James N. Atkins, MD

CHAPTER 10
Getting Started

An ounce of prevention is worth a pound of cure.

The Week Before the Diet Starts

          What are your motivating forces that will help you lose weight? How will you make certain that you are successful with your life quest?
          Do you even know what you need to be successful? Probably not. The number one need of all people in the world is acceptance and the number one fear is rejection. Most of us do not know what we need as it relates to reaching our goal of weight reduction; if we did we would not have the problem in the first place. Because of this, we will begin by looking at some needs that people have, and you can see if they are pertinent to your own case.
          Some people need friends to encourage them on the quest to lose weight. You have to be careful with friends because if you start looking better than they do, they may try to sabotage your efforts so you do not succeed. It seems petty that people would do that, but they do. So if you are going to have friends there to help you, try to make sure that they are really your friends and really are there for you. Once you start looking better than they do, they may feel threatened and then encourage you to go off your dietary plan so that you can put the weight back on. They might plan a pizza party or bring you a shopping bag full of your weaknesses or some other event that will start you down the hill. This may be done so that they feel better; it may be conscious or unconscious, but at this point they are not being there for you, it is now about them. The friends may not even be aware that they are doing it or why. It could be subconscious on their part, but nonetheless it will have a devastating effect on your plans. You need friends that are secure in their own body and journey so that they can encourage you.
          Some people do better if they have a social support system that has a group associated with it; Weight Watchers, Overeaters Anonymous, TOPS are all such programs and there are many more. The question you must ask yourself is what is best for you? How do you respond, what support mechanisms work best for you? Only when you have some understanding of what your needs are will you be able to meet the challenge and succeed. Some people are very introverted; they may not do as well in social situations, whereas others thrive on it. Some find that the social pressures of a support group allow them to stick with the diet better than if they did it on their own. What are your needs? What will work best for you? What has worked in the past? If you have found that the social system works for you then find one again and use it; if not, then don’t. If you try one system and it does not work, then try another. Try other programs that will give you the support that you need. You are the one that counts. Find the system that allows you to be successful and meets your needs.
          Some people do well just using internal support systems, but many cannot. It is good when others give us a pat on the back for our efforts. It is nice to have a few ego strokes that let you know that what you are doing has been noticed by others. The number one need of people is acceptance and the positive strokes go a long way. Many of us will notice how well someone is doing but not say anything to him or her. Perhaps because we feel that we do not know them well enough to say anything, or perhaps because we feel that it is a topic that we are uncomfortable about discussing. I know this has happened to me. One person at the hospital where I work has done a great job at weight reduction, but I only know her to say “hi” in the halls and I do not know what is going on in her life, so I do not feel comfortable saying “You have done a great job.” I would hate to say it and find out that she is dealing with grief of some sort. Acceptance is the number one need of patients in the world; a pat on the back can go a long way in supporting those who are dealing with the problem of obesity. Regardless of the reason, we frequently do not give the strokes that would benefit people; if only we would say “You have done a great job” or “I am impressed,” it would probably make their day. To be honest, we probably are impressed with their success. We need to be free enough to tell them. Some people have enough internal strength to lose weight without external support, but most of those with a weight problem need the external support.
          One area where there is a lot of difference of opinion is whether or not you should get on the scales every day. I am of the opinion that it is good to do so. I feel that way because I do it. Different people are different, so it is important to remember that you are not necessarily like me. You may prefer to get on the scales on a weekly basis. The only thing that I think is a mistake is that if you do not get on the scales at all. If you are trying to lose weight, then regularly weighing yourself can have a very positive influence when you begin to see the number change. It is good to see a number down by 1 to 3 pounds. You realize that your efforts are not in vain and that it is paying off. Yes, there are some who prefer to measure their weight loss by the dress size or belt notch that they are using; however, you do not get the positive rewards as often if you use this method. It may take 2 or 3 weeks to see a change in the belt notch, but by then you have lost 10 to 15 pounds. In order to give yourself the positive feedback that we all need, weigh yourself at least weekly or even daily. You have to remember that when you do weigh yourself, there can be 2-4 pounds fluctuation in your weight on a daily basis based on how much sodium or salt you have had in your diet in the last day. For women, there can be a few pounds of weight increase before your period due to fluid retention. You have to be aware of this so that when you see the weight jump up and down by a pound or two, you don’t get discouraged.
          How are you going to be successful with your weight loss until you begin to see the changes that you are looking for? One challenge is maintaining your motivation until you see positive results. It is great if you and your spouse are battling weight together, since you have someone else that is behind you, trying to keep the program on track. You know that the ultimate results will be worth it when you are just having a bad day. You need to think about this since bad days will occur from time to time; you will have to deal with them. Your boss may be acting up or the children are on your nerves or a whole list of other concerns. The problem is to maintain your focus and keep on track as you battle the weight problem. This battle is for you; you have to maintain your focus, since you are the one that is important. Try not to slip off the path; try to focus on your goal.
          Let’s say you’ve done well: you’ve been on the program for 6 months and have lost 30 pounds. You have gone down 6 dress sizes or your pants have dropped 5 inches in the waist. You still have 40 more pounds to lose, though, and you seem to be stuck. Now what do you do? First, go back to the basics. You are doing one of two things: either you are taking in too many calories for your level of activity or you are not doing enough to burn up the calories and still maintain a weight loss pattern. It all works out to the same thing. If you stop losing weight, you will need to either start doing more to burn off more calories, or you will need to cut back on the number of calories you are eating. It is possible that your metabolism may reset itself and your body will become more efficient with the calories that you eat. If that happens, then you will not need as many calories for the amount of work that you do. However, you can keep your metabolism revved up by exercising. The more you exercise, the more you will increase the metabolism of your body. So if you want to burn off more calories, you may want to start a more vigorous workout program.
