The first week of January is the traditional time for overweight people to start a diet.  For years I’ve told my patients (and anyone else who would listen) to fight the holiday eat-a-thon and start the new year at the same weight they started the month of November.  During the time between Thanksgiving and the end of the year, so the media typically reports, the average weight gain is anywhere from five to ten pounds per person.  A study in Nutrition Reviews showed the weight gain to be much less on average but a little over five pounds in those who are already obese.  This same study confirms a belief I’ve had for many years.

The best and easiest way to stay slim is to never become obese in the first place.

What I mean by making this seemingly obvious statement is that when a person goes from being normal weight to being overweight it is an indication that something metabolically has gotten broken.  At this point, no one knows for sure what gets broken, but many (and I count myself in this ever growing group) believe the damage occurs in the mitochondria, the organelles within the cells that are the energy furnaces.  Once whatever it is that gets broken breaks, it is difficult from that point on to lose weight and maintain weight loss without effort.

The study I mentioned above showed that the non-obese didn’t really gain anything over the Thanksgiving through New Year’s holidays, and I’m sure it’s not because they didn’t go face down in the fudge.  They didn’t gain because their metabolic systems were working properly.

MD and I both had our struggles with excess weight starting a few of decades ago.  We were both thin, both ate whatever we wanted, and both never gained weight.  Until, that is, our metabolic systems became damaged.  Once that happened, we ballooned, then lost, then have fought it since.  We both have kept our weight under control for years now with a few exceptions here and there by judiciously following a low-carbohydrate diet.  Since we’ve both stayed pretty much in the normal weight range for at least the last several years, we decided to try an experiment over the holidays.  And not over the entire Thanksgiving to New Year’s stretch but for a fairly short stretch between Dec. 20-Jan 2.  We had planned to make a multi-state trek to visit relatives over this period, so we decided that while we were traveling, we were going to eat like normal Americans just to see what would happen.

We didn’t go out of our way to overindulge in anything.  We had a maybe two hamburgers with the bun and had two or three orders of fries (I’m talking about during this entire period – not every day).  We had a Christmas cookie or two, downed several pieces of fudge, drank a bunch of eggnog, ate some fruitcake, and had a couple of bowls of ice cream.  And MD had a little more wine than usual while I probably doubled up on my Jameson.  Other than those indulgences we ate what would be considered sensibly by most people.  We ate some mashed potatoes, grits (we were in the South), beans (not the green bean variety), more fruit than usual and meat of one sort or another.  Pictured below is my plate (which I doubled down on) on New Year’s day.

As you can see, I ate ham, cheese grits, black-eyed peas, curried fruit, and corn bread.

The point of this exercise was to see what would happen to us if we followed a sort of modified typical American diet.  We avoided trans fats and vegetable oils as much as we could and had absolutely no soft drinks.  We had no breakfast cereals of any kind and took it easy on the wheat, but we did eat a little bread occasionally.  Except for the bits of fudge and other Christmas goodies we consumed – all of which were homemade using butter and/or lard as the fat source – we didn’t really go overboard on the sweets.  Our fructose intake was doubtless considerable less than that the average American, especially during that time of year.

So what happened to us during this couple of weeks of much better than average typical American dieting?

We gained weight!  And a fair amount of it.

I don’t know exactly how much we each gained because neither of us ever weighs – we go more by how our clothing fits.  (We didn’t plan on starting this little experiment before we left or we probably would have weighed.  We started it once we were already on the road.)  When I left on the plane, I wore a freshly laundered pair of jeans that fit loosely around my waist and that scrunched up a bit when I tightened my belt.  When we flew home, I wore the same pair of jeans (also freshly laundered), and they were tight around my waist and my belly actually spilled over a little.  MD had the same experience except her weight distribution was a little different.

If I had to guess, I would say we both gained somewhere around five or six pounds.  We were clearly at the top of the range of weight gain as described by the study I linked to earlier, and it happened in two weeks not the six weeks as it did in the study.  Which would indicate that we fall into the obese category, since the obese are the ones who most readily gain weight over the holidays.

But we aren’t really obese, or at least weren’t when we started.  But we obviously have the same metabolic defect that the obese have.  Our metabolic machinery has been damaged.  And even though we’ve keep our weight under control for years, the problem is still there, lurking in the weeds, ready to strike the moment we drop our defenses.

The take home message here is, to paraphrase Wendell Phillips, eternal vigilance is the price of thinness.  At least after you’ve once become obese.

So, MD and I are back on a rigid version of our own program, we are taking Metabosol, and, with the exception of a party we attended last night, are eschewing booze until we get back to our regular sizes.  Some of my GERD symptoms re-appeared during our modified debauch and I was thankful I had an old bottle of out-of-date Protexid to see me through.  One day of solid low-carb, and no more GERD, thank God.  And already after just a few days our clothing is starting to fit again.

If you are one of the many who are committed to a program of weight loss and rehabilitation this January, know that MD and I are right in there with you.

I want to forewarn you, though, that you’ve got to get your head right if you seriously plan to succeed.  Don’t be a Tara Parker-Pope.

I’ve had a number of people send me the link to her long piece in last week’s New York Times Magazine (Parker-Pope is a health columnist for the New York Times) about her struggles to lose weight and to maintain her weight loss once she is finally able to shed a little.  In the article she describes her despair as she tried first this program then that to lose weight.  She fits perfectly the description of so many patients I’ve dealt with over the years.

