• Most of the fad diets incorporate a strategy that has some potential merit in fat loss, or perpetuate a belief that has existed for many years. These diets pick and select amongst the techniques and package them as the new wonder diet. Almost all fad diets require strict adherence to a plan, which means that people are not learning how to cope with their own environment. Very few use the main principle espoused in this book which is that for a fat loss plan to be successful, it has to be something that can be done comfortably for life.

    Some of the characteristic strategies employed by fad diets, which may be useful in a more ‘balanced’ food intake program, but which are ineffective when used alone are:

    Monotony: (e.g. Meal replacements, single food groups/items, fasting (with or without juice), ‘macrobiotic’ diets. These limit the selection of foods in an effort to reduce temptation and often use foods that people believe are ‘healthy5 or to have special properties that bum fat. Examples are the ‘grapefruit diet and high-protein diets.

    Aversive conditioning: (e.g. Water-drinking diets, grapefruit diets, fibre supplements, meal replacements). These work through two general methods: (a) by either linking an unpleasant task such as being sick prior to eating (particularly if about to ‘binge’), or (b) by eating a least-liked/filling food first. Examples are ‘bran diets’ and the ‘water diet’.

    Ritual: (e.g. Single food items, fibre supplements, soup diets, meal replacements, fasting). Rituals may take many forms and have a basis in behavioural therapy. Eating may be delayed by completing a set ritual such as setting the table or by preparing an appetiser of raw vegetables. Food may only be consumed in one place with no other distractions (including conversation!) And food records must be updated prior to eating. Enjoyment does not figure greatly here. Examples are the ‘egg diet’ and the ‘macrobiotic diet’.

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  • Unfortunately, the few good studies on the use of antidepressants in treating self-starvation have produced nothing like the results seen in bulimia. The specific antidepressants studied so far include clomipramine and amitriptyline. Clomipramine, recently approved for use in this country and sold under the brand name Anafranil, is used to treat obsessive-compulsive disorder, which has some features in common with anorexia. The theory was that the same drug might prove effective in both. So far, however, results have been inconclusive. We need more studies, especially ones looking at the use of clomipramine in higher doses.

    If we can one day find the right antidepressant, we may help anorexics in two ways. First, these medications can improve depressed mood. When that happens, the patient’s attitudes may improve not just about eating but about life in general. Second, such drugs may correct the underlying biological malfunctions that produce the symptoms of the disorder.

    Depression by itself can cause weight loss. Conversely, weight loss can lead to depression. If her mood improves, fine; no medication is needed. If not, I will think about using an antidepressant. In certain circumstances I may try these products before the patient regains weight if her mood disturbance is severe, or if she engages in compulsive rituals that interfere with her ability to function.

    Even so, antidepressants pose risks, such as lowered blood pressure or problems with the way electric signals travel through the heart. One common side effect may be weight gain. As you might expect, an anorexic who is aware of this may resist taking her medication.

    Studies on lithium carbonate haven’t shown that it is of much use in treating anorexia. Some reports state that patients gained a little weight and experienced better moods. However, the weight gain may have resulted from salt and water retention, a known side effect of lithium. I wouldn’t use this drug on an anorexic unless she also happened to suffer from manic-depressive illness.

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  • When Adrienne Sussman’s sister-in-law lost weight, it was the proverbial straw that broke the camel’s back. “I had always been thinner and fitter than she was,” explains the 52-year-old mom from Silver Spring, Maryland. “Now, she looked better than me.”

    Envious of her sister-in-law’s success, Adrienne was determined to get back her former shapely figure. A svelte 103 pounds for most of her life, she began to gain after giving birth to her son in 1984. Once he started nursery school at age 2, Adrienne turned to food to make her feel better. “I missed my son so much and felt so guilty for sending him to school that I started eating just to calm my nerves,” she recalls. “I went to the bakery every day to buy a pastry for myself, one for my husband, and one for my son, Then, I’d eat all three.”

    Within a year and a half, Adrienne’s weight rose to 139 pounds.”At that point, my self-esteem had hit rock bottom,” she explains. “I looked in the mirror, and I really didn’t like what I saw.” Ironically, that mirror would later become a critical component of Adrienne’s I ^ weight-loss program.

    Determined to get rid of her excess baggage, Adrienne signed up for Weight Watchers. “My sister-in-law had joined, and I figured that if she could do it, I could do it,” she explains. But it wasn’t easy at first. “I didn’t want to go to the weekly meetings, because I felt really self-conscious,” she says. “So I wrote ‘doctor’s appointment’ on my calendar to fool myself into attending.” Eventually, she started looking forward to the meetings, where she learned to use a combination of portion control, exercise, and behavior modification to slim down.

    To monitor her progress, every couple of weeks she’d stand in front of the mirror completely naked and do a head-to-toe body check. Over the course of a few months, she saw her body changing. That’s what kept her motivated. “I stopped looking in the mirror and telling myself that I was destined to be overweight forever,” she says. “I accepted that whatever was broken, I had the power to fix.”

    With this new, positive attitude, Adrienne was able to shed 30 pounds. She has maintained her weight at a healthy 109 pounds for 8 years.

    These days, Adrienne serves as a program leader for Weight Watchers. She constandy reminds people in her group to stop obsessing about the number on the scale. “The most important questions you should ask yourself are, Are you happy with what you look like? Do you like the way you perceive yourself? And do you like the way you carry yourself?’ she says. “It’s what you think when you look in the mirror—not the number on the scale—that matters.”

    WINNING ACTION

    Let your mirror be your friend. Self-acceptance—even when you’re naked—is an important first step of any weight-loss program. Once you feel comfortable with yourself, you’ll have the confidence and patience to achieve lasting weight-loss success. Try the same strategy that worked for Adrienne: Every 2 weeks or so, take off your clothes and stand in front of a mirror completely nude. At first, you may not like what you see. But find one part that you do like, even if it’s your elbows! Over time, as your body changes, you’ll find more to like, and you’ll continue your weight-loss efforts.

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  • So there you have the Fat Blocker Eating Program, which I truly believe is the very best way to eat. A billionaire who could afford to hire his own team of scientists and nutritionists couldn’t end up with a better, more nutritious diet than this. Yet it’s simple, easy to follow, and all of the foods are readily available at your local grocery store. All that’s necessary is a little advance planning. Keep healthful foods at hand, prepare dishes in advance for quick reheating, and bring food along with you when you’re not sure what will be available. It’s when we’re unprepared that we tend to grab whatever food is nearby—and that’s when we have problems.

    But, above all, don’t forget to bring the Chitosan. Without that, you will be in trouble. And only the traditional draconian diet (the ideal that shows us the way but may never actually be achieved) will be enough to save you. Without Chitosan, you’ll be back trying to attain an impossible dream. With Chitosan, you’ll be able to lose weight in the real world.

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  • Splurges should be carefully planned and reasonably infrequent. If you let Chitosan enable you to splurge more often than you used to, you will undo all of your good efforts. Splurges are difficult to categorize because by their nature they are spontaneous. In general, however, I feel that you should try to limit them to no more than 20 grams of fat and a maximum of 300 extra calories. (If the splurge contains food groups from the Eating Program, the extra calories you should count are those above and beyond what you typically eat. For example, at lunch your plan may call for 1 serving of meat and 2 grains, which would equal 270 calories. If you decide to have a hamburger instead, which contains 330 calories, your extras would only amount to about 60 calories). Of course, since most of that extra is fat, 1 or 2 grams of Chitosan will take care of it.

    To help you with your planning, use this list of typical treats that might be used for a splurge, including the fat and calorie amounts that they contain.

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