          Let’s say the worst possible scenario just happened: you got on the scales last week and did not lose any weight, but instead gained 5 pounds during the week. What do you do then? As long as you go back to the basics you will be fine. Remember that it may be the salt load that you had at dinner last night that got you in trouble. You do not use the salt shaker; well, the low-fat salad dressing that you put on your salad was loaded with sodium, which is the same as salt. You may not have been aware of it but you did get a salt load. You have retained the fluid and yes, your weight is up, but it is fluid. If, on the other hand, you know that you have not been faithful to the diet and have been cheating, then you know why your weight is up. Once again, go back to the basics and see what your goals are, and why they are your goals. You may have to re-evaluate your plans and see what the issues are. Maybe you don’t really want to lose any more weight. Perhaps being thin would be too threatening to you emotionally. Perhaps you will have to act differently, or be perceived differently. You may need to consider getting professional help to look and see if there are issues that you need to resolve.
          The most important thing is not to let yourself get caught up in the negative talk that you can engage in. We all have the ability to do it. When we do not do as well as we would like with something, then we tend to berate ourselves, and such negative talk is not good. If you have failed to meet one of your goals, that is okay--just redefine the goal. Make a new one and try to reach it. If you never set goals, then you will never have to worry about not reaching them. You need to have long-term aspirations, but you need short-term goals that are attainable. You will never succeed in reaching your goals if you don’t try. Goals are important; you also have to set the goal high to hit the mark. The archer does not aim the arrow at the bull’s eye; instead he aims a little high because he knows that the force of gravity will pull the arrow down towards the ground. So you have to aim high to hit the mark, and if you do not hit it then simply re-evaluate the situation and see if the goal needs to be redefined, or if you simply need to re-double your efforts to reach the goal.
          As you get ready to start the program of weight reduction, you need to keep in mind that you may hit some roadblocks or detours. Take these as simply a new route around the problem on the way to your goal. As you know, there may be hundreds of roads that will carry you to your destination, and if one road is blocked for whatever reason, simply take another road. If you want, you can sit and pout, stamp your feet and develop road rage, or you can accept that you were not supposed to be on that particular road. Take the detour and see where it leads you. Always keep your goal in your mind’s eye.
          As you begin, I have already said that I don’t like to remove things that you like from your diet; however, there are some caveats. You do need to get rid of your weaknesses. You do need to go to the pantry, refrigerator and freezer and open the doors, look at the food and be honest with yourself. What are the things that you eat when you are not hungry but rather bored, tired, frustrated, angry, happy, mad, hurt, or any other emotion? Throw those foods away. Do not let them stay there and you promise that you will not eat them, because you will. When one of the emotions hits you, you will go and pick it up and eat it. You don’t mean to and right now you will tell yourself that you won’t, but the odds are that when push comes to shove you will. If you are one of the people who do not have any weaknesses other than just food, you need to start using a smaller plate at meal time until you learn portion control.
          The only food that some people forget to think about is soft drinks. Some do not consider it food, but it is sugar and salt. I think that you need to be completely off all soft drinks while you are trying to lose weight. The sugar and the salt will not help you. I have had people drink 12 liters of soft drinks a day and not understand why they are overweight. That is a lot of calories. I do not even like diet drinks, because they tend to give you a sodium load from the sodium bicarbonate that is used to make it fizz. The best approach is to get away from them completely and switch over to water. If you look at every diet that is out there they all tell you the same thing: drink water. Well, if you drink water then you will not have room or the desire for other liquids. Some programs tell you to drink 64 ounces or a gallon of water a day. For most that is fine. If you drink that much you probably will not drink a lot of other things like soft drinks.
          I know that people will tell you that you have to avoid certain foods in the first two weeks of a diet. The purpose of that is to get you away from your weaknesses. If you know what they are then you don’t need their list; you can make your own. For some, chocolate will be on their list, and for someone else it will be cookies. Many diets recommend that you avoid all alcohol for the first two weeks and that is reasonable because alcohol lowers your blood sugar, thus making you hungrier so you will eat more. You don’t need to do something that is going to make you hungrier; that would not be beneficial. You know your body; I know that if I drink more than one cup of coffee in the morning, my stomach will tend to growl and I will be hungrier than if I only have one cup. It is important to pay attention to what your body is telling you.
          With most diets, you will lose between 8 and 15 pounds in the first two weeks. Many of the testimonials that you will see on television will tell you the individuals lost 15 to 30 pounds in the first month. Why is that? Well most of it is just fluid that you were retaining. As you modify what you eat, you will be cutting back on the sodium in your diet and you will see the weight come off. After that, it tends to drop at the rate of 1 to 2 pounds a week when you are losing fat. It is impossible for you to loose 15 pounds of fat in 2 weeks even if you don’t eat anything unless you are also out there jogging 10 miles a day. In that case, yes, you could do it but you would also be harming your body, and you would feel miserable. So when you lose weight to start with, that is good and yes, you are on track but don’t fool yourself into thinking that you have just lost 15 pounds of fat, because a lot of what you lost was fluid.
          So the things that I want you to avoid are your weaknesses--and you know what they are--soft drinks of any sort, buffet lines and alcohol. If you do this as you start, then you will do well. If you are not honest with yourself about what they are and if you are cheating on yourself, then you need to ask yourself why? What are your real goals and issues? What are your real needs and why? You have to be honest with yourself and do it now--for if not now, then when?

