The COMPLETE LIFESTYLE MAKEOVER MANUAL

by Douglas M. Cluff, M.D.

SLIM TLC® Online materials and resources are copyrighted. Please do not share your password or anything else without permission.

Table of Contents

The Whatever! Calorie (WCal©) Budget

You’ve heard of Calorie Budgets, right? A Calorie Budget is essentially how many calories you should (be able to) consume each day in order to help you reach your weight goal. To explain: There are 3500 calories in a pound of fat, so if you desire to lose a pound per week, you’ll have to consume an average of 500 fewer calories per day below your metabolic needs. You can use a calorie calculator to determine how many calories you need to consume to maintain your weight (although different calculators will tell you different things – it is not an exact science). Keeping a Calorie Budget requires that you count every calorie that crosses your lips. Ummm…way too difficult, and therefore rarely sustainable long enough to make a long-term difference.

On the other hand, miracles will occur if all you do is track (when you start tracking) your Whatever! calories (WCal©), set a “WCal© Budget,” and try to stay under it! Until you start counting them, you’ll never appreciate how quickly WCal© add up, which is why I am convinced that the greatest driver of the obesity epidemic (and our poor health) is the consumption of too many WCal©!

My mission, therefore, which I have chosen to accept, is to convince you to swallow this (free, all-natural) magic “pill” – hook, line, and sinker. I guess you could call it the “Whatever! Pill.” And it will work for you, if you will swallow it.

I’ll explain more about what, how, and why soon.

I respect your timing; I'm sure you'll do it whenever you see (others) fit. But for whatever reason, if you find this pill to be a little bitter to swallow initially, please do not flush it down the toilet or otherwise discard or dismiss it. You may decide to break it up and swallow it in pieces, whether referring to the learning process or implementation, or you may sugar-coat it in a way that it’s easier for you to swallow. We’ll talk about ways to do so shortly.

Prior to the advent of “Free Food? Whatever!”, my eating strategy was this: “Eat 4:1 when actually hungry.” It focused on both quality and quantity. My (previous version of the) SLIM TLC Map was designed to motivate you and keep you accountable by tracking what percentage of each day’s diet consisted of 4◊F (Four-Diamond Foods). Needless to say, it was “hard to swallow” (yes, much more bitter than the Whatever! Pill) – but it worked…when you did it. But it was not sustainable, and did not work anywhere near as much magic as “Free Food? Whatever!” When you swallow this Whatever! Pill and follow the “Free Food? Whatever!” strategy as recommended, you will be at risk for the following magic to occur, and accomplish things you’ve likely (because of past experience) concluded are impossible. You will:

1. Desire and be driven to make healthier eating choices (it’s EASIER because it takes less work!).

2. Be motivated to get off your rear end (and do more resistance exercises – because as fat melts, more muscle shows!).

3. (perhaps for the first time in your life) Appreciate more the flavor of real food.

4. See your overall “Drive to Eat” decrease as you gain power over food and break your addictions (remember, when it comes to food, “breaking” is defined as “controlling”) – which occurs naturally over time as you decrease your Whatever! intake.

5. Successfully create an environment of success (see Lesson 15, Surviving the Snack Attack), which will also improve the health of those around you.

6. Effectively troubleshoot what needs to be done, finally, to successfully move towards your weight loss goals!

7. See long-awaited, welcome improvements in your health (decreased blood pressure, cholesterol, glucose, gastroesophageal reflux disease, erectile dysfunction, constipation; and improved energy and endurance!).

8. Stop living in fear of regaining the weight you lose.

9. Save money (primarily from eating out less and eating less expensive foods…until you have to buy new clothes).

10. Lose weight in a more consistent manner (reduce plateauing), as long as you stay under/around your WCal© Budget.

What if I Don’t Agree with Your Nutrition Star?

Chances are, until and unless I’m successful at “converting” you, you are in the majority – however, once you fully understand its customizability, you may not need converting.

I have learned that for many, nutrition is like religion. If you have learned nutrition from people you deeply trust, or if you have been challenged and/or have done a lot of research, and arrived at a strong conclusion, then it will be difficult, possibly impossible, to change your mind. But that’s OK! You get to decide how you define Whatever! AND how you define “very healthy.” But you still set a WCal© Budget, and treat whatever you call “very healthy” as “Free Food.” Most are familiar with red-, yellow-, and green-light foods. For those who flat-out disagree with my Nutrition Star, at least try to assign each of your foods (or food categories) to one of these colors. For you, Whatever! will be like “red-light foods” (the less you eat, the better), and your “very healthy” foods will be like “green-light foods” (the more you eat, the better). You’ll find out soon how this works magic. We’ll discuss what to do with, and how we might define, “yellow-light foods” in Lesson 2.

The Whatever! Pill is an integral part of the “Free Food? Whatever!” eating strategy, which, if you will allow it, will change your life – even if you are absolutely convinced that your eating preferences are more effective or appropriate than my Nutrition Star, for whatever reason. See Lesson 2 to learn more about how you can take advantage of the “Free Food? Whatever!” eating strategy by adapting it to fit your preferences, and watch the magic happen!

How Customizable Is SLIM TLC?

Let me count the ways. SLIM TLC is fully customizable to meet your needs, whether you are what my kids call “totally CHILL,” on the nerdy side, or anywhere in between:

1. You get to define “Whatever!” and your version of “4◊F” (in other words, how you customize The 4:1 Rule discussed in Lesson 2)

2. You get to choose what percent of your BMR (basal metabolic rate) constitutes your WCal© Budget (huge range: 20-50%).

3. You develop your own Favorite List of Healthy Snacks (and Meals), creating a customized environment of success.

4. You get to choose which SLIM TLC tool(s) to use and what Program Intensity Level(s) suit(s) you the best.

And you can change any of the above as you see fit, as you learn what works and what doesn’t! Do what you feel is needed, and not what's not! Review this summary:

Simply weighing yourself once weekly and recording it on the SLIM TLC “Light” Log or SLIM TLC Map (Level 1) may be all you need to achieve success, of course combined with striving to create an environment of success. Combining the rest of the Levels (2-7), which includes completing all components of the SLIM TLC Map, will require the up-front learning time described below (and requires the greatest ongoing time commitment), but it will also be the most effective – and yet it may only be needed initially, until you “learn the ropes.” The good news is that you can combine any Levels you desire and go up or down in Level intensity (= commitment) whenever your needs and desires change! However, we discourage you from ever stopping all Levels completely – consider at least continuing Level 3 for life. Recording your progress is a way of being accountable to yourself – but to increase the power of accountability, we also recommend sharing your Log or Map once monthly with one or two people you know and trust, thus increasing your likelihood of success. Those people can be us if you have joined the formal SLIM TLC program.

I do have to warn you that if you are all in, and want to maximize the value of the SLIM TLC program by “following” the full SLIM TLC Map, you will need to learn some new skills – and it will take a…very…long…hour (or two – really, not that long in the grand scheme of things!) to learn them. But it will be the greatest time ROI (return on investment) you’ve ever experienced, i.e., the best rewards for the shortest investment of time (and money, for that matter). And I’m beyond thrilled to be able to help you in this way.

Towards the end of this lesson you’ll see a preview of what happened (finally!) when I implemented the full SLIM TLC program (the “Free Food? Whatever!” eating strategy and all components of the SLIM TLC Map). The tools provided in SLIM TLC Online will help you achieve your weight loss goals and improve your overall health. It is designed to provide you with all the tools and support you need to make lasting lifestyle changes. In our formal SLIM TLC program we also offer one-on-one coaching, group support (and interaction through our Facebook group, Fit Together), personalized nutrition plans to help you reach your goals, and more.

My Philosophy

You’ll have to draw your own conclusions, but know that I have done my very best as a Primary Care Physician highly interested in health, nutrition, longevity, weight loss, truth, and reality (trying to leave bias out of the equation) to study the landscape thoroughly and obtain real-world experience, all with the end goal of putting it all together and providing you with the best possible advice and tools. I have seen and studied a lot, and I truly believe that SLIM TLC, TLC University, and my nutrition guidelines (the Nutrition Star – see Lesson 2) will provide you with the answers for which you’ve long been searching.

The main purpose of TLC University is to teach you simple, invaluable principles of health (using what I consider to be the latest in nutrition science and lifestyle medicine, combined with an indispensable dose of livability), which will empower you to make the most sustainable changes in your lifestyle necessary to meet your long-term health and weight loss goals.  These “Therapeutic Lifestyle Changes” are the key both to preventing and reversing disease.  Without them, not only will your health suffer, but the entire health care system will continue to crumble.  The good news is that the power to prevent and reverse disease is in our hands.

The reality is that the grand majority of diseases from which Americans suffer and die can be prevented by a healthy lifestyle and achieving a healthy weight.  An individual who makes these lifestyle changes will not only significantly increase the chances of living a longer life, but it will also be a much more healthy, functional, and enjoyable life.  In other words, he or she will add both more and good years to his or her life.  In addition, he or she will be much less of a burden to the health care system – i.e., be part of the solution.

My hope is to make TLC University:

1. Understandable

2. Interesting, even enjoyable

3. Invaluable

I would appreciate any feedback that you can give me to help accomplish those goals, and if you find any errors in the text.

Lesson Format 

I initially thought it would be ideal to conduct these lessons in person, one-on-one, at whatever time or place was most convenient.  However, I realized that not only is it impossible for me (or anyone else) to teach all of these principles to everyone individually, it is essential to use the Internet and technology to allow me to reach you in various other formats than in person, at whatever time or place is convenient.  I then thought it would be helpful to create videos for you to watch, or interactive multimedia presentations in which to engage.  Doing so might be more enjoyable and less work for you. However, trying to do so would not only come at a much greater (prohibitive) cost, but it would also prevent me from being able to easily update the lessons with the latest scientific and other helpful information available. As such, I decided it would be best to create an “O (online)-book,” which would facilitate regular updating. In addition, an electronic format allows the invaluable inclusion of links to content, files, and other websites, simple navigation (“jumps”) between topics, submittable forms, and simplified searching of content (press [Ctrl] + [F] or click the three dots in the upper right-hand corner, then click “Find”).

Yes, fortunately for you, the use of good old-fashioned text and graphics (or maybe “digital content” sounds more impressive), combined with the leveraging of technology, provide the best format for being able to keep your educational experience as up-to-date and dynamic as possible.

My Story

My interest in weight loss came as one of those necessity-mother-invention things.  I have told many people that I am a 350-pound man in about a 200- (now <190-) pound body – I say that because I love to eat every bit as much as (if not more than) the next guy – and had I not discovered what I am going to share with you, I am confident I would weigh that much or more.  I must inform you that I am used to telling everyone that I’m 6’5” (I was 6’5 3/8” at my peak), although now I’m actually 6’4 5/8” due to significant degenerative disk disease. So, at a body mass index (BMI – recognized by most as an imperfect indicator of adiposity) of 24.9 I would weigh 208 (18.5-24.9 is considered “normal,” but a BMI of 18.5 is way too thin in the opinion of most). Currently I’m well into the normal weight range (see my SLIM TLC Map towards the end of this lesson).

My weight gain started in my mid-20s (I was born in the mid-1960’s – I’ll let you do the math), around the time I met my wife, Sandy (funny how that works, huh?).  Prior to that, I was (younger and) active enough that I could eat about anything I wanted without gaining weight (saying nothing about the seeds of disease that were being planted because of my inflammatory diet, of which I was ignorant, erroneously equating health with a normal weight).  I was determined never to be one of those men who immediately gained a bunch of weight after getting married, so I was quite disappointed in myself when I quickly gained 20 pounds, passing the 200 pound mark (my average weight prior to that was a skinny 185, a BMI of 21.7).  Although I still tried to stay active, my focus shifted more and more from sports with the guys to spending time with my new-found love (yes, we should have spent more of our time together doing active things and eating healthier).

Over the next 10 years or so, my waistline kept expanding little by little, despite many weight loss efforts and short-term successes at losing a few pounds (which I guess cannot be defined as true success).  By the time I finished my residency, which provided an around-the-clock infusion of stress combined with free (unhealthy) food, I had added >50 pounds to my frame (my weight peaked a little over 235) – despite the fact that throughout medical school and residency I had developed several tools and strategies in hopes of reversing my weight gain.

It wasn’t until after residency – after I began to actively treat obesity – that I was able (finally) to begin seeing a promising reversal of my weight gain.  Like almost everyone else, over the many years since then it has been a (fortunately average downward) roller coaster, and I can attribute the most significant gains (i.e., losses) to specific things I learned and changes I made. Within a few years of finishing residency, excited to share all I had learned and accomplished, I wrote a couple of books, held a weekly weight loss support group for three years (2003-2006), created a kids’ program, an online program (quite the joke compared to what you now have in front of you), and more.  Between those efforts and my own medical practice, I have counseled thousands of patients about how to lose weight and become healthy.

In spite of, and through, all that, I held onto an embarrassing secret:  I still struggled to achieve and maintain a normal weight, usually oscillating between 205-220 pounds – and, like everyone else, I continued to struggle with my “drive to eat” (which I’m convinced is stronger in overweight folks – not so strong in the thin people who look at overweight folks and ask, “Why don’t you just stop eating?”). Also see Lesson 14 for a more in-depth discussion of our drive to eat.

Besides being unable (until December 2023) to figure out how to break my addictions, I also struggled to stay active.  I (thought I) had all the right answers, and I thought I had a pretty good handle on what worked and what didn’t – and I also thought I knew a lot about nutrition.  As it turns out, at least until about 2012, I did not.  More about that in a minute.

Despite the reality that all weight lost through any modality comes back when that modality is stopped, time after time I had patients request phentermine (a potentially addictive appetite suppressant FDA-approved only for short-term use) to boost their efforts. In 2009 I came up with a program to use it in a way that did not allow one to get addicted, and would hopefully give patients the highest chance of sustaining the weight loss they achieved. The plan consisted of using phentermine Short-term, at a Low dose, Intermittently, and in the Middle of the day (it was a total fluke – and blessing – that it ended up as the acronym SLIM), instead of how it was usually prescribed, in the morning, which wore off in the late afternoon when people needed the most help – combined with the Therapeutic Lifestyle Changes (TLCs) necessary for long-term success. I figured the phentermine would be a “carrot” of sorts, to get people into the program so I could teach them the TLCs necessary. And thus was born SLIM TLC.

SLIM TLC has evolved significantly since then, and now it primarily means becoming SLIM through TLCs (although the medicine options have been part of that evolution, and as you likely know, the “SLIM” now also means “Shortest-term, Lowest effective and tolerated Intervention with Medicine” – but I no longer offer phentermine). In reality, not only can it stand all on its own, it can be combined with any other effort, whether it be a medicine (to provide the best chances of long-term success once the medicine is stopped) or as the missing link between what you are doing now (or have done in the past) and true, long-term success.

Permission Granted

As alluded to above, up until around March 2012 I thought I had a good handle on nutrition.  However, everything changed when I read Dr. Joel Fuhrman’s book Eat to Live, followed by many other books (and going to conferences) that I now consider representing the “new nutrition.” I was so moved and convinced (“cognitive dissonance”) by Dr. Fuhrman’s work that I stopped recommending the 380-page book I’d written in 2006 (called SvelteLife: The New Weight Loss Reality – don’t buy it) and started recommending Eat to Live. Patients who read it were frequently also “converted,” and I started seeing the same miracles in them that Dr. Fuhrman saw in the patients highlighted in his book (which, until then, I just considered anecdotal, “results not typical”). I started keeping a list of those patients, and started calling them “Fuhrmaniacs.”

Problem: One by one, over the subsequent few months, patients began falling off the list, as they slipped back into old habits. Why? Because his diet, as powerful (effective) as it is, is unsustainable for most.

How can one get that magic intersection between both effective and livable? Well, I combined all I had learned through the process (with just enough doses of livability), and after many iterations (it’s actually somewhat comical to me now), eventually came up with my Nutrition Star (Lesson 2). For a few years it appeared as a rookie artist, doctor-drawn graphic, until my sweet niece Naomi Sweet (graduated in graphic design) created the current attractive iteration.

However, the SLIM TLC program continued to evolve (and my roller coaster continued) until December 2023, when I came up with (more accurately, frankly, was inspired with the idea of) SLIM TLC’s “Free Food? Whatever!” eating strategy. Not only did that give me and my patients full “permission to eat” (primarily 4◊F, but also some Whatever! – I cannot tell you how refreshing and life-saving that was!), but other educational experiences over the years gave me “permission not to eat” when I wasn’t actually hungry, including intermittent Whatever! fasting (see Lesson 10). All together, these strategies finally provided me and my patients with the tools necessary to achieve and sustain both a normal weight and many of our health goals! Permit me now to share…

Warning: Graphic Material!

You may cringe at how busy my SLIM TLC Maps below appear to you, but remember how I warned you that it may take an hour or two to learn/digest/set it up? Let's just say that once you learn how to set it up, it looks busier than it is difficult. Fortunately, thanks primarily to a talented friend, Ben Campbell, we now have an Excel spreadsheet option, which drastically simplifies the set-up process! However, be aware that, due to the nature of Excel, its bar graphs display total Calories Burned with physical activity and Total XWCal for the week instead of Exercise and Activity minutes as illustrated and tracked on the paper version of the SLIM TLC Map – see mine below, and Lesson 3 for detailed instructions.

Before moving on to Lesson 2, I wanted to give you a preview of what might happen if you follow the full SLIM TLC program. Being a study of one, I fully understand how biased or inadequate it could be, but know that I’m also seeing some promising results in my patients – hopefully in a few months, with their permission, I'll publish a few of their Maps, minus any personal identifiable information. My SLIM TLC Maps below are current as of October 19, 2024.

Doug’s SLIM TLC Maps

Busy, right?! Can’t say I didn’t warn you.

As you can see, if all parts of the SLIM TLC Map are followed (I only follow the parts I find most productive over time, and change my mind frequently), provides a full picture of one's efforts and progress (and reveals one's strengths and weaknesses). Each one covers three months (13 weeks), so I have just started my third Map for the year. The first one starts on New Year's Day (January 1), 2024 (actually I plugged in data from the day before, New Year’s Eve), shortly after my “Free Food? Whatever!” eating strategy “came to mind” and I started logging my Extra WCal© (“XWCal” – you’ll learn about all of this in Lessons 2 and 3) instead of my old “percentage 4◊ Foods” or “%4◊F” each day. I was amazed at the magic that occurred, unlike anything I’d ever done before! Note how many XWCal I consumed on New Year’s Eve and New Year’s Day, the first two days after I started, how quickly that changed, and how rapidly the weight started falling off after the change! And no, I’m not taking any weight loss medicine.

You'll notice a few changes or updates in each Map (as our system continues to evolve and improve, as I set new goals, and as I try to figure out which components and efforts are necessary to continue or maintain my success). Starting the end of April I stopped actively counting/logging my WCal© every day, trying to keep track and calculate them in my head; a week later I stopped recording my Exercise and Activity minutes. Just as with medicine, if you take it, the goal is always to maintain the SLIM (Shortest-term possible, Lowest effective & tolerated Intervention with – in this case lifestyle – Medicine) TLCs (Therapeutic Lifestyle Changes) that are necessary for whatever definition of long-term success you have. I wanted to see if I had learned what I needed to learn about, and continue to stay within, my WCal© Budget, and maintain at least the same level of Exercise and Activity.

As such, I stopped tracking and calculating the hard stuff for a month, only monitoring my weight (Intensity Levels 2 & 3). I “kind of” maintained, but as our weight tends to do when we’re not careful enough, mine slowly crept up almost two pounds over the course of that month, and there’s no question that some addictions started creeping back in. So, I decided to increase the Intensity back up to Level 7 again AND lower my WCal© Budget from 555 (30% of my BMR) to 444 (24% of my BMR) – and surprise! The more I track, the better I do, and the less I track, the worse I do. My intent is to revert back to Intensity Level 7 whenever I start to struggle, or maybe just one or two days per week.

You'll also notice that my original goal in Map 1 was 188 pounds. Well, as I entered the low 190s, I realized that at 188 I would still have too much weight around my midsection (also = visceral fat), so I dropped my goal to 185 for Map 2. Then, after I entered the upper 180s, I felt it would be best to drop my goal even further for Map 3, to 182. Although I’m quite happy where I am (for reference, at 190 and 6’4.5”, my BMI would be 22.82), especially compared to where I've been, I'm really excited and motivated to keep fine-tuning things. I doubt I'll want to drop lower than 182, especially since my plan is now (a little public accountability here) to build some muscle and track only my Exercise minutes, something in which I've been sorely lacking.

I’ve done more resistance and cardio exercises recently than I have in a VERY long time. You’ll notice that, as often happens, I put on a couple of pounds since I started, and although I do believe I’ve put on a little muscle, I guarantee it wasn’t a couple of pounds. It’s a lot easier to gain two pounds of fat than two pounds of muscle, which most do when we start exercising – not only because our appetite is greater (and “you can never outrun your mouth” – look up how long it takes to work off a bacon double cheeseburger or large milkshake), but we (even if subconsciously) give ourselves permission to eat more because we think we can, or to reward ourselves. Never get caught in the “I need to lose weight, and I just started exercising but I’m gaining instead – it must be muscle!” lie). I wasn't really motivated by keeping track of my Activity minutes, so I'm not tracking that for now. Stay tuned...

If you could see my weight history, you would understand how thrilled I am, having seen progress and changes in my body I’ve never seen so quickly. Seriously, >26 lbs in the first four months (which means I was consuming an average of >750 XWCal/day!)? And for someone who was only mildly overweight (the closer you approach your ideal weight, the slower you are able to lose), without medication or killing myself with exercise? You can really see it in my face, but I can really feel it in my neck, when I button the top button of dress shirts. I feel so blessed.

Notice that I was out of town and used two sets of different scales from February 21st through March 4th (I knew they were being too kind), so I didn’t lose as much as I thought I did during that time – but when I got home I realized I hadn’t “lost a step,” a wonderful illustration of how being out of town does not have to ruin your efforts! You will notice that I’ve had a couple little bounces, but that will happen! You must not allow yourself to get discouraged and fall off the bandwagon.

But what I was not prepared for was how much easier it became within just 3-4 weeks, as I noticed the “pull” of my addictions fall significantly (I guess because I stopped feeding them so much!), giving me a power over food and ability to make healthier decisions that I’d only previously preached and dreamed possible!  What a concept.  I’ve been teaching my patients how that’s supposed to work for years, but never actually experienced it myself!  My taste buds have changed, I crave healthy foods (I’ll share which ones in Lesson 15, Surviving the Snack Attack) every bit as much as Whatever! foods, and it takes a lot longer to feel hungry.  Oh, I still indulge a little, almost every day (some days more than others) – but indulging isn’t the problem.  Overindulging is.

In all my experience, both with patients and personal, I have now learned that the way you overcome food addictions is NOT by stopping Whatever! foods altogether for 3-6 weeks and then at some point trying to slowly introduce a small amount back into your diet with the hopes of not becoming addicted again (which is what I, and many others, have tried over and over without success). I also know that I will never, nor will the grand majority of my patients, be willing or able to stop eating Whatever! foods altogether forever. You can stop drugs and alcohol, but you can’t stop eating (or at least you will never be able to avoid ALL sugar, white flour, etc.). If you deprive yourself, as soon as you get a taste of your addicting foods, you will almost always relapse. In essence, I now know that the way to break food addictions (I’m confident this will apply to most people) is to slowly lower your consumption until you cross the point where you have more power over them than they have over you! Imagine the state of bliss!

“Free Food? Whatever!” Capitalizes on Our Laziness

One of the most magical things about this new SLIM TLC eating strategy, and perhaps the main reason it works so well (you will quickly learn), is that having to keep track of, count, or calculate WCal© takes more work – depending on what WCal© you eat! When have you heard these words used together in a sentence? “I eat healthier because I’m lazy.” I understand that’s not fair for the majority of us who we know aren’t lazy, for whom the more appropriate statement is, “I eat healthier because it’s easier.” But again, when have you heard those words used together in a sentence? Of course, the ease of this increases dramatically when you have been successful at creating an environment of success (see Lesson 15, “Surviving the Snack Attack).

For example, you’re watching TV and encounter a commercial about you-name-it, giving you the time and urge to get up and grab a bite. You may or may not have Checked Your Fuel Gauge first. You’ve been following this program faithfully for 3-4 weeks, so not only do you have several healthy options around, with your SLIM TLC List of Favorite Healthy (4◊ Food) Snacks posted in clear sight on your refrigerator, but your addictions no longer have the best of you. You still haven’t broken the habit of going straight to the pantry, but you open it and see a ton of old, stale, half-eaten bags and boxes of processed snacks, and think, “Man, not only does none of this sound appetizing, but counting WCal© takes work, and I’ve already paid my dues today. And that Honeycrisp apple over there (or shrimp cocktail or handful of cashews or smoothie or anything on your SLIM TLC List of Favorite Healthy Snacks) sounds really good!” And the magic continues.

Imagine a world where every label and menu item lists their WCal© content! Obviously it would be a world fuller of healthy, slender people! Food manufacturers and restaurants, take note! It’s a long road between now and then, but together I hope we can travel it quickly.

My plan is to publish many SLIM TLC Light Logs and SLIM TLC Maps from other participants, minus any personally-identifiable information, which will be WAY more powerful than any before-and-after pictures – which have many limitations, as you know, e.g., How much weight did they actually lose, and in what period of time? How tall are they (affecting their BMI)? How healthy were their eating habits, actually? How much exercise did they do? Etc., etc., etc. Oh, the data we’ll be able to extract.

Quiz for Lesson 1: Orientation

This lesson is dedicated to nutrition. If you were to ask a thousand health care professionals about nutrition and weight loss, you’d get a thousand different answers. Even in my case, opinion is the average of messages received – so the more you pursue the line of thinking that seems right to you (or desirable, perhaps because of addictions or philosophy), the more you will believe it.

That being said, I would be remiss if I didn’t share what I strongly believe, and why I believe it. However, as I mentioned in Lesson 1, no matter how you customize your approach based on what you have concluded, you should still see some success. How much? That depends on how you customize it, and all the other factors that work for or against us. If you do not see as much success as you would like, or it does not last, please reconsider my approach.

Plant protein powerhouses include nuts and seeds, legumes (things that come in pods, e.g., beans, peas, lentils, peanuts), whole grains, and dark greens. One can get plenty of protein from plants – just ask a gorilla. The protein section of MyPlate includes both animal-based and plant-based protein – so don’t fall into the trap of equating protein with meat. Because the protein section should be divided into both animal-based and plant-based protein, all-in-all MyPlate represents about a 70% plant-based diet.

The guidelines provide tips for each section:

1. Fruits: “Focus on whole fruits” (100% fruit juice – which is “processed fruit,” containing no fiber, lots of simple sugar, and far fewer micronutrients – qualifies as a serving of fruit, although it’s recommend that at least half of your servings come from whole fruit – whether it be fresh, frozen, canned, or dried/dehydrated).

2. Vegetables: “Vary your veggies” (100% vegetable juice qualifies as a serving, and thankfully it is far healthier than fruit juice; similarly, vegetables can be fresh, frozen, canned, or dried, whole, cut-up or pureed/mashed). Five subgroups are listed: Dark green; red and orange; beans, peas and lentils; starchy; and other vegetables (in my book, you cannot go wrong with any kind of vegetable – the more, the better!).

3. Grains: “Make half your grains whole grains” (which means half is refined – although it is recommended that the refined grains be enriched (thiamine, riboflavin, niacin, folic acid, and iron added back in).

4. Protein: “Vary your protein routine” (“Meat and poultry choices should be lean or low-fat, like 93% lean ground beef, pork loin, and skinless chicken breasts. Choose seafood options that are higher in healthy fatty acids and lower in methylmercury, such as salmon, anchovies, and trout”).

5. Dairy: “Move to low-fat or fat-free milk or yogurt” (interestingly, “The Dairy Group does not include foods made from milk that have little calcium and a high fat content. Examples of this are cream cheese, sour cream, cream, and butter” – suggesting these are discouraged).

*e.g., in reversal of weight gain, diabetes, hypertension, hypercholesterolemia, erectile dysfunction, and constipation; and increased energy/endurance

It must be explained that not all components of the Whatever! diamond are created equal – in other words, some things are obviously going to be less healthy than others. For example, certain healthily-prepared non-red lean meats are far healthier than processed meats, and/or foods I call “plant waste” (plant products containing no fiber, water, nor micronutrients) and “animal secretions” (dairy and dairy products, eggs, and grease/animal fat – see Lesson 5 for more information about “plant waste” and “animal secretions”). Essentially, I categorize anything that I (and the many from whom I’ve learned) believe causes more harm than good as Whatever!

I’m not sure this is a fair comparison, but similarly, not all 4◊F are created equal. Certain fruits (especially berries) have more micronutrients than others. Vegetables are usually the lowest in caloric density (most helpful for weight loss). Personally, I don’t stress too much about these minutiae, because the more you do, the more restrictions you place on your diet, and the less likely you’ll be able to sustain it. The good news is that you get to choose what works best for you, and which of the 4◊F you eat.

How critical is it that I get 20% of each of the 4◊F?

