The definitive guide to weight management for the chronically obese.

• Are you lonely?
• Have you spent half your life ordering in, pursuing sins of chicken wings and pizza?
• Are you sitting in a beanbag chair, naked, eating Cheetos?
• Do you have the sudden urge to get up and send me a thousand dollars?

Damn – oh well – it didn’t work for Ron White either so I guess I can’t complain too much. Notwithstanding, if you are like me, weight is a constant pain in the back (and legs, and hips, and ….). Whether it is the result of illness, injury, genetics, depression, stress, medications, lack of medications, menopause, heliopause – whatever – the end result will likely have been the same old problem. As much as we try to ‘diet’ – we are constantly gaining weight.

There are really only seven (7) things you need to know to help solve the problem. Believe me when I say that knowing the answer and living the answer are two different things. In general however if you can follow these seven principles, you should lose the weight and be able to get your body back in balance.

One thing to know up front. The body takes between 7-10 years to replace most of the cells in your body. That means the ‘you’ you are looking at now isn’t the same ‘you’ you were 7 years ago. Fat cells for example are replaced every 10 years. So if you are looking for permanent weight loss you cannot be thinking in terms of losing 100 lbs in 6 months but rather a reduction in fat cells over 7-10 years. That may not be what you want to hear, but its one of the key reasons we tend to gain weight back after having lost large amounts of weight quickly.

Let’s look at the math for a moment

If you are 200 lbs and 35% body fat and you want to get down to 20% body fat, you need to lose about 38 lbs of fat. However when we lose fat we don’t necessarily loose the fat cells – we only lose the fat that they contain. So if we start overeating again right away – those cells are still around to fill back up again. If you only lose 10% of your fat cells per year – it will take approximately 8 years before your body sheds itself of enough fat cells to be in balance with your proper fat-lean proportions.

So what we need to do to fix the problem is look at the following 7 lifestyle changes – in order of importance.

1. Sleep

The body needs time to rest and repair itself. Lack of sleep leads to a number of complications but the most serious of which is a hormonal imbalance that will sabotage everything else you try to do. As quoted from WebMD

The two hormones that are key in this process are ghrelin and leptin. “Ghrelin is the ‘go’ hormone that tells you when to eat, and when you are sleep-deprived, you have more ghrelin,” Breus says. “Leptin is the hormone that tells you to stop eating, and when you are sleep deprived, you have less leptin.”

More sleep means your Ghrelin-Leptin balance is more properly in tune and you are not as likely to snack. Your body has time to rest and repair and to flush out toxins that have accumulated throughout the day. Without proper sleep everything else on our list operates at half efficiency.

2. Water

Cars need oil to lubricate all the various moving parts. Your body needs water for much the same purpose. Without it all kinds of nasty things start to occur and the engine will seize up. Water is the key ingredient in many bodily processes including digestion and the breakdown of sugars and fats for energy. Without adequate hydration, our body processes do not function optimally. The breakdown of fats specifically is a water intensive process. Albeit mostly as a catalyst, for every 1 Kg of fat broken down, 8L of water are used in the process.

That isn’t to say you need to drink 8L of water per day as most of the water comes from the fat itself. But lack of hydration can put the breaks on these cycles if the body’s overall water needs are not being met.

Think of each cell in the body as being a sponge. If the cells are properly hydrated then they aren’t going to try to take water from anywhere else. If the cell’s aren’t hydrated however then as fat is broken down, the water produced part way through the process will be consumed by other cells and processes around it and fat breakdown itself will stall. Sort of like choking off the gas line to the fuel pump.

BTW – when we are talking about water, we mean water water – not pop, coffee, tea, juice, milk, etc. Water ‘additives’ need to be processed which takes away from the effectiveness of the drink being consumed. That isn’t to say things like herbal tea and such are not good for you. Just don’t expect to get the same benefit as drinking straight water.

3. Nutrition

Cars need gas to run. Your body needs food for the same purpose. Too much food energy and the excess gets turned into fat and stored in fat cells. Not enough food and fat is released as energy to be burned in the body as fuel.

Let’s be clear about this – its all about FOOD.

There is no other way to gain or lose weight – everything is dependent on this balance.  Everything else before and after this point is about how we can influence this balance but the balance itself is based on what we eat. You want to lose weight – this what you need to get under control.

Fortunately, the process doesn’t need to be complicated.

Look at how much you weighed 7 years ago.
Look at how much you weight now.