The First Week

          Now that you are ready to begin and it’s the first week, what do you do? You would think that the first step would be easy. Well, it is. The first thing to do if you have not done it already is write down your goals.
          You need to see them in written format, in your own handwriting. That will help you commit to them. Before you start you need to go over your goals and your plan. You cannot fight a battle and hope to win if you do not have a plan. If you want to be successful, then you have to plan this like it was a war. So what plan are you going to use? What diet plan--the one in this book, the low fat diet, the high fat diet, low carb, high carb, zone, Weight Watchers, what are you going to use? If you have used a plan in the past and it did not work, then you may want to try a different one. Not every diet is for everyone.
          While you are at it, it is time to go to the local bookstore and check out some of the magazines on health and fitness. Now that you are starting a new program, it is time to start reading more about your goals. You’ll be surprised by the little tips you will pick up; there are many that we all can use. In general, most of the material is good and you know what they say-- knowledge is power and the more you know the better off you will be. As a runner, I read running magazines and when I did triathlons, then I read magazines that dealt with that subject. So go ahead: a check out a couple of the magazines and see if any of them fit your goals and lifestyle. When you stop learning you are dead, so keep on reading and learning.
          So you now have your goals and a plan; well, let’s begin.

The First Week

What To Do and How To Do It

Day 1

          Get up and start the day. You can choose to be in a good or a bad mood; it is your choice. It is your life. Let’s say you choose to be in a good mood; you get up with more than enough time to get the things done that you always do in the morning, such as empty the trash, load the dishwasher or do the dishes, and of course eat breakfast. If you have tended to skip breakfast, then this may be a challenge for you but one that you need to work on. If your goal is important, then you must stop skipping breakfast and lunch. If you are going to skip a meal it needs to be supper. You have now had your cereal that you measured out and the juice, coffee, and milk. It has been a light breakfast; you have taken in about 300 calories. You are satisfied, you are not hungry and you are ready to go to work or whatever you have scheduled for the day. It is important that you try to get a reasonable amount of sleep each night; that way you feel better and you have more control than if you are sleep deprived. One reason that people feel so exhausted is that they may not get enough sleep, but another is that their diets are poor. We also have learned through the years that if we get tired then food, or specifically sugar will give you a boost and allow you to continue on for a little while longer. So try to get enough sleep so that you don’t fall into that trap.
          You have gotten to where you were supposed to be and 3 hours have gone by and your stomach is starting make a little noise. Not a lot of noise, but it is time for a quick hit with just a few calories like 100 to 150, such as a snack of fruit, nuts, or seeds. A small amount that will give your stomach something to work on and let you get back to what you were doing. Your stomach is back under control and you are able to focus on what is at hand. It may be another 2 hours before you are ready to eat your lunch. With your stomach happy you will not hear from it for a while; by then it should be lunchtime. Now if you have been hitting coffee and tea too hard, your stomach may give you a lot of trouble by grumbling and growling. If that is the case, try to start cutting down on coffee and tea. We are all different, but I have cut tea out of my diet because it affects my stomach so much. I get a lot of heartburn and stomach grumbling. If it does not bother you, then enjoy it.
          Well, it is now lunchtime. If you are lucky, you take more than the 5 minutes that I usually take for lunch. If you can, sit down and relax and enjoy the food and the company that you are with. It is important that not only the food meet your nutritional needs, but also that your social needs are met, too. Enjoy the company. If you find, however, that the company is stressful, then you may need to find different people to eat with, or eat alone with a book. Hopefully you took the time before leaving this morning to make your lunch. It should be a moderate lunch, with perhaps 800 to 1000 calories. It should be your largest meal of the day. I know a lot of the new diets do not count calories, but to be honest, calories are the basic unit of food and weight. So if you don’t count them you will not know how many you are eating. If you don’t measure the gas you put into the car you may not put enough in, or you may put so much in that 5 gallons spill out on the ground. You have to know how much energy you are putting into your body. Some diets don’t include this because the people who developed them know that if you eat a lot of protein, for example, you will only be able to eat a certain amount before you either become full or feel miserable. If you want to be scientific about it, then you need to have a good idea of how many calories you are eating.
          Three hours later you will not be hungry yet, but nonetheless now is the time for the fruit, nuts or seeds that you have brought with you for your afternoon snack. Even though you are not hungry, now is the time to eat it. You will be leaving work in an hour or two and if you do not eat it now, then when you get out of work you will find that you are thinking a lot about food and you will make some bad choices. If you have the little snack 3 hours after your lunch, then when you get ready to go home that food is still there being digested and you are not as hungry. You are not looking for the nearest fast food store that you can find. You are still satisfied. You can eat supper and the odds are that you will keep it under control. Supper should be between 500 and 600 calories. That will put you around 2000 for the day. If you are overweight, then you should lose weight on a 2000-calorie diet.
          It is best if you don’t eat anything after supper. Now this is not because it will be converted to fat. I know that you have heard that if you eat food late in the day that it will be converted to fat. The folk tales that you will hear will be many, but it is not the time of day that is the issue when you gain weight--it is the total amount of food that you have eaten. The reason not to eat anything after supper is that if you do, it is probably not out of hunger but out of boredom, or some emotion that you don’t need to be driving your appetite. If you get hungry, then you need to eat the kind of food that you had for your snack at 10 or 3, and roughly the same amount.
          This is not complicated. To be honest, most people eat the same foods over and over. You probably only have 40 to 50 foods that you eat on a regular basis, and for some people it is much lower. So you do not have a lot to learn. Many times, it is simply a matter of reading the label on the package. Most foods will tell you what you need to know.
          Hopefully you are going to incorporate some exercise into your day. Perhaps before supper you and your significant other can go for a walk together. Get some time together. I know you are tired, but I guarantee and I don’t guarantee much, that if you walk, you will feel better. Of course use common sense: don’t start with a 50-mile walk; if you are not used to walking, then just try going around the block, or perhaps a ¼ or ½ mile walk. Try to do something; if you cannot walk then spend 30 minutes doing some exercises in your house. Get a can of soup and use it as a weight and begin to tone the muscles.
          Well, you have just made it past the first day. You did it! You need to set simple goals that are attainable. You can always make new goals as you attain the old ones. You need to continuously re-evaluate your progress and make changes as they are needed.