Obviously, it’s generally wise to try to get a good variety, for a variety of reasons. However, I’m going to simplify things drastically for you. Yes, some plants may be considered healthier than others, so you may choose to select those you feel are most beneficial. Nonetheless, because of what I have learned about how plants of all types, as long as they are prepared healthily (see Lesson 6, Committing Planticide, to learn more about what that means), have a powerful anti-inflammatory, disease-fighting effect on our bodies, I have grouped them all together into a more simplified guideline (for even more customization!):

To break Whatever! down, it consists of any non-4◊F, such as beef, chicken, turkey, pork, eggs, dairy, sugared drinks and candy, non-whole grain bread and pasta products, cake, donuts, low-fiber cold cereal, most pizza, fried foods, fried chips, fatty or sugary toppings or dressings, oils, alcohol, etc. Not only are these foods less healthy (they have a high caloric density and/or bad cholesterol, and are more inflammatory), they are also very addictive (again, see Lesson 5, Might as Well Face that I’m Addicted to Whatever).  As such, you have to treat them with kid gloves – even within The 4:1 Rule.

Doesn’t milk do a body good?

I believe strongly that the latest in nutrition science does not support the belief that milk (or milk products, i.e., dairy) is healthy, no matter how many celebrities you see smiling with a milk mustache. Therefore, it goes into the Whatever! section. Again, see Lesson 5 for more information.

Where’s the beef?

Similar to dairy, I categorize all meats (other than fatty seafood) as Whatever!, based on what I consider to be the latest in nutrition science – including chicken, which has about as much bad cholesterol (LDL, or low-density lipoprotein) as red meat. Depending on how you prepare it, chicken may be leaner, but it’s not a health food. However, two caveats:

1. Healthily-prepared non-red lean meats are the least harmful members of the Whatever! category.

2. Processed meats are the least healthy of all meats, followed by red meats (and then fowl and non-fatty fish, in decreasing order of concern).

If you feel strongly that healthily-prepared lean (hopefully not red) meat belongs in the “High-Quality Protein and Good Fats” section, you can try including it, but please reconsider if you are not meeting your health and weight loss goals.

What if I’m low-carb and/or high protein?

Most low-carb proponents will take one look at the Nutrition Star and immediately conclude that it promotes a high-carb, low-protein diet, and therefore immediately disagree with me. If you have done that, not only are you missing the point, but you will miss out on the amazing benefits, especially provided by the “Free Food? Whatever!” eating strategy. As such, may I offer you a hearty invitation (e.g., strongly encourage you) to reconsider? You will have also misinterpreted the Nutrition Star. It is a low-simple carb, lower-animal protein, and low oil diet.

However, remember (again) that the Nutrition Star and 4:1 Rule can be customized to fit your preferences, just like those of (almost) any other diet, made possible by the Whatever! (flexibility and livability) section. There are plenty of options for you. Just do your best to keep the Whatever! foods to <20% of your total intake, and/or the total WCal© within whatever you set as your WCal© Budget (for details, see the “Free Food? Whatever!” section below).

What about vegans and vegetarians?

As I suggested above, vegans and vegetarians (V/V) are usually far healthier and slimmer than the average SAD (standard American diet) follower. However, by definition, vegans can eat plant waste (see Lesson 6, Committing Planticide), and vegetarians can eat plant waste AND dairy – so being V/V is not synonymous with health. I’ve known morbidly obese vegan patients who are every bit as unhealthy and addicted to plant waste as the average Joe. As such, I try to leave the “V/V” words out of the health discussion, and instead put the two Vs together to get a “W.” And this isn’t the same as “W!”, which I’ve used as an abbreviation for “Whatever!” In this instance, I’m using “W” as an abbreviation for whole, short for “Whole Plant-Based,” or WPB (most WPB dieters insert an “F” and instead use “WFPB,” AKA “whole-foods, plant-based,” but I don’t know why one needs the word “foods” in there). V/V are philosophical and religious terms, which I fully respect. But V/Vs who fill the “Whatever!” section with WPB foods need to use the term “WPB” when talking about a healthy diet, so as not to confuse the picture. WPB V/Vs have my greatest respect and are the healthiest.

The Magic ELF

This ELF is real AND works magic. The Holy Grail of weight loss, which all have sought through the ages but have never found (until now), is the ideal combination of, or intersection between, Effectiveness, Livability, and Flexibility. Eating only 4◊F is effective, but rarely livable long-term. Eating only pizza, donuts, burgers, fries, and ice cream primarily consisting of Whatever! ingredients is livable long-term, but not effective. The magic of the Nutrition Star (perhaps more so The 4:1 Rule) is that it will accommodate most (rational) diets, and is adaptable to almost any eating preference, because you can fill in the Whatever! part with whatever you’d like! 4◊F are what makes the Nutrition Star Effective, and Whatever! is what makes it “Flexible and Livable.” As stated above, if you are a low-carb meat eater, you can fill the Whatever! section with meat (etc.)!  If you are vegetarian or vegan, fill the Whatever! section with something else.

I guess you could call the Nutrition Star a “mostly whole (low-processed-food), mostly plant- and fatty seafood-based,” or “MW(LPF)MPFSB” (kidding – you do, and you’ll clean it up), diet. Better: “The >80% 4◊F Diet” – or maybe “The <20% Whatever! Diet.” You get the idea. The key is to overwhelm whatever (hopefully small amount of) Whatever! foods you consume with a large amount of 4◊F.

There are two different ways to look at The 4:1 Rule:

1. Volume (≥80% of the total volume of the meal consists of healthily-prepared plants and fatty seafood)

2. Calories (≥80% of the total calories of the meal consists of healthily-prepared plants and fatty seafood)

Obviously the latter is the more stringent and therefore the more effective strategy, since most meats, dairy, and processed foods generally have a much higher caloric density. On the flip side, the former is more livable. The challenge is to find that magical intersection between livable and effective (for excellent health and weight management), which you can sustain. For general ease, especially while meal planning (Lesson 7) and snacking (Lesson 15), consider at least starting with the former, but you will be using a version of the latter when you implement the “Free Food? Whatever!” eating strategy, which is effectively weaved into our powerful goal-setting system, the SLIM TLC Map (Lesson 3).

Because when you eat right (4◊F, with low caloric density and without Hidden Calories) you get to eat more food, the more you choose healthily-prepared plants and fatty seafood, the more you can eat without gaining weight!  Not to mention (OK, I have to mention, because you must know) that it is estimated that nearly 1/4th (23%) of the complex carbohydrate calories in the whole plants you eat are burned up as your body tries to turn it into fat.¹ When I first learned about or realized these phenomena, which essentially gave me permission to eat whenever I was (“actually”) hungry, I was hooked – for life.  Like you, I love to eat, and until now that was always a bit counterproductive to my weight loss goals.

Indeed, eating a mostly 4◊F diet is the key to lifelong weight management and health.  However, there are two very important points we must reiterate:

1. Being able to eat whenever you are (“actually”) hungry is dependent upon choosing the right foods (i.e., 4◊F – see Lesson 6, Committing Planticide).

2. Being able to choose the right foods is dependent upon making them available, i.e., creating an environment of success (see Lesson 15, Surviving the Snack Attack).

You cannot expect to eat healthily if you do not prepare accordingly!  You must keep your kitchen (primarily the pantry and refrigerator) appropriately stocked with 4◊F (this starts in your grocery cart, which must reflect The 4:1 Rule), in addition to any other areas where you spend your time.

Practical recommendations

Don’t know where to start?

1. For breakfast, if you are in the habit of eating non-plant-based foods (or less-healthy versions thereof such as most cereals), try to change your habits.  Consider starting a habit of eating two fruits (or a healthy smoothie) and a whole grain (toast, oatmeal) or a serving of nuts for breakfast every other day, and moving up from there.

2. For lunch, depending on your dietary preferences, consider developing the habit of eating (as your main dish) a healthy salad and/or soup, and/or a potato loaded with 4:1 Rule toppings (e.g., seasoned black beans, salsa, spicy bean-based chili), and/or fatty seafood as the main dish.

3. For snacking ideas, see Lesson 15, Surviving the Snack Attack.

4. For dinner and other major meals, see Lesson 7, Meal Planning the SLIM TLC Way.

By the end of the day, your ratio of 4◊F:Whatever! should be at least 4:1.  One simple way to think about it is to try to get an average of one fruit, one vegetable (and/or legume), and one whole grain (or serving of nuts or seeds) for each meal.  Then you know you’ll be getting enough of the good stuff.

Think about what your momma always told you – “Eat your veggies!”  If she was doing her job right, and also included fruits, whole grains, legumes, nuts and seeds, and fatty seafood, then The 4:1 Rule was right down her alley!

Now that you better understanding of the Nutrition Star, The 4:1 Rule, 4◊F, and Whatever!, you are ready to learn more about…

SLIM TLC’s “Free Food? Whatever!” Eating Strategy

I put the heading in big, bold, black letters to emphasize our revolutionary eating strategy, which was introduced in the Orientation (Lesson 1).

SLIM TLC’s “Free Food? Whatever!” eating strategy, in simple terms, requires that you establish, and try to live within, a “Whatever Calorie Budget” (WCal© Budget) – an amount of Whatever! calories (WCal©) that you are free to consume without feeling guilty or countering your weight loss and health efforts (see the Establishing your WCal© Budget subheading below). For those who choose SLIM TLC Program Intensity Level 5c (see Lesson 1), any WCal© you consume over (or under) your WCal© Budget (“Extra WCal©” – or “XWCal” for short) will be reported or recorded on the SLIM TLC Map.

Yes, this strategy does require that you keep track of all the WCal© you consume – but herein lies the magic! The fewer WCal© you consume, the less you have to count! That is what motivates you to make healthier choices. The more you choose to consume “whole” (healthily-prepared) 4◊F, the less work you have to do! What this means is that:

1. All 4◊F or 4◊ calories are (or can be consumed guilt-) “free.” You don’t have to keep track of them, write them down, or tell anyone.

2. All WCal© under your WCal© Budget are (or can be consumed guilt-) “free.” As mentioned above, you will have to keep track of the WCal© you consume. However…

3. All you need to worry about recording or reporting (on the SLIM TLC “Light” Log, SLIM TLC Map, and/or the SLIM TLC Whatever! Item and WCal© Tracker – whichever meet your needs) are your “Extra WCal©” (“XWCal”), those WCal© you consume over your WCal© Budget (you will record the difference between your WCal© Budget and how many WCal© you consume, so if you stay under your WCal© Budget, you will record a negative number).

What about yellow-light foods?

As mentioned in the Orientation (Lesson 1), if you disagree with some of the components of the Nutrition Star, or are uncomfortable with the “bright line” that I (or you can) draw between (what you consider) 4◊F and Whatever!, I invite you to divide your foods into red-, yellow-, and green-light foods. Red-light foods would represent your version of Whatever! (i.e., the less you eat, the better), and green-light foods would represent your version of 4◊F, “Free Food,” or very healthy food (i.e., the more you eat, the better).

Yellow-light foods would have some nutritious value, but contain too many WCal© to consume as readily as green-light foods – yet they do not have to be limited as much as Whatever! foods. You can have some, but need to “slow down” if you start to overindulge. The simplest way to “manage” them is to count 50% of their calories towards your WCal© Budget. However, if you deem them to more closely resemble red-light foods, consider 75%; or green-light foods, 25%. Choose what you think is best, then experiment. Change the number as needed. The number (percent) on which you decide (that counts towards your WCal© Budget) will depend on what you consider to be yellow-light foods, and how much they interfere with your efforts.

Establishing your WCal© Budget

Your WCal© Budget is a certain percent (we recommend anywhere from 20-50%) of your BMR (Basal Metabolic Rate), which you can calculate by clicking on the link or in most calorie counting apps. YOU get to choose the percent (and may change the percent over time, according to your needs and desires)! What percent you should choose will depend on:

1. Your current eating habits (how closely you already follow the Nutrition Star)

2. Your desires (how much weight you’d like to lose, and how fast you’d like to lose it)

3. Your ability – which is affected by many things, such as how close you are to your goal weight (the closer you are, the harder it is to lose), the severity of your addictions, your environment, and time, health, financial, and transportation limitations

4. Whether or not you define Whatever! the way I do, and if not, how you define it

5. How tall, old, or heavy you are, and whether you are a man or a woman – unfortunately for women, men have a higher BMR than women, primarily because of body composition and hormones (for example, 2000 calories/day is the BMR for a 30-year old, 5’10”, 200-pound man or a 30-year-old, 5’10”, 265-pound woman; the taller, younger, and heavier you are, the higher your BMR)

The closer you already follow The 4:1 Rule, the faster you’d like to lose, or the closer you are to your goal weight, the lower the percent of your BMR that you should choose for your WCal© Budget. For example, if your BMR is 2000 calories/day, and you are disciplined and want to lose weight fast, or if you aren’t far from your weight loss goal, I’d recommend choosing 20-25% of your BMR as your WCal© Budget – and therefore your first 400-500 Whatever! calories are free (20-25% of 2000 = 400-500). Any Whatever! calories you consume over your WCal© Budget (of 400-500 – your “XWCal”) are recorded on the SLIM TLC Map. On the other hand, if you’re just starting out and eat pretty poorly, and/or you are quite obese, you may want, or it might be wise, to choose 50% to start – and therefore your first 1000 WCal© are free (50% of 2000 = 1000). If you are somewhere in between, you may decide to choose 35% (700). And remember, you can change that percentage down the road as needed to achieve your goals.

For instance, being the Lifestyle Master I (thought I) was, I figured I’d jump all in and start with a WCal© Budget of 20% of my BMR (380 WCal©/day). I simply couldn’t do it. So I relaxed it to 30% (569 WCal©/day – it was still difficult at the beginning, but it was mostly doable for me over time), and the magic began. As my weight fell, my BMR decreased, and so my WCal© Budget decreased. As I got really close to my goal, my “system” was in place (I had some experience and created an environment of greater success), so I was able (and had) to decrease it to 24% (444 WCal©) to see the weight changes I wanted.

Clear as mud? Once you decide on a starting percent and calculate your daily “free WCal©,” you’ll write and circle that number on the SLIM TLC Map, so you can see it easily. Any WCal© you consume above (or below) that number are the “XWCal” (which will be a negative number if below your WCal© Budget) that you will record daily.

SOUNDS FUN, DOESN’T IT?! You will find that keeping track of your WCal© will become easier over time, both as you make healthier choices and become familiar with the process. I recommend using a calorie-counting app like MyNetDiary to assist in the process (at least until I can finish my SLIM TLC app with the WCal© content of most foods listed – i.e., ain’t never gonna happen). What also makes it easier is observing that Whatever! foods usually travel together – think hamburgers, pizza, and breakfast burritos. Unless the buns or crust or tortillas are whole grain, any plants they contain will constitute a very small portion of the total calories.

It is normal, as you are getting started, to record (sometimes much) larger amounts of “XWCal” at the beginning, so do not get discouraged! Within a few weeks you’ll “get the system down,” become encouraged by your progress, see the magnitude of your addictions diminish, have a much greater understanding of what it takes (ability to troubleshoot), and have much greater power and hope to achieve your goals (it also takes about that much time to determine the best 4◊ substitutions for your favorite “Whatever” foods with which to stock your pantry and refrigerator).

“CHEAT” DAYS: At least an average of monthly there are special occasions – holidays, birthdays, anniversaries, etc. I think it is wise, if you can still accomplish your goals (perhaps by compensating with Exercise and/or active Activities – see the SLIM TLC Map), to consider allowing one “cheat” day per month where you can double your WCal© Budget for the day.

TIP: To avoid becoming hungrier as you shift to more (usually low-caloric density) 4◊ foods, be sure to include plants high in fat, protein, and unprocessed starch (complex carbs that expand in your stomach when combined with water) in your diet!

The Missing Link

If you have not seen satisfactory results with, or you’ve not been able to stick to, your dietary preferences (notice I didn’t use the word “diet”), the “Free Food? Whatever!” eating strategy and SLIM TLC Map (below) are your missing link! As previously discussed, they can be adapted quite easily to about any eating preference. Although I am quite confident about my Nutrition Star guidelines, if you have deeply-held nutrition beliefs, or you agree with most, but not all, of it, you can adapt your dietary preferences to fit The 4:1 Rule and the “Free Food? Whatever!” eating strategies! In other words, to remind you, you can assign the foods you call healthy (“on your diet”) to the “Free Food” part, and the foods you are trying to avoid to the Whatever! part, and…voilà! Set your WCal© Budget, count the WCal© you consume, and record your Extra WCal© (XWCal) on the SLIM TLC Map! It is so powerful that you will likely see more magic occur than you’ve ever seen before. If you don’t, however, strongly reconsider my Nutrition Star.

For example, wine, cheese, and olive oil, in moderation, are considered a healthy part of the Mediterranean diet – but these have either empty calories (wine) or a very high caloric density (cheese and olive oil), so they are part of the Nutrition Star’s Whatever! diamond. As such, all other things considered equal, you will lose weight faster (and I feel strongly you’ll be healthier) with my guidelines vs. the Mediterranean diet.

You may prove that your dietary preference trumps the Nutrition Star (whether to help you lose weight or improve your nutrition – although remember that numbers in regards to nutrition do not paint the whole picture); however, whatever you do, because they are customizable to your needs, do NOT shoot yourself in the foot by refusing to follow the “Free Food? Whatever!” eating strategy and SLIM TLC Map! At least try it now, so you don’t wish you had later.

One more major point: You can do this all by yourself (or with the help of a friend or two)! There is no need for expensive programs, medicines (or their side effects), meal plans, supplements, etc.! Oh, the money you’ll save…

¹Weight Management: State of the Science and Opportunities for Military Programs, Chapter 3: Factors that Influence Body Weight, accessed June 9, 2204 at https://www.ncbi.nlm.nih.gov/books/NBK221834/

Quiz for Lesson #2: The 4:1 Rule and Nutrition Star

True success in any endeavor is highly unlikely unless you have some type of effective goal-setting system in place.  Such is the SLIM TLC Map.  Remember that “a goal not written is only a wish,” and your journey towards health is one of the most important journeys you will ever make.  Without an accurate Map, you will get lost and never reach your destination.  The SLIM TLC Map will help you chart your course on this journey, and guide you steadily down the road to long-term weight loss success.

For those who find the SLIM TLC Map too busy, consider using, or starting with, the SLIM TLC “Light” Log. Whether you choose to do that first or dive in now, I encourage you to ponder and review the following sample SLIM TLC Map, which covers three (3) months (start a new Map every 3 months or whenever you desire). It probably seems a little busy at first glance, but once you learn about it and set it up, it is extremely easy to follow, and takes only a few minutes a day to update!

Remember, you can choose what and what not to do with (i.e., which components to use or not to use of) the SLIM TLC “Light” Log and/or SLIM TLC Map, depending on the SLIM TLC Program Intensity Level you choose. Do what works best for you.

You can even forego most of the setup work of the SLIM TLC Map by choosing to use the Excel spreadsheet option, if you prefer, which drastically simplifies the set-up process. However, to reiterate what I shared in the Orientation (Lesson 1), due to the nature of Excel, remember that its bar graphs display total Calories Burned with physical activity and Total XWCal for the week instead of Exercise and Activity minutes as is illustrated and tracked on the paper version of the SLIM TLC Map described below.

I have created two versions of the SLIM TLC Map, which can be downloaded by clicking on the links:

• The 10-minute version (for non-, mild, or moderate exercisers, for which the boxes used to log exercise are in 10-minute increments)

• The 20-minute version (for moderate to vigorous exercisers, for which the boxes used to log exercise are in 20-minute increments)

Notes regarding the three completion steps summarized in the illustration above:

1. Your average weight is plotted once weekly to create a line graph, using the descending weight scale you create on the left side (in one- or two-pound increments, depending on how much weight you would like to lose). 

2. Your “Exercise” (defined as anything that makes you “huff and puff,” e.g., roughly the equivalent of running) and “active Activity” (defined as getting “up and doing,” e.g., roughly the equivalent of walking – AKA “N.E.A.T.” – Non-Exercise Activity Thermogenesis, briefly discussed in Lesson 4, Another Magic Pill) minutes are plotted as bar graphs, preferably in different colors, filled in from the bottom up, anytime you Exercise or do an active Activity within a given week, using the ascending scale at the right. 

3. Try every day to record your Weight (to get an average to plot in #1) and how many “Extra WCal©” (XWCal) you consume (above – or below, if under – your WCal© Budget; see the end of Lesson 2, “The 4:1 Rule and Nutrition Star,” as a reminder).

There are a few important points to make regarding the SLIM TLC Map:

1. Some people feel that weighing themselves frequently is not healthy. You have to find what works best for you. Studies show that those who weigh themselves frequently have better long-term success, but if you find yourself obsessing about the number on the scales to your detriment (see Troubleshooting topic, "I ate right and I still gained two pounds since yesterday!" for more information), you may be an exception. You may decide to do it every other day, twice weekly, or weekly (but never less frequently) – do what works best for you (this may take some experimenting). For consistency, I recommend weighing yourself in the morning before you eat or drink anything (your “dry” weight), around the same time.

2. When plotting your weight you may use the exact weight from that day; however, it is more accurate if you average your weights from the previous week (if you record your weight daily, it may be wise to discard your highest and lowest weights when averaging them to plot them on the Map).

3. The most powerful weight management tool that SLIM TLC provides is the “Free Food? Whatever!” eating strategy outlined at the end of Lesson 2, “The 4:1 Rule and Nutrition Star.” Keeping track of your “Extra WCal©” (“XWCal”) calories is the most critical key to transforming your previously unhealthy habits and addictions into new, positive ones. By going through this exercise, and by sharing and troubleshooting with your “TLC Trio” (see below), you will be amazed at how helpful it is both in getting a reality check of your eating habits and in accomplishing your goals.

Now let’s get started!  Take out your blank SLIM TLC Map (you can use this version that shows the exercise and activity minutes in 10-minute increments, or the 20-minute version).  It is usually better to use a pencil (consider colored pencils) when filling out most of it, in case you make a mistake or desire/need to change something later.  Please refer to the sample SLIM TLC Map above as you fill it out.

Setting up your SLIM TLC Map is accomplished through the following steps:

A) Fill in the blanks at the top:

1. At the top left, write the (Original) date you and the other members of your TLC Trio (see #6 below) want to get (or got) started. Depending on what day of the week you start, the first “week” may be shorter, but from then on each week will start on a Sunday, since the section at the bottom starts on Sunday. You will update the weight line (see D below), and calculate your net Exercise/active Activity minutes and “XWCal” (see F below), at the end of each week. Also write down your starting weight (“Wt”).  This date and weight will be transferred to any new Map you start.

2. Decide on a “Look and Feel Great” Weight Goal, and write that in at the top right (155 in the example). This should be a healthy and ultimately achievable weight. Consulting a BMI chart (e.g., from the NHLBI) or your doctor can help you decide on a goal weight.  BMI can also be calculated using the following formula:  Weight (in pounds) ÷ Height (in inches) ÷ Height (again) × 703.

3. Next, fill in your Starting and Goal BMI (the BMI that corresponds to your “Look and Feel Great” Weight Goal), using the link or formula above.

4. Decide how you will reward yourself for achieving that goal and write it in the space provided.  Make sure the magnitude of your reward matches that of your achievement (consider a new wardrobe, a trip, some nice electronic gizmo, a car, or an island). I recommend waiting on rewarding yourself until you can maintain that goal weight for 3-6 months. You should also consider setting short-term goals and rewards, e.g., for every 5, 10, or 25 pounds you lose.

5. Under that, in the “What is your WHY?” space, write down the main driver(s) of your desire to lose weight and get healthier.

6. Next, choose a couple of partners to join you on your journey. Instead of having a single “weight loss buddy,” I like you to have two, creating a “TLC Trio” – for various reasons, including: 1) There is power in numbers; 2) if one of the other two can’t join you (for troubleshooting, dinner, exercise), hopefully the other can; and 3) you can fire and replace one if he or she is not helping/contributing... If you can prepare meals together, that is ideal – and whether you live together or not, imagine how helpful it would be to cook dinner for each other so that you can have every other night off (or however often you decide to do it)! Take that principle a step further and trade off with another “TLC Family!”

7. In the Daily “Whatever Calorie Budget” box, fill in your BMR (basal metabolic rate), which you can calculate in most calorie counting apps by clicking on the link), and multiply it by the percent you have chosen to calculate your daily “Whatever Calorie Budget” (30% in this example, i.e., BMR x 0.30 – see the end of Lesson 2, The 4:1 Rule and Nutrition Star) – then write it down in the space provided (use a pencil!). Circle that number for emphasis, as illustrated in the sample Map above.

8. Lastly, you will calculate the estimated number of calories you burn per minute through both Exercise and active Activities (represented by the two colored bar graphs on the Map). This is done by first dividing your BMR by 1440 (the amount of minutes in a day), to get the number of calories you burn per minute at your BMR, then multiplying that number (assigned the variable “Z” on the Map) by 7.7 to get the Activity Factor, AF), the estimated number of calories you burn per minute with Exercise, and by 3.85 to get the estimated number of calories you burn per minute while doing active Activities. Obviously these are estimates, and will vary depending on a multitude of factors. If you have a more accurate way of measuring your specific E & A minutes, of course you may do so. As I said before, I like to simplify by defining “Exercise” as anything that makes you “huff and puff,” e.g., roughly the equivalent of running, and “active Activity” as any activity that gest you “up and doing,” e.g., roughly the equivalent of walking, which I estimate as burning about half as many calories as running. This is important to calculate about how many total calories you have burned (through E & A) at the end of each week. Again, for emphasis, circle those numbers as illustrated in the sample Map.

B) Start filling in the spaces reserved for your weight at the left by writing in your current weight (rounded to the nearest whole number) next to “Start Wt” (180 in the example).  Then, label each space/hashmark below that with descending numbers, in one- or two-pound increments (only choose two-pound increments if you have a lot to lose – and never more than two), and write that weight in the space below. Continue that process all the way to the bottom of the scale.

C) Next, fill in the weekly date fields at the bottom as suggested on the sample Map.

D) Now you are ready to start creating the Weight Line on your SLIM TLC Map.  Plot your current weight on the first vertical (bold) line at the point corresponding to today’s weight (see the example Map).  The Weight Line will be drawn as you weigh in and plot your weight (or average weight if you follow the strong recommendation to weigh yourself daily) at the end of each week (on the intersection between solid gray lines – skip the dotted lines).  You may wish to draw your Weight Line in black pen, to emphasize its importance and so it can be easily seen in case it overlaps with the boxes you color in for your Exercise and Activity minutes.

E) The pre-drawn blue horizontal line on your Map is the Exercise and Activity Minutes (Goal) Line, which is a great motivational tool. This line crosses the Map at the 100- or 200-minute mark (using the scale on the right side of the Map), depending on which SLIM TLC Map version you use (10- or 20-minute increments). Your goal should be to work towards trying to hit this line each week (start low and build slowly, if you are generally sedentary like most Americans), at a minimum (you are more than welcome to go above it).  However, make sure your goals are realistic, something you can maintain for life – and that your exercise goal doesn’t cause you to work up such an insatiable appetite that you end up eating more calories than you burned off.  From this day forward, color in your minutes as you Exercise and/or are Active, with the minimum goal of eventually reaching the Exercise and Activity Minutes Line each week.  Two “stacks” of boxes (one for Exercise minutes and one for Activity minutes) represent one week, and they are filled in from the bottom up, during the dates listed.  Trying to hit the Exercise and Activity Minutes Line is akin to the game played at fairs and amusement parks – where you use a huge sledgehammer to pound a pad, sending a piston upwards in hopes of ringing the bell. Reaching it provides a sense of satisfaction.

F) In the bottom section you will track your weights and “XWCal” (“Extra WCal©”), as discussed at the end of Lesson 2, The 4:1 Rule and Nutrition Star. Remember to consider using a calorie calculator like MyNetDiary to help simplify the process, and if you consume a lot of XWCal, consider setting a goal to work at least HALF of those calories off with Exercising or active Activities.

OPTIONAL (e.g., for fellow math nerds): At the end of each week, calculate the total “XWCal” you consumed for the week, in addition to the total calories you burned through Exercise and active Activities (multiply the total minutes by the numbers you calculated in step 8 above, e.g., 9.2 for E and 4.6 for A, and write the total calories burned on top of the E and A stacks, as illustrated in the sample Map above), and subtract the calories you burned for the week from the total “XWCal” you consumed. Lastly, divide that number by seven (7) to get your average daily “XWCal” consumed. If you are really dedicated, that will be a negative number, but of course will depend on a variety of factors. If you are not losing weight as fast as desired (or at all), you’ll need either to set a goal to beat that number or change how you define “XWCal” (reduce the percent – see the end of Lesson 2, The 4:1 Rule and Nutrition Star). That number may or may not seem to correlate initially with your quantity and/or velocity of weight loss (although obviously the smaller it is, the better you’ll do); however, over time it will not only help you know what needs to be changed, but it will also motivate you to make those changes!

If you ever “fall off” the Map or otherwise get lost, or if whenever you complete one (every 3 months), grab another blank one and restart.  If at first you don’t succeed…

TIP: If you wear a watch or wrist band that tracks your daily steps, consider using those steps to record (color in the boxes for) active Activity minutes. Divide your total steps for the day (but do NOT include any steps you made doing things that will count towards your Exercise minutes) by 200 (about twice the amount of steps you usually take per minute while walking casually) and record that number as active Activity minutes. Why not divide by 100? Because many of the steps that are recorded by your watch or wrist band probably shouldn’t count. But use whatever you think is a legitimate estimate for you.

