CHAPTER 7
Calories

Calories: Do They Count or Not?

          This is a question that I know has gone through your head many times. Is the answer yes, no, maybe, sometimes or what? You need to know.
          Do you need to count every calorie, or just some of them? Are there good ones and bad ones like there are with carbs and fats? If you are not confused, then you probably have not read many of the diet books out there. If you go by the other Dr. Atkins diet, then no you do not have to consider calories at all, and if you go by the South Beach Diet you also do not have to go by calories. If you use this diet then you do. Many diets do require that you keep up with what you eat.
          Why do some diets require you to keep up with calories, while others do not? The answer lies in what you eat on the diet. If you are eating a diet that is high in protein and fats, then you may not have to monitor the calories because after you have eaten as much as you can, you don’t want any food for a while since it takes so long for it to digest in the stomach. While it sits there you feel full. When you are full, hopefully you will not go nibbling and looking for other food or drinks. It is hard to get in 3000-4000 calories a day when you are on a high protein diet. You are not going to sit around and nibble on steak while you watch TV.
          However, with this diet, because we limit very little--just soft drinks and your weaknesses which in some cases are large portions and food bars--you will have to keep up with what you are eating. Calories are the main unit of energy that the body uses. If your metabolism is revved up and you are burning more calories per hour then you used to, you will need to put more fuel in than before. The same is true with a car: if you let it idle at 1000 rpm, it will use a certain amount of fuel per hour, but if you let it idle at 3000 rpm’s, it will require a lot more fuel. Next time you are in your car try it. See how the engine sounds at 1000 and 3000 rpm’s, and you’ll see the difference. If you put enough fuel in it--assuming that you are going to run it at 1000 and instead run it at 3000--you will run out of fuel early. You have to know how much fuel you are burning and plan accordingly.
          So with this diet and many others, yes, it is important to keep up with calories. The advantage of this is that you do not have to remove as many types of food from your diet as on the other diets. I do not make you come off all carbs for the first two weeks as the South Beach Diet does, nor do you go on a very low carb diet the way the other Dr. Atkins diet does; in fact, you continue to eat what you usually do, except that you get rid of pure sugar such as soft drinks, as well as your weaknesses. The reason you have to get rid of your weaknesses is that you recognize right up front that you have a problem with them; I know I have mine, and you know that if you don’t get them off your diet that you will fall right back into the pattern that you were in before that caused you to become overweight. For some it is a pattern of simply overeating at meal time.
          If you are using diets that don’t require you to keep track of how much you eat, that is fine as long as it works for you. I don’t think there is only one way; I think that there are many ways that work--you just need to find the one that works for you. If one plan doesn’t work, fine--use a different one. Do not expect that one plan fits all, just as one shirt won’t fit everyone. Find the one that works for you, and stick with it.
          Are there good calories and bad calories? The answer is both yes and no. Yes, some calories are bad because all they do is provide you with calories that do not do anything good for the body. An example is sugar, which you find in soft drinks, and sweetened tea; you will find the fermented variety in the form of beer. The only thing those calories do is run the body for a while, and if your total energy input is not excessive then they will not go to fat. If on the other hand, you eat large portions of food containing these extra calories, they will rapidly turn into fat. The good calories are the ones that supply not only energy but also amino acids so that you can build muscle, good fats so that you can try to keep your heart healthy, and complex carbohydrates that will give you nutrients and fiber. If beer is bad, what about wine? I suspect many of you know that red wines seem to help prevent heart attacks. It is interesting that this does not seem to be true for white wines. So the calories in red wines may be good, because they do have a beneficial effect on the body while the ones in white may be bad.
          Finally, do you need to count every calorie or just some of them?
When you start off, the more you know about what you are putting into your mouth, the better off you are. The more you know, the better control you will have over the situation. So yes, to start with you will need to think about all the things that pass your lips from gum to drinks, food, and snacks. Everything counts when you are talking about fuel. Calories are simply the fuel that the body uses. There is no free ride. Popcorn has calories, and so do carrots. If you do not know what you are putting into your body, it will be hard to lose weight. That is one reason why I want you to monitor everything that passes your lips when you start the diet, so you will have a better idea of what you are eating. Some diets don’t require you to count calories, but if you look at the diet you will find that they have a developed recipes for you to follow and they tell you how much is a serving; they expect you to eat one serving not two. So in effect they are counting the calories for you. They are trying to get you into the habit of eating smaller portions, and learning what a normal portion size is. If we could learn to eat until our hunger is satisfied and not to the point of being bloated, we would all do better. This is easier said then done. When you are around food there is a tendency to eat it even if you are not hungry; that is why it is so important to make sure that you do not set yourself up to fail. Protect yourself, get rid of the weaknesses that you have, use smaller plates, avoid soft drinks, and buffets and salad bars. If you don’t you will set yourself up for failure, then you will have to start again. If you do fail, do not beat yourself up; look at it as a learning experience, ask yourself what could I have done differently, how could I have been successful? Be honest with yourself. Then you will succeed.