Day 2

          I hope Day One went well for you. If you backslid some during the day, that is okay--you had the opportunity to learn. Today is a new day and today you will be able to keep to your schedule. This is the second day of the workweek for you, so you need to get up and get off to work. Today don’t forget to eat breakfast. If you get in the habit of eating it you will find that you will feel better and that you will be more productive at work. You will also feel better at work and hopefully enjoy your day more. Breakfast should not be a large meal. Perhaps all you want today is a ½ of a cantaloupe, a cup of coffee, and perhaps even a glass of orange juice. You are doing great. Don’t forget to make your lunch and get your snacks ready.
          You don’t want to make your lunch, you say! That is fine but realize that when you make your lunch, you know exactly what is in it and how much there is. You know what you are eating and you have made a plan. If you insist on going out for lunch then it is important to be aware of what you are eating, and how many calories are in it, because if you don’t know then you will pay the price. If you don’t make your lunch, you need to become very knowledgeable about what you are eating at restaurants.
          Three hours have passed and you have forgotten to have your snack. Get it and enjoy it. I enjoy an apple for my snack; I have one twice a day. I can’t stand an apple that is mealy so if you are like me you buy your apples every week at the store and keep them in a refrigerator. If left at room temperature, they will ripen more and become soft. That is great if you are making applesauce, but I like a nice hard crisp apple at 10 and 3. I find that by the time lunch gets there I have not gotten hungry yet which is great, because I am usually behind in my work and it takes me an extra 45 minutes to get caught up. By then it is time to eat.
          So what did you make for lunch today? I am having salmon on fettuccini. I got an order to go from a restaurant last night and now I will have it for two days. I cut the order in half and I will have half today and half tomorrow. I will put it in the microwave for 2 to 3 minutes, sit down and enjoy lunch with some friends. It will hit the spot and will give me the protein and carbohydrates that I want. I will also be getting the 3 omega fatty acids from the fish, as I try to take care of my heart.
          Again, it seems that 3 hours fly by and you grab your snack and sit down and enjoy it. If you eat it without thinking, then you will not get to enjoy the flavors and texture as much as if you just stuff it in your mouth and keep on going. So take a minute or two and savor the snack.
          You’re on the way home again. Today perhaps you packed your gym clothes, and you changed at the office and have gone out for a brisk walk around the office or building, or perhaps on the wellness track or the high school track. There are a lot of good places to walk. If you do not like your neighborhood, then go to someone else’s neighborhood and walk there. You can find a safe and enjoyable area to walk. Go to the mall if you do not feel safe anywhere else. Today try to go for the walk before you get home. You will probably find that if you do that, you will have more energy when you get home--sort of a little energy boost.
          Supper needs to be moderate in size—smaller than your lunch. If you have gone for the walk, then you probably will not be as hungry anyway. Again, you want to restrict your total calories for the day to 2000. Hopefully during the day, you drank a lot of water. I would hope that you drink between ½ and 1 gallon of water a day if you are healthy. If you have medical problems, then you need to talk with your doctor and ask him how much water would be appropriate for you. Remember if you are sweating a lot, you will need to drink extra water so that you do not become dehydrated.
          Many diets indicate that that you can lose weight when you eat normal portions of food. The problem is that most people do not know what a normal portion is. To be honest, most people think that double portions are the normal size. They are used to large portion sizes, and when they actually find out what normal is they are amazed that they are that small. This is one reason that people gain so much weight. They overeat. You could try to deal with this by using smaller plates at mealtime; it’s an optical illusion but it does look like more food.
          It’s also a good idea to write down everything that you put into your mouth for the next week or two, so that you will not make a mistake and eat things and forget that you have done it. If you cheat and eat 3000 calories a day that is fine, but you will not lose weight. The only one you are cheating is yourself. If your goals are real, and you really do intend to reach your goals, then you have to have a plan and stick to it. It will not happen by wishful thinking. You have to do it. You can do it. You have the power, you are in charge; the question is, do you really want to reach your goals or not?

Day 3

          The day has started again. I hope you have been getting on the scales every day, but if not now is the time to get on the scales. Knowledge is power, and you need to know how you are doing. You need to be getting on the scales on a regular basis, either daily, twice a week or weekly, but have a pattern that you will be able to remember. If you don’t get on the scales then you will not know how well you are doing. Yes, you will see more fluctuations in your weight based on the amount of salt that was in your diet, but you can accept that.
          Hopefully you are starting to feel a little better at work; you have more energy and are not as fatigued. A good small breakfast is what you need to get the day started right. So this morning it is going to be a quick and easy breakfast like cereal and yogurt. It is really quite good. I first had it in Germany and since then, that is what I prefer for breakfast. I use some granola-type cereals and measure out a ½ cup, then add vanilla yogurt to it, stir it up and it is very tasty. You ought to try it. The yogurt people tried to take advantage of the combination and at one point had a package that had some cereal on top of some yogurt that you would mix and eat a crunchy yogurt.
          So what are you going to take for a snack today? If you are someone who likes routine, then you need to find something that you like and stick with it. If you are someone who can’t stand the same thing all the time, then you need to experiment. Try fruit on alternating days, and on the other days use nuts, grains, or seeds. If you use nuts, grains, and seeds, be sure to measure out 100 calories’ worth and put it in a plastic bag that closes. If you don’t measure it out and just take the large bag with you, then you will eat more than you should for your snack. It is important to be precise and actually use the measuring cup and measure the amount that it says on the bag will give you a 100 to 150 calories. Use two separate bags--one for the first snack and one for the second.
          Well, what is it for lunch today? Shall it be the other half of the salmon and fettuccini that we had yesterday, or shall we make a sandwich? A wrap might be a good idea for today; I like to take a large tortilla and make a wrap. It is very simple. One wrap on the counter, two slices of low fat ham or turkey or one of each, then two slices of cheese. I like to add mustard because then I do not have to worry about refrigerating it at lunch. Sometimes I will add in a few jalapino peppers or banana peppers; you can add what you would like--perhaps some lettuce. Then roll it up, and wrap it in either foil or clear wrap so that you can take it to work with you. Lunch took less than 2 minutes to make and it only cost you at about one dollar.
          Work went well and you are back home for supper. Did you go for your walk at work or are you going to do it tonight? If you do something on a daily basis for 30 days, it will become a habit and it will be easy to do. You will get out there and want to do it. You will feel better. By now you are starting to feel better, you have been on the diet already for three days, and you are doing well. If you occasionally get a little hungry, don’t worry-- that is just a sign that you are in fact breaking down some fat for energy and getting rid of the fat that is harming your body. You are now on the road to helping your body heal. You ought to review your goals. Look at them again and make sure that they are realistic; if not, you can change them.
          Did you drink the water that you need to? Water is very important, and it does not matter if it comes in a bottle or the tap. I happen to be a tap person, but there are many who prefer the bottled variety. Either way try to drink 32 to 54 ounces a day.
          So what are you going to have for supper? Again, it is important that you look at portion size as you think about what you are going to eat. If you had your snack, you will not be as hungry as if you skipped it. If you avoid alcohol then you also will be less hungry. Until you get into the diet it is best to avoid alcohol, as it will just stimulate your appetite and you will eat more and not lose weight. Many diets like to avoid carbohydrates early in the diet. I only recommend that you avoid pure sugar in any form, including soft drinks and foods that you add sugar to when you make them. If you want to avoid white bread, white potatoes and pasta that is fine, but as long as you consume a normal portion size, I do not have a problem with you eating them. When you buy potatoes and cook them, try not to buy the large baking potatoes; you need to buy a medium-sized potato, unless you plan on cutting it in half and only using ½ of the potato. Usually if you cook the large ones you will eat the whole thing. So to help protect yourself, buy smaller potatoes; that is also true with other items. Do not buy large bags of food, because if you do you will eat them.

