society, taste or simply habit - are secondary. Or, in the well-known words of the famous French playwright, Jean Moliere, which are as apt today as they were in the 17th century: 'One should eat to live and not live to eat'.