Eat more and more, do you know chemicals in foods blow you appetite?

In a very real sense, everybody has direct reactions to foods. Direct reactions are reactions caused directly to cells by chemicals in foods. Among the most obvious direct reactions are those caused by alcohol. If you drink alcohol, you are almost certain to experience sedative effects, due to the direct effect of alcohol on your brain cells.

Often, people with Asian heritage react quite negatively to alcohol, and the common belief is that they're allergic to it. Technically, though, they don't have an allergy; they have a sensitivity — because this is a direct reaction, which doesn't involve the immune system. I believe that it's clearer and more sensible to say simply that Asians often have a food reaction to alcohol, since food reactions include both allergies and sensitivities.

Direct reactions, however, can eventually involve the immune system, because sooner or later the immune system is called in to repair the mess that direct food reactions cause. Therefore, the symptoms of direct reactions can feel much like allergies. Because of this, direct food reactions are sometimes called false food allergies.

Alcohol has obvious direct actions, but most direct food reactions are more subtle. Often, direct reactions occur when chemicals in foods bind with the cells that produce histamine; these cells are called mast cells. When this happens, it can cause the release of histamine. The food chemicals that are most likely to do this are lectins, which are most often found in wheat, peanuts, and beans. Another cause can be certain partial proteins, or peptides, that are found in tomatoes, strawberries, shellfish, pork, chocolate, and eggs.

Other foods that often seem to cause direct food reactions are mustard, pineapple, papaya, buckwheat, and sunflower seeds. Ironically, one patient of mine had terrible digestive symptoms, including severe heartburn, and took large amounts of digestive enzymes to help the problem. However, his enzymes were full of papaya, which he later found he was reactive to. When he stopped taking the digestive aids, his digestion improved immeasurably. Moral of the story: don't trust common knowledge about what's healthy — trust your own experiences. Everyone is different.

Other foods that sometimes cause direct reactions are those that contain high levels of natural histamines. Histamines are formed in foods that are allowed to age and ferment. Therefore, histamines are often found in aged cheese, sausage, and salami.

Other foods that can cause direct reactions are those that contain the partial proteins tyramine, phenylethylamine, and octopamine. These chemicals, like histamines, can cause blood vessels to expand and contract, which causes tissue swelling. In the head, blood vessel constriction and expansion can cause migraine headaches. That's why people who get migraines often shun the foods that are high in these partial proteins, such as wine, aged cheese, citrus fruit and yeast.

Another common foodstuff that often causes direct reactions is the artificial sweetener aspartame. Aspartame is mostly composed of the partial protein, or amino acid, called phenylalanine. In some people, it acts directly on brain cells, causing symptoms such as agitation and depression. In other people, it causes blood vessels to contract and expand, triggering migraines. In most people, though, it causes no reaction at all.

Many people also react to MSG, or monosodium glutamate, with headaches, nausea, dizziness, heart palpitations, and confusion. Others react to various additives, including nitrates, sulphites, and artificial food colours.

Another name for direct food reactions is pharmacologic reactions. That's a good description, because it implies an important point: foods, like drugs, are chemicals. Not all drugs are good for you — and not all foods are, either.

Now let's look at the last type of food reaction: immune complex reactions. This type of reaction is not well known. But it should be. It can be a killer.

Foods, like drugs, are chemicals. Not all drugs are good for you, and not all foods are, either.

Why you will lose false fat

Donna didn't look fat, at least not in the leggings and long sweater she was wearing as she entered my office. Her legs looked slender and fit, and her sweater hid the rest. But she felt fat.

`I've got a guy's type of weight problem,' she said as she sat down. She was animated and energetic, but obviously frustrated. 'Women are supposed to collect fat in their hips and thighs — aren't they? — but mine sticks right here.' She patted her stomach. When she was sitting, I could see that it bulged, even under the thick sweater. 'I hardly ever overeat,' she said, `but since I've hit 40, I get no forgiveness from my body. It's like my metabolism took early retirement. I take two bites and I can feel the fat cells around my waist start to expand. Literally. I pinch my love handles, and they're thicker before I even get up from the table.' She looked at me expectantly, as if I might not believe her. 'My last doctor,' she said with a sour look, 'told me there's no way that food could make me fat that fast. But I can feel it happening.' Again, she searched my face for reassurance. She had an upbeat personality, but she was almost ready to give up. She ate carefully, exercised hard, and still carried 20 extra pounds.