Quiz for Lesson #3: The SLIM TLC Map

Imagine this scenario.  You are sitting at home, relaxing in front of the TV with your favorite “Free Food,” thrilled with your weight loss progress, and a knock comes at your door.  You are surprised (of course pleasantly) to see that it is I, your humble family doctor, with an excited look on my face.  I exclaim, with confidence, “In addition to my ‘Free Food? Whatever!’ dietary approach (Lesson 2, The 4:1 Rule and Nutrition Star), which is the ultimate magic pill to weight loss and health, believe it or not, I have found yet another magic pill!”  I then tell you that it is also free, and your excitement builds even further.  I also tell you that it has no concerning side effects, and that besides helping you lose weight, it also helps improve three of the most common and difficult symptoms to treat in America – fatigue, insomnia, and stress! 

But wait – there’s more!  It also results in an improved sense of well-being, endurance and stamina, higher bone density, improved strength, reduced severity and frequency of migraines, and prolonged life expectancy.  In addition, it reduces the incidence of colds, along with the risk of heart disease, high cholesterol, diabetes, high blood pressure, colon cancer, Alzheimer’s disease, depression, anxiety, and stroke, along with the severity of fibromyalgia and other musculoskeletal ailments.  It may even help people stop smoking!

What would you give me for this magic pill?

1. Your right arm?

2. A kidney?

3. Your first-born?

4. Your eternal soul?

5. One million dollars!?

You’re right – there is a little catch.  It does take an average of 10-15 minutes of your time each day.  But trust me – it is well worth the investment.  Yes, that other magic pill is EXERCISE.  If you are already exercising and are not yet seeing the magic, then there are other things in your life that need to be addressed.  If the weight is not coming off, then you need to review Lesson 9, The Chinese Insanity Test, along with the heading below, “How does exercise affect my weight?”  If your stress persists despite a regular exercise regimen, see Lesson 14, It’s Emotional!  If sleep quality is still an issue, see Lesson 19, Get Your Vitamin Zzzzz.”  And I guarantee it will help with the other things mentioned above.

As previously explained, I define exercise as any activity that gets you huffing and puffing, which is a direct result of elevated muscle use.

Some might question the value of only 10-15 minutes/day.  It is true that, within reason, the more you exercise, the more benefits you’ll see.  However, the question is, “How much is enough to accomplish most of my health goals?”  My recommendation is not only supported by research,¹ but it averages an amount not far from that recommended by most health professionals, which is 30 minutes on most days of the week.  In fact, for many years, my recommendation was 30-40 minutes, 3-4 times per week – I always counseled folks to put it on the calendar, like any other important appointment.  I didn’t recommend it daily because 1) I didn’t want it to become a daily drudgery, and 2) I thought it was nice to have a few days off each week.  But over time I noticed a repeating pattern that significantly called into question the wisdom of that recommendation – when folks would attempt to follow my guidelines, the grand majority of time they would still dread the days they planned to exercise, and then they would feel relieved on their days off.  To me, that’s a problem, as I’m trying to help people develop effective, livable long-term habits.  I found that my 30-40 minutes, 3-4 times per week recommendation rarely became a long-term habit.

On the other hand, targeting 10-15 minutes a day has several benefits:

1. Folks don’t dread doing that amount anywhere near as much.

2. There is a much higher chance that it is livable and therefore will become a long-term habit, which is imperative if you wish to see all the benefits listed above.

3. Once you develop the habit of exercising 15 minutes a day, there is a decent likelihood that you’ll want stretch it to more than that, especially when you notice how much better you feel and look.

4. You don’t work up as much of an insatiable appetite as most do when they exercise for a longer period of time (thus undoing your efforts by overeating – which is SO easy to do).

5. You don’t have to spend as much time warming up or cooling off.

6. Missing a day here and there is not that big of a deal (and you can more rationally compensate the next day, if desired).

7. If you can reach deep down inside you and find 10-15 minutes a day (who can’t do that?) and do it for 2-3 weeks, then it will become a lot easier (more of a habit, and you’ll begin to see the health benefits, which will incentivize you to continue) – and therefore, it will change your life.

The cool part is that exercise need not be a double four-letter word.  Do you very best to have some fun with it!  Do it with your spouse or child or friend.  Listen to music, a podcast, or book on “tape.”  If it is conducive to watching TV (e.g., treadmill, elliptical, recumbent bike), find a daily program that you will only allow yourself to watch if you are exercising.  You always wanted an excuse to binge watch Doctor Who, Doc Martin, or Call the Midwife, right?

Following is a list, by no means comprehensive, of ideas for exercise (some more enjoyable than others):

1. Aerobics

2. Badminton

3. Baseball

4. Basketball (my 3rd favorite), including just shooting hoops by yourself

5. Boxing

6. Brisk walking

7. Canoeing

8. Cycling/Biking

9. Dancing

10. Elliptical

11. Fencing

12. Football

13. Frisbee (my 4th favorite)

14. Gymnastics

15. Hiking

16. Hockey

17. Ice skating

18. Jump rope

19. Lacrosse

20. Laser tag

21. Obstacle course

22. Paintball

23. Pickleball

24. Ping-pong (my 5th favorite)

25. Pogo stick

26. Pullups

27. Pushups

28. Racquetball (my 2nd favorite)

29. Rock climbing

30. Run/Jog/Walk

31. Sit-ups

32. Skiing

33. Soccer

34. Surfing

35. Swimming

36. Tennis

37. Trampoline

38. Volleyball (my favorite)

39. Water skiing

Yes, I am aware that many of these aren’t conducive to just 15 minutes.  Really, it is OK to exercise for a longer period of time, which will likely yield even greater benefits.  But if this is your argument, you’re missing the point.  I’m sure you can find something to do.

Another thing that might help you start exercising is to find something else you need to do, and do them together!  Repeat after me:  I need to…

1. Spend more time with my spouse

2. Spend more time with my kids

3. Listen to an educational program

4. Listen to the scriptures

5. Listen to a talk or speech

6. Watch a special TV program (i.e., while on recumbent bike, elliptical, treadmill)

7. Something else you think will mix with any form of exercise: _______________________________

Now pick one and go!  If one doesn’t “work out,” move to the next one!

The Never Look Back™ Exercise Strategy

Because regular exercise can work wonders for many health conditions, energy, and overall sense of well-being (see above), it’s critical that you make it happen. However, if you are really struggling to get a regular exercise program going, try this “Never Look Back™” strategy. Set a goal, right here, right now, to exercise at least one minute a day, at least six days a week, for the rest of your life. Admit it – you can do that, right? Then, once you have done that for at least 2-3 weeks (how long it usually takes to develop a habit), increase it to two, and so on. There are four caveats or rules you must follow:

1. This exercise must be extra effort, i.e., outside of normal Activity (no matter how active you are otherwise – see That’s N.E.A.T.! below).

2. After 2-3 weeks, if you are not ready to add a minute, wait until you are – until you can stick with it, for life! Set a goal for eventually reaching __ (at least 10-15) minutes per day – but if you don’t ever reach your goal, do not beat yourself up! For instance, as you are progressing forward with your “Never Look Back™” strategy, and you have set a goal of eventually exercising 30 minutes per day, but you can’t get yourself to increase past 13, whatever you do, don’t get discouraged and give up! Thirteen minutes of quality exercise per day can do wonders for your health! Even if all you can eke out is five minutes a day, doing that for the rest of your life will still provide much more benefit than none.

3. It is OK to go over your goal minutes for the day, but do not increase your daily goal until you are ready (i.e., if you are at the stage of three minutes per day, but one day you exercise for 15, the next day your goal is still three).

4. If you forget to exercise, don’t beat yourself up – just resume at the same level the next day. You may choose to try to to make up the missed exercise the next day, but DO NOT stress about it if you cannot. However, DO what you can NOT to forget (set reminders, involve your TLC Trio to keep you accountable – see Lesson 3, The SLIM TLC Map, etc.).

Give it a try, and let us know how it goes!

How does exercise really affect my weight?

Some think that’s an incredibly dumb question – after all, it burns calories, right?  Not so fast.  A funny thing happens when you exercise, especially if you do so vigorously – you work up an appetite, thanks to our body’s (and Giant Fat Organ’s – see Lesson 23) lovely self-protective mechanisms at work. It is highly likely that you have experienced this phenomenon – and it is also highly likely that when you experience this hunger you give yourself permission to eat more or indulge on something less healthy (which inevitably gives you a ton of calories in a short period of time) because you’ve been such a good little exerciser.  You may even gain weight and then blame it on muscle, because you rationalize that muscle weighs more than fat (the correct word is that it is denser than fat).  It is actually impossible (against the laws of physics) to gain fat without consuming more calories than you burned off.  So, now you know how one can exercise a ton and still not lose weight (and even gain!).  Always remember that the output part of the energy equation is nowhere near as important as controlling the input (see Lesson 9, The Chinese Insanity Test), and that it is a whole lot easier to put things in than to take them out (one can rarely outrun one’s mouth).

However, and this is a big HOWEVER, at least as important as the calories it burns, exercise also helps you lose weight in a very different, very important way.  Perhaps the most important reason that a regular, rational exercise regimen helps you lose weight is because something magical happens when you invest the time and effort necessary to develop it:  You tend to eat smarter, because you want to protect the investment you are making in your health.  You want to maintain your healthy trajectory instead of putting the calories you expended right back where you found them.  And that is the main reason that exercise helps you lose weight – not as much because of the calories you burn.  Said another way, you do not lose weight so much by exercising more, you lose weight primarily by exercising regularly.  Funny how that works, huh?

Never say, “I don’t have time to exercise.”  In rare instances that may be accurate, but the grand majority of time the correct thing to say is, “I don’t make time for exercise.”  10-15 minutes is all that it takes.  Make it so, if needs be by employing the “Never Look Back™” strategy above.

Remember that exercise also relieves stress and helps you sleep better, and therefore it helps to temper your drive to eat – yet another way it helps you eat smarter! 

That’s N.E.A.T.!

When you are not formally exercising, the more you can stay busy doing something Active, which I’ve previously defined as being “up and doing” (something called “N.E.A.T.” – Non-Exercise Activity Thermogenesis²), you will not only burn more calories, but you will hopefully be so busy that you don’t think about eating (a 2-in-1 way to help you lose weight!).

The lowest hanging fruit

I have long reasoned that, in order to improve our long-term health, the five most important Therapeutic Lifestyle Changes we can make are:

1. Eating right

2. Exercising

3. Losing weight (if needed)

4. Sleeping well

5. Reducing stress

I’m not sure if they are in order of importance, but all of them feed off of each other.  In other words, improving in one area will make it easier to have success in the others.  I want you to think about these five areas – which one is the simplest to implement, i.e., the lowest hanging fruit?  I contend that exercise is.  One cannot exactly snap one’s fingers and suddenly lose weight, sleep better, make stress go away, or eat right.  On the other hand, one can decide suddenly to get up off the couch and go exercise.  You and I both know that it is not easy, but it is a lot more simple than the other changes.  Try it out, and you’ll begin to see pretty quick improvement in the other areas.

The goal, then, becomes to do whatever you possibly can to implement a daily (or almost daily) exercise regimen.  Remember that it must be livable (e.g., starting low and building slowly, up to the recommended 10-15 minutes or maybe more) or it will not become a long-term habit.  Carve the time out of your day whenever you can.  One idea is to keep a pair of dumbbells at work to do a quick set of Metabolava exercises (see below) during a break, especially a regularly scheduled break, like lunch.

Should I worry about resistance exercises?

It is always wise to try to get a good mixture of cardiovascular and resistance exercises.  Resistance exercises will increase strength, bone density, and joint stability, and reduce the chances of strains, sprains, and fractures.  If you want a simple, yet comprehensive resistance regimen that you can do at home without any special equipment, try SLIM TLC’s Metabolava exercises (reviewed and approved by Stacey L. Billyard, PT, DPT, MTC – physical therapist, and Christina Mackenzie, BA, Kinesiology – personal and group fitness trainer):

(Click HERE for a description)

Putting It All Together

To get a good overall workout, consider alternating cardio with resistance exercises every other day. You can do about 30 reps of all three Metabolava exercises in 7 1/2 minutes, i.e., it takes about 2.5 minutes for every 10 reps.  Without spending more time exercising, you can increase the intensity and value of your workout by increasing the speed (and/or resistance) of your cardio workout or the weight of the dumbbells you use for the Metabolava exercises.  And of course you are allowed to spend more time as you desire, always making sure that you satisfy the resulting appetite you likely worked up with healthy choices.

• ¹Moore SC, et. al.: Leisure Time Physical Activity of Moderate to Vigorous Intensity and Mortality: A Large Pooled Cohort Analysis. Published online November 6, 2012, accessed February 18, 2019 at www.ncbi.nlm.nih.gov/pmc/articles/PMC3491006

• ²Levine JA, Vander Weg MW, Hill JO, Klesges RC. Non-exercise activity thermogenesis: The crouching tiger hidden dragon of societal weight gain.  Arterioscler Thromb Vasc Biol 26(4):729-36, 2006

Quiz for Lesson #4: Another Magic Pill

I may have been sheltered, but the first time I ever heard the word “addiction” in reference to food was when I read Dr. Joel Fuhrman’s 2005 book, Eat to Live – and boy, did it ring true. Ever since then, I’ve been trying to figure out the best way to overcome my own addictions, along with those of my patients – all with only partial success…that is, until my “Free Food? Whatever!” strategy came about (Lesson 2).

As briefly mentioned in Lesson 1, I had many patients experience the miraculous health benefits and weight loss imparted by Dr. Fuhrman’s 6-week GBOMBS (greens, beans, onions, mushrooms, berries, and seeds) diet; however, as soon as they started re-introducing “Whatever” foods, they fell off the wagon. I even came up with my own (although never effective) 3-week version, which consisted of eating only 4◊ Foods (many more “free foods” than GBOMBS), called the “Con-Tradiction Diet” (play on words – countering traditions/habits and addictions). Time and time again over the years patients have begged me for help in overcoming their food addictions, usually to sweets – and no matter what response I had, I knew it was woefully inadequate. That’s why I’m so excited about “Free Food? Whatever!”

No matter what percentage of your BMR you choose as your Whatever Calorie Budget you will likely consume fewer
“Whatever” calories than ever before – and there begins the addiction-breaking process!

As you move forward, it will slowly, but surely, come to pass!

Indeed, probably the biggest contributor to both our obesity epidemic and disease is that we are flat-out addicted to several types of food, essentially all of which are contained in the “Whatever” section of the Nutrition Star.  The most powerfully-addicting foods are the ones that are the least healthy for us, i.e., the most pro-inflammatory, can be grouped nicely into two categories, which I call:

1. “Plant waste”

2. “Animal secretions”

Plant Waste

What makes plants nutritious are the 1) fiber, 2) micronutrients, and 3) water. Our bodies were designed to extract the nutrition out of food and expel the waste, which of course is contained in our urine and feces.  Plant waste, on the other hand, is created when we extract all the nutrition out of plants – but instead of consuming that nutritious parts, we throw them away, and consume the waste!

There are many types of plant waste, but the most obvious, and most harmful, types are:

1. Sugar

2. White flour

3. Oil

4. High-fructose corn syrup

5. Alcohol

And there are other forms.  Anytime you process out the fiber, micronutrients, and/or water, you are creating a form of plant waste.  Other lesser forms of plant waste include juice (which belongs in the “Whatever” section because, although it still has water and some micronutrients, the sugar content makes it much more inflammatory than not) and plant-based milk (which, however, if there are no added calories, I categorize as a 4◊ Food).

“What about white rice?”

White rice is created by removing (“milling”) the fiber- and nutrient-dense bran and germ from brown rice. However, since it still has some nutrients, it’s not all bad. The majority of inflammation that may result from eating white rice comes from preparing it with plant waste and animal secretions. When prepared without those things, I would count about half of its calories as “Whatever” calories.

“But I only use olive and coconut oils!”  

What would you think if I told you that there is no such thing as a healthy oil?  There are definitely healthy fats – those found in plants and fatty seafood.  But once you extract fat from a plant, throwing away the nutritious parts, it becomes oil, which is not healthy.  

Oil is oil is oil

Oil of any kind is a 9 calorie-per-gram sludge that contains little-to-no nutritional value, being devoid of fiber, water, and most micronutrients.  I do not care what type of oil it is.  Oil should be used for fuel, lubrication, and conditioning – it’s not for our insides, and almost exclusively causes harm.  I’m not the only one who believes this, but there is a growing suspicion that the Mediterranean diet is healthy in spite of, not because of, the olive oil. Eat the whole olive!  Eat the whole coconut!  You get the drift.

“But then how can I cook?”

You got this: Grill, steam, bake, boil, broil, roast, sous vide, other.  You can also sauté using non-stick spray (which I am comfortable using), vegetable broth, and or water!  Use whole fruits (e.g., ripe bananas, Medjool dates) to naturally sweeten your foods.  Use puréed cashews to create salad dressings and make things creamy.  The internet is full of ideas and recipes that are oil- and/or sugar-free.

“But I heard that a little alcohol is good for you!”

Don’t believe everything you hear. It’s inflammatory and consists of empty calories, and most people don’t drink just a little.

“What about artificial sweeteners?”

I am not in the camp that believes that most artificial sweeteners are just as bad as (or worse than) sugar-sweetened sodas, or make you gain weight, despite popular belief. However, I call them “gateway drugs” – they perpetuate the sweet tooth, i.e., the addiction to sweets. However, if you must have sweets (cannot resist the craving), I think indulging in a small amount of something that is artificially sweetened is far less damaging than sugar- or high-fructose corn syrup-sweetened treats. Obviously water is always best.

Animal Secretions

OK, I know that’s a bit disgusting, but part of the reason I call it that is for effect. Essentially this is anything that comes out of an animal that is not the meat itself. In other words, it is synonymous with dairy, eggs, and grease (including animal fat). Cow’s milk is made to turn a calf into a cow, and it and its products do the same to us. No matter how many celebrities smile with a milk mustache, milk does not do a body good. And did you know that it takes about 10 pounds (5 quarts) of cow’s milk to create one pound of cheese?¹ That’s all we need – concentrated cow’s milk. Sadly (because I love it, too), cheese is one of the most addicting and least healthy foods there is, packed with LDL (low-density lipoprotein, or "bad") cholesterol. And butter? People argue about which is healthier: Butter or margarine? No and no. See the discussion above about oil. And yet I’m OK with no-calorie spray butter. See www.NutritionStar.org for my brief discussion about eggs. And don’t consume or cook things with or in their own grease.

One thing that makes dairy products addicting is the texture – creamy and smooth – especially ice cream. Whoever comes up with a “Whatever”-free frozen treat that stays creamy like ice cream after it’s frozen will have my gratitude AND make bazillions (plant-based concoctions, because of their water content, freeze rock-hard – but I overcome that by nuking/microwaving frozen smoothies for 30 seconds or so, making it have the texture of shaved ice).

The Meat Façade 

Sadly, meat is also addicting. I can enjoy sinking my teeth into a good steak just as much as the next guy, or a flavorful piece of grilled chicken.  Many say that meat and chicken are simply more flavorful than plant- and fatty seafood-based foods.  However, Dr. John McDougall, in his book The Starch Solution makes a fascinating point.  He asks the question (paraphrased), “How many times have you eaten chicken by itself, without any seasoning or flavoring?”  To me, an unseasoned piece of chicken is less flavorful than most raw vegetables, which many have a hard time enjoying.  Ironically, most of what we use to season meat is…plants!  Think herbs, spices, even ketchup, steak sauce, mustard, relish, and barbecue sauce.

Indeed, we expend great energy perfecting the flavor of different kinds of meats and processed foods.  If we spent the same amount of effort perfecting the flavor of healthily-prepared plant- and fatty seafood-based foods, we’d get addicted to them, too!  And that is a healthy addiction – eat to live!  One day (I predict) there will be cooking competition shows using only 4◊ Foods. I wager that these will not only rival the less-healthy cooking shows that are so popular, but they will become even more popular.  Is it really that difficult to imagine a chili cook-off that qualifies for The 4:1 Rule?  Makes my mouth water just to think about it.

One thing that makes meat addicting is its texture – most, if they can’t chew (and chew) on something with a meaty texture, feel like their meal is missing something. Consider using cooked mushrooms as a substitute.

Does this mean I can never eat plant waste, animal secretions, or meat? Of course not. Just try to keep them cumulatively to <20% of your overall intake, and preferably the total daily calories under your Whatever Calorie Budget.

Because the “Whatever” section of The 4:1 Rule is packed with foods that are powerfully addicting, I, like you, have historically had a hard time steering away from these types of foods.  Fortunately, these foods have become much less addicting as you follow the “Free Food? Whatever!” eating strategy. Eating “Whatever” foods won’t kill us.  What’s killing us and ruining our weight loss efforts is how much we indulge in them.

Did you know that the average American gets over 80% of his or her calories from “Whatever” foods?  Some estimates are even higher.  That is mainly because these foods have such a high caloric density (calorie:volume ratio).  If you follow the SLIM TLC program, where all 4◊ Foods are “free,” you will be able to eat whenever you really want to eat.

I’ve found that completely avoiding all “Whatever” foods for a time (no matter how long you avoid them) rarely truly breaks your addictions – as soon as most people start eating them again, the addictions come back. I’ve learned over time that the goal need not be to “break” your addictions to “Whatever,” any more than you can stop eating (in other words, it’s very different from stopping smoking). The goal, and what is actually effective, is to slowly taper down until the addictions become satisfyingly controllable. And it WILL happen if you follow the program!

Playing with Cinnamon Fire 

I must make the point that certain “Whatever” addictions may need to be stopped for a time to gain power over them. Let me tell you a personal story.

When I was in medical school, in order to help me stay awake while I studied, I ate – initially almost entirely garbage.  It didn’t take long to start taking a major toll on my weight and health. As such, I tried to switch to things that were less damaging, like gum and hard candy – less damaging, I reasoned, because they do not provide as many calories per unit time as soft candy or most other “Whatever” treats.  During that time I (realized I) became addicted to Cinnamon Fire Jolly Ranchers®.  I would suck on 2-3 at a time, and each time the “bolus” shrank too much I would add another “log to the fire.” I could easily go through 20-30 (= 450-700 calories!) in one sitting (which happened almost daily) if I let myself.

That addiction lasted a long time, even after I discovered the power of a mostly plant- and fatty seafood-based diet and changed my eating habits accordingly – albeit I didn’t indulge in as many or as frequently. I tried the experiment of completely cutting them out for two weeks – and it worked! Yes, it was hard the first few days, but after that it became progressively easier.  Now I rarely think of them, and when I do I usually don’t partake.  If I do partake, I find that it is quite simple to limit myself to a small amount.  Again – it will be different for everybody.

If you have a particularly damaging caloric Achilles’ heel, I challenge you to try my experiment. Prove to yourself that you can do it.  If I could, you can. The really neat part is that now, if I’m craving something sweet that my typical clementine, honey crisp apple, raisins, frozen grapes, or smoothie doesn’t satisfy, I can reach for (and thoroughly enjoy) a couple of Jolly Ranchers® (total 47 calories) or Atomic Fireballs™ (total 40 calories) without falling back into my old addiction – and I do it guilt-free if I’m within my Whatever Calorie Budget, and because they take so long to consume that they do little damage.

Treat Treats and Most Meats Like Treats 

Our weight loss and health goals would be so much easier if we treated the “Whatever” section as treats instead of as every-day, every-meal indulgences.  Welcome to America – the Standard American Diet (SAD):

Breakfast 

1. Bacon, eggs and buttered white toast

2. Biscuits and sausage gravy

3. Low-quality cold cereal, with (dairy) milk

Lunch 

1. Burgers and fries

2. Pizza and breadsticks

3. Crispy chicken salad, smothered with croutons, cheese, and dressing

Dinner 

1. Steak and smothered baked potatoes

2. Spaghetti and meatballs or fettuccini alfredo

3. Taco salad (It’s sad – one of the easiest and tastiest ways to eat healthily is with Mexican food, if we primarily used whole wheat or corn tortillas, guacamole, salsa, pico de gallo, beans, and fresh vegetables, and went light on the animal-based foods like sour cream, cheese, and meat.)

Snacks 

1. I think you can fill in the blanks here.

I could enjoy the above foods every bit as much as the next guy.  I’m not lying to you.  However, if we were to reduce the above fair to <20% of our intake, imagine the health and weight loss that would result.  Better yet, plan your meals almost completely around plants and a small amount of fatty seafood, and use the above only as rare exceptions or treats – I like the word “sparingly.”  Then, when you do indulge, you do it guilt-free and even enjoy it more.  See Lesson 2, The 4:1 Rule and Nutrition Star, to learn how to replace these addictive foods with healthily-prepared, flavorful plant- and fatty seafood-based foods.

“I’m Addicted to Food, Period.” 

Do not presume you cannot overcome food addictions until you have followed the “Free Food? Whatever!” eating strategy. That being said, whether overweight or not, almost everyone I know enjoys food, so some might argue that everyone is addicted to food to some degree.  Indeed, the reality is that everyone has a different drive to eat.  Some who claim addiction actually do okay most of the time, and struggle only part of the time, or perhaps struggle only with certain foods.  Others, on the other hand, truly do consider food to be a constant addiction, and fall all the way to the right on the “drive to eat continuum” (see Lesson 14, It’s Emotional).

If there is no middle ground for you, and it is all or nothing, you may need to seriously consider getting some professional or other assistance.  You may find it helpful to attend Overeaters Anonymous and/or seek counseling from a mental health professional (preferably trained in eating disorders). Some will find the Bright Line Eating (by Susan Thompson, Ph.D.) method helpful or necessary, or Overeaters Anonymous.

You should also see your personal physician, who may determine that other (comorbid) conditions are present.  In such cases, treating the other condition(s) may help. Maybe you would benefit from a medicine used to treat anxiety and/or depression.  Appetite suppressants offered as part of the SLIM TLC program can also help reduce cravings/addictions and help you develop healthier habits.

Most of us are also addicted to feeling full, even overstuffed. We’ll keep eating even after we are well past the “satiated” stage. If you have not already done so, you need to review thoroughly the Troubleshooting topic, “I never feel full!”  The need to learn to Check Your Fuel Gauge (CYFG – Lesson 10) is of utmost importance to you.  As you try to CYFG, if you cannot discover a sense of satiety initially, practice it over and over until you do. You must not give up. Your future health depends on it. At a very minimum, if you eat after feeling full, try hard only to eat 4◊ Foods – that will minimize the damage.

Kicking the Habit

Stephen R. Covey, in his book, The 7 Habits of Highly Effective People, teaches that our habits play a powerful role in our lives, to the point that they even define our character.  He tells us that habits consist of three things:  1) Knowledge, 2) skill, and 3) desire.  In order to change our habits, we must learn why they need to be changed (develop the knowledge), learn how to change them (develop the skills), and have the motivation to change them (develop the desire).

Although SLIM TLC is designed to teach you the knowledge and skills, then to motivate you to make the changes necessary to achieve long-term health and weight loss success, it will be a journey that requires you to take ownership of the outcome.  To take charge of our own destiny, Dr. Covey moves us from a state of dependence (relying on others to take care of us) to independence (taking care of ourselves) and then to interdependence (cooperating with others to achieve things we cannot achieve alone).

Your job is to take away whatever power over your health that you have given to others, thus becoming self-sufficient, and then to work with others to create an environment that makes it easier for everyone to be healthy (starting with the other members of your TLC Trio).  Yes, it’s a process, but you can do it.  I have faith in you.  No one else can or will do it for you.

• ¹Accessed December 8, 2023 at www.thekitchn.com/how-much-milk-makes-one-pound-131332

Quiz for Lesson #5: Might as Well Face that I’m Addicted to “Whatever”

For most Americans, the only plants they consume are completely overshadowed by “Whatever” food products.  Understandably, it is hard for most people to figure out how to enjoy them in a healthier way.  There is a long list of casualties, including:

1. French fries and chips (probably the most common)

2. “Loaded” baked potatoes

3. Mashed potatoes (usually made with butter, milk & cheese) and gravy

4. Sweet potatoes soaked with cinnamon butter

5. Fried okra

6. Broccoli and cheese

7. Fried rice

8. Fried zucchini

9. Sautéed vegetables (in oil)

10. Most commercially-made fruit smoothies and other frozen treats (with sugar and/or dairy)

11. Buttered popcorn

12. Refried beans made with shortening

13. White bread and pasta

14. Vegetarian pizza (almost always on a white crust and smothered with cheese)

15. Vegan pizza (usually smothered with vegan cheese, which, because if the high oil content, is probably as unhealthy as regular cheese!)

Uber Tuber Consumers

Potatoes are the most classic example.  What confuses people into thinking that potatoes are bad for us is the direct correlation America sees between the amount of potatoes we consume and our weight and poor health – however, it’s not the potato! It’s what we do to the potato before we eat it!  In other words, don’t kill the messenger!  Vilified by most dieters and health care professionals alike, these tubers are packed with satisfying complex carbohydrates and vitamins, are extremely low in fat, and even have a decent amount of fiber and protein!  Yet, as you can see above, all that healthy power goes right out the window when we kill potatoes by deep frying them (who would survive that process?) or smothering them with (not one, not two, not three, but FOUR animal products) butter, bacon bits, cheese, and sour cream.  I was thrilled once when I saw a baked potato on a menu that was smothered with vegetarian chili, but when I got it I could barely see any of the chili through the mountain of melted cheese!  Even vegan meals are often made unhealthy by the amount of sugar, white flour, and oils that are added.  So much smoke, and so many mirrors.