If you think the work of losing weight is too much, try diabetes

Overeating

          Overeating is the number one problem causing obesity. Overeating consists of consuming more calories than you burn up. So some of the calories that you have eaten are going to turn into fat.
          Why do people overeat? As you probably know by now, it can be for many reasons. What you need to do is look at your life and see if you can answer the question for yourself. For some it is simple oral gratification; the act of eating is enjoyable. For others, the food simply tastes good. Some people eat when they are stressed, and others because they are bored. Some may have a gnawing sensation in their stomach because they have drunk too much coffee or tea, while others just eat so fast they do not give their stomach time to let them know that they are full, and they stuff themselves. Others have psychological problems and eat to escape from whatever pain is afflicting them. One of my patients felt that to be thin was to be attractive to the opposite sex; she was so filled with fear about relationships that she chose to stay obese so she didn’t have to deal with that feeling. Still others believe people may overeat because in a previous life, they had to starve and this is a compensation for what they went through in that lifetime. What are your own particular triggers for overeating?
          As you can see, there are many reasons why people overeat, and sometimes it is difficult to know the exact cause. You may not even know the reason in your own case. To find out, some people go to psychiatrists to see if there is a psychological reason for their obesity. Others have tried past life regressions to see if that will resolve their obsession with food. There is no one answer to the problem. What you have to do is to look at your life and try to see if there is any factor that you can identify.
          So what do you do if you do not have a psychological problem? You need to identify whether the cause is stress, boredom or other factors that tend to stimulate overeating. Once you can begin to identify the factors, then you will be able to have some control over them. You have to acknowledge them before you can control them. The hardest part is being brutally honest with yourself. We all tend to take it easy on ourselves when dealing with this subject. Many people like to blame genetics, or the fact that their mothers made them clean their plate when they were small. Well, genetics will dictate where you are going to put on fat if you gain weight but it is not going to make you fat unless you overeat. Genetics will not make you overeat.
          If you want to blame your parents because they made you clean your plate, then you need to acknowledge that was in the past and this is now. The past is the past and you cannot go back and relive it. So let the past go and live in the present; accept your responsibility for where you are today. Your parents are not making you clean your plate today--that is your choice, so accept responsibility for it. There is an old saying: “If you do the crime, you do the time,” so take responsibility for your actions and stop blaming them on someone else. Our society has a tendency to blame others for our problems, when in fact what we need to do is to take a good look in the mirror.
          Not long ago, I saw a lady named Linda, age 42, a secretary, very well dressed and attractive, who had put on 20 pounds in the last 4 months. Why? She was upset that she had done it. She acknowledged that she had set herself up for the problem. She had gone to the bulk food store and bought a large cake and a lot of large muffins that were filled with chocolate chips. She did this last week and has continued the practice regularly. When she is in the house she will nibble, and with the temptation she fails.
          We all have to deal with temptation. We have to figure out how to deal with it. We all know our weaknesses and if you put them right in front of you every day, then eventually you will succumb to the temptation. That is only human. When I go to the grocery store, I do better if I don’t buy ice cream then if I do and put it in the freezer at home. If it is in the freezer, then it will get eaten, and I will be the one who eats it.
          If at work someone has brought chocolates to the office, I am fine if I do not eat the first one, but if temptation wins then I may eat 20 pieces before I stop. Why? It is easier to avoid something then to stop once you started. If it is not in the office then I don’t crave it, but if I see it, and think about it, then I may eat it. Some people can eat one piece and walk away. That is not their weakness, but they know what their weaknesses are and they have them. We are all human and have our weaknesses; for some it may be food, for others something else. No one is perfect.
          Still, we don’t need to put temptation in our way. If you know that coming into the house through the kitchen will result in you nibbling food before supper, then come in through a different door. Do something different so that you don’t have to deal with the temptation.
          As you can see, a lot of things can cause us to overeat. It is not just the extra-large portions of food and drink sold everywhere. You need to look at yourself and see what unique issues are confronting you. We are all different and see the world differently. You know the things that set you up for failure. The question is whether or not you will admit them to yourself. Some people don’t want to, and unless you acknowledge what the problem is you will not be able to overcome it.
          Just acknowledging it is not enough but it is the first step. Intentions are not enough. You have to take action as well. Just because you intend to lose weight, if you never take any action, you will not succeed. If you are driving your car and you are heading for a tree and you intend to turn the steering wheel but you never do, then you will hit the tree. What you intend to do, without action, means little. The world responds to action, not intention.
          As you deal with overeating you need to look at your issues, your weaknesses, your “buttons” that get pushed. You have to take care of yourself; no one else will. Don’t set yourself up for failure. Realize that if you stumble with your diet, you did not fail--you only had a temporary setback.