`It's not your imagination,' I said. 'That feeling of instant weight gain happens to a lot of people. But it's not fat you're gaining. It's fluid retention and bloating, and you're probably getting it from food reactions. A lot of the swelling and bloating from food reactions occurs directly in and around the gut.

That's why you feel it in your midsection right away.'

`If it's not fat,' she said, 'why doesn't it leave as fast as it comes? I look like this almost all the time.'

`Your biochemistry won't allow it to go away, because your body is trying to protect you. When you eat reactive foods, your body sees them as foreign substances, almost as poisons, and it goes all out to protect you. It can take two to three days to stop reacting to some foods.'

Tut it's not like I eat junk. I'm an old-time you-are-what you-eat type. I was eating granola before they even had a name for it.' She smiled, but I could see she felt cheated. For many years, she'd followed all the rules — but the rules had been wrong.

`People can become reactive to healthy foods,' I said, 'even granola, if you eat it all the time. Do you eat a lot of non-fat and artificially sweetened foods?'

`Now that my metabolism has slowed down, I've got to.'

`I hate to say it, but some of those "lite" foods may be doing you more harm than good. If you're reactive to a food, it can be virtually calorie-free and still make you gain weight. Even diet soda can cause bloating and swelling.' She looked surprised. Most people these days are so accustomed to counting calories and fat grams — the quantity of their food — that they forget about the importance of quality.

`I don't think you're eating too many calories,' I said. 'And I don't think your age is the real problem. Your metabolism is slowing down just 5 per cent every decade, and that's not enough to cause what you're experiencing. I think you've just developed some food reactions over a long period of time. When you resolve them, you'll lost your weight.'

Tut I was tested for allergies and they didn't find any.' `Did they explain that not all food reactions are allergies?' I asked.

`No.'

I wasn't surprised. Most doctors don't really understand food reactions. They usually have an all-or-nothing attitude; they think that you either have a classic food allergy, with hives and wheezing, or you have nothing at all.

I gave Donna a brief rundown on how food reactions work and how they cause bloating and swelling. I explained it out of respect for her. Some doctors think it's acceptable to tell patients what to do, without telling them why, but I object to that approach. If patients are willing to change their lives by taking my advice, they deserve to know exactly why these changes will help.

As I gave all the details to Donna, she listened attentively and took notes. Over the next few weeks, she eliminated her false fat foods — one of which was oats, a primary ingredient in most granola — and dropped about 15 pounds.

Now I'll give you the details on how food reactions get started. Then we'll look at how they cause bloating and swelling.

If you're going to make changes in your life, you deserve to know exactly what's going on.

I'm sure some of this information will hit home. Often, when I tell patients about food reactions, they say, 'That's me you're describing.'

ROUTINE FOR PUTTING ON WEIGHT

Plenty of rest and exercise, a good diet of fattening foods and no worries—those are the essentials

PUTTING on weight is very much more difficult than taking it off. Even thosefew extra pounds which can make all the difference to the appearance, comfort and, no doubt, general health, can be quite a problem.

Before embarking on a diet, it is always advisable to seek the advice of your own doctor. This is particularly important if there has been a sudden or prolonged loss of weight for no good reason and without affecting normal appetite. Where loss of weight is the result of an illness or operation, it is usually quite quickly and easily regained after recovery. The routine to be described will help in such cases, subject to the approval of your own doctor.

We are concerned here chiefly with that large army of men and women who are anxious to put on weight but who are the thin type by nature. Such people are born worriers, with excitable and energetic natures and over-active bowels, whose food does not remain in the intestines long enough to be properly absorbed.

Essential in the fattening process are:

• Keep calm and stop worrying. That is obviously a counsel of perfection to those who easily get worked up, but it can be achieved by cultivating outside interests that take your mind away from the source of anxiety (it may be professional, domestic, financial, or all three).

• Take plenty of rest. A minimum of between 8 and 9 hours in bed at night, plus between 10 and 30 minutes after every meal.