Dr. John McDougall (The Starch Solution) reminds us that populations that live primarily on potatoes and other starches are some of the healthiest and most slender on the planet.  They rarely suffer from the diseases that are commonplace in America.  He also reminds us of their nutritional value, and how filling and satisfying they are (thus preventing us from overindulging on other stuff). In fact, when you cut starches out of a weight loss plan, you are shooting your feet full of holes (for young folks, that means you are sabotaging your own efforts or making things worse), because of how they expand in your stomach when water is added, thus making you feel as though you’ve overindulged, when really you haven’t. If you eat a big baked potato, prepared without plant waste and animal secretions (Lesson 5), you will eat less the rest of the day and wake up lighter on the scale.

For those concerned about their pocketbooks, potatoes, beans, and corn are also among the most affordable edibles!

I invite you to make whatever alterations are necessary to transform the above less-healthy options into healthy options.  There are many ways to do so, but here are some ideas:

Quiz for Lesson #6: Committing Planticide

Many, many a patient has told me, “If you’ll just tell me what to eat, I’ll lose weight.”  In other words, they would like someone to provide them with a daily menu to follow.  There are at least three problems with relying on someone else to plan your meals for you:

1. It is a short-term solution (which is not true success) – you won’t have someone available to tell you what to eat for the rest of your life.

2. You will never learn how to plan meals (how and what to eat) on your own – unless you do so, long-term weight loss will never be a reality.

3. You will never truly stick with “the plan” because there will always be temptations and hunger that will cause you to eat things that are not on the prescribed menu.

A drug rep once provided me with a mountain of sample two-week “healthy” menus to give to interested patients. However, after examining them, I became acutely aware that the shopping list I would have to create (not to mention the cost and time it would take to shop) would be longer than Santa’s naughty list! I never use half (and hadn’t even heard of a few) of the ingredients that were on the list. You may feel differently about trying to follow menus like this.

That all being said, I understand that everyone could use a little help getting started. That is why I created My (Doug’s) List of Favorite Healthy Snacks and Meals. Take a look. Make your own, and adapt it to your liking (see Lesson 15, “Surviving the Snack Attack", to go through this exercise). In addition, the Nutrition Star is a great template to use when planning meals (consider simply preparing something from each section), recognizing that each meal doesn’t have to be perfect – we’re looking at an overall picture that resembles those proportions, or even simpler, The 4:1 Rule.

More about meal planning…

One of the most important things you must develop in order to maintain a healthy weight is a solid knowledge base of what foods are healthy and what foods are not (of course it’s nice to have a simple guide like the Nutrition Star).  And there is probably no better way to do this than through meal planning.  Unless you plan on paying a personal chef or service (it’s almost impossible to find restaurants that do it right) to do it for you for the rest of your life (and yet that rarely works even for celebrities, who can afford it), it’s a skill you must develop.  And this skill will improve with practice.

According to a September 2018 report, affluent Americans eat out 5.5 times per week, while poor Americans eat out 4.2 times per week.¹ If you eat 21 meals per week, that means on average over half (50.2%, as of 2010) of your food budget is spent on 23% of your meals (the ones you eat out)!  In addition, between 2005 and 2008 31.6% of the average Americans calories came from eating out, up from 17.7% from 1977-78. Eating out frequently, as you likely know, is a recipe for disaster.  Planning your own meals will allow you to achieve your health and weight loss goals much easier, and will also save you money. Nonetheless, when you do eat out, remember that you can do so in a healthier fashion!

Meal planning need not be as difficult and time-consuming as most make it.  When you use mostly whole plant-based foods, it even becomes easier!

The Four T’s 

Linda Larsen, a professional Home Economist, suggests you consider three things to create a wonderful, satisfying, healthy meal:  Temperature, Texture, and Color.  I suggest remembering a fourth word:  Type.  And, if you call color “Tint,” then there are four Ts:

1. Type

2. Temperature

3. Texture

4. Tint

If you always try to include a variety of these four things in your meal, you will soon become a meal planning master.

For example, for a main meal, follow The 4:1 Rule and consider choosing four items (of different temperature, texture and color), each from the main different sections of the Nutrition Star:  Fruits, Vegetables, Whole Grains, and High-Quality Proteins (nuts, seeds, legumes, fatty seafood).  Then you can play with the “1” (“Whatever”) part – if you are vegetarian/vegan, make it another plant; otherwise you can fill it with “Whatever” you’d like.  For example:

1. Fruit:  Chilled watermelon (mix with cantaloupe and grapes if desired)

2. Vegetable:  New potato wedges, seasoned and baked with no-calorie spray

3. Whole Grain:  Whole grain rolls with spray butter and a little honey (the latter of which you’d still have to count, of course, towards your “Whatever Calorie Budget” – see Lesson 2)

4. High-Quality Protein:  Salmon, shrimp, or green beans (with spray butter and a little salt and pepper – or by themselves)

5. “Whatever”:  Whatever (trying to stay within your budget)

Divvy up your plate with 1/5th of each of the above items.  Simple as pie, huh?  The “Whatever” can be a dessert, too; however, you don’t have to have dessert.  You do not always have to choose one thing from each section – the above is simply an example.  In other words, for a certain meal you may choose two fruits instead of a fruit and a legume.  Simply follow The 4:1 Rule and try to eat a large variety of plants throughout the day – and try keep your “Whatever” calories within your Whatever Calorie Budget (Lesson 2). Many, including myself, will try to eat all 4◊ Foods for an entire meal or even day, then enjoy a “Whatever” item (or two or three) guilt-free at the end!

Notice that most of the above items do not take a ton of effort to prepare, although for some reason everyone thinks that a lot of time has to go into food preparation in order for it to taste good.  Do as you wish, though – use your imagination.  The simpler you can make it, and the more experience you get, the higher chance you will do it long-term.

Recipes 

At one point or another you will want to follow specific recipes. With an understanding of The 4:1 Rule and the above principles, consult whatever resource you desire that has recipes (books, websites, etc.) that appear to be…

1. good enough,

2. healthy enough, and

3. easy enough

…that you’ll want to make them – perhaps repeatedly in the future.  I recommend starting with the following search string on the Internet: “Oil-free whole plant-based recipes,” and adapt from there, perhaps adding a little “Whatever” (if desired). Collect several such recipes (perhaps five each for breakfast, lunch, and snacks, and 15-20 for dinner), and then organize them in a way that you’ll be able to find them again when needed.  I strongly recommend developing some basic, simple routines for breakfast, lunch, and snacks, and spending more time on dinner, to keep things interesting.  For example (this may be a review for you):

1. Breakfast:  Two fruits (perhaps in a smoothie) and a whole grain like toast or oatmeal (with raisins, cinnamon, walnuts, and a little brown sugar, or even better, date paste)

2. Lunch:  Soup and/or salad or a baked potato (follow The 4:1 Rule)

3. Snacks:  Fruit, cut-up vegetable, nuts, whole-grain slice of bread, light popcorn, olives, pickles (unless salt-sensitive), raisins (see Lesson 15, Surviving the Snack Attack)

4. Dinner:  Follow one of the recipes you have identified.

Make it so!  Remember:

1. Eating is not an option, so you might as well make it enjoyable.

2. You should develop healthy “go-to” habits on which you can capitalize to save time, money, and brain cells.

3. You don’t have to carefully plan every meal.

4. You don’t have to eat every mealtime (see my discussion of intermittent Whatever fasting in Lesson 10).

5. Don’t be too consumed with making perfectly balanced meals.

6. Variety is the key.

7. Plan a few days or a week at a time, and plan on shopping twice a week.

8. Try to use “Whatever” foods as small sides or for flavoring (“treat treats like treats”).

9. It’s OK to wing it occasionally, but the less wingin’ the better.

10. Make meals easier to prepare by trying new ways to cook foods, like in a slow cooker or crock-pot.

11. Do “batch cooking” to save both time and money – cook a large batch of a main dish, divide it into family-size portions, and freeze some for meals later in the week or month.

12. Make your shopping list while in the kitchen so you can check on what you have or don’t have (and make sure it follows The 4:1 Rule).

• ¹Saksena MJ et al September 2018 report: America’s Eating Habits: Food Away From Home, report from the USDA’s Economic Research Service, summary accessed February 19, 2019 at www.ers.usda.gov/webdocs/publications/90228/eib-196_summary.pdf?v=1045.6

• ²Lin BH and Guthrie J: Nutritional Quality of Food Prepared at Home and Away From Home, 1977-2008, report from the USDA’s Economic Research Service, summary accessed February 19, 2019 at www.ers.usda.gov/webdocs/publications/43698/34514_summaryeib105.pdf?v=0

 Quiz for Lesson #7: Meal Planning the SLIM TLC Way

I know the above title is a bit harsh.  But you can call me Frank, as I felt it necessary to be so, given the magnitude of the problem. 

A significant percentage of overweight, especially obese, people across the nation are fully convinced that their metabolism is frozen, and that no matter what they do they cannot lose weight.  Even a significant percentage of health care professionals are convinced, or perpetuate the myth, that such people are somehow exceptions to the laws of physics.  I sincerely apologize, and I know you don’t want to hear this, but that is simply not true – in fact, it is impossible.  This is one of the most harmful myths in all the world of weight loss – yet many folks who believe it may never be convinced otherwise (opinion is the average of messages received).

I cringe whenever I hear someone say, “I even gain weight when I drink water.”  Hopefully you are not one who is convinced you gain weight even when you drink water.  Yes, we gain water weight when we drink water, but it is not fat.  Other cringe-worthy exclamations include “I can’t eat a hamburger without putting on two pounds” (not true unless it is a 7000-calorie hamburger) or “I’m not losing weight because I must not be eating enough” (hoping not to offend, and I’ve heard all the arguments, but I’ve yet to meet an individual who lives outside the laws of universal physics).  However, let’s talk about more realistic misunderstandings.

One of the most common things I hear from patients is something like “I’m doing everything right – exercising 90 minutes and eating 1200 calories per day, and I’m still gaining (or at least not losing) weight.”  I have been doing this a loooong time, and fortunately I’ve learned to receive the expression of that concern and frustration through a filter – and what I actually hear is “I’m so beyond frustrated! I’m not seeing anywhere near the kind of results I feel I should be seeing based on what I’m doing.” I know that few people actually believe they are doing everything right, but I hear and sympathize with the frustration – and absolutely need to make sure they do not have a thyroid condition (a few other conditions that cause weight gain are far too uncommon to mention); however, if the thyroid function is normal, I know my mission at that point is not to:

1. Tell him or her that she is right, and that he or she just needs to exercise more and/or eat less.

2. Tell him or her that she needs to consume more calories because eating so few will make his or her metabolism freeze.

3. Give up all hope.

The good news is that if you follow SLIM TLC’s “Free Food? Whatever!” (Lesson 2) eating strategy you will almost always figure out what needs to be changed to start seeing greater success. However, if you’re still at a loss…

The only way I can get a glimpse into what I need to know to be able help such patients is to have them keep a two-week diary of everything that goes into his or her mouth, along with every bit of exercise he or she does.  However, when I recommend that, almost without exception one of three things happens:

1. The patient returns and has lost a few pounds.

2. It is quite obvious what needs to be changed.

3. The patient does not return (I can only assume he or she figured it out on his or her own).

Of course following and learning SLIM TLC principles, especially those described in Lessons 2, 9 and 20, The 4:1 Rule and Nutrition Star, The Chinese Insanity Test and Hidden Calories, respectively, will likely enlighten even the most confused and desperate.

It may be possible (and some feel strongly) that at least temporarily, during phases of rapid weight loss or starvation diets, one’s metabolism slows a little – but it is not a permanent phenomenon.  As such, we need to quit perpetuating the myth (or using it as an excuse, as some do), because it obscures reality and distracts everyone from the real problem, which is that too many (and/or the wrong types of) calories are being consumed.

I understand that I am likely in a minority when I challenge prevailing dogma that one’s metabolism frequently slows down to a clinically significant level.  Someone I respect once said that if I suggested such a thing to a room full of experts in the field I would be laughed off the stage.  If that is the case, I would love to see a definitive study to the contrary.  I haven’t found any, and I’ve looked.  Yes, it may seem so to you, but when you obtain a detailed and accurate diary of one’s caloric intake and output (which is hard to do), the laws of physics win every time.

Yes, we know that the metabolism of certain mammals (e.g., bears and squirrels) slows down when they hibernate, but humans don’t hibernate.  So do yourself a huge favor and stop insisting that your inability to lose weight is because of a slow metabolism – otherwise you will never be able to find the real problem:  Caloric intake beyond one’s caloric needs.

Yes, we also know that everyone’s metabolism differs, depending mainly on age, weight, activity level, gender, muscle mass, and percentage of diet that is plant-based (your body has to work harder to convert plants to fat, effectively increasing your metabolism by as much as 20+%).  Other smaller contributors include genetics.  However, your metabolism does not slow based on what you have done in the past.  You can consume more calories if you are a young, obese, active male with a large muscle mass and eating a whole-foods, plant-based diet.  You must consume fewer calories if you are an older, slender, sedentary female with a small muscle mass and a high “Whatever” diet.

Why has this myth become so widely accepted as reality?  It is because when dieters try to cut their caloric intake, at least for a short time, they rarely see the results they hope to see based on the efforts they are making (unless, of course, they are closely following SLIM TLC’s “Free Food? Whatever!” eating strategy in Lesson 2 :)). They see others lose faster, and so they assume they are somehow defective.  This may happen repeatedly, and then it inevitably becomes a self-fulfilling prophecy.  In addition, as mentioned above, since opinion is the average of messages received, they are repeatedly told their metabolism must be frozen, even by health care professionals.

Likely other explanations include that folks lower their caloric intake or increase their exercise level to such an unsustainable degree that the resultant hunger causes them to eventually consume more than their average allowed caloric intake.  Or, there are hidden calories that cause them to consume more than they realize (“non-perceived overeating”).  Also see the heading below, “The Weight Loss Secret ‘We’ Don’t Want Others to Know About.”

How do I know that slow metabolism is a myth?  Besides the fact that 1) not a single patient has ever proven it to me (via the detailed two-week diary) and 2) I cannot find a definitive study to prove it, two words prove I am right:  Bypass surgery.  If it were true that people could consume so few calories that their metabolism would freeze, then no one who has weight loss surgery would lose weight.  Instead, they lose weight at an amazing pace, usually with little to no exercise, averaging a loss of as many as 100 pounds the first year.  And, the folks who resort to bypass surgery are often the very ones who insisted their metabolism was frozen.

Let me be clear – I never fault those who choose to have surgery.  In fact, there are amazing health benefits, and one’s life is even prolonged, even if the weight is regained over time. I am only arguing my point, and hopefully giving hope to those who cannot afford, or are nervous about having, surgery.

The Weight Loss Secret “We” Don’t Want Others to Know About 

We all have secrets we pray others won’t discover.  Such secrets frequently have something to do with weaknesses or foolish things we have done.  I won’t go into details about my secrets or weaknesses, but they are probably not that different from those of most.  Nor do I care to discuss secrets or weaknesses you or others may have.  But I’ve got news for you:  We are all flawed.  I know – surprise, right?

The weight loss secret “we” have that we hope others won’t discover is that we almost always eat more (and more of the “Whatever” stuff) than we want others to believe (often consumed in secret).  I have many patients who aren’t shy and admit that they know what they are doing wrong. Others, since everyone else is saying it, tell everyone (including their doctors), that they are convinced their metabolism is frozen.  We may have said that to ourselves and others enough times that we have begun to believe it, perhaps to the point that we are 100% convinced.  Yet we have not proven that to ourselves or anyone else.  To do that, you must keep, as mentioned above, a 100% detailed log of everything you eat or drink, and every activity you do, for an extended period of time – at least two weeks, weighing yourself regularly during that time.  It will likely be enlightening.  If not, take it in to a knowledgeable (about SLIM TLC principles) health care professional to evaluate it.

By Their Plants (and Fatty Seafood) Ye Shall Know Them 

If you are serious about your health and achieving a normal weight, your actions will reflect it, mainly manifested by choosing a diet consisting mostly of healthily-prepared plants and fatty seafood.  If you choose to eat too many “Whatever” foods, there is no mystery as to why you are not accomplishing your goals.  In fact, it could be argued that the only reason people are overweight is because of consuming too many animal-based, processed, or unhealthily-prepared plant-based (“Whatever”) foods.

Boosting Your Metabolism

Can one really increase one’s metabolism?  The answer is yes, but a specific answer to “how” depends on the specific question you are asking.

Some argue that stimulants may speed up your metabolism, but if that happens it is a temporary phenomenon that carries some risk with it; as such, you must not rely on them exclusively to do the work for you.

See the Troubleshooting Guide for a discussion of steroid use, which many feel freezes their metabolism.

Quiz for Lesson #8: Freaks of Nature - My Metabolism Is Frozen and other Urban Legends

Now for a brief but invaluable proverb:

The story is told that in ancient China, in order to determine if a man was sane, he was placed in front of a pool of water that was being fed by a small stream.  He was then given a bucket and told to empty the pool with the bucket.  If the man began to furiously empty the pool with the bucket, without somehow reducing or diverting the stream that fed it, he was deemed insane.  The man who looked at the stream and figured that he would not get very far unless he did something with the inflow, was determined to be sane (thanks to my good friend, Edwin Seymour, for this amazing drawing).

In a similar fashion, a person who tries to exercise away poor eating habits will fight a losing battle. “You cannot outrun your mouth” is how I heard a bariatric surgeon once phrase it. You may find that you can outrun the consumption express for a while, but you will eventually stumble – especially when you understand that the more you exercise, the harder it is to control your hunger (because when you work out, you work up an appetite).  See Lesson 23, The Giant Fat Organ, for more information.

This proverb, true or not, perfectly illustrates the balance we must find between our intake and our output.  To have any hope of finding the formula for long-term weight loss success, it is absolutely imperative to understand, and to balance, the energy equation, i.e., the true role that both eating and exercise play in your weight loss journey.  Eating right is by far the most important key, so please think twice before you tell your friends, your doctor, or yourself, “I eat right – I just need to exercise more.”

 Quiz for Lesson #9: The Chinese Insanity Test

In this lesson you will learn a crucial concept and strategy that, when learned, should assist greatly in your ability to gain power over food (and therefore lose weight). The better you can learn this strategy, the more you will be able to lose weight without stressing, going hungry, or over-depriving yourself.

The secret? Four simple words (rudely interrupted by three symbols alternating with two numbers). Brace yourself…

Eat (4:1) when actually Hungry

Up until the idea of the “Free Food? Whatever!” eating strategy came to mind, I was convinced that eating when not actually hungry
was the #1 cause of the obesity epidemic. Now I think it comes in at #2. Together, following the “Free Food? Whatever!”
eating strategy and eating 4:1 when actually hungry are an unstoppable 1-2 punch for winning the battle of the bulge. 

Besides eating when we are hungry, why else might we eat? Let us count the ways:

1. Addiction (or craving) – this tops the list. We are addicted mainly to “plant waste,” “animal secretions,” and meat (see Lesson 5, Might as Well Face that I'm Addicted to "Whatever”). We are also addicted to being overstuffed.

2. Habit (including gum)

3. Because it's there. This includes candy just staring at you from the candy jar at work and food sitting on your plate that you served yourself or purchased (packaged, supersized, or upgraded) above and beyond what you would need to be comfortably full.

4. It's scheduled (lunch, social situations) – what should you schedule, cancel, or plan differently?

5. Reward

6. Celebration

7. Tired (this is a big one for me – see my story about studying during medical school in Lesson 5)

8. Stress

9. Sore throat

10. To take medicines that require food

11. Thirsty

12. Bored

13. TV commercials

14. To get energy

Can you think of any other reasons? If you're not actually hungry, try either not to eat or to eat less (i.e., a small, healthy snack) – and/or just drink water!  And it goes without saying that if you do eat, eating the 4:1 way will cause less damage and guilt. If partially hungry, eat a partial meal!

As we learned in Lesson 9, The Chinese Insanity Test, one of the most important, albeit one of the most difficult, aspects of losing weight is controlling one’s intake.  If we control that front end of the energy equation (what goes in), then we do not have to stress as much about having to increase the back end (taking it out, i.e., exercising so much or starving ourselves).

What concerns most people about beginning the weight loss process is that they do not like to go hungry.  Imagine that.  In fact, going hungry and depriving oneself is why most diets and weight loss programs fail to work long-term.  The very thought of the word “diet” can make one hungry and start craving less-healthy foods before even starting (“I’m starting a diet tomorrow, so I’m splurging tonight.”).

In fact, you must not go overly hungry as you lose weight!  The more hunger you experience, the less chance you will have of long-term success.  The body always wins that battle. One of the greatest revelations you will have as you follow a mostly plant- and fatty seafood-based diet is that you get to eat more food, not less!  Therein lies the key, the magic.  Review Lesson 2, The 4:1 Rule and Nutrition Star, to remember how this works.

Really – It’s OK not to Eat

As we learned in Lesson 8 (Freaks of Nature: My Metabolism Is Frozen and other Urban Legends), you cannot eat so little that you gain weight. There are two additional myths that are ever-so-counterproductive to your weight loss goals:

1. Don’t skip meals, especially breakfast!

2. Eating six small meals a day keeps your metabolism running faster.

It is becoming more and more clear that the longest-living and healthiest populations on the planet eat the least food¹ (also see the heading below, “Hara Hachi Bu” – and if you have not yet read it, I strongly encourage you to read Dan Buettner’s book The Blue Zones), and that going without food intermittently is good for you.² I will admit that I used to be in the “Don’t skip meals!” camp, but I have since learned that the belief that skipping meals is bad for you is a myth. Generally, the less food you eat, the better!

The whole “eating six small meals a day keeps your metabolism running faster” myth practically kills me. There is no good scientific evidence anywhere to support this. In addition, we can’t get people to plan two or three healthy meals per day – and you want them to plan six? I don’t care if some are considered “small” meals or snacks. In Lesson 13 (Diet Is a Four-Letter Word) we learn that one should never make any changes to lose weight that one cannot continue for the rest of one’s life, and this goes completely against that. It’s simply not true, a myth, and completely counterproductive.

I do need to preach wisdom here, however, to those of you who like to go all in: Be wise. Just because I’m counseling against trying to “eat six small meals a day to keep your metabolism running,” that doesn’t mean you can ONLY eat three (or fewer) meals a day. Don’t go all “diet mode” on me and and allow yourself to go hungry and restrict eating between meals. This will trigger your hunger hormones to excess, not to mention eating disorders. EAT 4:1 WHEN ACTUALLY HUNGRY! And you may need to eat (4:1) more frequently, e.g., if you are pregnant, feeling sluggish, or have diabetes and are on medicines that have a risk of hypoglycemia.

Intermittent Whatever Fasting (for those who need or desire to try)

As referenced above, it’s OK not to eat (when not hungry).  You shouldn’t be surprised that, according to the laws of physics, eating less than your body’s metabolic needs is when weight loss occurs. Please believe me on this.  Most people know whether or not they will be alright if they skip meals, or at least know they can get by for a while on just water.  But if you’re not sure you can, and would like to try, don’t let anyone convince you otherwise with one of the above-mentioned myths.  Just remember that eating is not the problem with gaining, or an inability to lose, weight – it’s eating too much Whatever!

There are many ways to approach intermittent fasting, and you can explore those online.  I like to start by talking to patients about the 16/8 rule, which simply involves trying to avoid calorie consumption for 16 hours of the day and packing all of your calorie consumption into the other eight (however, recognize that you can easily consume the same amount of calories in an eight-hour period that you normally do in 16). Most do this by skipping one meal, most often breakfast (unless you find skipping dinner works better for you; however, most feel the least hungry and tempted/driven to eat in the morning, especially if they have eaten a lot the night before, which is OK if eating the 4:1 way, especially 4-Diamond foods).  

However, I must present a modified approach to intermittent fasting that I call intermittent Whatever fasting. It abides by the spirit and principles of SLIM TLC:  Do not torture yourself or go overly hungry, or it will not become a permanent change.  Doing so is a perfect example of the always-proven-to-fail diet mentality (see Lesson 13, Diet Is a Four-Letter Word).  If you torture yourself, eventually you WILL "make up for lost time" by eating too much, or too much of the "Whatever" foods (which is what we do when we’re starving), and therefore you WILL fail.  

In intermittent Whatever fasting, you will not carry around a caffeinated drink, in a shaky hand, feeling starved the whole time you fast, always watching the clock to see when you can eat again.  Try to keep yourself busy to keep your mind off of food, and if you find yourself getting hungry, Check Your Fuel Gauge (see heading below).  If you are indeed actually hungry, comfortably (guilt-free) eat one or two 4-Diamond foods (see Lessons 2 & 3, The 4:1 Rule and Nutrition Star and The SLIM TLC Map, respectively), and chase it/them down with a big glass of water.  Then, move on (go back to what you were doing)!

If you are unsuccessful at intermittent Whatever fasting, try at the very least to set a goal of only eating 1-2 meals a day and plan on replacing the other meal(s) with a hearty snack (always trying to follow The 4:1 Rule, of course). Over time and with practice, especially as you follow the “Free Food? Whatever!” eating strategy (Lesson 2), it will become much simpler.

Checking Your Fuel Gauge

So how does one learn to eat mainly when actually hungry? You have to start paying more attention to your true hunger (or “fuel” level), and try to “stop and check” each time you are presented with an opportunity to eat. In other words, ask yourself, “Am I actually hungry, or am I eating for other reasons?” I call this “Checking Your Fuel Gauge” (or CYFG, for short).  It helps you retrain your stomach to be satisfied when full, instead of waiting until you are overstuffed to stop eating.

You have undoubtedly heard or experienced that it takes about 20 minutes (I’m sure it varies, depending on many factors) for the satiety (fullness) signal to reach your brain.  Checking Your Fuel Gauge is a way of actively looking for that satiety signal, instead of passively waiting for it to arrive, all the while mindlessly overstuffing your tank.  If you CYFG as you eat, you can significantly short-circuit the seemingly long pathway between your stomach and your brain. It is a common-sense skill that, with practice, will become both second nature and a great tool in your weight management toolkit!

Put another way, CYFG is a metaphor for assessing your level of fullness or hunger both before you eat and as you eat.  It is a wonderful method of “volume control” that helps you regulate the quantity of food and liquid with which you fill your fuel tank.  CYFG helps you keep your finger on the pulse of your hunger or fullness level.  It helps you determine how full your tank is, and also to distinguish true hunger from a craving.

By CYFG, you will know whether or not you really need to eat or continue eating.  Before you gas up, CYFG will help you determine if your tank is already adequately full – if so, then you do not really need to eat.  At that point, you have to ask yourself, “Is it really worth it?”  However, just because you find you are full enough and do not think it is worth it, you will not suddenly drum up the necessary, instant willpower to resist all temptations.  You are already fully aware of this (pun intended).  But the more you learn to CYFG, the less you will eat when you are not actually hungry.

At least one study³ supports the reliance upon internal cues such as CYFG to know when to stop eating.  Those who rely on external cues such as whether their plate is clean, their glass is empty, or the television show or movie is over, gain more weight.  How important it is to listen to your insides!

Another way to curb your tendency to overindulge is to brush your teeth once your tank feels full (not before – that’s a diet!).  Calories simply don’t taste as good after you brush your teeth (I call this “The Toothbrush Diet” – see Lesson 13). Flossing may further help to discourage unnecessarily feeding the “need.”

An Inside Quart 

There is something else you must understand well in order to learn to CYFG.  Did you know that the “resting” stomach capacity of an average adult is little more than one quart⁴ (32 ounces)?

This is about the size of a small cantaloupe.  Yet stomach sizes differ based on body size, age, and other factors.  You can estimate the size of your stomach by making a hollow ball with your hands, palms facing each other and fingertips together:

Unless your fingers are abnormally long or short, that is about how big your stomach is.  Keep this in mind as you are eating, but not with the purpose of obsessing about portion control.  That’s another concern that should melt away the more you eat a healthy, mostly plant- and fatty seafood-based diet (i.e., The 4:1 Rule).

Anytime the stomach is full, we should feel full, or “satiated.”  Unfortunately, there are at least two things that prevent us from stopping at that point:

1. Our stomach, unlike a car’s fuel tank, can expand.  In fact, it can, and all too often does, expand to 2-4 times that much.⁵ The problem is that we keep eating absent-mindedly until it is too late, which is a learned behavior.

2. It takes several minutes before we detect this “satiety signal,” and by the time we do, the damage is done.  That is why it is so important to be proactive in CYFG.  By the way, the faster we eat the more damage we do, so it wouldn’t hurt to try to slow down (also notice that most “fast food” is easy to eat fast, and it rarely consists of healthy calories).

Most who overeat confuse “full” with “overstuffed.”  I challenge you to learn the “new normal” of feeling full before you are overstuffed.  In other words, you may need to get away from being accustomed to being overstuffed, so that you misinterpret anything less than that as hunger.