How To Gain Weight

          This part is easy, you say, so why do you include a section on how to gain weight? The answer is simple; it is just as hard for a thin person to gain weight as it is for an overweight person to lose weight.
          It may be easy for you to gain weight, because you already have a problem with being heavy. When you take someone who is thin and has never been able to gain weight, then it is a different matter altogether. If you know how to gain weight, then you will be better prepared to lose weight.
          This is not an unusual problem. It is true that 65% of Americans are overweight, but there are some adults who only weigh 80 pounds who are full grown, with ages ranging from their 30’s to their 80’s. For them, gaining weight can be as critical as losing weight for the obese patient. When someone who only weighs 80 pounds gets sick with pneumonia, he does not have much in the way of nutritional stores to draw upon if he were to lose his appetite for a few days. If the person did not eat for a week and lost 5 pounds, he could be at death’s doorstep. For such individuals, gaining 5% to 10% of their body weight could give them the cushion they need if they were ever to get sick.
          When you have a person who is thin, one thing that you have to worry about is whether or not the individual is getting an adequate amount of vitamins in his or her diet. They are probably only eating 1000 to 1200 calories a day, so it is very probable that their diet is deficient in something. These patients need to consider taking a high potency vitamin each day. If one is good then two must be better. Probably not, but it should not hurt them, and if they wanted to take a vitamin twice a day I don’t know anyone who would tell them not to. Some people end up taking several hundred dollars’ worth of vitamins a month. There is no evidence that this is beneficial; in some settings it could be harmful, depending on what is being taken. Many people feel that if one is good, then surely 10 is ten times as good. Not true. Two aspirins may help a headache, but 20 may give you an ulcer and ears that are ringing; if you are a child, then 20 could put you in the hospital.
          You have to be careful about vitamins. Keep in mind that the people selling them have an ulterior motive; they want your money, and they are not always honest in the claims they make about their products. For example, many people want you to buy their calcium tablets because they come from an area where people live a long time, as if the two were related. They want you to buy a special vitamin C because it is better for you. This is all salesmanship. If you fall for it, fine--send them your money. I will buy mine from the grocery store. The vitamin industry is a multi-billion dollar business. You need to look at what is being put into the vitamin that you buy because there may be some ingredients that you don’t want such as herbs.
          So, returning to our main topic, how can we get thin people to gain weight? They have to take in more calories then they burn up. Nutrition supplements can be helpful for this population. If we could simply get them to eat more food, that would be great but many times that is not an option because they just can’t get it down, they don’t want it. There are a lot of nutritional supplements that come in cans and are convenient, but expensive. A lower-cost alternative that is also excellent is Carnation Instant Breakfast; mix it with either milk or soy milk. To add extra protein, you could mix in a couple eggs. Today you can get eggs that are pasteurized and then you do not have to worry about infections with bacteria. Most experts do not recommend adding eggs that are not pasteurized. The risk of infection is small, but if you are already underweight and get a bad case of diarrhea from salmonella or shigella it could be lethal. People also use supplements from health food stores or local gyms to increase their consumption of protein and calories. If you are trying to gain weight, you do not want to do it just with empty calories like soft drinks or beer. You want to increase the intake of all nutrients including proteins, fats, carbohydrates, and vitamins