• Avoid rushing about, but take regular exercise. On no account jump up immediately after a meal; take life at a leisurely pace. Strenuous games are good if you really enjoy them, because they create appetite; so does any form of outdoor exercise, however mild.

• Eat well and regularly, and concentrate on the fattening foods (list follows). But be careful not to stuff between meals or you will defeat the whole object and be unable to eat your main meals, which are far more important. You must also avoid over-eating, with the inevitable danger of indigestion and biliousness. Aim at three good meals a day, plus any extras (such as sweets, etc.) which you really fancy and a hot, preferably milk, drink last thing at night. The housewife should take as many meals out as she conveniently can because she will not have the worry of preparing them.

• Cut down your smoking. It diminishes the appetitite, so, if you must smoke at all, only after meals, please.

Sugar, sweets, jam, marmalade, fruits in syrup, treacle, honey, Golden Syrup.

Cakes, scones, pastry, cereals, bread, biscuits, puddings.

Thickened soups and gravies, sauces made from flour, butter and/or milk.

Fried foods, cream, salad dressings, butter, dripping.

Pork, duck, goose. All fat meat and bacon. Tinned fish in oil.

Sweet wines, beer, stout, spirits, sweet aerated waters.

Dried fruits. Bananas, grapes, plums. Potatoes, peas, dried beans, parsnips, beetroot.

Cod-liver oil, Virol, olive oil.

Salt with food.

Foods with very little fattening value

Meat extracts. Marmite. Clear soups. Gelatine. Egg-white.

Green vegetables and salads. Vinegar. Tea. Coffee.

SPECIMEN DIET FOR PUTTING ON WEIGHT

Minimum: 1 pint of milk per day

On waking: Cup of tea, preferably with milk and sugar.

Breakfast: Cereal or porridge with milk and sugar or honey or syrup.

Bacon, egg, fish, etc.

Toast, butter and marmalade.

Coffee or tea.

11 a.m.: Coffee, cocoa or milk and a biscuit, or try this cocktail: One teaspoonful Spanish olive oil sandwiched between layers of orange juice in a wineglass. You can increase the quantity of olive oil gradually.

Lunch: Thick soup, if liked (if this makes it impossible to eat main course, substitute tomato or orange juice as an appetiser instead).

Meat, fish, game, poultry, etc.—both fat and lean. Serve with gravy, roast or fried potatoes and a green vegetable or salad with plenty of oily or cream dressing.

Pudding and / or cheese, butter and biscuits.. Coffee.

Tea: Tea with cake or bread and butter or banana sandwich.

Dinner: Thick soup (see Lunch).

Fish, meat or poultry, with gravy, at least one vegetable from list of Fattening Foods; one green vegetable or salad with cream or oil dressing.

Steamed or boiled pudding or milk pudding or ice cream.

Cheese with bread or biscuits and butter.

Coffee.

NOTE: Cocktails, wines. etc., may be taken as desired and obtainable. Stout or beer is good.

Bedtime: A hot drink, preferably containing milk.

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.

My recommendation: The 3-step dietary programme Do what I did, look the results

The dietary plans that follow offer simple, nutritious and delicious recipes on a staged regime that should take you from overweight to optimum weight and enhanced well-being.

The reason many people depend on junk and convenience foods is because they lead such busy lives. Most of the recipes in these plans are quick to prepare, and should be within the capabilities of even the most reluctant cook. There are exceptions: preparing the Chicken Soup will take a couple of hours, but it makes a lot and you can freeze separate portions, ensuring that you can have a nutritious low-carb meal even when the clock is ticking away.

So blitz your cupboards and discard any foodstuffs that don't fit the bill. The journey to a healthy, lean body begins here.

The Plans

The 3-step programme includes 3 eating plans. The Fast-Track Plan will help you lose weight quickly and give you that all-important boost on a 50 per cent protein/20 per cent carbohydrate/30 per cent fat regime that will initiate benign dietary ketosis. It should last for 7-21 days, after which you are ready to move on to the next stage. Your weight loss should be around 2-5.5kg (4-121b) if you are a woman and 4-7.25kg (8-161b) if you are a man, depending on how long you remain on this plan.