The difference is what you need to get under control.

So – let’s do the math.

If you weighed 220 lbs 7 years ago and you weigh 255 lbs now, the difference is 35lbs or 5 lbs per year. At 3600 cal/lb that means you need to reduce the diet you are eating now by only 50 cals per day on average in order to maintain your current weight and 100 cals per day on average in order to lose weight.

That takes into consideration birthdays, thanksgiving, holidays, office parties – everything.

Now we need to put that into perspective.

100 cals = 1 slice of white bread, ½ glass of milk, ½ glass of coke – in general not the most difficult of things to do if you pay attention to what you put past your lips.

In fact – the easiest way to reduce the total number of calories you consume at a give meal is …. wait for it …. drinking 2 glasses of water before eating. It has been shown in numerous studies that drinking water BEFORE a meal not only improves digestion but we tend to consume 10-20% fewer calories that we would otherwise. Score 1 for water.

4. Aerobic Exercise

Exercise for weight lost doesn’t work. That is because if your diet is off, when you stop exercising the weight will simply come back. That isn’t to say that you shouldn’t exercise – rather you should exercise for different reasons.

Aerobic exercise provides benefits beyond creating a calorie deficient in the body. The primary one is the circulation of body fluids which is critical to effective maintenance. Think on it this way – you have this wonderful house with a great big pool of water in the backyard. But if the pump breaks down eventually the water goes all crusty and starts to gum up and evil mosquito thingies start popping up. Sure the ducks like it but then they are fowl creatures anyways (ba dump baaaa! – okay – bad joke).

Aerobic exercises like walking, jogging, running, swimming, etc are like weight lifting for your heart and lungs. They strengthen your cardiovascular system and make other parts of the body work more efficiently. Afterall – there is no point in turning fat into energy if it’s just going to sit in the fat cells and not make its way to the muscle cells. If energy isn’t being used on a regular basis it’s just going to go back into storage.

Look Joe – I got me an ATP molecule – wadaya want me ta do with it.
I dunno – damn delivery truck isn’t here so throw it back in the warehouse. 
Gotcha boss – back it goes.

If you want to lose weight more effectively – you have to get your body to do things that require energy on a continuous basis and get your heart pumping to move energy from where it is being stored to where it will be consumed. There are two traps however that lie in wait but which aren’t hard to overcome.

1. Your body has a reserve gas tank that has to be depleted first. Usually about 20 minutes of any form of aerobic activity will drain the tank after which point your body will start to call up the reserves. Its sort of like watching a redneck mining operation. All the little fat miners are just standing around watching the world go by until the fuel stockpile starts to get to empty. Its only then the foreman starts to run around kicking butts and saying ‘get to work you yahoos!” that anything happens to the fat build-up;

2. If you push your body too hard all the little fat miners start to cheat and instead of mining energy from fat they start to mine energy from muscle. This is because muscle contains higher levels of raw ATP (the fuel that muscle cells need to work). In fat – the fat has to be broken down first to get to the ATP. When there is lots of time to get the job done – this is actually the easy way out. But when the big boss shows up saying “I need 100,000,000 units now!” – the foreman directs the fat miners to start to cannibalize the energy produced and stored previously in muscle cells. The body literally starts to digest itself and at these levels fat becomes the last source of energy to be used.

So you want to tend to avoid high stress aerobic activities. Keeping your heart rate between 60-75% of maximum is the ideal target range.

5. Anaerobic Exercise

Similar to aerobic exercise, anaerobic exercise shouldn’t be used to lose weight. Rather, you should use strength training for entirely different reasons.  While aerobic activities push the body to use energy generally, anaerobic exercise controls how effectively each individual muscle cell will use that energy once it is received.

Energy usage in the body is controlled not by the muscle cell but by a small symbiotic structure in each cell called mitochondria. It is mitochondria that is responsible for the creation of ATP which is the cell’s major fuel source.

What anaerobic exercise does is two-fold: 1) it increases the size and number of muscle cells that are available in the body. 2) it helps increase the number of mitochondria available in each cell in order to create / burn fuel. So while aerobic exercise gets fuel to the cell, anaerobic exercise determines how hot the fire will burn once it gets there – ergo how much fuel is required. More mitochondria, more muscle, more fuel, higher calorie deficit requirements.