Gaining control over food will not happen overnight.  In fact, gaining perfect control will probably never happen – nor is it necessary for achieving your health and weight loss goals.  Indeed, we are not looking for perfect control – we are looking for adequate control, enough to turn the corner and move towards long-lasting health and weight normalization.  As you follow SLIM TLC’s “Free Food? Whatever!” eating strategy, over the course of just a few weeks you will find that your ability to feel perfectly satisfied with smaller and less frequent “feedings” will grow and grow, especially as your addictions lessen and your taste buds change. And herein lies the magic.

Like every valuable skill, learning to CYFG comes through practice, practice, practice.  Do not delay the learning process – try it out!  The next time you go to eat something, before you eat it, stop and check! Consciously think about how full your stomach is.  Then repeat the process each time you eat, wherever you eat!  In addition, make a conscious effort to CYFG as you eat.  Soon you will become accustomed to the pleasant feeling of fullness without bursting at the seams; then, whenever you do overstuff yourself, you will actually feel uncomfortable.

Hara Hachi Bu

The Okinawans in Japan hit the nail on the head many moons before the concept of CYFG came to be.  Many practice a Confucian-inspired technique to help them remember to eat only until about 80% full.  It is called “hara hachi bu,” which they say before they start eating, to remind themselves to check their fuel gauge and avoid overeating.  Many outside of Japan have found this to be a very helpful concept.

Become a CYFG Master 

CYFG is a skill that may take some time to develop, but eventually you, too can become a CYFG Master.  CYFG Masters are those who can approach any eating situation or temptation and survive without damage to their waistlines.  CYFG Masters do not starve themselves or go hungry, nor do they always deny themselves of indulging in less healthy fare – they simply eat smarter.  You can be a CYFG Master in any situation, whether you travel or eat out often, work around food or snacks, cook frequently, or are in any other environment that can deter your efforts to lose weight.  No matter where you are or what you eat, you can always be a CYFG Master.

I Can’t Lose Weight if I Fill up! 

If you do not feel you can stay full and still lose weight, then you may need to work on making better food choices and further work on CYFG.  With practice, it will come.  You would be surprised at how much volume even 1500 calories of the right food takes up – although few people need to survive on fewer than 1500 calories a day.  Anyone that tells you they eat less than that on a regular basis and cannot lose weight, especially if they exercise, is telling a fish story.  Even a somewhat sedentary, 60-year-old, 100-pound woman burns more than that on an average day.

At the end of every day that you are successful at CYFG, instead of going to bed overstuffed, you will be pleasantly satisfied (definitely not hungry).  Even with a full tummy, you will retire with a wonderful peace of mind knowing that your eating habits for the day have moved you closer to, not further from, your goal.

The Law of Compensation

No matter how good you think you are or want to be, because life is complicated, it is likely that you will overindulge on occasion, even while trying hard to CYFG and follow The 4:1 Rule.  The Law of Compensation is a law of health that simply states that if (when) you overindulge in “Whatever,” instead of getting frustrated and discouraged (which can easily result in your giving up), simply alter your habits accordingly and compensate by eating a little better the next meal (or day). You may even decide to exercise a little more.  Note that I said a little.  You must not overcompensate, or you will get caught in an unhealthy cycle that will result in a losing battle (the wrong kind of losing), i.e., you will deprive yourself too much or work up such an appetite that you’ll eventually overindulge again – likely on the wrong things (as suggested above, the hungrier you are, the more you crave and indulge in “Whatever”).

A perfect example of the Law of Compensation is illustrated in a study of teens eating at a fast-food restaurant.⁶ When given free reign of what they wanted to eat, the more slim teens ate every bit as much as the overweight teens.  But a fascinating thing happened throughout the rest of the day.  The slim teens naturally compensated by eating less the rest of the day, so that their total daily caloric intake was within their metabolic needs.  On the other hand, the overweight teens continued to eat a large amount, so that their total daily caloric intake far surpassed their metabolic needs, resulting in further weight gain.

This is a valuable study for at least a couple of reasons:

1. It illustrates the value of the Law of Compensation.

2. It illustrates that people have different abilities to self-regulate.

The slimmer teens probably did not make a conscious decision to eat less throughout the rest of the day.  Either through some constitutional or subconscious tendency or learned behavior, they just did.  On the flipside, the more overweight teens probably did not make a conscious decision to eat more than the slim teens, i.e., not to compensate – they simply did what they normally do (and I’m sure stress played a role, whether physical or emotional).  That does not mean that they cannot learn a new skill (i.e. CYFG) or behavior to address the problem – it simply means they will have to work a little harder, and be willing to learn and change.

If you just went on vacation and threw all caution to the wind, gaining three pounds in a week, just make the decision that you will do better now that you have gotten “it” out of your system (but remember to be “better” in moderation).  And believe it or not, you will likely find that the extra weight comes off easier than you would have expected (also see Lesson 16, Taking SLIM TLC on the Road).

The Bottom Line(s) 

1. Great peace of mind can come from developing power over food, instead of the other way around.

2. You do not have to, and in fact you must not, go hungry nor over-deprive yourself if you want to be able to achieve long-term weight loss success.

3. Do not believe the myths that you must not skip meals, that eating six small meals a day keeps your metabolism running faster, or that if you eat too little your metabolism will freeze.

4. To gain power over food, you must follow SLIM TLC’s eating strategy, “Free Food? Whatever!” and learn to Check Your Fuel Gauge.

5. Practice becoming a CYFG Master, and use your skills whenever and wherever you eat.

6. Overstuffing your stomach can stretch it to 2-3 times its normal size.

7. Cows have four stomachs.  You only have one, so you cannot eat like a cow.

8. If you overindulge, try to live the Law of Compensation.

• ¹Weir HJ et al: Dietary Restriction and AMPK Increase Lifespan via Mitochondrial Network and Peroxisome Remodeling. Cell Metabolism 26(6):884-896.E5, accessed February 24, 2019 at www.cell.com/cell-metabolism/fulltext/S1550-4131(17)30612-5

• ²Mitchell SJ et al: Daily Fasting Improves Health and Survival in Male Mice Independent of Diet Composition and Calories. Cell Metab. 2018 Aug 24. pii: S1550-4131(18)30512-6, accessed February 24, 2019 at www.nih.gov/news-events/nih-research-matters/fasting-increases-health-lifespan-male-mice

• ³Wansink B, Payne C, Chandon P: Internal and External Cues of Meal Cessation: The French Paradox Redux? Obesity 15:2920-2924, 2007, accessed February 24, 2019 at www.ncbi.nlm.nih.gov/pubmed/18198299

• ⁴Emedicine Consumer Health, Stomach Cancer, accessed February 23, 2019 at www.emedicinehealth.com/articles/9773-1.asp

• ⁵Volume of a Human Stomach, The Physics Factbook, accessed February 23, 2019 at http://hypertextbook.com/facts/2000/JonathanCheng.shtml

• ⁶Ebbeling CB, Sinclair KB, Pereira MA, Garcia-Lago E, Feldman HA, Ludwig DS: Compensation for Energy Intake From Fast Food Among Overweight and Lean Adolescents, JAMA 2004;291:2828-2833, accessed February 24, 2019 at www.ncbi.nlm.nih.gov/pubmed/15199032

Quiz for Lesson #10: Checking Your Fuel Gauge

When you are following SLIM TLC’s “Free Food? Whatever!” eating strategy (Lesson 2), unless you’re only willing to eat plants in their native, whole form, it’s very difficult to know how many “Whatever” calories are in meals you don’t prepare yourself. Unless you do some homework or pose some pointed questions, you have no idea how many Hidden Calories (Lesson 20) each meal contains. The most obvious solution, albeit extremely unreasonable for most people, is never to eat any food you don’t prepare yourself. I would be impressed if you could pull that off in real life, but for most that would be at the expense of a social life, diverse friend group, marriage, and/or their sanity. Personally, I would never, and I could never ask you to, sacrifice those things. So, until restaurants start posting “Whatever calories” (I propose “WCal©” for short) for their meals, we are forced to figure things out on our own. That being said…

If you are a restaurant owner (or food manufacturer) and are willing to post the amount of “WCal©” contained in your meals (or products – and offer several low-”WCal©” options), besides my heartfelt gratitude (and that of many others), I would be more than happy to shout your restaurant’s (or company’s) name from the rooftops.

Similarly, if you know of any restaurant (or food manufacturer) that does that very thing, whether independently or after much coaxing, please let me know!

In the meantime, try to choose restaurants that have healthier options, and special order when needed.  Most restaurants (trust me, I know there are glaring exceptions) have at least something on their menu that, with a little creativity, fits into The 4:1 Rule.  However, you must be prepared, if necessary, to substitute things or request that they leave certain things off.  Stick as much as you can to healthily-prepared salads (light/healthy dressing, on the side, topped with hearty vegetables, legumes, fruit, and seafood, instead of a bunch of “Whatever” things on top or mixed in, like grilled steak, cheese, egg, croutons, etc.), vegetable- and legume-based non-creamy soups, potatoes (not loaded with butter, sour cream, bacon bits, and cheese), grilled shrimp and salmon, and sides of fruits, steamed vegetables, or beans.  It is rare to find whole grain bread, but look for it.

Once you have decided on a meal, unless you already know everything from previous research, you will have to consult a counting calorie app (the one I use is My Net Diary) or find a similar recipe online to try to determine the “Whatever” calorie (WCal©) content (that is, until I/we can develop a SLIM TLC app that does it all for us!).

FYI, see the Calories per Gram and Estimating “Whatever” Calories (WCal©) section of Lesson 22 (Product Labels) for a more in-depth discussion of calories and estimating WCal© content.

You’ll start with the “Whatever” things that are visible (pretty easy), then try to guess how many are Hidden (difficult, unless you’ve found a similar recipe online). Many calorie counting apps have the specific item (or base item) you are eating, from that very restaurant. If not, I’ve found it helpful to try to find a similar recipe online, a similar meal from a restaurant that is listed, or a similar meal that is commercially-available (one that can be purchased at a store). HOWEVER, even though the dish you find may list total calories and break down the fat, carb, and protein grams, those things are next to useless for our purposes, because they don’t determine the source, 4◊ or “Whatever” (unless it’s listed in a recipe) – and all in which you are interested is the “WCal©” content. You’ll have to estimate which fat, carb, and protein calories are from “Whatever” sources, in addition to portion size, but do your best to figure it out.

For example, I like Thai food. If I order Pad Cashew with Shrimp (100% 4◊ except for the Hidden Calories), I can either search for that recipe online or go to my My Net Diary app (whichever works best for you, and that may depend on the dish) and try to find a dish that is similar enough (accounting for variations in portion size). If I was fortunate enough to find a similar recipe online, I would then estimate or count the “Whatever” calories (e.g., oil, sugar, white flour, at 9, 4, and 4 calories per gram, respectively). If I found it on my app, I would try to do the same, and since I use the My Net Diary app to keep track of my “WCal©,” I indicate that I consumed a certain percent that correlates closest with the “WCal©” content. For instance, if the total calorie content of the dish is 560 calories, but I estimated that only 260 calories were “Whatever” calories, I would divide 260 by 560 (= 0.46) and indicate that I ate 0.46 (46%) of the dish to add to my “Whatever” calories for the day. I hope that all makes enough sense.

“Healthy” Restaurants

Don’t assume that restaurants claiming to be healthy really are healthy, like vegetarian or vegan restaurants that make no effort to limit plant waste or, in the case of vegetarians, animal secretions (see Lesson 5). The same goes for seemingly “healthy” menu items on a typical menu.  Most include a surprising amount of calories, whether they be from animal-based foods or plant waste like oils, white flour, and sugar.  You can figure that out by looking at the restaurant’s nutrition guide, but make sure you look at the asterisks and fine print.

For example, most would consider a grilled chicken Greek salad to be healthy.  After all, it’s a staple on the Mediterranean diet.  However, if you look at the details, even though more than 80% of the volume may be taken up by plants, because of the grilled chicken, olive oil, and feta cheese, over 80% of the calories are probably WCal©!  This point cannot receive enough emphasis: Because of differences in caloric density (in general, plants are low and “Whatever” foods are high in caloric density), a dish that appears to be mostly good for you may not be! Imagine the same salad without (or with a significantly reduced amount of) “Whatever” foods.

Other Tips

It will likely take a few tries before you figure out how to eat out in a healthy manner.  If at first you don’t succeed, try, try again.  Other recommendations for being a smarter diner include:

1. When you pick up a menu, immediately look for healthily-prepared plants and fatty seafood (remember that the list of plants you can eat is a mile long, including beans, whole grains, and potatoes); if you are going to include any other animal-based or processed foods, those things should only make up <20% of the meal by volume, or mainly be used for flavoring.

2. Do not be afraid to special order things, i.e., substitute fresh vegetables for French fries.

3. Minimize the frequency of eating at all-you-can-eat (AYCE) restaurants, which includes Mexican restaurants that have AYCE chips, or Italian restaurants with AYCE bread sticks – you know your weaknesses.  However, if you have the experience or willpower, a buffet that offers a lot of (healthily-prepared) plant- and fatty seafood-based foods can be a blessing instead of a curse, as long as you make wise choices (which is 1000 times easier if you are following SLIM TLC’s “Free Food? Whatever!” eating strategy).  A wonderful feature of The 4:1 Rule is that you can allow yourself some of your usual foods without killing your efforts.  For example, you may allow yourself to eat a single breadstick or 1-2 slices of bread, or eat 5-10 chips with salsa and then stop; then try to eat healthier for the rest of your meal!

4. Split the dinner with someone or save half for another meal.

5. Remember to Check Your Fuel Gauge (Lesson 10) while you eat.

6. Ask for the dressing on the side, and use a much smaller amount than is typically used (some use the “dip and stab” method – dip your fork in the dressing and then stab your salad; that works great if you really want the flavor tartar sauce with your fish).

7. Split appetizers and desserts if you must have them.

8. Fill up partially on “Free Food” before you go, to help curb your appetite. Similarly, if almost all you eat is “Free Food” the rest of the day, you can worry less about adding a little “Whatever” when you eat out. But that doesn’t suddenly make it simpler to count “Whatever” calories.

9. There are many, many tips and tricks you can use, but the more you can develop the habit of eating a healthy, mostly plant- and fatty seafood-based diet, the less you have to rely on tips and tricks (therefore it becomes easier to eat right), thus increasing the likelihood of having long-term success.  Once more – if at first you don’t succeed, try, try again.

Quiz for Lesson #11: Eating out the 4:1 Way

Dr. Richard Carmona, the past U.S. surgeon general, stated, “There is no such thing as a magic pill to weight loss.” I used to agree with him wholeheartedly, and always echoed this statement – that is, until (of course), I identified 4½ magic pills.

Magic Pill #1, by far the most powerful, is the “Free Food? Whatever!” eating strategy outlined in Lesson 2, The 4:1 Rule and Nutrition Star.

Magic Pill #2 is Another Magic Pill discussed in Lesson 4, i.e., Exercise.

Magic Pill #3? The Chill Pill. What exactly do I mean by that? We have struggled so long and so hard to lose weight that “chilling” completely goes against everything we actually feel about losing weight. But if you’ll bear with me, I’ll explain four ways that The Chill Pill is a magic pill to weight loss (although they are all related):

1. Most people want overnight results, and some are willing to kill themselves to get them. This is an absolute recipe for disaster. Chill! The likelihood of getting slim overnight isn’t any greater than getting rich overnight. It is imperative to run the weight loss race like a Seasoned Marathon Runner instead of a sprinter. Trust me – if you follow the program as outlined, you’ll see very satisfying results!

2. Since stress is one of the biggest killers of weight loss efforts in the history of weight loss (through stress eating and sapping your energy so that it is almost impossible to start an exercise regimen), it is crucial that you address any sources of excessive underlying stress you have! For a little help doing that, see Lesson 14, It’s Emotional!

3. Chill in the way you think about weight loss and food! Most people get hungry and stressed just thinking about starting the weight loss process, which is incredibly counterproductive to long-term success. With SLIM TLC, there is no dieting, depriving yourself, measuring portions sizes, or tracking or calculating the carb, protein, fat, or calorie content of all you consume (which is what I call “looking beyond the mark”). Understandably, you may initially argue that the strategies and tools found in TLC University Lessons 2 (The 4:1 Rule and Nutrition Star) and 3 (The SLIM TLC Map) are the opposite of “chilling,” but I promise you that once you learn the “craft,” you will change your mind forever! How/why? You will 1) realize how glorious it is to be able to eat all the 4◊ Foods (Free!) you want, in addition to your Whatever Calorie Budget in “Whatever” calories, without feeling guilty (remember – when you eat right, you get to eat more food, not less, so you don’t go hungry!), and 2) you will finally gain power over your addictions, allowing you to stop fighting all the time to exercise self-control! Once set up, following The SLIM TLC Map takes just a few minutes each day (and you’ll actually start looking forward to updating it!), and you’ll get so skilled both at avoiding and keeping track of the fewer “Whatever” calories you consume that they won’t stress you out.

4. Try a “chilling exercise.” Before I explain what that is, I want to ask you a question: What would you be willing to pay for a weight loss tool that would burn some 1500-3000 calories a day with absolutely no cost or effort? Compare that to the amount of calories you might burn with a whole hour of exercise (usually only a few hundred). Well, guess what – you already have such a tool, and it costs you absolutely nothing and truly takes absolutely no effort to use. It is your very own inborn metabolism. If you sat around and literally did nothing (that includes eating nothing) all day, you would lose weight like a maniac. Of course that would be the true definition of a “starvation diet,” i.e., foolish to consider. But think about it – you can harness the incredible power of your own built-in metabolism (again – an amazing fat-burning tool, much more powerful than exercise) simply by sitting back and letting it do its job, i.e., simply letting it stay ahead of the calories you take in. Just chill. Think about it this way:

   Shhhh...Cálmete. You are more than food. Food does not define you. Break it up!
   Break up that dastardly, unhealthy, codependent relationship with food and your fat organ.
   You're in charge. You’ve got this. Take it when you need it, leave it when you don't.
   CYFG. Don't let the addiction win.

   “Chilling” is impossible when you are truly hungry (“true hunger” is determined by Checking Your Fuel Gauge – Lesson 10), so you must eat (the 4:1 way) when you are truly hungry. But if you are tempted to eat when you are not truly hungry, try just “chilling” by either doing nothing – or better yet, stay busy and distract yourself by doing something productive (and burn more calories in the process). Or, go brush and floss your teeth. If you ever find yourself in a situation where you would like to eat but no (or no good) food is available, chill! Let your metabolism work its magic!

Magic Pill #4: The Power Pill. This is a pill that makes you suddenly find the wherewithal and motivation to simply flip on the “healthy lifestyle switch,” i.e., transform yourself almost overnight from an inactive, poor eater into an active, healthy eater. Unfortunately, it is a pill that you must discover on your own. I’ve tried to figure out how to create it artificially, but my efforts have come up short. I thought about calling this “The Motivation Pill,” “The Anger Pill,” or “The Passion Pill,” because it often involves getting mad at your weight (or some consequence thereof) or passionate about reaching a goal, but those things usually expire (an event like a cruise or reunion) or fade with time. The decision and power to make permanent lifestyle changes usually comes from some significant event or realization, one that kicks us in the pants hard enough to do whatever it takes to jump firmly onto the healthy lifestyle bandwagon. Studies have been done to determine what factors might contribute to this change.¹ Some examples include:

1. Fear of death

2. Medical problem

3. Doctor’s advice

4. Negative comment from others

5. Seeing self in mirror or photograph

6. Desire for increased fitness or mobility

7. Getting tired of being overweight and just deciding to do it

8. Inspiration from others

The Power Pill may come with a new diagnosis, like diabetes or heart disease (even though 2/3rds of all heart attack victims return to their previously unhealthy habits within 6 months of the event). It may come when we learn or see something (like watching the documentary “Forks over Knives”). It may happen when a relative or close friend dies of a preventable illness, or with the birth of a new child for whom we want to stay alive and well. It may come from a desire to do something active, such as playing a sport, dancing, or playing with your kids. It may come from being tired of having to wear oversized clothes, or shop in the oversized section of the department store. It may come when you see a picture of yourself. Whatever it is, when you find this Power Pill, swallow it whole – and if it can apply to others, spread the word!

Magic Pill #½ (the last ½ of the 4½ Magic Pills): This simply refers to the medicine option of SLIM TLC, which you should set a goal to taper off once you’ve mastered the SLIM TLC system – and which is why I don’t give it a full Magic Pill point!

And that’s a wrap!

• ¹Klem ML, Wing RR, McGuire MT, Seagle HM, Hill JO: A descriptive study of individuals successful at long-term maintenance of substantial weight loss. AM J Clin Nutr l997;66:239-46.  Also Colvin RH, Olson SB. A descriptive analysis of men and women who have lost significant weight and are highly successful at maintaining the loss. Addict Behav 1983;8:287-95.

 Quiz for Lesson #12: The 4½ Magic Pills to Weight Loss

What makes SLIM TLC different from most other weight loss programs is that we only have one thing in mind:  Long-term health and weight loss success.  SLIM TLC, unlike most other programs, does not aim to help you lose a large amount of weight in a short period of time (although that often happens) – it is about giving you by far the greatest chance of having long-term weight loss success.  Dieting (making unsustainable changes), on the other hand, may give you an impressive amount of short-term weight loss, but that’s not true success, is it?  The key is in the “C” part of TLC:  Changes – for good.  To be permanent, changes must be livable.  Unsustainable changes include losing weight through products you have to buy – you will not purchase the product every day for the rest of your life.

It doesn’t take a rocket scientist to notice that something needs to change.  The health care system is slowly being crushed by the weight of the obesity epidemic and related metabolic diseases such as diabetes, heart disease, stroke, cancer, Alzheimer’s disease, and many others.  At the current pace it will not survive, and will likely be completely overwhelmed by 2030, when 39 states are projected to pass the 50% obesity mark (13 of those states will be above 60%, and all 50 states above 44%).¹ But we’re going to change that, aren’t we?

To turn this massive tide, it is imperative that we rid ourselves of the diet mentality, and throw away the yo-yo.  Diets are the problem, not the solution.   You are reading this lesson because everything you have tried thus far has failed.  Notice that I did not say you have failed, but instead everything you have tried has failed.  Diets fail you, not vice-versa.  Diets inherently set you up for failure.  Your past failures have occurred mostly because of the diet mentality.

Another reason diets fail is because at some point they inevitably require you to be Superman (or woman), and…newsflash!  You are not.  You will feel like a hero soon enough – you just don’t have to be a superhero.  So relax.  Take off the cape.  Stop the guilt.  Live again.  For good.

Wanting to lose weight quickly is perfectly natural, just like wanting to get rich quickly.  However, expecting to lose weight quickly without actively working towards a healthy lifestyle is like refusing to work until a six- or seven-figure dream job is handed to you on a silver platter – both scenarios are completely unrealistic.

Keep the Change 

There is a “prime directive” or dictum that I have been preaching for over 15 years.  It is:

Never make any changes to lose weight that you cannot maintain for life.

I continue to be amazed out how surprised dieters are when their weight returns after “getting off” a diet.

Indeed, we must make changes that are sustainable.  Once we have used wisdom in deciding what changes to make, if we find it’s sustainable, then make another decision once and for all to Keep the Change!  Yes, you will fall off the wagon periodically – but the good news is that you can always jump back on!  Success, of course, is not measured by how many times you fall, but by the getting up an equal number of times.

There is one exception to this prime directive, which is:  …unless you are doing something as a learning process.  For instance, I cannot expect you to “attend” TLC University for the rest of your life.  I want you to learn the trade and then go practice it and teach it to others.  The job of health care professionals is to put themselves out of business by making it so their patients become more self-sufficient, so they need them less. Follow whatever aspects of the SLIM TLC system are necessary for you to achieve success, and until the healthy changes you make become habits, then set your speedometer to cruise control and maintain the magic.

The Toothbrush Diet (Oops – I mean tool!) 

I have found one exception to the whole “diets are the problem” scenario:  Something I call “The Toothbrush Diet.”  For some, after they have already satisfied their hunger but cannot stop eating, this may be the answer to the dilemma, “I’ve got to stop eating!”  Sometimes it’s a great way to turn off The Hunger Gene or curb The Munchies.  However, you must not do this as a substitute for eating when you are actually hungry.  That would still be a diet.

Whenever you can’t seem to stop eating even after you are perfectly satisfied, whether it’s at the end of a satisfying meal or any other time you are eating for reasons other than actual hunger, go brush your teeth.  It’s a way to put something flavorful in your mouth that has few, if any, calories, and at the same time suppress your appetite.  Few folks want to eat or drink (something other than water) after brushing their teeth, especially because the food or drink doesn’t taste right.  And if you really want to turbo-charge the effect, floss afterwards.

This is also a great tool to help curb unhealthy night-time eating or bingeing.  Stop yourself before you do too much damage and go brush your teeth, then do something else to bide your time and wind down for a good night’s rest (which is harder when you have food bubbling up your esophagus).

• ¹Report:  39 States on Pace for Obesity Rates Above 50%. Costs in diabetes, heart disease, health care dollars will skyrocket if current trends go unchecked.  Report released September 18, 2012 by the Trust for America’s Health (TFAH) and the Robert Wood Johnson Foundation (RWJF), accessed February 23, 2019 at http://health.usnews.com/health-news/news/articles/2012/09/18/report-39-states-on-pace-for-obesity-rates-above-50

 Quiz for Lesson #13: Diet Is a Four-Letter Word

I have a particular interest in stress management, as I believe stress to be one of the greatest drivers of the obesity epidemic (unless you are one of the few in whom stress suppresses your appetite). This is the case for many reasons, including: 

1. It makes you hungry, so you eat more, you eat faster, and you make unhealthier choices.

2. It makes you too tired to exercise. 

3. It causes insomnia, which also leads to obesity and further stress (it’s a downward spiral) 

Stress is the great antithesis of the Chill Pill, which I consider to be one of The 4½ Magic Pills to Weight Loss (see Lesson 12), for many reasons.  Indeed, it is an endless cycle – stress causes obesity and vice-versa. In addition, stress has many other negative health effects. Stress is a key factor in most cases of depression and anxiety. 

Some important stress reduction techniques include: 

1. Exercise (one of the most powerful). 

2. Chomp on “Free Food,” AKA healthy snacks (see Lesson 15, Surviving the Snack Attack) 

3. Make “me” time mandatory (take a hot bath, read a book or visit a library, visit a museum or allow yourself to bask in “life” some other way, get out of the house, take some time off, enjoy the great outdoors, experience nature, get away).

4. Forget yourself in the service of others (without overwhelming your schedule).

5. If a parent, read a book or play a sport or game (active or not) with your child.

6. Call a good friend or family member to talk. 

7. Take up a healthy hobby. 

8. Get a pet (unless it causes more stress). 

9. Play, or learn to play, an instrument. 

10. Smile more and lighten up a tad. 

11. Hum, whistle, or sing a pleasant song. 

12. Meditate or pray.

13. Relax through modalities such as deep breathing, massage, listening to soft music, taking a nightly bubble bath, etc. 

14. Get a good night’s sleep – this is paramount. Reducing stress (with the above techniques) can help you sleep better, too (again, it is a cycle). See Lesson 19, Get Your Vitamin Zzzzz for more information.

Indeed, stress and feelings of being overwhelmed are ubiquitous. They come as a result of a job situation, financial difficulties (including the pursuit of “things”), health issues, loss of a loved one, relationship problems, current events, time restraints, deadlines, and more. And stress usually significantly increases one’s drive to eat (see below). 

Psychological issues probably play a much larger role in the obesity epidemic than most realize. When we have deep emotional issues, we may eat because we are trying to fill some void in our lives. If this applies to you, it is imperative that you address these things. This treatise is not the place to provide a detailed dissertation about managing deep, unresolved issues. If you struggle with any of these things – especially if they are starting to affect, or have long affected, how you function in different areas of your life – please tackle them head-on by seeking help from a competent healthcare professional. The two of you may decide that counseling, support groups, or medicine will help. 

Everyone has a different threshold for handling stress without overeating. You will never know how much it is contributing to your drive to eat until you begin to identify and address each cause of stress one by one, especially those that are self-imposed. Self-imposed deadlines and the pursuit of material things may also need to be reevaluated. Simply sorting through these things may allow you to breathe more easily. 

Besides the items mentioned above, other things you can do to help reduce stress include: 

1. Have faith that one day things will get better, and allow yourself to be at greater peace knowing that (trust in or “surrender the outcome”).

2. Recognize that the hardest things in life bring the greatest rewards, even if it means just in strength, growth, wisdom, and empathy. See each challenge as an opportunity or a puzzle to solve, look at the big picture, and search/reach for the light at the end of the tunnel. Remember that necessity is the mother of invention, and many of the greatest discoveries and blessings to mankind have come from finding solutions to problems. Remember that the darkest nights give birth to the brightest stars.

3. Avoid triggers. 

4. Change the way you react to stressful situations. 

5. Try not to worry about things you cannot control, and do something about the things you can (remember the familiar “Serenity Prayer?”). 

6. Recognize that bad things happen to good people all the time, completely beyond anyone’s control. All you can do is your best, and then do your best to deal with the rest. In the end, at a minimum you will have grown and learned empathy. 