During the Keep on Tracking Plan you increase your levels of low-tomedium GI carbohydrates and move into a 35 per cent protein/35 per cent carbohydrate/30 per cent fat regime. You still monitor ketosis and watch how introducing higher levels of carbohydrates affects your weight loss, which should now even out to 0.25-1 kg (¹/2-21b) per week.

The No Backtracking Plan is your eating regime for life. You can gradually introduce fruit and vegetables, grains and pulses from the higher GI ranges, in moderation. It is important to keep an eye on how your body reacts to these and to establish your perfect weight-management level.

If you are a vegetarian, there is plenty of advice on how to adapt the plans and recipes to suit your dietary requirements. Granted, your choice isn't as varied as that of a non-vegetarian, but don't use this as an excuse not to give it a go. If you follow the basic guidelines and make simple changes to the recipes where necessary, you should lose weight and eradicate insulin resistance successfully.

FOOD TO THROW OUT

• White flour and sugar
• Honey
• Biscuits
• Crisps
• Sweets
• Sugary drinks
• White rice, bread, pasta
• Processed foods high in carbohydrates
• Ready-made sauces
• Gravy mixes

Customize the plans to suit your lifestyle and dietary preferences

The suggested menu plans are not set in stone - they are templates to encourage you to eat the right sort and amount of food.

If you wish to change a recipe - because you don't like lamb and would rather have chicken, say - it really doesn't matter. Just try to use foods of a similar dietary value. When swapping vegetables and fruit, go for ones in the same GI category; try to exchange meat for meat, or fish for fish, in the same amounts. If you change a recipe from meat to fish, you may need to use slightly more fish to give you the same level of protein. For example, 125g (4oz) of poultry or lean meat should be replaced with 175g (6oz) of fish.

Simplify the recipes

If you are short of time, or like your food a bit plainer, simplify the recipe. If you don't fancy Baked Tuna with Tomato and Herbs, adapt the ingredients, ensuring that you still have sufficient protein, carbohydrates and healthy fats - have a tuna salad with tomatoes and dark green leaves.

On a budget

If money is short and you find some of the suggested ingredients a little expensive, use some budgetary ingenuity to bring down the cost. Fresh salmon can be replaced with coley or whiting, or even tinned salmon.

Use the suggested meals as inspiration. In order to manage your weight in the future, you will have to experiment and be prepared to adapt.

Monitoring weight loss

There are two schools of thought on how to monitor weight loss:

• Daily weighing
• The once-weekly weigh-in.

This is an individual issue. If you are the sort of person who needs a daily date with your weighing scales, then by all means do so. Keep a record of your progress using a chart like the one opposite. You may see weight-shifting patterns emerging and be able to isolate foods that have a negative effect on your weight. If you prefer the surprise-at-the-end-of-the-week, that is fine too. You should still keep a record and watch out for any plateaux where weight loss dries up, which may mean that you need to lower your carbohydrate levels or increase your physical activity.

Whichever your preferred monitoring method, keep a tight-fitting pair of trousers or other item of clothing and try them on regularly to establish how your shape is changing. Your weight may stabilize for a while, and if you are exercising regularly and increasing your muscle-to-fat ratio you may even may weigh slightly more for a bit, but you will be fitter and - in the end - leaner.

TOP ANTI-SNACKING TIPS

• Try not to snack while watching television, playing video games or using the computer. Eat meals and snacks in the kitchen or dining room, so that you are more aware of what- and how much — you are eating.
• When you feel a snack attack coming on, run a bath, go for a walk, ring a friend... Do anything that will keep you away from the refrigerator.
• Don't go shopping when you are hungry — it is then that you may reach out for that chocolate bar.
• If you are going to snack, make sure it is a protein snack.