Day 4

          The week is quickly moving on. The start of the day is here again, and it is time to get up and going. It is important that you not skip your breakfast; you have done well but we all have a tendency to backslide on the plan. That is the number one reason why diets don’t work: people fall off the wagon and cheat. Not eating breakfast is a form of cheating because it will set you up for failure later in the day. A lot of people who suffer chronic fatigue have this condition because of improper diet. They simply are not taking care of the machine they have. They would never consider driving their car without gas, so why do they try to run their body without some new fuel. You say that you have plenty of fuel around your middle; well, that may be true but you have to get that fuel to the point that you can use it. You can have a lot of gas at the gas station, but you have to drive there in order to get the fuel. So it is with your body; you will have to destroy some of the fat that is in the fat cells before you get the nutrition out of them. That is our ultimate goal, but if you skip breakfast then your hunger will drive you wild as the day goes on. As your body chews up the fat, you will have some hunger pangs and most people do not like that feeling; when they have it, they go and get something to eat. You will do better with the calories if you take the time to eat a small breakfast.
          It is time to go ahead and make your lunch and get your snacks for the day. Have you gone by the health food store yet to see what they have that might make a good snack? You may find all sorts of nuts and grains that you could try. Don’t just rely on the grocery store; it is okay to check out the health food stores, as well. It is still important to measure out what you are going to eat; you need to get into the habit of measuring all of the things that you consume. Portion control remains the number one factor in obesity and in weight control. You will not be able to control the portions if you have a large bag of nuts in your office; you will eat them all before the day is over. I know I would. In addition, don’t forget to drink the water that you need for the day.
          So the day went well. Now it’s suppertime, and what shall you eat? Some people opt to have one meal a day that is entirely fruit. That could be something that you could try. For supper today you could have a fruit plate, perhaps with apples, bananas, pears, watermelon, cantaloupe, etc.; you can make it as interesting as you would like. The important thing is to stop eating when you start to feel satisfied. It is okay if you do not clean your plate. Plan it in advance; get the fresh fruits from the store to make it. Do not use canned fruits, as they are in a sugar base. If you are going to use fruits they need to be fresh or frozen. You can find fruit that has been cut up in the freezer section, but make sure that you look at the label and see if anything else has been added.
          So how did the walking go today? You only have to walk on the days that you eat. That is what I tell my patients. Walking is just as important as anything else that you do. If you do not walk or exercise, then you will not maintain your muscle tone and muscle mass. As we proceed with the diet, it is important that you build the muscles and get rid of the fat tissue. As you walk, the muscles will be more effective in utilizing sugars and this is very important if you have diabetes or borderline diabetes. So don’t forget to do the walking: it is very important. Your life depends on it. You owe it to yourself to stay as healthy as you can, and walking or going to the gym and doing some kind of exercise is important on a daily basis.

Day 5

          This is the last of a five-day workweek. The time has flown by and you have already completed the first 4 days. Don’t give up now; you still need to eat breakfast. So don’t even think about skipping it. You have done well, you should be doing well at work and you should be noting some improvements already. Keep the breakfast simple. Lets not get complicated; we need to use the KISS method for breakfast. The KISS method is Keep It Simply Simple, lets not make life any more complicated then it has to be. Get the glass of juice, cereal, yogurt or milk and cup of coffee and you will feel fine. Perhaps you would rather have two pieces of cheese toast and your coffee. That is fine; try to avoid breakfast bars--they probably will not stick with you very well.
          You need to make your lunch and grab your snack. What do you want for your snack today? Sometimes I will take a little sandwich bag full of baby carrots for the morning and afternoon snacks. I love carrots, but there is nothing wrong with using something else like radishes, celery, squash, or whatever you want to use. If you take vegetables and you are not just going to eat them plain, but you are going to use a dip with them, don’t forget to count the calories of the dip. Also be careful because some of the dips are loaded with sodium or salt. So read the labels. That is important.
          What shall you have for lunch today? Again you need to be thinking about 500 to 600 calories. You might want a deli sandwich; however, it may be half of the sandwich or you may choose a sub that is low-calorie. You could make your own sandwich with some whole-wheat bread or with a bagel. You have to count the calories. A bagel will be 250 but you can easily add in the meat, mustard, lettuce, and have a great sandwich for less then 600 calories. If you don’t want to bother, then swing by Subway and get one of their subs for less than 600 calories. Whatever works for you is fine.
          How did you do today with your walking? Is it getting better? One problem I have is that if I come home and say that I am going to go for a walk, generally if I sit down in the chair then it will never happen. I have to go for the walk or go to the gym before I come home. Know yourself; we are all different. Don’t get caught in your weaknesses.
          Keep supper light--hopefully less than what you had for lunch. You have done well for the week; you are on a roll, so let’s keep going.