7. Have faith that as long as you are doing your best, things will always work out for your good. 

8. Do not wrap up your emotions in things of little redeeming value, such as when a sports team loses. 

9. Resolve conflicts and relationship issues with others. 

10. Make sure you are not the cause of stress for others (you will reap what you sow). 

11. Work to change your environment for the better. 

12. Make tough decisions to reverse self-inflicted causes of stress. 

13. Do not procrastinate; prepare well ahead of time for deadlines. 

14. Take care of health problems (a huge source of stress), and seek regular preventive care from your doctor. 

15. Get out of debt, live within your means, and quit trying to keep up with the Joneses (read Dave Ramsey’s Total Money Makeover) 

16. Leave for work, the airport, and appointments with time to spare, so you do not have to stress over traffic. 

17. Keep a positive attitude and do not focus on negative things, alone or in discussion with others. 

18. Look outside yourself and reach out to help others. 

19. Allow others to help you. 

20. Turn off the cell phone and pager. 

21. Delegate. 

22. Free your schedule of unnecessary or excessive meetings or appointments. Unclutter your life. 

As mentioned above, stress usually leads to overeating – and usually the less-healthy (“Whatever”) things.  And I am 100% convinced that this “drive to eat” is much greater in those who are overweight.  Some people who are thin simply don’t understand this.  They break their arms patting themselves on their backs, and will tell overweight folks, “Why don’t you just stop eating?!”  The reality is that everyone falls on a different point of the “Drive to Eat Continuum”: 

Drive to Eat Continuum 

If you are reading this, it is likely that you know exactly what I’m talking about, and probably fall somewhere to the right on this continuum.  The magnitude of our drive to eat depends on a variety of factors, including: 

1. Genetics 

2. Congenital factors (as we develop in the womb) 

3. Learned behavior 

4. Our environment 

5. Stress level 

6. Eating too many addicting (“Whatever”) foods 

There’s nothing you can do about the first two, but fortunately you can work on the last four.  You can learn new behaviors by following SLIM TLC principles, you can help to change your environment (see the next lesson, Lesson 15), you can reduce your stress with the above principles, and you can try to break your food addictions (see Lesson 5, Might as Well Face that I’m Addicted to Whatever, and do your best to follow SLIM TLC’s indispensable eating strategy, “Free Food? Whatever!” – see Lesson 2).  The more you can do these things, the more you will nudge yourself to the left on the above continuum.  So take a deep breath, chill, and always remember:  You can do this.

Quiz for Lesson #14: It’s Emotional! The Role of Stress and Depression

It’s late afternoon or evening, and things are winding down at work or at home. Although you’ve already had a good lunch or dinner, since you apparently don’t have anything else to keep you distracted, the old munchies start – the Urge to Splurge, the Need to Feed.  Our minds and stomachs turn to thoughts of snacking, and probably by habit, we end up in the kitchen, automatically opening up the pantry or refrigerator.  This will likely be tempered if you chose to take medicine as part of your weight loss journey, or if you have been able to create an environment of success and control your addictions by carefully following SLIM TLC’s “Free Food? Whatever!” strategy outlined at the end of Lesson 2 (The 4:1 Rule and Nutrition Star), along with The SLIM TLC Map (Lesson 3). However, it is imperative to come up with a healthy snacking strategy either way. 

Your Healthy Snacks List

Your first order of business is to be prepared for snack attacks. If you haven’t done this already, pull out My SLIM TLC List of Favorite Healthy (4◊ Food) Snacks and examples of SLIM TLC Free (4-Diamond) Food Options from the SLIM TLC Folder. Going through this exercise is beyond critical for providing yourself with healthy options that you enjoy, making them available whenever and wherever you need them, thus creating an environment of success. Identify (by circling) the perfectly healthy foods that you enjoy. Once they have been identified, they must be purchased (always keep your list handy, e.g., by taking a picture with your phone, and add to it whenever you think of a new healthy snack you enjoy), then they must be kept visible or prepared and kept in a specific place so they are easy to grab. I recommend designating a specific area in your pantry or refrigerator (shelf or drawer) where you will keep a variety of single-serve healthy snacks, possibly packaged in ziplock baggies. It’s all about preparation!!!

To find additional snacks to add to your list, I recommend the following search string on the Internet: “Oil-free whole plant-based recipes (or snacks),” and adapt from there, perhaps adding a little “Whatever” (if desired).

Snack attacks are completely survivable – but only if you are prepared. You may wish to keep (your) My SLIM TLC List of Favorite Healthy (4◊ Food) Snacks on your refrigerator and/or pantry door (and/or other locations as needed), so you can have frequent reminders of options. Remember to Check Your Fuel Gauge each time a snack attack hits, and always to drink water to wash things down. Just be careful not to torture yourself by trying to “control your hunger.”  The more you deny yourself, the more likely you’ll eventually splurge on “Whatever.”  If you are still in grazing mode after your snack(s) and water, consciously go do something else. Again, brushing your teeth may help.

If you follow The 4:1 Rule, you can snack guilt-free! If you snack primarily on animal-based or processed foods, then lots of damage can be done in a very short period of time.  Remember that for every ten (10) calories you consume each day beyond your metabolic needs, you will gain a pound by the end of the year.  100 calories/day extra = ~10 pounds after one year. 

Click here to see my (Dr. Cluff’s) List of Favorite Healthy Snacks and Meals

Quiz for Lesson #15: Surviving the Snack Attack

In this modern world, many of us spend a lot of time away from our hometown.  I live near the Dallas-Fort Worth airport, and over the years I have known many, many patients who travel frequently, finding themselves away from home for more than half their meals.  And when they are away, they are in a foreign environment, subject to the foods others provide, and/or eating at many restaurants to which they are not accustomed.  In addition, folks who travel a lot have a hard time developing a routine, and therefore experience more stress, not to mention difficulty sleeping.

If the mystery is taken out of the weight loss process (primarily by following SLIM TLC’s “Free Food? Whatever!” eating strategy, described in Lesson 2, The 4:1 Rule and Nutrition Star), and you are armed with a correct understanding of nutrition, then you can apply what you know to any eating situation.  No, it won’t be easy; and no, mastering the challenge won’t happen overnight – but with practice you can and will make it happen.

Obviously the eating part, especially the eating out part, is the most important area in which to concentrate your efforts.  See Lesson 11, Eating Out the 4:1 Way, for that discussion.  If meals are provided, they usually contain at least some healthy options – eat more of those and less of the others. But there are other things to consider.  For example, depending on the place and type of travel, you may have the opportunity to go shopping and plan your own meals while you are there.  This is particularly true in regards to snacking.  You can almost always control your ability to snack healthily (buy your own as an alternative to less healthy snacks that are provided).

If all else fails, if the only food provided or available is less healthy, then that is when or where you really need to practice your skill of Checking Your Fuel Gauge (Lesson 10).  Eat a smaller portion (just like you used to try to lose weight in the past!), and don’t stress about it too much.  You can usually compensate with healthier foods soon enough.  Portion control (which is less necessary the more 4◊ Foods you eat) can be difficult in this setting because often the flavor of less healthy food (plant waste and animal secretions) is more powerful, and may awaken some old addictions (see Lesson 5).  Simply do your best – if at first you don’t succeed…

If you take a road trip, you are in far more control, especially if you take a cooler. Take your healthy snacks list (Lesson 15) with you to the store before you go, and shop away.  Plan healthy (mostly plant-based) sandwiches.  If you must indulge on less healthy fare, give yourself a little break – simply try keep the indulgence to <20% of your total intake (i.e., follow The 4:1 Rule).

Also:

• Try hard to make time for exercise (remember – only 15 minutes will usually do the trick!).  A hotel gym is the perfect place to do this, but not a prerequisite.  Consider checking out a local exercise facility, many of which may provide a day pass as a free trial.  Grab a colleague and go for a brisk walk.  Do some sit-ups, push-ups, jumping jacks, jump rope (easy to take with you), or MetaboLava exercises in your hotel room.  Use your imagination.

• While you are eating out on trips, with different folks than your usual eating companions, take the opportunity to show a little more discretion and practice healthier eating behaviors.  When you are asked, “Would you like an appetizer?”, respond (repeat after me):  “No, thank you.”  “Would like a dessert?”  “No, thank you” (or “I’ll split one with…”).  “Would you like some more chips?”  “No, thank you.”  We could all develop better discretionary habits.

Quiz for Lesson #16: Taking SLIM TLC on the Road

True or False: 

1. The Holidays are “The most wonderful time of the year.”

2. Holidays are times of joy, happiness and relaxation.

3. It’s impossible to maintain your weight during the holidays (63DFH).

4. It’s a good idea to try to lose weight during the holidays.

Answers: 

1. True.  Of course this depends on a variety of factors, including what you consider to be the holidays and what you might associate with the holidays (for instance, you do not consider that to be true if a loved one died during the holidays and you are reminded of that every year).  Most people in America consider the “holidays” to be a period sometime around the Halloween (October 31st) through New Year’s Day (January 1st) time, usually including Thanksgiving and/or Christmas.  However, most everyone has special days that could qualify as holidays throughout the year, including birthdays, anniversaries, and other occasions for celebrations.  No matter the special occasion, anticipate each with excitement!

2. Joy, true.  Happiness, not always.  Relaxation – NOT!

3. False.  The “63DFH” are the 63 Days From Heck when it comes to weight management, the period from Halloween through New Year’s Day.  If I asked you what the average weight gain was during the holidays, how would you respond?  Most people think it’s around 5 pounds.  However, it’s actually closer to one pound!¹  Nonetheless, some studies suggest that those who are overweight actually gain closer to five pounds!²  The unfortunate part is that most weight that is gained during the holidays never gets lost, and it accounts for the majority of all weight gain that occurs in America from year to year!  That’s why it is so crucial to address this issue – if we could avoid the usual weight gain during the holidays, we would almost stop America’s weight gain!  Doing so takes preparation and forethought – discussed below.

4. Sure – why not?!  It might strengthen your resolve not to allow the holidays to wreak so much havoc along your waist line – with the hopeful end result at least of not gaining any weight.

General Principles of Holiday Weight Management

It is important to enter the holiday season (and any other holiday or special occasion) with some goals, and be determined not to be defeated!  Remember to do your best to follow SLIM TLC’s “Free Food? Whatever!” eating strategy, and try not to fall off The SLIM TLC Map, i.e., continue to track your progress and habits, and do your very best to follow The 4:1 Rule.  I definitely do not recommend starving yourself or being unrealistic in your expectations; however, you cannot simply throw caution to the wind, either.  The best thing to do is to fill up with healthy (4◊) foods before going to events where you fear those things won’t be available.  Then it will be much easier to avoid eating damaging portions of any less healthy (“Whatever”) options available.  Either way, always remember to Check Your Fuel Gauge (Lesson 10), and keep a healthy beverage on hand at all times. 

The smartest strategy or scenario is to have some role in preparing holiday foods.  If you are in charge, be a brave pioneer by bucking the usual tradition of having mostly less-healthy fair.  There are plenty of ways to prepare tasty treats without all the processed and animal-based foods.  If you do not know how to do so, do some homework (including an internet search), and with practice it will become easier and easier.  If you are in charge of the activities, plan ACTIVE-ities as much as you can – at least some of the time.  Put a little forethought into how you are going to survive (from a snacking standpoint) specific activities like football games and movies.  Provide yourself with healthy options (see Lesson 15, Surviving the Snack Attack)!

One example of starting a healthy revolution:  Instead of joining the crowd by handing out loads of sugary snacks at Halloween, buy something healthier, or at least hard candy that takes longer to eat.  One great idea is to slow kids down a little bit (so they will get less candy) and liven up the Halloween scene by providing a carnival-type game they have to play before they can get some candy.  The kids will have more fun and be healthier, and parents will appreciate you (they better).  Be creative.

Holiday Stress

There are many potential causes of holiday stress, including:

• Dysfunctional families

• Sad memories/missing loved ones

• Financial difficulties

• Great expectations from guests/family

• Unmet expectations for yourself

• Scheduling too much/taking on too many responsibilities for parties/gifts

Remember to employ the strategies found in Lesson 14, It’s Emotional!  Include planning ahead financially, committing that you will be patient with yourself and others, employing relaxation techniques like deep breathing and warm bubble baths with music, getting plenty of sleep/rest, and allowing or assigning others to take some responsibility.  Do not forget to schedule exercise – a great stress reliever and Another Magical Pill (Lesson 4)!

In the end, if you do splurge too much, live the Law of Compensation (Lesson 10) and recommit yourself to following a healthy diet (The 4:1 Rule), and you will soon be back on the road to success!  Don’t let discouragement beat you!  It will take practice to be good at navigating the holidays, so if at first you don’t succeed…

• ¹Holiday Weight Gain Slight, but May Last a Lifetime, NIDDK, March 22, 2000.  Accessed May 11, 2024 at www.nichd.nih.gov/newsroom/releases/holidayweightgain

• ²Roberts SB, Mayer J: Holiday weight gain:  fact or fiction? Nutr Rev. 2000 Dec;58(12):378-9. Accessed May 11, 2024 at www.ncbi.nlm.nih.gov/pubmed/11206847

Quiz for Lesson #17: Navigating the Holidays

Scientists and doctors have long known that there was a common root cause of most chronic diseases, from which the grand majority of us die – inflammation.  The more inflammation you have in your body, the more disease you’ll have.  This inflammation causes oxidative stress on our cells and DNA, producing “free radicals,” which are unstable molecules that wreak havoc – causing aging, making cholesterol stick on the inside of our coronary arteries, interfering with anti-cancer genes, etc.  Our body tries to keep up, repairing this damage.  But the more inflammation there is, the less likely our bodies will keep up.

What causes this inflammation?  There are a multitude of causes,¹ many of which are relatively recent phenomena and/or man-made:

1. Plant waste (see Lesson 5)

2. Animal secretions (see Lesson 5)

3. Excess fat cells

4. Inactivity

5. Smoking

6. Overeating

7. Stress/depression/anxiety

8. Processed meats

9. Air pollution

10. Sleep deprivation

11. High blood pressure

12. Diabetes

13. Radiation

14. Family history

And there are others.  The more of these inflammatory factors you have, the more disease you’ll have, and the earlier you’ll die.  The sad part is that each of these things feed off of each other, causing more and more inflammation – it’s a deadly cycle.

Did you know that a significant number of heart attacks occur in people with normal or only mildly elevated cholesterol?  That’s because it’s not all about cholesterol (numbers)!  It’s about the factors that make the cholesterol stick, i.e., the above inflammatory factors.  In fact, you could have high cholesterol all your life and never develop heart disease.  On the flipside, you could have normal cholesterol, and still die of a heart attack if enough of the above inflammatory factors apply to you.

If you believe the results of The China Study² (summarized in the documentary Forks over Knives), animal-based protein is also a previously unappreciated cause of inflammation and contributor to many diseases, including:

1. Many cancers

2. Heart disease

3. Stroke

4. Diabetes

5. Autoimmune diseases

6. Osteoporosis

7. Kidney stones

8. High blood pressure

9. Diverticulitis

10. Cataracts and macular degeneration

11. Dementia (memory loss)

12. Early death

Many criticize the methods or findings of The China Study (and probably more that criticize the critics).  Note that as a realistic scientist, even the principal author, Dr. Campbell, states that the study’s findings do not provide absolute proof that animal-based protein contributes so much to disease.  I personally wish that it better delineated how obesity, decreased activity level, poor sleep quality, and stress (so common in industrialized areas) also contributed to disease.  That all being said, the findings are very hard to dismiss.  In fact, you may consider reading the book (or at least watch Forks over Knives).  Then you may draw your own conclusions.  

This doesn’t mean that you can never consume any animal products ever again.  The amount of animal-based protein we consume must simply be overpowered by a much larger dose (>4:1 ratio) of the sheer anti-inflammatory, antioxidant, vitamin- and phytonutrient-packed power of healthily-prepared (“whole”) plants and fatty seafood.  If not, we are likely to be at a much greater risk of succumbing to many of the above diseases.

Yes, in the vernacular of Dr. Seuss³, if you follow The 4:1 Rule, “Oh, the Diseases You’ll Prevent!”

• ¹Egger G. In Search of a Germ Theory Equivalent for Chronic Disease. Prev Chronic Dis 2012;9:110301, accessed February 24, 2019 at www.cdc.gov/pcd/issues/2012/11_0301.htm

• ²Based on a variety of powerful, well-designed studies, culminating in The China Study (T. Colin Campbell, Ph.D.) – also see Eat to Live (Joel Fuhrman, MD).

• ³Dr. Seuss, Oh, the Places You’ll Go, Random House, 1990

Quiz for Lesson #18: Oh, the Diseases You’ll Prevent!

You may know that there is strong evidence that a lack of sleep leads to weight problems. As such, especially because insomnia is so very common, I wanted to give you my personal take on it. I will try to do so without writing a whole book, which has already been done many times (try searching for one that meets your needs).

Why does insomnia increase your chance of obesity? We may not understand all the reasons, but undoubtedly it is primarily because 1) a good night’s rest relieves stress (so you don’t stress-eat as much), 2) it makes one too tired to exercise, and 3) while one is asleep, one cannot engage in destructive nighttime eating.

Insomnia is more common in women and the older we get, but it is more of a symptom than a disease. It can be caused by excessive use of caffeine, alcohol, nicotine, appetite suppressants, sedatives, and narcotics. It can also be caused by steroid use, consuming too much food or drink too close to bedtime, and medical conditions like sleep apnea, acid reflux, restless legs syndrome, menopause, anxiety, depression, chronic pain, breathing problems, and situational stress.  The most important thing you can do to get a good night’s rest is to identify and then treat the underlying cause if there is one.

In turn, insomnia can cause stress (and stress-eating), fatigue, dizziness, irritability, poor work function, mental sluggishness, illness, and even early death. The resultant sleepiness contributes to an unacceptable number of motor vehicle accidents and resultant deaths.¹ I can tell you that the days I am well rested I am happier, less stressed, and more relaxed, in addition to being a better dad, husband, and physician.

So how do you treat insomnia? Well, as is the case with weight loss, stressing about it is counterproductive. Chill. The first thing that it is crucial to do is develop what are called good “sleep hygiene” methods, as follows. Try to approach the troubleshooting process methodically, and do whatever works best for you.

Sleep Hygiene Methods

1. Establish a relaxing nighttime routine, just as you would for an infant who is struggling. Try taking a hot bubble bath while reading a good book and listening to relaxing music.

2. Make your environment more conducive to sleep by setting the thermostat at a comfortable temperature and reducing light and noises (and when you wake up in the middle of the night, NEVER look at the clock).

3. Try to go to bed and wake up at the same time each day, and try not to sleep longer than is needed (7-8 hours).

4. Avoid naps, especially longer than 15-20 minutes, so that you are more tired at night.

5. Exercise regularly (Lesson 4). Most sources say not to exercise too vigorously too close to bedtime, but you may find, as I have, that exercising a little right before bedtime might actually contribute to a good night’s rest.

6. Use your bed only for sleep and intimacy.

7. Listen to relaxing music or a CD or sound machine that has a variety of relaxing sounds, music, or “white noise” (which can also be accomplished by a loud fan). You may find it valuable to read or listen to something that isn’t overly exciting; for many, scriptures meet that criterion.

8. Try to work on reducing your stress through stress reduction/relaxation techniques (Lesson 14).

9. Prior to going to bed, try stretching various muscle groups, especially your calves if you get nighttime cramps.

10. Since insomnia is mostly a mind game, try some of the mental and relaxation exercises below, starting with my EaZzs method.

My EaZzs Method to Help You Fall Asleep

1. Trying to mimic how you think you might breathe while you are sleeping, breathe in slowly to the count of five (5), while slowly spelling the word “TRUST.” During this time, try to release all your worries into the “ether” by trusting that all will be well (trust in God, if you believe in Him), that no matter what happens, the sources of your worries will somehow work themselves out – essentially surrendering the outcome.

2. Breathe out slowly to the count of five (5), while slowly spelling the word “RELAX.” While doing that, try to relax every muscle in your body, including your brain (the main “muscle” that you’re trying to relax), melting into the bed.

Repeat, sometimes over and over for several minutes, until you fall asleep.

Tip: When counting while breathing in and out, if you can feel your heart beat, try to count a little slower than your heart beat.

The Military Sleep Method

1. Start by relaxing your entire face, including your foreheads, eyelids, jaw, and tongue.

2. Drop your shoulders and then your hands, letting them fall to either side of your body.

3. Inhale and exhale to relax your chest.

4. Then, progressively relax your legs, starting with your thighs and then your calves, ankles, and feet.

5. Clear your mind for ten seconds. You might visualize a relaxing scene, like watching the rolling waves at a beach, being in a dark room, or swinging in a hammock looking at clouds in the sky. When thoughts come up, don’t get frustrated; just let them come and go. If visualization doesn’t come easy, try repeating “don’t think” to yourself over and over.

6. Once you have relaxed your body and cleared your mind, you should be able to fall asleep.

Other Mental/Relaxation Exercises

1. If you are lying in bed and your mind is going 100 miles per hour, try to “erase and replace” your racing thoughts with a song or pleasant memory. Try thinking of a few good things that happened that day, and why they happened. This can be a healthy mental exercise in a variety of ways. If you have an idea that you cannot get out of your head, let it go by writing it down, and then think of something more relaxing.

2. Try this variant of the “Counting sheep” or “Count backwards from 100” trick, neither of which I have found very effective, because I can do either “in my sleep” (while my mind still races, thinking about other things). My variation is to count backwards from 100, but go “two steps down and one step up,” i.e., “100, 99, 98; 99, 98, 97; 98, 97, 96; 97, 96, 95,” etc. That may help to distract your busy mind better.

3. Tell yourself a story with you in it (one that you make up is best). 

4. Pray (not out loud, which is a technique I employ to help me focus and stay awake while praying)! I cannot disagree that kneeling by the side of your bed in humility should be your primary method of prayer. However, I doubt you could convince me that also praying while lying in bed, while trying to fall asleep, will distance you from God. Instead, if done with the right state of mind, prayer should bring you peace of mind, and distract you from the mind race, allowing you to fall asleep easier.

5. Stare at the back of your eyelids and try to determine what color they are.

   Any other mind game may help.

If you have not fallen asleep for more than 30 minutes, get up and do something relaxing until you feel sleepy.

If you do not fall asleep quickly, don’t stress about it – enjoy the peace and quiet, and realize you are getting some benefit by relaxing and resting your eyes and body. Although sleep is important, if you sleep poorly one night, don’t stress about it the next day – simply go about your usual activities and you will likely sleep better the next night (and do your best NOT to take a long nap during the day!).

Cognitive Behavioral Therapy for Insomnia (CBT-I) and Sleep Restriction Therapy

More and more evidence is mounting that cognitive-behavioral therapy for insomnia (CBT-I) by an experienced mental health professional is a very effective treatment for chronic insomnia. Do an Internet search for “CBT-I provider near me,” and if fortunate you’ll find a provider certified in CBT-I (the only one of which I know my area is Carrie Coplen, MS, NCC, LPC-Associate). Consider looking for a self-help book on the subject. It isn’t the “quick fix” like a pill might be, but it should be far safer, valuable, and lasting.

A rather daunting-sounding treatment is something called “sleep restriction therapy” (thoughts of Hitler may come to mind). If done right, however, it can be a very effective treatment for chronic insomnia. If you are a chronic insomniac, my guess is that you’d give anything for an average of 6.5-7 hours of quality sleep per night – so you may be willing to pay the price (of course being careful that, during the process, you are not endangering yourself or others). There are many ways to do it, but here is the general gist of what I tell my patients:

1. Estimate the average amount of sleep you get per night. Come up with a specific number, not a range (which can be difficult to do).

2. Pick a time to go to bed, the same time every night, and set your alarm clock to wake up that many hours later – and you must not lay your head anywhere (!) to sleep until bedtime the following night. For example, if you decide that you sleep an average of four hours per night, and you go to bed at 11:00 p.m., set your alarm to get up at 3:00 a.m., and stay up until 11:00 p.m. that next night.

3. Do that every night until you have slept for at least 80% of the time you are in bed (80% “sleep efficiency”) for three nights in a row. Then, and only then, can you give yourself another 15-30 minutes by setting your alarm clock for 3:15 or 3:30 a.m. Repeat the process, adding 15-30 minutes after three nights of 80+% sleep efficiency, until you are able to achieve 6.5-7 hours of quality sleep.

It may be best to consult your personal physician before trying sleep restriction therapy, but if you do, please let me know about the experience you have, whether good or bad.

Medicines to Help you Sleep

Ideally, try to get a good night’s rest through the above techniques, without having to rely on a pill. However, if all else fails, you may have to take medicine, which is generally safe (although that is arguable according to one study), especially if only taken short-term. Everyone responds differently to different medicines – you have to find one that works for you, and make sure you research any options thoroughly. Many have side effects, and may leave you feeling “off” the next day. The goal is to find one, at the proper dose, that gets you the rest you need and doesn’t leave you feeling overly hung over the next morning (“minimum effective, tolerated dose”).

My first recommendation for the occasional insomniac is non-addicting, generic medicines, starting with over-the-counter diphenhydramine (e.g., Benadryl). You can kill two birds with one stone if you have allergies. It is also found in Tylenol PM (good if you also have pain) and other combination medicines. It should only be used short-term or on an occasional basis, as over time it can cause a counterproductive decrease in sleep quality if used regularly. Melatonin may help in mild cases, but is more of a sleep regulator than a sleep agent. Non-addicting, generic prescription options include low-dose sedating antidepressants such as trazodone and amitriptyline, or cyclobenzaprine if you have muscle spasms. 

No matter what medicine you take, make sure you are aware of all potential side effects. For instance, trazodone, although quite safe (and a good place to start because it’s cheap, titratable, and has a low side effect profile), may cause (have a rare side effect of) priapism (i.e., a prolonged erection – not a good thing). I start patients at 50 mg/night, instructing them to adjust up or down (by breaking the pill in half) as needed (you can take up to 300 mg/night, but the higher you go, the higher chance of drying side effects, like dry mouth, nasal congestion, and constipation, and daytime sedation). If amitriptyline is chosen, I start patients at 10 mg/night, increasing in 10 mg increments as needed (some may need up to 100 mg or more, but the like trazodone, the higher the dose, the higher the likelihood of drying side effects and daytime sedation).

Habit-forming medicines for the treatment of chronic insomnia should be avoided. This includes benzodiazepines such as alprazolam (Xanax) or lorazepam (Ativan). Like alcohol (they work on the same receptor), they initially help you fall asleep, but if taken regularly they eventually interfere with sleep quality. Newer non-benzodiazepine sedatives such as zolpidem (Ambien), zaleplon (Sonata), and eszopiclone (Lunesta) are approved for longer use, and are less problematic or addicting, but can still be habit-forming (primarily zolpidem). Therefore, it is always best to try not to take them long-term (although for some it is required and safe). If all else has failed for the treatment of chronic insomnia, I prefer eszopiclone, but a common side effect is a bad taste in your mouth (to which most will adapt over time). However, I strongly recommend that periodically you try to wean down or off, or try to fall asleep once in a while (when deemed safest/wisest) without medicine (or just trying a half tablet), employing the sleep hygiene or mental/relaxation exercises above.

If you cannot find the solution to your chronic insomnia, I strongly recommend considering CBT-I or sleep restriction, as discussed above.

A great “Guide to Healthy Sleep” can be downloaded for free from the National Heart Lung and Blood Institute (NHLBI), at www.nhlbi.nih.gov/health/public/sleep/healthy_sleep.htm.

• ¹Laugsand LE et al: Insomnia Symptoms and Risk for Unintentional Fatal Injuries—The HUNT Study. SLEEP, 2014 Nov 1; 37(11): 1777–1786, accessed February 24, 2019 at www.ncbi.nlm.nih.gov/pmc/articles/PMC4196061/.

Quiz for Lession #19: Get Your Vitamin Zzzzz

I want to thank all the restaurants and other food producers that are making concerted efforts to create healthier options. That being said, we still have a long, long way to go.  Creating menu and food items that follow The 4:1 Rule can help you become an even bigger part of the solution.  As I said in Lesson 11, I will promote any restaurant or food manufacturer that makes a concerted effort to list the number of “Whatever” calories (“WCal©”) contained in their meals or products.

Part of the problem is that there is so much misinformation out there regarding what is actually “healthy” – hopefully we (e.g., SLIM TLC) are burying that hatchet.  Another big part is that making healthier foods takes more effort (according to conventional wisdom, which I would challenge).  However, if we, the market, speak with our wallets, things will change a lot more quickly.

Hidden calories could easily be blamed for a large percentage of extra fat cells in existence.  They are the calories that you wish weren’t there – usually it is because you think that what you are eating is healthier or less calorie-laden than it actually is.  What is responsible for this is plant waste and animal secretions (see Lesson 5). Even when you are good at looking at the calorie content in the foods you eat, you must look at it with a huge grain of salt, and know that labels and other reports likely list the lowest estimate, or not that of the full meal you eat (e.g., leaving out the nutritional information for toppings), obviously for marketing purposes.  Hopefully you already know that the listed information on labels usually represents a single serving, which is usually disappointingly small.   

Eating out is probably where this occurs the most (although it also happens at home).  Even when caloric content is posted, it is usually not the “whole truth.”  It is likely the “bare bones” version of the item – you must be very careful to look at the asterisks and small print, and be conscious about what you need to add to the picture. 