Dietary demons - and how to beat them

1. Not so well-meaning friends and family members: one of the mostdifficult things to deal with is the friend or relative who tries to sway you off-course. Don't be bullied into breaking your resolve. Decline politely andexplain that you are relying on them for support. If you are visiting them,take a whey-protein smoothie with you.
2. Boredom: you shouldn't get bored following the plans,because there are so many different things to eat and ways to prepare your food. Even if you aren't a natural cook, experimenting in the kitchen willkeep you motivated.
3. Alcohol: you are allowed a couple of glasses of wine when you start the
4. Keep on Tracking Plan, but don't be tempted to have more. There is nothing like a little extra alcohol to persuade you that you'll start againtomorrow. Avoid the 'drunken munchies'.
5. Snack attacks: the three dietary plans allow for a couple of high-proteinsnacks each day between meals, but you could easily undermine all your efforts by hitting the biscuit jar in a moment of weakness. Clear out anything vaguely tempting from your refrigerator and cupboards, and be very carefulat times when you normally seek comfort food.

Curb your cravings by curbing your carbs

When you start eating more healthily and reducing the amount of potentially addictive carbohydrate-laden foods, you should find that your cravings begin to diminish as your blood-sugar and insulin levels even out. This will usually take about 48 hours when you start the Fast-Track Plan. If you do get a 'snack attack', try making yourself a whey- protein smoothie; or keep a plate of cold chicken in the refrigerator for weak moments. You can't necessarily kill a craving, but you can wrestle it into submission.

Taking pills and supplements

Pills and supplements both have their uses, but only in moderation and only as long as strict guidelines are followed.

Over-the-counter (OTC) diet pills

The 1991/2 Weight Loss Practices Survey, sponsored by the US Food and Drug Administration (FDA) and the National Heart, Lung and Blood Institute, found that 5 per cent of women and 2 per cent of men trying to loseweight use diet pills. Products considered by the FDA to be OTC weight- control drugs are primarily those containing the active ingredient phenylpropanolamine (PPA), such as Dexatrim and Acutrim. PPA is available over the counter for weight control in a 75mg controlled-release-dosage form. The medicine should be used in combination with a restricted diet and exercise.

Using diet pills containing PPA will not make a big difference in the rate of weight loss, says Robert Sherman of the FDA's Office of OTC Drug Evaluation. 'Even the best studies show only about a half pound (250g) greater weight loss per week using PPA combined with diet and exercise,' he adds. Sherman cautions that the recommended dosage of these pills should not be exceeded because of the risk of possible adverse effects, such as raised blood pressure and heart palpitations.

Supplements

To rely on taking pills as a way of supplying nutrients is not ideal, for in a perfect world such nutrients should come from our food. But when you consider the quality of some of our food — fruit and vegetables grown in mineral-depleted soil, picked before they have ripened and shipped over vast distances in refrigeration, then put into long-term storage; meat full of hormones; grains stripped of most of their nutritional content — then taking a good multivitamin supplement and possibly extra vitamin C can benefit most people. And while you are trying to balance your blood-sugar levels, reduce body fat and rebuild lean muscle tissue, there are a few supplements that may help.

Key supplements

Magnesium

A fundamentally important mineral that counters insulin resistance.

It is hugely deficient in the Western diet. Consider taking 230-600mg per day, unless you have suffered kidney failure or have a high degree of AV heart block.

Quercetin

A flavonoid with powerful anti-inflammatory properties that helpsto control high insulin levels and inhibit fat production. Take 200-400mg three times a day before meals.

Omega-3 fats

If you don't eat fish, take 1,000-3,000mg of fish oil daily in capsule form. Vegetarians can use flaxseed oil or crushed flaxseeds instead of fish oil capsules. Try flaxseed oil in salad dressings (or even in smoothies) to ensure you get enough of this health-enhancing fat.

Chromium

A trace element that plays an important role in carbohydratemetabolism and regulating blood-sugar levels. It has proved useful in treating diabetes and shown to be effective in encouraging the body to lose fat, not muscle, when dieting. Take 400-600mcg of chromium picolinate or chromiumpolynicotinate a day.

L-carnitine

Used extensively by athletes to ensure maximum performance inendurance or aerobic sports. It is also useful for weight loss because it is involved in burning fat in muscle cells. Take 1,000-3,000mg per day.

DIETARY MYTH

Myth: I will get quicker results if I use diet pills.

Fact: there are no shortcuts — no magic pills. Losing weight sensibly and safely requires a multifaceted approach that includes setting reasonable weight-loss goals, changing eating habits and getting adequate exercise. Appetite suppressants (diet pills) may help some people in the short term, but they are not a substitute for adopting healthy eating habits in the long term.