Day 6

          Well, if you are like most people, today is a day off from work. Of course in our world people work all kinds of schedules. That will also make your life complicated when it comes to dieting. If you work swing shifts, then it requires more thought than for someone who works a straight 8-to-5 five days a week. If you work the graveyard shift, it also requires a little thought as to how you are going to use the plan. No matter what your schedule though, most people eat breakfast, lunch and supper. It may not be at 6 a.m., noon, and 6 p.m. but nonetheless, there are times when you eat those meals. For those of you who do work unusual shifts, then you need to be aware that you may tend to nibble just to stay awake. If that is the case, make sure that what you are nibbling on is low in calories like raw vegetables. I know that when you get tired and have pulled a long shift or perhaps a double shift, that one thing that we do to keep going is to put fuel in the machine. Sometimes you may have to do that but just be aware of what you are doing. Acknowledge that you are putting extra food into the machine so that you will not fall flat on your face, but after you get some extra sleep then go ahead and try to burn up the extra calories.
          Since today is your day off, you may have chosen to sleep in. Instead of getting up at 5 or 6 a.m., you are going to sleep till 8. Now what do you do? If you get up and eat breakfast at 9, then lunch at 12 and supper at 6, it seems that you will be eating a lot in a short period of time. You need to eat your breakfast when you get up. You do not need to skip breakfast even if it is just a bagel with low fat or regular cream cheese and a cup of coffee. Now lunchtime is only 3 hours away. That would be your snack time if you were at work. This is a case where you may want to just have a snack at lunch time--an apple or a few nuts or grains or seeds--perhaps 250 calories rather then the usual 100 or so that you would normally eat at snack time. You could make a small sandwich with 250 calories, or eat some frozen foods that are micro-waveable. That will leave you with 1500 calories for supper. Perhaps you want to go out for supper tonight. With 1500 calories for supper you can go to any nice restaurant and have a salad, an entrée, and a small dessert and be within your limit. If you call the restaurant ahead of time, they may be willing to tell you how many calories they think are in specific dishes. You need to ask. Don’t assume that just because you have been good and ate a small breakfast and a brunch, that you can do whatever you want at supper, because you can’t. In some restaurants, they will give you enough food in one meal to equal 2000-3000 calories. Learn what they have at the restaurants that you go to. You may find that with some dishes, you only need to eat half the food they bring you. If that is the case, you can take the rest home and have it for lunch or supper tomorrow or you can eat it. If you choose to eat it, acknowledge that you choose to eat it and that you choose to be in variance with your diet. That is your choice.
          Since you are off today, I hope that you choose to take the time to do some extra walking or exercise. Perhaps you choose to do something different. You may have chosen to go for a bike ride. The problem with bike rides is that people will go for a 2-mile ride and think that they have done a lot. If you are going to go for a ride and it is a social ride, acknowledge it for what it is--a slow gentle ride around the neighborhood to look at the birds. You will not use very many calories doing that. If you want to burn off calories--which is what is necessary to lose weight--then you need to go for a ride for 30 to 60 minutes and get your heart rate up into the fat-burning range. You need to sweat a little. If you do not sweat you may not be getting your heart rate up. It is best to use that heart rate monitor that you bought to see if you got your rate up. For adults 40 to 60 years of age, you should be getting your heart rate up to 108 to 96, and for adults 70 to 80 years old, you should be getting your heart rate up to 90 to 84 beats per minute. The younger you are, the higher you are able to push up your heart rate. As you get older, you need to be sure that you have discussed this with your physician. If they don’t agree, then go by what they recommend as they know your case better than anyone else.
          So you’re back to walking for the day. If you put in some additional walking, then you may have burned off extra calories, which is the goal when it comes to losing weight. You have to burn off some of the extra that you have stored. I know that all of us live a life that is full and no one that I know has a lot of extra time. Still, it is important for you to take the time and go for the walk every day. It will make the difference that you are looking for, both in terms of weight loss and enhanced health. It will give you more energy and you will feel better. You will probably have more time for your family because you feel better, and you are in a better frame of mind, and you can enjoy them.

Day 7

          Well, today is the last day of the first week. I hope that you are still getting on the scales on a regular basis. I hope that the first week has been successful. Tomorrow morning you will know how much weight you lost in the first week. You need to realistically shoot for 1-2 pounds a week. If you are losing more, then you may be cutting back on more calories than you should. During the first week or two of a diet, most people lose 5 to 8 pounds due to loss of fluids and sodium. So keep that in mind.
          You still should eat breakfast. It’s still the most important meal of the day, even on weekends. If you are going to skip a meal, it should always be supper. By now you know what you want to eat in the morning, and you probably have a bit of a routine down. You should be getting in 200 to 300 calories and getting the day off to a good start. You need to continue to get a snack like a piece of fruit 3 hours after breakfast, and a moderate lunch. It may be good to occasionally eat just fruit for lunch. In general, you don’t want to eat by the clock. You can eat your lunch at 2, and it is okay to eat supper at 8 p.m. Many times people get caught up in the specific times of the day and feel that they have to eat at that time; well, you don’t have to. People who work the swing shift have to be flexible, and you can be as well. It is not the time of day that you eat that is important; it is the amount of calories that you consume each day that counts. You can eat a high-protein, high-fat diet with 3000 calories a day and gain weight, just as you can with a 3000-calorie, low-fat high-carb diet.
          The weekend is a time when people have more time for outdoor activities, so try to take advantage of that. If your children have to go to soccer, baseball or dancing, then go with them, but don’t just sit down and watch them--go for a walk. If they are playing sports, you can walk around the field for the entire time that they are out there running. If they have gone to a dance practice, then go to the mall or go outside and go for a walk. You need to multi-task. Help out a friend and get them to walk with you. You can chat and walk at the same time. Both of you can benefit.