          How can you tell if you are doing well? One method is to use dietpower.com; this is program will allow you to follow your progress as you gain weight as well. This program will allow you to keep up with the calories that you eat as well as the calories that you burn up. You record everything that you eat and it will tell you how many calories you have eaten, and you record the extra exercises that you did and it will tell you how many extra calories you burned up. It will plot your weight on a graph and let you know how many calories you need to eat to reach your goal for the day. It is great if you are trying to gain or loose weight. The scales represent one benchmark, but what is more important then simply weight is your muscle mass and percent body fat. This can be monitored by a body composition analysis. It is important when you are gaining weight that you are not just putting on fat, but that you are putting on fat and muscle and that you are keeping the percentage of body fat to a reasonable number. If you are already starting off with a low percent of body fat such as 6%, then as you gain weight it would be good to see the percent of body fat increase closer to normal. You would not want to see the percent of body fat go to 30% with no increase in muscle mass, because then all you have done is make the person fat without making him healthier.
          When should someone see a physician? If you are thin and trying to gain weight, it is a good idea to see your physician and make sure that you do not have any other problems that could interfere with your goal such as an overactive thyroid gland, or diabetes. There could be medical problems that need to be corrected so that you can gain weight.
          Are there medicines that can stimulate the appetite? The answer is yes; however, it is important if you use them, that you are doing things to stimulate muscle development, such as exercise. If you don’t, then you are more likely just going to add fat tissue and not healthy muscle. These medicines include megasterole acetate, dronabinol, eldertonic, and prednisone. Some of these agents could be harmful and therefore, you need to discuss them with your physician.
          As mentioned earlier, it is very important that you stay active and work on developing your muscle strength. If you don’t, then you will gain mostly fat tissue. It is the muscle mass that is the healthy tissue in your body and therefore, this is the tissue that you want to develop. You do not have to go to the gym to work out; you could just take up walking as a good form of exercise.
          If the underweight person can consume an extra 200 calories a day, then he or she has the ability to gain approximately 2 lbs. a month. This amounts to just two donuts, one bagel, or ¾ of a can of food supplement, in addition to whatever else they were eating. If you are going to gain weight then you have to get in more calories then you are burning up. If you do not, you will not gain weight. You do not have to increase your consumption of food by large amounts you just have to be consistent and get in extra calories every day.
          To sum up, gaining weight is as complicated as losing weight. Many times overweight people look at the underweight person and think: You can eat anything. The problem is that they might be able to eat anything but it may not taste good to them, and they have trouble getting it down. It is important to recognize that we all have a difficult journey to travel; some have different lessons to learn, but life has bumps in it for all of us.

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