For example, suppose you decide to order something called a “Tabouli Orzo Salad” (brace yourself – I’m throwing it under the bus).  It’s a salad – something that is supposed to be healthy and will move you toward your weight loss goals, right?  Not so fast.  When you look at the nutritional information you may find that it contains 460 calories, 25 g of fat (accounting for almost half of the total calories), and 45 g of carbohydrates (the orzo in it is made from white flour – it only looks like rice).  

Most people will think, “460 calories for lunch – not bad!”  Then the games begin…  “Since I’m being good, I think I’ll go ahead and order a bowl of tomato bisque soup, or a soda, or a dessert!”  Hold your horses!  That bowl of tomato bisque soup has 16 g of fat, accounting for 50% of its total calories!  After discovering that, you also notice the small print next to the Tabouli Orzo Salad and realize that those 460 calories don’t even include the dressing or the pita that comes with the salad!  Those things add a few hundred calories to your meal.  The nutritional information is provided for 2 tbsp of dressing, which is all oil, but there’s no telling how much dressing is used!  Before you know it, you’re passing the 1000 calorie mark, for a “healthy” lunch!  “But at least it’s olive oil!” you rationalize.  Don’t fall into that trap.  Remember, oil is oil is oil, and is a plant waste (see Lesson 5). 

Just remember that most restaurants that seem or claim to be healthy are not truly healthy, and may not actually move you towards your weight loss goals.   

Cooking with oil, no matter what type, flavoring with fatty or sweet toppings, or topping with cheese or other sauces can add many, many unexpected (and unhealthy) calories to your meal, completely ruining a perfectly good plant (see Lesson 6, Committing Planticide).  All these things will sabotage your efforts. 

The above discussion doesn’t even include other ways that calories sneak past your lips.  Nibbling (e.g., French fries) off of others’ plates, or even sneaking a few sips of soda can add a quick 50 or more calories.  Similarly, finishing off someone else’s hamburger or dessert can add a few hundred calories to your daily intake.  Remember that for every 10 calories extra you eat on average each day you are adding more than a pound to your frame each year (10 x 365 days = 3650 calories).  100 calories extra per day = 10 pounds per year.  The good news is that the more you can eat healthily-prepared plant- and fatty seafood-based foods, the less you need to worry about counting calories.  Establishing a “Whatever Calorie Budget” and following SLIM TLC’s “Free Food? Whatever!” eating strategy will reduce the temptation to indulge.

The bottom line, so that the calories don’t end up on your bottom’s line, is:  Caveat emptor (buyer or consumer beware)!

Quiz for Lesson #20: Hidden Calories

This brief lesson originated with KidTLC, but the concept is so effective that I added it to TLC University.

Sometimes some of the best lessons in life are learned when you add a good dose of perspective.  Considering the challenges through which others pass is a perfect example.  The perspective I’d like to consider with you, not surprisingly, deals with eating right, along with overcoming addictions that prevent us from doing so.

I want you to imagine what it would be like to be stranded on a desert island.  I don’t care how you got there – plane crash, shipwreck, Jonah’s whale, or massive earthquake followed by continental drift.  On that desert isle you have nothing to eat or drink, since nowhere can you find any type of food or fresh water.  There is no shade on this island.  After a couple of days in the sweltering sun, imagine how you’d feel if someone dropped a cooler out of an airplane with lukewarm bottles of water.  How would they taste?  What if the bottles were cold?  Then how grateful would you be?  Would you complain that the water wasn’t flavored?

Now let’s say you go another couple of days without any food.  Then you find a hidden compartment in the cooler containing a large loaf of whole grain bread.  Would you not enjoy every bite?  Would you complain that it wasn’t white bread, or that you had to eat it plain?  Would it not taste incredible all by itself?

You know where this is going.  Your generous benefactor now provides you with a fresh cucumber or carrot (substitute whatever vegetable you want here, including ones you may not like as much), without ranch dressing.  Do you throw it into the ocean and exclaim that you “can’t eat this garbage?”  In other words, do you bite the hand that feeds you because the food isn’t prepared the way you want?  What about a bowl of fruit – such as watermelon, strawberries, oranges, or bananas?  What about a serving of seasoned black beans or new potatoes?  What about a handful of mixed nuts?  Again, you may substitute any 4◊ Food you desire.  Wouldn’t you be the happiest person ever if you discovered a basket full of these things?

Unless presented with this scenario, some feel they would practically die if they couldn’t have their usual bacon and eggs, biscuits and gravy, or bowl of frosted flakes for breakfast, but instead had to eat a bowl of oatmeal mixed with raisins, walnuts, and a little cinnamon, all sweetened with date paste.  I’ve had multiple patients look me straight in the eye and tell me that they simply would not be able to live on a healthy, mostly plant- and fatty seafood-based diet.  I appreciate their honesty, and I know it is difficult, but I have to wonder – is it because they cannot or will not?  Maybe they are waiting for a little more incentive?

You know the problem – it is that we live in a country where there is lots of food available, especially food that is not good for us.  Our taste buds have been hijacked (or spoiled) because of the rich, fatty, fried, and sugary foods all around us, available in copious amounts, much of which is easy to afford/obtain/eat.  And it’s killing us.  What we need to try hard to do is taste and appreciate the flavor of foods that are healthier for us.  We have become accustomed to eating a certain way, and it’s really hard to change.  We must discover the flavor of nature.  If we were on a desert island, we would have no complaints about the flavor of healthier foods, even without the butter, gravy, or dressing!  We might even learn how to cook without oil! Sorry to beat a dead horse, but the point must be driven home: If you follow SLIM TLC’s “Free Food? Whatever!” eating strategy, your taste buds will change more quickly than you ever thought possible.

I’ll finish up by likening whole plant- and fatty seafood-based food to the “high-octane fuel” with which one might fill one’s gas tank.  The more you eat, the more your engine will run smoothly, the better your car will perform, and the longer it will last.  Low-octane fuel, of course, includes the “Whatever” portion of The 4:1 Rule – things that have less nutritional value per calorie:  Fried, fatty, and sugary food, in addition to meats (including chicken!) and dairy foods (including milk and yogurt, especially cheese!).  Again, it does not mean you can never eat low- or lower-octane fuels – you must simply overwhelm them with a much larger amount of high-octane fuels!  If you must consume them, it is best to use the low-octane fuels as small sides or to flavor foods.

Quiz for Lesson #21: The Desert Isle

A lot of nutritional and other information can be found on product labels; however, there are several limitations.  For example, there is some, but not enough, information to help you distinguish between good and bad (“Whatever”) types of carbohydrates, fats, and protein.

In addition, the listing of vitamins present can either give you a false sense of nutritional value and ignore the fact that there are likely hundreds, if not thousands, of other ignored or yet undiscovered micronutrients contained in whole plant foods – or, ignore the inflammatory nature of “Whatever” foods.  The reality (and good news) is that the more you move towards a diet of predominantly healthily-prepared plant- and fatty seafood-based foods, the less you have to worry about labels.

Despite all the above, getting to know labels can still help you develop healthier eating habits.  However, when it comes to weight management, probably the most common mistake people make when they evaluate labels is looking only at the total calories, without looking at the number of servings in the container, or the serving size.  It is important to recognize that serving sizes are rarely as large as people prefer.

Here is a side-by-side comparison of the old with the new (2016) Nutrition Facts label:

Changes with the New Label include:

• The Serving Size font is larger and bolded

• The Calories font is larger and bolded

• Added sugars are listed

• Amounts of nutrients included

• New footnote (one day it will read something like “With rare exception, you can eat as many 4◊ calories as you desire, and only need to consider the ‘Whatever’ calories, trying to stay under you ‘Whatever Calorie Budget,’ as prescribed at SLIM TLC.” A man can dream, can’t he?)

Manufacturers with $10 million or more in annual sales were required to switch to the new label by January 1, 2020; manufacturers with less than $10 million in annual food sales had until January 1, 2021 to comply. 

Calories per Gram and Estimating “Whatever” Calories (WCal©)

Remember that there are 9 calories per gram of fat and 4 calories per gram of both carbohydrates and protein.

To estimate the “Whatever” Calorie (WCal©) content in what you are consuming, you will only need to consider the Total Fat, Added Sugars, and Protein on labels. However, start by determining the obvious: Does the product appear to contain any 4◊ Foods (“whole”/non-processed plants or fatty seafood), either by appearance or the fiber content (“whole” or non-processed plants have fiber) listed on the label, if it has one? If not, then all the calories are almost guaranteed to be WCal©. If so, but the grand majority of the item is “Whatever” (e.g., a cheeseburger with bacon on white bread, topped with lettuce, tomatoes, and onion; or a supreme pizza with a white flour crust and a few veggies on top), then you can almost guarantee that >95% of the calories are WCal©, since “Whatever” foods have such high caloric density in general. If you even think it’s worth it, you’ll just have to estimate how many calories are in the whole plants and subtract those from the total.

The easiest WCal© to count are the calories provided by “Added Sugars.” Just multiply the grams of Added Sugars by 4 to get the amount of calories provided by Added Sugar. In the above label there are 10 g of Added Sugar, so Added Sugar accounts for 40 of the total 230 calories.

The fat and protein calories provided by oil or animal sources are only hard to calculate if the food also contains fat- or protein-containing 4◊ Foods (e.g., fatty seafood, nuts, seeds, avocados, edamame, coconut) – in which case you can’t know what percentage of the total fat grams comes from animals or plants. Since store products are rarely as complicated as restaurant meals, most things are fairly straightforward. But many are not, like mixtures of things (e.g., trail mix). Be aware that even some low-fat vegetables have about a gram of fat per serving, like corn. This comes into play when eating corn chips and popcorn. Attribute one less gram of fat to the oil found in corn chips and popcorn (in other words, if the popcorn or corn chips have 6 grams of fat, only 5 grams come from oil, so in this particular illustration, the “Whatever” calories from oil = 45).

Now let’s go over some of the specific nutritional information listed.

Total Fat

Again, this does not tell you the source (good = from whole plants; bad = from animals or oil). Remember that one gram of fat provides you with nine calories, no matter the source.

Saturated Fats 

Saturated fats are those packed full of hydrogen ions (attached to carbon atoms), which keeps them solid at room temperature (this is not good for you). Examples include animal fats (found in dairy products, meat, etc.), coconut oil, cocoa butter

Trans Fats 

• Unsaturated fatty acids that have extra hydrogen ions added to them artificially by heating vegetable oil in the presence of metal catalysts.

• The straighter molecular configuration gives them a longer shelf life (this is bad).

• Used to make shortening and margarine

Cholesterol

Cholesterol is only found in animal products. However, “good” cholesterol (HDL, or high-density lipoprotein), is increased by eating the good fats found in plants and fatty seafood. “Bad” cholesterol (LDL, or low-density lipoprotein) is found in animal products, including chicken (which has 85% as much cholesterol as red meat), but especially red meat and cheese.

Saturated and trans-fats increase your risk of developing heart disease, as does non-HDL (LDL isn’t the only “bad”) cholesterol.  It would sure be nice if the labels distinguished between types of cholesterol, but at least the total is a good start.  It is important that all three of these things (saturated fat, trans-fat, and cholesterol) be included on product labels because of their contribution to heart disease.  If the right inflammatory processes are present (consumption of plant waste, obesity, diabetes, hypertension, high animal-protein consumption, stress, sleep deprivation, smoking, inactivity, radiation, autoimmune disease, family history, etc.), that cholesterol and fat will build up or deposit on the inside of your coronary arteries (the ones that surround your heart and provide blood flow and oxygen to the heart muscle walls), and slowly grow.  Over time the “plaques” start to become calcified, causing hardening of the arteries, AKA “atherosclerosis” – the #1 cause of death in America (not in countries that consume a primarily plant- and fatty seafood-based diet).  Cardiovascular disease, including stroke, kills more people than the next six causes of death combined, including cancer!

I would not pay much attention to the “% Daily Value” column on the right side of the product label in reference to fat and cholesterol, because 1) they are too generous and reflect a diet that has far too many animal-based products and processed foods, and 2) we want you to chill and not obsess so much about details.  I do, however, want people to pay attention to the amount of grams of total fat, saturated fat, and trans-fats, consuming as few of the bad fats as possible.  Labels do not distinguish enough between the good and bad fats.  Simply try to reduce animal-based and processed foods to <20% of your intake (The 4:1 Rule) and reduce as much as you can the amount of oil, butter, and margarine you use to cook (including the “good” oils!).

Sodium 

I learned in medical school that a significant portion of the population has adequate mechanisms in place (well-functioning kidneys) to handle a fair amount of salt, and although a lot has changed since then, the continuing medical education I read seems to suggest the same.  The problem is that we don’t have a great way of predicting who can and who cannot tolerate a lot of salt.  As such, it is wise to do your best to avoid excessive salt, and follow the guidelines on product labels (see the “% daily value” column on the right – I agree with looking at that) – especially if you have found that you are sensitive to salt (blood pressure goes up, fluid collects in your lower legs, etc.) or are at high risk (personal or strong family history of high blood pressure, heart disease, diabetes, etc.). It is also my very strong opinion that what you put the salt on is far more important than whether or not you use salt (in other words, it’s the “fry” in French fry that hurts you, not the salt on it).

Carbohydrates  

Carbohydrates (“carbs” or “CHOs”) are sugar-based molecules, and include complex and simple carbs.  Complex carbs are what are found in whole plants, and are good for you, including the starches and fiber contained therein. Fiber has many health benefits, such as decreasing your risk of heart disease, regulating your bowel movements, and decreasing your risk of colon cancer.  Fiber can be soluble or insoluble, and both are good for you; as such I don’t want you to stress about whether a certain type of fiber is soluble or not.  Again, good sources of fiber include all kinds of plants. When considering things with fiber (especially “whole grains”), try to make sure there are at least two, but preferably more, grams of fiber per serving.

Simple carbs consist of the simple sugars and flour, and are inflammatory, i.e., disease-causing. Sources high in simple carbs include sugared soda, juice, white bread, chips, and candy.  Fortunately, in the new Nutrition Facts label, the amount of added sugars is listed.

FYI, it is not a good idea to go “low-carb” unless it is just “low-simple carb.”  As mentioned above, complex carbs are good for you, including potatoes, corn, and beans (as long as they are prepared healthily).  General low-carb diets promote animal-based food, which is not healthy in excess.  The 4:1 Rule is a “low-simple carb” (and “low-bad fat and protein”) eating plan.

The more you move towards consuming whole plant-based foods, the less you have to worry about simple and complex carbs.  If in doubt, however, look at the ingredient list and see how high up the simple carb (sugar, high-fructose corn syrup, etc.) is listed.  If it is one of the first 3-4 ingredients listed (especially if before the healthy ingredients, if any), you know the food needs to be moderated.

Protein 

Notice that there is no “% Daily Value” next to protein – why?  Because there is not a consensus among experts.  I personally like the fact that they don’t list it, because there is not a lot of evidence we need to stress about it, unless you have certain medical conditions.  If you eat a well-rounded mostly plant-based diet (not even counting fatty seafood), you will get the proper balance of all three macronutrients – protein, carbohydrates and fat (and the right type) that your body needs.  You will also get all the vitamins and minerals you will need, unless you go completely vegan – in which case you will need to get your Vitamins B12 and D via supplements or (plant-based) foods fortified with them.

Great sources of plant protein include legumes (things that come in pods – beans, peas, lentils, peanuts), mushrooms, nuts, seeds, dark greens, avocados, and even potatoes!

Calories 

For a discussion of calories, see Lesson 8, Freaks of Nature.  Most experts familiar with the virtues of a mostly plant-based diet (can I be included in that category?) do not recommend obsessing about caloric content, as the more you can move toward a mostly plant- and fatty seafood-based diet the less you will have to worry about counting calories.

Low-Carb vs. Low-Fat

Which is better, low-carb or low-fat? The debate will continue until people learn (actually, the frustrated side of me says get a clue) that the question is based completely on false premises. Low-carb is not good unless it is low-simple carb (carbs should be complex, i.e., the kind found in plants). Low-fat is not good unless it is low-bad fat (good fats are those found naturally in plants). Similarly, high-protein is not good unless it is high-plant protein. Product labels would be so much simpler and more helpful if they simply listed (preferably in table format) the grams of plant carbs, fats, and protein vs. the grams of “Whatever” carbs, fats, and protein. Work on that for me.

Quiz for Lesson #22: Product Labels

What is the main reason we get hungry if we don’t eat?  Why is it that we “work up an appetite” when we exercise?  What is primarily responsible for regulating our hunger in both scenarios?

Our fat!  Most people don’t think of it as such, but our fat is actually an active endocrine organ, which is defined as “a group of tissues that performs a specific function or group of functions.”¹

So what is the function of the fat organ?  I think the best way to summarize its function is this:  To keep us alive – no different than the function of other organs.  It helps to do so by:

• Storing fuel

• Insulating our bodies

• Protecting vital organs

Most people assume that the only function of fat is to be a dormant storage facility.  There could be nothing further from the truth.  At least 230 proteins have been identified that are created and/or secreted by adipocytes (fat cells)².  Scientists are very far from being able to understand all the functions and implications of these proteins, but we do know that they interact with other tissues (especially our brain and stomach) to regulate our hunger – and they also affect other metabolic processes.  We also know that many of the substances they produce are inflammatory, so the more fat cells you have (i.e., the more inflammation you have), the more disease-prone you’ll be – as discussed in Lesson 18, Oh, the Diseases You’ll Prevent!

Unfortunately, your fat organ likes to stay there.  It has many self-protective mechanisms, which is the main reason it is hard to lose weight.  There is a constant battle going on between the two of you.  If you try to get rid of it too quickly through the average diet (see Lesson 13, Diet Is a Four-Letter Word), your hunger will go through the roof – and although you may initially lose some weight and win the occasional battle, you will almost inevitably lose the war.  You already know this through personal experience.  You MUST NOT underestimate the power of the FAT FORCE!

Unless you are only making changes that you can maintain for life,…

Your degree of long-term success will be inversely related to the pace at which you lose weight. 

This occurs both because of the fat organ AND because it is hard to change our habits and overcome addictions!  This is why SLIM TLC’s “Free Food? Whatever!” eating strategy, which encourages a diet consisting mostly of whole plants, is such a wonderful tool for winning the battle – because you are not as limited in how much food you can eat. In case you forgot, that is because of two reasons:  1)  The low caloric density of plants, and 2) because the body has to work harder to convert healthily-prepared plant-based food to fat – so you can actually consume more calories of plant-based food (which already has a low caloric density)!

We are looking for that magical intersection between effectiveness and long-term livability, and that’s where SLIM TLC comes in.  It allows a little “give” and is more livable in the real world than more strict approaches.  I do not want to criticize 100% plant-based approaches; I simply want to offer an alternative for those who feel they cannot or will not follow them.

I’ve said it before – we need to run the weight loss race like a seasoned marathon runner instead of a sprinter.  We didn’t say “like a tortoise” (like I proposed in a book I wrote many years ago), but instead like a seasoned marathon runner, who still clips along at an impressive pace!

How Big Is a Pound of Fat? 

We all know that a pound of fat weighs a pound, but that is not my question.  The question is, “How big is a pound of fat?”  In other words, how much space does it take up?  I did a little experiment of my own (through water displacement), using a model pound of fat.  To my surprise, it is around the size of a 12-ounce can of soda pop.  That brings a whole new meaning to the term “Six-pack!”

If you lose 25 pounds, it’s like losing the equivalent size of over a case of soda!  Very impressive.  Even losing a few pounds is an impressive feat, so try never to catch yourself getting on the scales and saying, “I only lost two (or three) pounds – I’m so disappointed (or discouraged)!”

• ¹Biology Online dictionary, accessed February 4, 2019 at www.biology-online.org/dictionary/Organ

• ²Pogodziński D et. al.:  Secretome of Adipose Tissue as the Key to Understanding the Endocrine Function of Adipose Tissue, Int J Mol Sci. 2022 Feb; 23(4): 2309

Quiz for Lesson #23: The Giant Fat Organ

For your final TLC University lesson (please suppress the “Booyahs”), let’s go over the top ten most important things you can do to achieve long-term health and weight loss success.  This is a short but important “lesson,” so please review it more than once.

1. Thou shalt diligently follow SLIM TLC’s “Free Food? Whatever!” eating strategy (Lesson 2), which includes following the 4:1 Rule.

2. Thou shalt follow the SLIM TLC Map (Lesson 3).

3. Thou shalt create My SLIM TLC List of Favorite Healthy (4◊ Food) Snacks (Lesson 15), both to place on your refrigerator and to use as a shopping list – and make (dad-gum) sure those snacks are available wherever and whenever needed.

4. Thou shalt learn to pay more attention to your true hunger level by Checking Your Fuel Gauge (CYFG), and Eat (4:1) when actually hungry (Lesson 10)

5. Thou shalt develop a regular, rational exercise routine, targeting a daily (at least six days/week) regimen of at least 15 minutes (Lesson 4).

6. Thou shalt work to identify, then Slay, Your “EOs” (see the Troubleshooting topic Slay the EOs, Evil Ogres that Engender Obesity at Every Opportunity – intentionally address habits or behaviors that sabotage your efforts).

7. Thou shalt not make any changes to lose weight that you cannot maintain for life (unless you are doing it as a learning process – Lesson 13).

8. Thou shalt get a good night’s rest (Lesson 19).

9. Thou shalt strive to reduce your stress level (Lesson 14) – starting with #5 & #8 above.

10. Thou shalt run the weight loss race like a seasoned marathon runner, not a sprinter (Lesson 13).

Thanks for choosing SLIM TLC and TLC University.  I recommend “attending” as often as is needed.  If you ever find your efforts or resolve slipping, repeating the lessons may be just what the doctor ordered.  Repetition is the key to long-term retention!  I wish you the very best in all your efforts.

Quiz for Lesson #24: The Ten Great SLIM TLC Commandments

When troubleshooting, it is crucial to understand that the intake (eating & drinking) part of the energy equation is where you need to focus the grand majority of your efforts (i.e., following SLIM TLC’s “Free Food? Whatever!” eating strategy). In other words, you are likely eating or drinking too much (mostly eating when not actually hungry, not Checking Your Fuel Gauge enough) and too much of the wrong thing. Also, use the following Troubleshooting Guide as needed.  This will be updated as new recommendations become available.

Over the years, I’ve had hundreds of patients tell me in desperation that they are doing everything right – i.e., exercising a ton and/or eating right, and still not able to lose weight (see Lesson 8, Freaks of Nature: My Metabolism is Frozen). I have learned through troubleshooting with these folks that those words (“I’m doing everything right!”) need to be passed through a filter – the more correct message is “I’m not seeing the results I think I should be seeing based on the efforts I’m making.”  You see, if a person were doing everything right, he or she would be having success.  The question then becomes “Then what do you suggest?”  And the answer is RARELY “eat less and exercise more.”

First, and you have to take my word for it, the role of exercise in weight loss is far more limited than most people realize.  This is because 1) the intake part of the energy equation is the most important part (if you don’t put it in, you don’t have to take it out), and 2) when you exercise you naturally “work up an appetite.”  See TLC University Lesson 4, “Another Magic Pill” to learn more.  Indeed, one’s primary efforts need to be focused on one’s intake.  As I discuss in Lesson 2, following SLIM TLC’s “Free Food? Whatever!” eating strategy is the answer.  It completely eliminates the diet mentality, i.e., needing to try to eat less/control your appetite, count unnecessary calories, or measure portion sizes.  You simply try to eat mainly when you are actually hungry – making sure at least 80% (you may have to go higher) of your intake consists of healthily-prepared plant- and fatty-based based food.  Trying to eat less and control your hunger means you are dieting – and as you know, that only works short-term.  If short-term success is not your goal, then please take this to heart and start doing things differently.

If you are still struggling with your weight, you are likely eating too many “Whatever” foods and not enough healthily-prepared plant- and fatty seafood-based foods (you may need to review Lesson 20, “Hidden Calories“).  In order to be able to have long-term success, you cannot deprive yourself when you are hungry.  In order to be able to eat whenever you are truly hungry, you must eat mostly healthily-prepared plant- and fatty seafood-based foods. In order to be able to eat mostly plant- and fatty seafood-based foods, you have to make them available, in an interesting-enough variety that you will not become bored.  That needs to be your primary focus. When you do so, success will be yours.  And until you do so, you will continue to struggle.

Those who feel they are doing everything right fall into one of three categories: 1) They are consuming more calories than they think they are (“non-perceived overeating” – the volume and/or calorie load of the foods they eat are higher than realized); 2) they do well most of the time but fall off the wagon more than they should (perhaps giving themselves too much leeway in the evenings or on weekends); or 3) they are trying too hard for too short a period of time (the regimen they are following is so excessive that it cannot be maintained long enough to see real results).

As mentioned in Lesson 8, Freaks of Nature: My Metabolism is Frozen, it may be necessary to keep a 2-week lot of everything you eat, weighing yourself before, during, and afterwards, and taking your record to your physician or another knowledgeable health care professional such as a dietitian who is familiar with SLIM TLC principles (not the old way most dietitians and physicians were trained).  It is likely that your approach needs some “tweaking,” or you may simply need to keep doing what you are doing for a longer period of time before you begin to see more measurable success.

Contrary to popular belief, it is impossible to eat so few calories that you cannot lose weight.  Yes, your metabolism may become more efficient (slow down) temporarily if you starve yourself, but that is not a permanent phenomenon.  See Lesson 8, “Freaks of Nature:  My Metabolism Is Frozen and other Urban Legends” for more information.  The reality is that you are always burning calories, and therefore losing weight if you do not consume more than you burn.  Even bears in hibernation are slowly losing weight, and no human’s metabolism slows down that much.

Case in point is what happens to those who undergo bariatric (weight loss) surgery.  This is very similar to a starvation-type diet.  Because of a much smaller stomach capacity, patients are forced to take in fewer calories, and therefore lose weight at a remarkable pace, even without exercise.  If you were to consume as few calories as those who receive bariatric surgery, you would also lose weight at a remarkable pace.  That being said, there is such a thing as not eating enough – but not because it slows your metabolism.  It’s because you are only human – if you go hungry long enough, you will eventually binge, and inevitably on less healthy fare.  You or others you know have likely proven that many times – when will we learn?

Just about everyone who has attempted weight loss has eventually hit a plateau.  It is extremely frustrating to see an initial weight loss, only then to hit a brick wall, as it were, preventing further weight loss.  The “plateau” you hit after an initial weight loss is a direct result of your body settling into the lifestyle changes you have made.

It is imperative to understand that when you hit a plateau, by far the worst thing you can do is dig in your heels and revert back to the diet mentality, i.e., start depriving yourself and/or exercising in an unsustainable fashion.  If you keep trying to win the battle by eating less and less and/or exercising more and more, your body will fight back with increasing intensity, matching every effort you make.  Eventually, you will get discouraged and give up all hope, and you will gain back any weight you have lost, and then some.  You will have lost yet another battle with your body (see Lesson 23, The Giant Fat Organ).

Instead, as usual, following SLIM TLC’s “Free Food? Whatever!” eating strategy is almost always the answer.

Unfortunately, unless you are unbreakable and don’t age, at some point or another you will likely injure yourself to the point that you will not be able to be as active as you would like.  Remember that as long as you control that front end of the energy equation (following SLIM TLC’s “Free Food? Whatever!” eating strategy), you will not have to rely as much on exercise to lose weight; as such, sustaining an injury will not be an adequate excuse to gain weight.

On the other hand, if you are unable to control your eating habits, but instead use exercise as your primary weight loss tool, when you injure yourself, you will gain weight.  That is why it is crucial to learn how to adjust your eating habits accordingly.  Following The 4:1 Rule is key.

Even if you do injure one part of your body, it should not preclude you from exercising the rest of your body.  If you injure your knee, you can still exercise your upper body.  It can definitely be discouraging if you thoroughly enjoy running, and the part you injure prevents you from doing so – but be creative and adjust your activities accordingly, so you can still stay in decent shape and feel good about yourself.

Even those who are wheelchair-bound can find creative ways to be active.  But the more they are able to control their eating habits, the less creative they will have to be.  Searching the Internet can yield many ideas.  Some of the activities recommended in the link at the end of the next section can be a great place to start.

Obesity, as we have already learned, is defined as a BMI >30.  Morbid obesity, which correlates to a BMI >40, deserves special consideration (the term morbid means “associated with disease” – not “disgusting,” as some may mistakenly think).  Those who fall into this category face a particularly difficult dilemma.  There is yet another, more concerning category – something that has been termed “super-obesity,” defined as a BMI >50.  The closer you get to the level of “super-obese,” the harder it is, as you might imagine, even to get around.

It seems that the heavier a person gets, the faster the person gains weight.  I do not know exactly why – it is undoubtedly a combination of many things.  One reason is that the common joint and back problems make it harder to exercise.  Another likely reason for many is that they begin to lose all hope, get increasingly depressed, and stop trying as hard.  Perhaps an increasing burden of fat cells exerts an increasingly greater effect on their hunger level.  Unfortunately, I have even seen a few who gain weight just so they can be eligible for surgery (depending on the insurance company).

Nonetheless, the fact remains that the morbidly obese face the greatest challenge when it comes to trying to reverse the trend, not to mention the longest road ahead of them.  That is why prescription medicines and bariatric surgery are such attractive options for them.  If you fall into this category, my heart goes out to you, as it has for many a morbidly obese patient of mine who has sought my help – in tears, feeling completely hopeless and helpless.  No one who has not walked in your shoes will ever, nor will I ever profess to, be able to understand.