Day 8

Well, how did you do? I hope that you were successful and that you felt good on your plan. I hope that after one week you have seen a little success. If you have lost 5 or more pounds, that is good--but remember that part of that is fluid and what you are most interested in is losing fat. You did not burn up 5 pounds of fat in one week, unless you starved yourself for the week and ate nothing. I hope that you did not do that. I know one person who was having trouble losing weight and figured that she would have to go to a 1000-calorie diet in order to lose weight. The person plugged her numbers into dietpower.com and found out that if she cut her food consumption down to 2000 calories, she could continue to lose weight. She was taking in a lot more calories than she thought. The more you know, the more control you will have over your life. Learn everything that you can. Knowledge is good, but it takes more than knowledge to lose weight. You have to implement and use the knowledge that you have. You have to be willing to put it in practice. You can do it. You can do anything that you choose to do. You will live with the consequences of your choices, whatever they are. If you don’t like the path that you are on, then you need to change it.
If you cheated during the past week, how did you do it? Was it during a time of stress or emotional turmoil? What events made you cheat on your diet? Were you internally giving yourself a lot of negative talk, or did you just feel sorry for yourself so you took consolation in food? What was going on; why did you do it? You have to be honest with yourself. What did you cheat with, was it one of your weaknesses? Which one was it? How many calories were in it? How did it make you feel after you ate or drank it? Did you really think that it would not matter? When you cheat on yourself, it always matters. You get berated by your inner-self and have a loss of self-worth. You then have to regain it. I want you to list all the things that you ate in the first week that were not on your diet and list why you ate them and how they made you feel.

What I have eaten today

Day 1
Breakfast Food __________________________________
Liquids ________________________________
Snack Food __________________________________
Liquids ________________________________
Lunch Food __________________________________
Liquids_________________________________
Snack Food___________________________________
Liquids_________________________________
Dinner Food___________________________________
Liquids_________________________________
After Dinner ___________________________________

Day 2
Breakfast Food __________________________________
Liquids ________________________________
Snack Food __________________________________
Liquids ________________________________
Lunch Food __________________________________
Liquids_________________________________
Snack Food___________________________________
Liquids_________________________________
Dinner Food___________________________________
Liquids_________________________________
After Dinner ___________________________________

Day 3
Breakfast Food __________________________________
Liquids ________________________________
Snack Food __________________________________
Liquids ________________________________
Lunch Food __________________________________
Liquids_________________________________
Snack Food___________________________________
Liquids_________________________________
Dinner Food___________________________________
Liquids_________________________________
After Dinner ___________________________________

Day 4
Breakfast Food __________________________________
Liquids ________________________________
Snack Food __________________________________
Liquids ________________________________
Lunch Food __________________________________
Liquids_________________________________
Snack Food___________________________________
Liquids_________________________________
Dinner Food___________________________________
Liquids_________________________________
After Dinner ___________________________________

Day 5
Breakfast Food __________________________________
Liquids ________________________________
Snack Food __________________________________
Liquids ________________________________
Lunch Food __________________________________
Liquids_________________________________
Snack Food___________________________________
Liquids_________________________________
Dinner Food___________________________________
Liquids_________________________________
After Dinner ___________________________________

Day 6
Breakfast Food __________________________________
Liquids ________________________________
Snack Food __________________________________
Liquids ________________________________
Lunch Food __________________________________
Liquids_________________________________
Snack Food___________________________________
Liquids_________________________________
Dinner Food___________________________________
Liquids_________________________________
After Dinner ___________________________________
Day 7
Breakfast Food __________________________________
Liquids ________________________________
Snack Food __________________________________
Liquids ________________________________
Lunch Food __________________________________
Liquids_________________________________
Snack Food___________________________________
Liquids_________________________________
Dinner Food___________________________________
Liquids_________________________________
After Dinner ___________________________________

Things that I ate during the first week that were not on the diet,

Things I ate______________________________________
Why I ate them___________________________________
How I felt after I ate them___________________________
Now you must forgive yourself.

Continue with week two:

What I have eaten today

Things that I ate during the second week that were not on the diet:

Things I ate______________________________________
Why I ate them___________________________________
How I felt after I ate them___________________________
Now you must forgive yourself.

Week three:

What I have eaten today

Things that I ate during the third week that were not on the diet:

Things I ate______________________________________
Why I ate them___________________________________
How I felt after I ate them___________________________
Now you must forgive yourself.

Week four:

What I have eaten today

Things that I ate during the fourth week that were not on the diet:

Things I ate______________________________________
Why I ate them___________________________________
How I felt after I ate them___________________________
Now you must forgive yourself.

The gold standard (your goal) is within everyone’s grasp.