The weight question continue…

Take a health check .. .

Before you begin a new dietary regime or exercise programme, check with your doctor that your health status allows you to do so. A health check is vital if:

• You are suffering from any ongoing health problems
• You take regular medication
• You are under 20 or over 65, because children, teenagers and the elderly have specific nutritional needs.

And a reality check ...

If you do have a problem with your weight, stop beating yourself up over it. Being fat is not a sin or a criminal offence. It is simply a consequence of careless eating and lifestyle.

Even if you have tried every diet going, this one does not have to be the same. You are going to change your lifestyle and give up a few bad dietary habits. So, unless you have a medical condition that prevents you from losing weight, this approach will help you become slimmer and, more importantly, fitter.

Being overweight can undermine your self-esteem and the way you deal with situations. Losing weight won't change the fact that you have money worries, an unsupportive partner or hate your job, but when the pounds start to fall away and you begin to feel better about yourself, you will deal with those issues very differently. Your confidence levels will rise and you will have lots more energy, which will help to make all of your problems seem more manageable.

Don't be negative even before you start. This is not the problem you think it is - it's the solution.

OBESITY AS A DISEASE - NOT A MORAL FAILING

`Obesity is a heterogeneous disease in which genetic, environmental, psychological, and other factors are involved. It occurs when energy intake exceeds the amount of energy expended over time. Only in a small minority of cases is obesity caused by such illnesses as hypothyroidism or the result of taking medications, such as steroids, that can cause weight gain.'

TAKING A HOLISTIC APPROACH

• What you weigh is the result of several factors:
• How much and what kinds of food you eat
• Whether your lifestyle includes regular physical activity
• Whether you use food to respond to stress and other situations
• Your physiological and genetic make-up
• Your age and health status.

Successful weight management should address all of these factors. That's the reason for ignoring products that promise quick and easy solutions, or permanent results without permanent changes in lifestyle. Any product that promises that you can lose weight without lowering your calorie intake and/or increasing your physical activity is trading on fantasy and false hope.

The weight question

'Those desiring to lose weight should perform hard work before food. They should take their meals after exertion and while still panting from fatigue ... They should, moreover, eat only once a day and take no baths and sleep on a hard bed and walk naked as long as possible.'

Theories on the weight-loss benefits of walking around naked and not bathing have not been proven, but Hippocrates' other dietary advice isn't completely off the wall and shows that even 2,400 years ago, the relationship between food intake and energy expenditure was recognized.

Today 'obesity' is becoming universally recognized as a disease in its own right. Obese and overweight are terms that are often used interchangeably, but let's clarify the difference between them:

¨ Overweight refers to an excess of body weight and includes all tissues, such as fat, bone and muscle, but not just excess body fat.

¨ Obese means that someone is carrying an excessively high proportion of body fat that could compromise their health.

If you are an athlete or body-builder, you may weigh more than the desirable weight range for your height, but this is normal because muscle weighs more than fat. Equally, you may be a relatively sedentary person who weighs in at the correct weight for your height, but who still carries too high a proportion of body fat. In this case, a good exercise programme is vital.

For those of you who feel that you are more 'lard' than 'hard', and don't like what you are seeing on the scales, a better way of calculating just how overweight you are is by working out your Body Mass Index (BMI).

You can tell if you have surplus body fat simply by seeing if you can pinch more than 2.5cm (1 in) on your hips, tummy, underarms and back.

Alternatively, get your doctor or gym instructor to check out your BMI using callipers, or buy a set yourself from your local pharmacy. If you have more than 25 per cent body fat, then the chances are that you are carrying too much weight, or at the very least need to change your diet and participate in exercise that will burn fat and build muscle.

Successful weight loss and healthy weight management depend on sensible goals and expectations - losing just 5-10 per cent of your weight is the kind of goal that can help improve your health.

You may be wondering how you have got this far without hearing about calories. But you don't need to become obsessed with the calorific value of everything you put in your mouth. Instead, it is much better to check food labels to see if the food contains unnecessary additives, sugar, hydrogenated fats and salt - and, of course, how high the carbohydrate content is.

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.