Indeed, I will not criticize anyone who decides to have surgery.  But because of what I know and have seen (the failures), it’s hard for me to get overly thrilled when someone excitedly shares how much weight they have lost afterwards.  Yes, I am happy for them; but that feeling is tempered by what I have good reason to fear will happen in just a few short years.  Nonetheless, I do not mind it at all if they prove me wrong.

Is it impossible to lose a large amount of weight without surgery?  Of course not – many have done it.  But I cannot blame you if you feel that you never could.  All I ask is that you consider seriously taking advantage of all SLIM TLC has to offer, especially following SLIM TLC’s “Free Food? Whatever!” eating strategy. The last thing that you should want to do is go through all that trouble and cost only to gain most of the weight back.

If you do decide to go forward with surgery, following SLIM TLC, including The SLIM TLC Map, will help prevent you from regaining the weight.

The reason most recipients of bariatric surgery regain weight is because they do not make the necessary lifestyle changes – the very changes they insist they will make if they could just get to a more manageable weight.  And these are the very changes that, if they did make them, would allow them to lose weight without having to go through the rigors of surgery (which, I must remind you, should rarely be repeated).

Losing a large amount of weight, and then keeping it off, usually requires some unique motivating factor that is difficult to produce artificially.  Whatever the reason, if you do choose to attempt weight loss again without resorting to surgery, I commend you.  I hope SLIM TLC has mapped out the path you need to take to reach your goal.  In order to avoid the excess skin many have when they lose a lot of weight quickly, make sure you exercise regularly and include toning exercises as you go.

Those who are morbidly obese express concern about the inability to exercise.  Yes, it is more difficult to exercise, but it can still be done, as explained in the next paragraph.  But please do not forget what we discussed above:  Exercise is not an absolute prerequisite to losing weight – if you can control your eating habits, you will have success.  In other words, you cannot blame all your inability to lose weight on a decreased ability to exercise.

Nonetheless, as I explain in no uncertain terms in TLC University Lesson 4, Another Magic Pill, exercising can be of utmost value.  A great resource for helping the morbidly obese find ways to stay active can be found in a publication called “Staying Active at Any Size,” available for download from the website for the NIDDK’s Weight-control Information Network, at http://win.niddk.nih.gov/publications/active.htm.

If you are one of many who insist they never feel full, I empathize completely.  Sometimes, like you, I simply cannot stop eating. However, I have (mostly) learned to stop and “Check My Fuel Gauge,” and it helps me slow down when I realize I’m past the point of being well-satisfied.  Also, one of the nicest things about healthily-prepared plant- and fatty seafood-based foods, especially vegetables, is that you can usually eat all you want without gaining weight.  So, the next thing you need to do whenever you feel you can’t stop eating is to make sure that what you are eating is healthily-prepared vegetables.  The last little trick I employ, if needed, is to go brush and floss my teeth.  Works like a charm, at least for a little while.

The reality is that some people are more successful than others at controlling their urges to splurge.  That is partially due to habit, genetics, stress levels, what tempting foods you have sitting around, and more.  It is key to create an environment of success (have tons of healthy options around – see Lesson 15, “Surviving the Snack Attack,” and significantly reduce – possibly eliminate – the “Whatever” items sitting around), choose mostly healthily-prepared plant-based foods, address stress levels, and perhaps go do something that keeps your hands and mind otherwise occupied.  If your overeating is associated with a specific activity (like TV), it is really helpful to change the habit or do something like a craft or iron or exercise to distract you (how productive is that?!).  You will likely be pleasantly surprised that once you put a little thought and effort into the above strategies, you can effectively address those harmful “need to feed” times.

Something else people confuse with “never feeling full” is “always being hungry.”  The drive to eat or cravings can be so strong for some that they have a hard time stopping eating even though they may be stuffed.  Either way, the above strategies should help you.  Always seeming to focus on food is a learned behavior.  For some reason you, just like so many who struggle with their weight, are always accustomed to focusing on food, or perhaps always trying to fill some void with food.  This learned behavior can be replaced with different, healthier behaviors that you have to relearn. In fact, once you have recognized that you can relearn a different behavior, it will be powerfully refreshing, because the new behavior will be so much more productive and so much less destructive to your waist line.

Relearning behavior, as you might imagine, is not an overnight process.  You already know this if you have ever tried to correct the inappropriate behavior of a child or teenager.  It is akin to the old “You cannot teach an old dog new tricks.”  So be realistic and set your mind to being in it for the long haul.  We are talking about long-engrained habits that have to be altered.  It is a city that may have to be rebuilt stone by stone.

I apologize in advance, but it behooves me to make a couple of points that many would rather have left unsaid: 1) People find time to do what is important to them, and 2) people who struggle with their weight always find time to eat.  Remember that it only takes about 15 minutes per day (on average) to make exercise work for you – especially if you control the intake aspect of the energy equation.

Societies center so many activities around eating, or doing activities that facilitate calorie consumption.  It will take innovation and courage to identify and then change things in a way that encourages less calorie consumption and more activity.  Be creative, and find a way to work exercise into your life.

Here are just a few ideas to find more time to exercise:

1. For those who feel they have to choose between exercising and spending quality time with their children, kill two birds with one stone by doing fun, active things together!  Do it outside and you’ll get some likely much-needed Vitamin D!

2. If you are a T.V. watcher or have to read or study up on something, hop on the treadmill, elliptical machine or “exercycle” while you do so.

3. Take every opportunity to be active, like climbing stairs, walking instead of riding when you can; try going for a brisk walk or doing some brief exercises during a lunch break or other down time.  You know this – now you need to make it happen.

Seeking ideas from others is a great way to add to the list.

Some consider “exercise” to be a double four-letter word, and have a really hard time getting motivated to do any.  The best recommendation I have for you is to plan fun activities that provide the necessary exercise without having to think about it so much.  Some suggestions include:

1. Go dancing.

2. Enroll in or otherwise play a sport or participate in another activity you enjoy.

3. Make it a social event by going on a nightly walk with a friend or many friends.

4. Listen to music or books on “tape” while you walk.

5. Play active games or sports with your kids or others.

6. Swim.

7. Jump on a trampoline.

8. Go roller- or ice-skating.

9. Ride a bicycle or dirt bike.

10. Participate in water sports.

Once you understand the magical effect of exercise on health, energy, weight problems, sleep issues, and stress, you will find a way.  It won’t take long before you look forward to it (more).

And yet, see “I Hurt My Knee” above for a reality check about the biggest contributor to weight problems.

If you smoke, kicking the habit is one of the greatest things you could ever do to improve your health.  If you have already quit, you have accomplished something most grand.  If you are overweight, the next item on your “to do” list, which will also add many healthy years to your life, is to lose weight – and I do not recommend that you start smoking again to facilitate that.

Indeed, many (if not most) who quit smoking turn to food as a substitute for smoking; and therefore they gain weight, sometimes substantially.  The challenge, which is a significant one, is to find something else to turn to besides food.  To help meet this challenge, following SLIM TLC principles is paramount to the troubleshooting process.  Learning to Check Your Fuel Gauge is imperative, and low-calorie options to put in your mouth instead (see Surviving the Snack Attack). Also don’t forget water – and I’m OK with gum in this circumstance.  Keeping yourself productive and keeping your hands busy can help to distract you from the urge to smoke.

If you currently smoke, whether you are overweight or not, I highly recommend four things:

1. Before you begin the quitting process, learn how to Check Your Fuel Gauge.

2. Consider reading The Easy Way by Allen Carr, to help prepare you for quitting cold turkey.  Although not recommended by Mr. Carr and other authorities, you may find it helpful to slowly taper down on the amount of cigarettes you smoke each day, preferably over several weeks to months.

3. Strongly consider a smoking cessation aid like Chantix – if tolerated and taken as directed, I’ve found that to be the most effective treatment available (make sure you discuss possible side effects with your physician).

4. Have a specific plan of action of what you will put in your mouth instead of a cigarette when you get the craving (water, gum, sunflower seeds, your favorite vegetable, nicotine lozenge, etc.).

Begin an exercise program if you do not already have one (start low and build slow) – it will help decrease the anxiety associated with quitting, and increase your overall sense of well-being.

Lots of patients see me because they have recently (over the past several weeks to months) begun to gain weight at a break-neck pace.  This almost always occurs because of one of four reasons:

1. You have recently lost several pounds, and your body is now fighting back by making your hunger go through the roof.

2. You are under a significant amount of stress (this may not be recognized until you put some thought into it).

3. You just started a vigorous exercise routine and are working up an equally-vigorous appetite (no, you can’t blame the weight gain on muscle).

4. You stopped exercising (and also became more relaxed in your eating habits – this often goes back to #2).

If none of these apply, your first order of business is to visit your doctor.  He or she will want to take a detailed history of your eating and exercise habits, any medicines you are taking, your emotional status, stress level, and family history.  In addition, he or she will likely do some blood work, especially to rule out a new-onset thyroid condition.  If one is found, it can be treated.

Obviously the SLIM TLC program and principles need to be implemented.

This special challenge may occur whether taking hormone replacement or not.  It is not completely understood why, but if not careful, most who pass through menopause gain weight.  Part of the reason is simply because of increasing age and a natural slowing of the metabolism.  There is no cure for that – one’s eating and exercise habits have to be adjusted accordingly.  The natural aging process that comes with menopause can also be combined with a variety of other things, such as:

1. A decreasing ability or desire to get out and exercise

2. Physical discomfort such as hot flashes and fatigue

3. Emotional distress, either from natural ups and downs or from physical discomfort, along with any other life stressors one may have (please talk to your doctor about how to relieve these)

4. The mixed feelings that come from realizing one’s days of fertility are passed

As is the usual case with any significant difficulty, there is no easy answer to this dilemma.  Hopefully some of the specific tools in SLIM TLC will help – especially since you can’t gain weight unless you consume more calories than your body needs.  Increase the amount of whole (healthily-prepared) plant- and fatty seafood-based foods and decrease the amount of animal-based foods and plant waste you eat.  Discussing your situation with others who are passing or have passed through the very same thing can be extremely helpful and therapeutic.  You may also want to talk to your doctor.

Exercise is an especially good idea for the post-menopausal, whether or not on hormone replacement.  Exercise is even more important for you, not only because of the emotional benefits and weight management, but also because your bones need strengthening now more than ever.  Not doing so, along with taking the necessary calcium and vitamin D supplements, will significantly heighten your chance of osteoporotic bone fractures – and you can imagine the even greater physical and emotional discomfort that would then follow.  It is likely that you already know people who have been so unfortunate.  So do yourself a favor and do your best not to join their ranks.

I have many patients in my practice, mostly women, who are well within the “normal” range of BMI (body mass index), but are still not happy with how they look.  Usually this feeling comes when they look at themselves in the mirror while in their birthday (or swim-) suit, and see bulges in unwanted places.  Some have a BMI as low as 21 and are still not happy, usually because they have previously been skinnier.  I have a really hard time recommending weight loss to these patients, especially because I am worried about it becoming an unhealthy obsession.

I do not fault a woman who has a BMI of 25 who really wants to be a 22 or 23, but if she refuses to be happy just because she cannot drop to a 20, I start getting concerned.  If I had my way, all women with a BMI of 23 (or even 25) or less would be quite content with how they look.  But I do understand that there are often certain “problem areas” with which they may not be happy.  For such, I highly recommend not worrying so much about slimming down as toning up.

In other words, rather than set a goal to change the way you look by trying to lose weight unrealistically, set your primary goal to change the way you look by toning up, i.e., changing your body composition (decreasing your percent body fat and increasing lean muscle).  I am not talking about becoming an Amazon woman.  I am talking about having more definition through resistance exercises, likely including weights.  See the Metabolava exercises in Lesson 4, “Another Magic Pill,” for a unique resistance regimen.

Of course for some, simply not eating sounds a whole lot easier than making a concerted effort to tone up, but it is far less healthy to starve yourself than to have a nice balance of healthy eating and exercise.  Plus, toning up looks far more impressive and attractive than being all skin and bones. And no, I would not recommend an appetite suppressant for you.

Many people, after they are sick, get excited because they have lost weight.  You must not get too excited, though, because most of the weight you lose when you are sick is due to water loss (and stool loss if you have gastrointestinal symptoms).  You will obviously gain all of that weight back.  The weight you may have lost beyond that will be due to a calorie deficit, and if you want to keep it off, you must eat better than you did before you got sick.  You will be subject to the same laws of physics, just as everyone else.

Steroids (the anti-inflammatory ones, e.g., prednisone – not the ones that pump you up) are powerful medicines, and in many instances can be lifesavers, both literally and from a symptom-control standpoint.  They are used for a variety of inflammatory conditions like allergies, sciatica, inflammatory skin conditions, rheumatoid arthritis, inflammatory bowel disease, and more.

Unfortunately for those who are struggling with their weight, in addition to other potential side effects like insomnia, increased blood pressure and sugar, and gastritis, they can increase your hunger level (and the stronger your hunger, the more likely it is that you’ll eat unhealthy food).  Short-term courses rarely result in long-term weight gain, despite what many claim.  Long-term use, however, is a different story.  In addition to increasing your likelihood of fat deposition, both in common places (such as around the waist) and uncommon places (e.g., behind the neck), long-term use can also suppress your immune system and decrease your bone density.  As it is with all medicines, you should never use them unless the hopeful benefit outweighs the potential harm.  And you should work closely with your doctor to know how best to avoid long-term complications.

From a weight management standpoint, it becomes imperative to work harder to avoid the consequences of the increased hunger.  Even though some insist that fat seems to accumulate easier with steroids, there still has to be a net calorie increase in order for the fat to form.  So the rules of “calories in = calories out” still apply (you cannot gain weight if you do not take in more than you burn off).  Regular exercise, eating mostly healthily-prepared plants, Checking Your Fuel Gauge, planning alternatives to eating, and having healthy options available when you do want to eat are imperative.  Weight gain from steroids seems to those who experience it to be harder to lose (although I don’t think that has been proven), so preventing weight gain in the first place would be the best option.

Regular exercise needs to become a fact of life for those on steroids, especially long-term.  Not only will exercise help prevent weight gain, but it will also help keep your bones strong (since bone density loss is one of the potential side effects).  One piece of good news is that steroids often give people extra energy, so that energy should be used to help you be more physically active!

Many, just as it happened with me, gain weight around marriage time.  This happens for a variety of reasons, including:

1. The incredible cooking

2. The slowing of one’s metabolism with age

3. The shift in priorities from taking care of self to family, which often distracts from being more physically active

4. The frequent chronological correlation with getting a “real” job, which often lends toward eating out more and also spending less time being physically active

You likely have other excuses – I mean – reasons.  You will have to adjust accordingly, and do whatever it takes to find ways to eat healthily and keep up with regular physical activity.  It usually helps to think back specifically on what was different back “then” – were you more physically active, like playing more sports?  If so, grab your spouse and start doing more active things together.  Call your old friends and re-organize a scrimmage or night out dancing (with your spouses) or something else active a couple of times a week.  Find other ways to get active.  If you were eating better, then take specific measures to alter your eating habits accordingly.

This point deserves reiterating.  If you eat right, there is no earthly way you can gain two pounds of fat in one day (any more than one can lose that much fat in one day).  That would require eating 7000 extra calories in one day, i.e., beyond your metabolic needs.  Nobody I know has that level of “non-perceived overeating.”  And yet it happens all the time – you eat right one day, and the next you weigh in two pounds heavier.  What’s up with that?  It is SO easy to get discouraged when that happens.

But the reality is that there is obviously something more than fat responsible for the variation.  It is imperative that you understand this point.  From one day to the next, your weight can fluctuate significantly depending on what time of day you weigh yourself, whether or not you have used the restroom, what scales you use, how much you have recently eaten or drunk, fluid retention, exercise-induced fluid loss (or gain if you drink a ton of water afterwards), and what clothes you may or may not be wearing.

That is also why not living by the number on the scale is so important – daily weight fluctuations must be taken with a grain of salt, and not result in emotional ups and downs.  Do not get overly discouraged if your weight is higher than expected, and, equally as important, do not get overly excited if it is lower than expected.  Stay the course and move forward.

My Facebook post from January 23, 2015 makes some additional points:

“The Game of Scales: Which Weigh is Down? There is more and more evidence that people who weigh themselves regularly have better sustained long-term weight loss. However, you must learn how to play the game. Your weight can fluctuate significantly based on a variety of factors (fluid or food intake or output, “that time of the month,” etc.), so you cannot base all your emotions on the number you see staring back at you. If you see a number that does not make sense based on the efforts you made, you get either unduly discouraged or excited, and may either lose hope or relax – both of which are unproductive. See the number as part of a general trend, and keep doing what you know you should, making livable adjustments as needed. You may choose to weigh yourself daily or twice weekly, but if you cannot play the game, at least weigh in weekly.”

Many feel they eat well most of the time but then go through discrete periods of lack of control, where they undo any progress they had made.  My suspicion in many of these cases is that during the times that they are eating “well” they are probably eating in a non-sustainable way, then they fall off the wagon and they binge.

If you find this is the case for you, and I am sure you do not mind hearing this, you may need to focus more on eating more food – but you must choose primarily flavorful (healthily-prepared) plant-based foods like oil-free baked fries or baked tostadas broken up for dipping in salsa, guacamole, or bean dip.  Otherwise you will feel like you are dieting and will eventually fail.  If you are not on the wagon (dieting or depriving yourself too much), you do not have to worry about falling off.

That being said, an occasional splurge should not be harmful if you are regularly living The 4:1 Rule.  But if your splurges are excessive, that is where you need to place your focus.  Try to limit or contain your splurges so they are less uncontrolled.  This can be done by being smarter in your food choices or setting a limit to your splurge (only allowing yourself to eat “X” amount or pieces).  And splurges will be smaller and do less damage if you are exercising (rationally) regularly.

Managing uncontrolled, frequent binges usually requires the help of qualified health care professionals.  They will help you identify triggers and develop healthier alternatives to bingeing.

Many get caught in the cycle of scrimping on breakfast and lunch because it is easier to eat light (being more rested, motivated, and/or distracted), especially if you take an appetite suppressant or drink coffee with caffeine in the morning, which only suppresses your appetite temporarily.  Then, because they have eaten so little, by the time the afternoon, evening and night come around, they are starving, stressed, tired, and no longer distracted, and have a very difficult time controlling their appetite.  So they binge, usually on “Whatever” foods.  Then, because they have eaten so much at night, the next morning they are not as hungry and feel guilty; and the cycle begins anew.

If this describes you, it is crucial that you break this cycle by eating an adequate amount when you are hungry, until you are adequately satisfied! That way you should not feel so famished by the time the afternoon and dinnertime come around that you make up for lost time (and calories).  It will also help to Check Your Fuel Gauge, stay busier at night, avoid activities associated with unhealthful mindless overeating, and provide yourself with healthier options for when you do want to eat (see Lesson 15, Surviving the Snack Attack).

This phrase has been coined for overweight folks who are active and may enjoy many of the health benefits of exercise, but cannot lose the weight they desire.  Despite the fact that “fat and fit” for most is an oxymoron, the hypothesis is that as long as these folks are active, they do not have to achieve a lighter weight to be healthy.

The health benefits of exercise are undeniable (see Lesson 4, Another Magic Pill); however, I am not convinced that fat can coexist completely peacefully with “fit,” mainly because of what we know about the harm excess fat cells (“adipocytes”) can cause (see Lesson 23, The Giant Fat Organ) – they secrete hormones, inflammatory factors, and other chemicals that are harmful to our health.  In the end, I believe it will indeed be the “survival of the fittest,” but only when interpreted as being coupled with svelte, not fat.  Yes, “fat and fit” is more desirable than “fat and lazy,” but you must not use the phrase as a security blanket to justify not continuing to do your best to lose weight.  Sadly, the likelihood is that those who are “fat and fit” have simply not learned how to control their eating habits.  The tools and principles in SLIM TLC should help even them move towards a healthier weight.

That being said, although “slim and fit” is the ideal, you must use wisdom in the goals you set for yourself.  Achieving a perfectly normal weight usually takes a great deal of time and “retraining” of your habits, and in some instances is nothing short of superhuman.

If you are successful at losing a significant portion of your excess weight but cannot lose the last 10-20 or even more pounds, you are far healthier for it, and deserve the greatest of accolades, especially when you have developed a regular, rational exercise regimen and eating mostly healthily-prepared plants and fatty seafood.  There is nothing wrong with continuing to seek a normal weight, as long as you are being rational about it (like a seasoned marathon runner, not a sprinter), but you must not allow yourself to get overly discouraged if it takes a significant amount of time and troubleshooting to get there.  If you do get too discouraged, you know what will happen.

Is “fat and fit” better than “thin and not fit?”  I think the answer is “yes,” but I also think that a lot of it depends on how “fat” and how “not fit.”

No, weight loss is not wise in pregnancy. Never expect or hope to lose weight during pregnancy.  Even maintaining your weight is usually not healthy. But of course excessive weight gain must also be avoided.  You need to moderate your eating habits and physical activity so that you gain according to established guidelines.

Believe it or not, the guidelines vary depending on your weight before pregnancy.  The recommended weight gain guidelines (which most women do not follow) for weight gain during pregnancy are as follows:*

If you are moving along at the wrong pace, whether it is too slow or too fast, adjust accordingly (and make sure you are staying active in a healthy way – see below).  If you have already surpassed the recommended amount, just set a goal either to maintain or gain much more slowly.

You have heard the old mantra, “You are eating for two.”  Well, unless your baby weighs as much as you do, then no, you are not.  Only 100-300 extra calories a day (above your own metabolic needs) will meet the needs of your growing baby.

As far as exercise recommendations are concerned, they are highly dependent upon the person and any medical conditions present.  I usually tell patients who ask (who are healthy and have a normal pregnancy) that it is probably okay to maintain their pre-pregnancy levels of exercise, unless it is too excessive or aggressive.  If they did not exercise previously, they should at least consider starting a reasonable walking program.  Either way, this should always be discussed with your doctor.

Obviously nutrition and exercise are important to provide a healthy environment for proper development of your baby.  Learning the TLC principles in SLIM TLC regarding healthy eating (the whole plant-based part) and exercise can help you moderate your weight gain so you do not gain too much, and so you will be prepared to apply those principles if needed after pregnancy.

With a little thought, each of us should be able to identify specific times or events during the course of our day or week that are major contributors to our weight gain.  They are specific moments of weakness, or certain activities or traditions, during which we consume far too many calories.  If we were able to overcome them, the effect would be amazing.  To overcome them, we must modify the way we approach them, plan ahead, or simply avoid them altogether if possible.

These moments of weakness need a name, so they may be readily identified and subsequently conquered.  I have chosen to give them the name of EOs.  EOs are Evil Ogres that Engender Obesity at Every Opportunity.  Once identified, all EOs must be slain, though it may take some time.  If you have not identified the EOs in your life, now is the time to do so.  Think about your day, or more likely your evenings or weekends – when do you engage in activities that completely counter every productive effort you make to lose weight?

Watching television (TV) and movies are good examples of EOs for many, including me.  Whenever I watch TV or movies, it seems like I have a never-ending temptation to engage in mindless calorie consumption.  I am sure commercials contribute to this somewhat.  Watching less TV has helped me avoid this.  The less TV I watch, the fewer calories I consume. However, ever since I started following SLIM TLC’s “Free Food? Whatever!” eating strategy, this has been far less of a problem!

Another valuable strategy I have discovered is that if I keep my hands busy doing something productive, it will distract me from using them to shovel food into my mouth.  Some productive or less harmful things one can do while watching TV include:

• Ironing

• Working on a hobby or craft (I actually used to work on a gum wrapper chain)

• Exercising on a treadmill, stationary bike, elliptical machine, etc. (I don’t care if you have to put the machine in front of the TV or the TV in front of the machine – do what you have to do), or doing other types of workout, like aerobics, jumping jacks, jump rope, or trampoline joggers (if your knees are in decent shape)

• Doing a puzzle

• Paying your bills

• Playing a quiet game with your kids

If you do something productive while watching TV, you will walk away from that time spent in front of the television with less of a feeling of having wasted your time.  With some thought, it should not take long to put together your own list of productive things you can do while watching your favorite must-see TV programs.  Then, you must keep that list and the necessary materials handy, near where you watch TV.

If you can garner up the mental fortitude, not watching TV at all is the best way to go (of course unless you have to be doing one of the above things anyway).  Instead, read a good book or do something that has been on that eternal list of things to do.  In other words, do not just omit – commit to do something.  Turn potentially destructive into productive.  Turn inaction into action.  Take it yet one step further, go the extra mile, and lengthen your stride.

For those who believe in a higher power as I do, if you have not already done so, you will find that praying for strength and assistance in your weight loss efforts will help you tremendously.  This is yet another way to do something productive.

Obviously, not all EOs are potentially negative or can be avoided like TV.  Take studying, for example.  Few can argue that studying (for school, etc.) is a bad thing.  However, many eat or snack constantly while studying (trust me – I remember those days well).  Others may inhale calories while reading (or writing) a good book, working on the computer, or during other similar positive or necessary activities.  These present a particularly difficult dilemma. Again, following SLIM TLC’s “Free Food? Whatever!” eating strategy an work wonders in overcoming these EOs. If you have a habit of eating while you read, try reading out loud (this is a great activity for couples who think it would be fun to read a book together).

If your EO is boredom, try calling someone who could use a call.

All-you-can-eat (“AYCE”) buffets/restaurants are EOs for many folks, for obvious reasons.  Because everyone there always tries to get the “best bang for their buck,” AYCE restaurants can be very effective obesity factories (“fatories?”).  If you have not noticed, the obesity rate in AYCE restaurants is usually greater than the normal population.  This is not a coincidence!

I do not know why, but it also seems that most AYCE restaurants have the least healthy fare.  Even if they have healthy fare, the unhealthy stuff disappears the quickest.  At AYCE restaurants, people usually follow the 20:80 rule instead of the 80:20 rule.

A classic illustration of the dangers of (over)eating at AYCE restaurants occurred when my family went to one while we were visiting my parents.  After we had finished eating, the waitress asked my father, “Did you get enough?”  He answered, “More than we should have.”  She replied, “That tends to happen a lot around here.”

Other restaurants can also be AYCE.  They include Mexican restaurants with AYCE chips and salsa, Italian restaurants with AYCE breadsticks, and any other restaurant that has AYCE items or serves larger-than-life portions.  In addition, fast-food restaurants are usually EOs, especially when you “super-size.”  And it goes without saying that you can overstuff yourself anywhere, whether out or at home.

Nonetheless, to be fair, not all people who eat at AYCE or other similar restaurants have weight problems, nor does everyone have to overeat when they go.  If you follow SLIM TLC principles, especially SLIM TLC’s “Free Food? Whatever!” eating strategy and The SLIM TLC Map, regularly check Your Fuel Gauge (CYFG), trying to follow the 4:1 Rule, you can indeed enjoy and still survive AYCEs!

Traveling is an EO for most, whether for business or pleasure.  See Lesson 16, Taking SLIM TLC on the Road, for tips on how to tackle this one.

I would love to hear about some of your EOs and how you were able to slay them.  If you would like to share them with me, e-mail them to me.

Back to Troubleshooting topics

NOTE:  The materials and resources on this page are copyrighted.

Get started with these first:

• KidTLC Parents' Toolkit

• KidTLC Parent Orientation (PowerPoint presentation)

• KidTLC Game (Lesson) Plans (pdf)

KidTLC Game Plan Materials

Game Plan #1 - "The Ultimate Goal" 

• KidTLC Team Member Stats

• BMI Chart - Boys

• BMI Chart - Girls

• KidTLC Contract - Initial

• KidTLC Contract - Behavior Modification

• KidTLC Fruits, Veggies, and Activity Log

Game Plan #2 - "Follow the Map" 

• KidTLC Map - Sample Preventive Version

• KidTLC Map - Sample Treatment Version

• KidTLC Map - Blank Preventive Version

• KidTLC Map - Blank Treatment Version

• KidTLC Map - Blank Treatment (loss) Version

• KidTLC Food and Drink Log

Game Plan #3 - "Check Your Fuel Gauge" 

• Fuel Gauge

Game Plan #4 - "Fun Fitness for Life" 

• Quiz - Calories Burned per Hour

• Answer Key - Calories Burned per Hour

• KidTLC Fun Physical Activities Sheet

Game Plan #5 - "The Island" 

• KidTLC High-Octane Fuel Tracker

Game Plan #6 - "It's Screen Time" 

• It's Screen Time

• Fun Alternatives to TV & Video Games

Game Plan #7 - "Transformers at Home" 

• KidTLC Fruit Basket

• Veggie Tools

Game Plan #8 - "Come and Get It" 

• 500-Calorie Snacks

• KidTLC Meal Planner

Game Plan #9 - "Snack Time" 

• KidTLC Healthy Snacks List

Game Plan #10 - "Choose Wisely" 

• Choosing Wisely

• Reasons We Eat

• Why Am I Eating form

Game Plan #11 - "Can We Go Out to Eat?" 

• KidTLC Restaurant Meal Study

Game Plan #12 - "In It for Life" 

• KidTLC Fun Activity Contest Form

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