The First Month

          The first month is over; how have you done? Look at your goals: did you reach them or not? If you did, that is great; if not, then you need to examine what the issues are.
          I assume that you did meet your goals; you need to be proud of your accomplishments. This battle that you are waging is not an easy one; if it were, then no one would be overweight. Every step forward that you take is for your health. The progress that you have made is for you, not for me, and not for someone else. It has to be for you. Even if no one else has noticed that you have reached the goal that you set for the first month, I want you to know that I am proud of your accomplishments. I know that I cannot personally tell you, but be aware that I am. Now that you have reached the goal for the first month does not mean that you can back slide because you can’t. The journey goes forward. You need to continue to focus on your goals and the reasons that you picked the goals that you did.
          If you did not reach your goals, why was it? Did you set your goals too high? Did you shoot for more than 1-2 pounds a week? If you did, then you need to be more realistic. If you want to lose weight and keep it off, then you will need to look at what is reasonable and manageable. Perhaps your goals were not attainable during a one-month time period, and you will need to allot a few more months to achieve them. If you set a six-month goal, are you on target or not? This is an important issue. If you are not on target, then you need to take steps to get back on track. Do you need to cut your portion size or do you need to walk more?
          There are only a few things that you can do to get back on target if you are not meeting your goals. First, go back to the basics: look at portion control. Are you measuring your portions or have you gotten lazy and slipped back into some of your old habits? Most people falter in their motivation and have slid back somewhat. They have increased their portion size and are not paying attention to the details that they need to. Some people succumb to their weaknesses; they did not get them out of the house to start with and now they are paying the price. You cannot win this battle as long as your weaknesses are there tempting you. Be honest with yourself. I am not coming to your house to ask you these questions; you have to ask them and provide answers to yourself. If you can’t be honest with yourself, who can you be honest with?
          Still other people fail to take up walking. They think it doesn’t apply to them; it is for others. “I don’t have to walk,” they say. If that is your belief, then you need to re-evaluate your goal and be honest with yourself. If you are looking for a magic pill or potion, then you need to read Harry Potter and go to Hogwarts, as that is where you are going to find it. It does not exist in the real world. Now there is nothing wrong with fantasyland, but that won’t get you very far with weight reduction. It simply won’t work. Your weight is a problem that only you have control over and only you can correct. I can help give you advice but you have to want it enough to do what it takes to get there. If you don’t want it badly enough, then it won’t happen for you. There is no easy road, and if there were then no one would have a weight problem. You are just like me; you have to watch what you eat every day, and if you don’t then you have to pay the price and deal with the weight. I hope that you will be successful. It is not an easy job, but you can succeed.
          So does your stomach really shrink? You might wonder about that because you have probably noticed that it does not take as much food to fill you up as it did before. It seems like it has shrunk. Well, it has not shrunk but what has happened is that the nerve fibers in your stomach that tell you when you are full have been reset. It is sort of like resetting the thermostat in your house. It now comes on at a lower level of food and tells you that you are full. You could probably still put all the food in it that you did before, but you would be miserable. You would feel so full and bloated and uncomfortable. So it has not really gotten smaller, but it seems to you that it has. If you really want to put all the food in it that you used to, you still can—but I don’t recommend it.
          You need to focus on the basics, and take in fewer calories then you burn up. If you don’t, then you will gain weight. If you take in the same amount as what you burn up, then you will keep your weight stable. If you use more than you take in, you will lose weight. The amount of weight you will lose or gain depends on how many calories you take in or burn up. You control that by what and how much you eat. It is not difficult, but it can be frustrating, because you may say “I don’t eat much,” and that may be true relative to someone else, but we are talking about you. We are talking about your body, not someone else’s. So you need to look at yourself. This is about you--not about them. Sure, I would love to eat anything that I wanted and as much as I could, but I can’t and neither can you. We must have controls in order to survive and have our weight where we want it and our health where we want it, too. You may need to read sections of this book over again. You are not expected to remember everything with one reading unless you are Superman. It may be helpful to re-read some sections such as those on calories and exercise to refresh your memory. Repetition and re-reading can be a powerful learning experience.
          Well, what else can you do? You could modify your diet plan and choose a different one. Perhaps you do not like the plan that you chose. You could also redefine your goals; they are yours and you have the right to make new ones whenever you choose. If you already have medical problems related to your weight problem, then you will have to deal with those issues. It is still your choice, but you also choose the consequences. Just as you cannot make the choice to speed and not accept the choice of receiving a speeding ticket. They are related and you have to accept your responsibility for what you choose. That is life, like it or not.
          Let’s assume that you have completed the first month of your diet and you are on target for achieving your goals. That’s great; you’re doing a great job. However, do not get complacent and cocky in your approach, or you will end up in a plateau and have trouble figuring out why. Do not take your eyes off your goals; they are your goals--don’t forget. They are not my goals. If the batter takes his eyes off the ball, he will not hit the ball and if you take your eyes off the goal, then you will not reach your goals either. You are the most important person in your life, or at least I hope you are. You need to take care of you, because if you don’t then no one will.
          I hope you met your goals and that you are right on target. Don’t falter; keep the faith--you can do it. You need to review your goals every month. Make sure that your goals are reasonable and the plan is something that you can live with. You have to have faith in the diet plan that you are using; if you don’t, then it won’t work for you.

The First Year

          Well, the first year has gone by. If you are reading this it means one of two things: either you are one year down the road and are doing great, or you are reading ahead. Either way, congratulations on your commitment; you have done a great job.
          If you are one year down the road and have lost 1-2 pounds a week, then you have now shed a total of 52 to 104 pounds. That is great. You may have lost less than that, but it’s still great. It is possible that you still have weight to lose, but that is okay: you have made significant progress in improving your health and well-being. You need to know that I am proud of you for what you have accomplished. I may not be able to tell you personally, but I am proud of you. Keep up the good work; it is hard—both for you and me--but we can do it. It is a challenge and one that all of us will face for the rest of our lives.
          When you hit the maintenance level, then you will be able to do some things a little differently but you will always have to get on the scales, check your body composition, and watch what you eat. You will never be able to eat everything in unlimited amounts, but you will be able to eat all the foods that you like in moderation. As long as moderation is your mantra, you will succeed. You will win this battle; you will learn what you are supposed to learn about obesity and weight control. As I have mentioned before, life is a series of lessons and when you learn one, then you get to learn another. This lesson may have been about self-control, obsessions, sexuality, food, or self-love. Only you will know what you learned from this journey. If you did not learn all that you were supposed to learn, then you may have to repeat the lesson. I hope not. I hope that you were open to the lesson that was there, and now you can continue on with life and the joy of the lessons left to learn.
          It would be great if all the lessons were easy; however, I hate to tell you just in case you have not figured it out yet, but many of the lessons in life are hard. They are good, and after you have learned them you are happy that you have had the experience, but during the lesson it is not a joy ride. Who said that it was all fun? But life can be a wonderful journey, filled with lots to learn and experience. Continue to fill your life with the joys of every day. This is your life. Take care of yourself; you are worth it--you do matter. Be kind to yourself.

Chapter 11 >