This doesn’t mean you need to look like Arnold Schwarzenegger. If you need to build muscle then you want to do high weight – low repetition type body building. This type of activity breaks down muscle tissue and creates new muscle during rest periods (i.e more mitochondria through an increase in muscle mass). If you are happy with your level of fitness then you want to do low weight – high repetition type body conditioning. This type of activity is closer to aerobic than aerobic with a net impact of increasing the number of mitochondria per lbs of muscle mass.

What is average? There is no really good consensus on this however Adam Campbell over at Mens Health has suggested 10 standards to assess your level of fitness including:

1. Bench 1.5 Times Your Body Weight
2. Run 1.5 Miles in 10 Minutes
3. Vertical jump of 2 ft
4. Leg-Press 2.25 Times Your Weight
5. Swim 700 Yards in 12 Minutes
6. Do 40 Pushups
7. Waist to Hip Ratio of < 0.9 (m) / < 0.7 (f)
8. Run 300 Yards < 1 Minute
9. Touch Your Toes (flexibility)
10. Toss a Basketball 75 Feet Kneeling

Keep in mind that these metrics are for those people who are “BMI friendly” in terms of normal. For those people who are obese, bench pressing 1.5 times your body weight is just unrealistic. The standard unit of measure is your ideal body weight as per the BMI charts and then use a trainer / spotter to help you get from where you are to where you want to be once you reach your ideal weight.  There is no point in being skinny at the expense of two broken ankles and a broken collar bone because you were stupid and tried to over exert yourself with unrealistic expectations.

Get the chart – do the math – error on the low side and work your way up – keep it safe.

6. Recreation and Social Activity

Humans are social creatures – even the introverted ones. While no one likes to be the 300 lb guy at the gym filled with 20-something show-offs – working out, hiking, biking, doing recreational activities with friends is almost always more enjoyable than trying to develop new habits on your own. You’ll have more fun and will stick with lifestyle changes longer the more you make them a part of who you are rather and what you need to do.

And much as this is not going to sound oh so P.C. – if your social friends and companions aren’t willing to support you in obtaining your goals, it’s time to get new friends or limit the time you spend with those people. Surround yourself with people who are like minded in doing the types of things you find enjoyable and you will find that the weight will start coming off without even thinking about it.

The other thing to keep in mind is that if you are forcing yourself to do something that you just don’t feel comfortable with, then find a different activity. There is no point in going to a gym for a 30 minute run every morning if you hate running and are a late sleeper. That isn’t to say that you shouldn’t give it an honest try. One month trying something new and pushing your comfort zone you may find that something you thought you hated is your next new passion in life. But if you are 6 months into something and it’s just getting you down – switch.  Life is too short to spend on things that don’t make you happy.

7. Visualization

Speaking of which – the last thing to keep in mind is to constantly visualize what makes you happy. What are those things you want to do that the weight is keeping you from accomplishing. Put it into your mind’s eye. See yourself there. Whether it is travel, career, social, personal, sex – doesn’t matter. To reach a goal you have to see yourself doing it, being it, living it. Take the best traits of those goals you want to accomplish and replay it in your mind’s eye so that once you are there, you will simply step into that role as if you have owned it all your life.

Beeeee the ball.

What to do with Everything Else

Everything else in the weight management world is a distraction.

Some will help. Some will hurt. If you think drinking 8 cups of decaffeinated, ginseng infused, green tea per day is going to help speed things along all the more power to you. If going to Weight Watchers is going to provide the social support you need to stay on target – great. If you have more money than brains and want to blow it all on Herbal Magic – I’ve seen it work for other people.

Whether we are talking stomach stapling, liposuction, nutritional supplements, acupuncture, reiki, fat farms … whatever … the important thing is to research the facts first before you engage in any of these activities and then determine whether what you are about to embark on is a result of peer pressure to engage in a short-term fad, or whether the activity in question is going to sustainably support one or more of the seven basic habits of weight management.

Believe me – while the basics habits are simple enough to know and understand – I know that it is a very difficult job to change destructive behavioural patterns. Sometimes we want the easy way out. But that doesn’t deny the fact that to accomplish our goals means creating real change in our lives. If it were as simple as following a set of best practice principles, everyone would be doing it.

Talk to your doctor. Talk to your friends. Talk to your family. When you find the trigger that is important enough to you, it is possible to change things. That trigger is different for everyone which is why people are spending $40B per year on something that isn’t complicated to understand. Once you find it thou – the heavens will open and you’ll be reaching your goals before you realize it.

Faith my friend. It’s in you to give.

— Kevin Feenan