Once your metabolism is broken, it’s difficult  to lose weight (other than the first time or two you try it) and even more difficult to keep it off.  In order to be successful, you’ve got to make a real commitment and stick to it.  You can’t drift here and there as Parker-Pope has done looking for some magic regimen that is going to ‘melt the fat away.’  It ain’t going to happen.  It takes a lot of hard work and resolve to see it through.  Even with a low-carb diet.

As you can see from the vintage ad above, Tara Parker-Pope is not the first to look for a miracle cure for excess ‘flesh.’  But she is at a bit of a disadvantage in that by virtue of her position she can pick up the phone and call the head of nutrition at Harvard, Yale, Johns Hopkins or any big institution and ask for advice for a column she’s writing.  Unfortunately, the advice she will get from most of these people is totally the mainstream academic party line and more than likely incorrect.  And, if she’s like many patients I’ve dealt with, as soon as she discovers that whatever she is doing entails real work, she will start looking for the next magic fix, only to be disappointed in that.  She will, as she describes, roller-coaster around weight-wise, quickly regaining whatever she loses, and end up fat, sad and miserable.  The only difference between Tara Parker-Pope and the millions of other people out there in her shoes is that she has a powerful platform to express the despair and hopelessness she feels to a large readership.  (I noticed that for a few days her piece was the most emailed of all the articles in the New York Times, which speaks to just how many people are struggling.)

The underlying message of her piece is that she has tried everything, and it has all been for naught.  Her obesity is a condition beyond her control because she has worked with all the greatest minds in the academic world of obesity treatment and has ended up fatter than when she started.

My contention is that if she would undertake a low-carb diet composed of whole foods (with maybe a shake or two thrown in here or there) and stick with it judiciously she would ultimately achieve success.  At least considerably more success than she has achieved thus far.  But if she followed the best low-carb diet known to man and lost to her ideal weight and body fat percentage, she would still have to continue to watch what she eats for the rest of her life if she were to want to maintain her new slim self.  MD and I just proved that over the past couple of weeks.
I have never been able to understand the mindset of people who think that once they lose to their ideal weight and body fat percentage they can then go back to their old way of eating without regaining all the weight they originally put on by their old way of eating.  It baffles me even more that people can lose considerable amounts of weight on a given diet, then go back to their old way of eating, regain all their weight, and view it as a failure of their weight loss diet.  But they do.

I always took a detailed dietary history of all my patients.  Many had been through two or three (or more) weight loss programs before they came to see me.  I would ask them about all the different programs they had tried, and they would list them out.  And most had had some measure of success on one or more (if not all) of these programs, in many cases having lost anywhere from 60-80 or more pounds, but they, almost to a person, considered these programs failures because they had regained their lost weight.

These people, like Tara Parker-Pope, MD and me, and anyone else who has crossed the Rubicon into the land of obesity have dysfunctional metabolic systems that will probably never be completely normal again.  They, like we, will always have to exercise vigilance to maintain what we maintained so easily before the damage took place.

As I wrote above, the easiest way to deal with obesity is to never become obese in the first place.

Which brings me to a real pet peeve of mine.  I want to go for the throats of people who let their kids eat and drink tons of sugary crap and justify it because their kids don’t gain weight from it.  Who knows when the irreversible damage begins to occur?  I feel the same about adolescents and young adults who seem to feel invincible and are face down in all kinds of crap all the time because they never gain weight.  And they assume, stupidly, that they never will.  But when they do, most will struggle with it for the rest of their lives.

In preparation for my own weight loss, I went back an reread a few of my old posts to gain inspiration.  If you are in the let’s-lose-weight boat this month with MD and me, you might want to read them, too.

Here is one of my favorites about a good friend who really committed to losing weight and turned her life around.  The post also tells you why you should gain control not just for yourself but for others.

Another old post gives some psychological insights as to why it can be difficult right now to give yourself over to a low-carbohydrate diet and some psychological tools to make it easier.

Here is one that gives a few more psychological tools to make dieting easier.

Years ago I wrote a regular column for a now-defunct low-carb magazine.  This piece on what it takes to really make a low-carbohydrate diet work may help with your struggles.

There are the two fairly recent posts on all the tips and tricks you can use to start (or restart) a low-carbohydrate diet.

I’m frequently asked on radio, TV and print interviews what my daily food intake is.  A couple of years ago I decided to do a photo diary of a week’s intake of food during a normal week.  The food I ate that week pretty much mirrors the food I eat now with a couple of exceptions.  The quality of the cooked food is better now because almost everything we eat at home is prepared sous vide for obvious reasons.  I go through periods from time to time in which I really like to have shakes for breakfast.  Then I burn out on them and almost can’t bear the thought.  During the non-shake periods I typically eat three eggs and three or four slices of bacon (Mangalitsa bacon if I can get it) every day for breakfast.  During my week’s photo log, I was in a shake phase, so realize that I am not now in shake phase, so it’s bacon and eggs, but that’s about the only difference.  The week’s diet you’ll see if you take a look is what keeps me at my normal weight.  It’s pretty much what I’m back on now minus the booze and a few of the little extra carb tidbits. Plus, I’m scrupulously avoiding wheat just to see what happens.  As soon as I lose the few pounds I picked up and my jeans are loose again, I’ll be back to this diet in full.

• Photo food diary day 1
• Photo food diary day 2
• Photo food diary day 3
• Photo food diary day 4
• Photo food diary day 5
• Photo food diary day 6
• Photo food diary day 7

If you, like we, have been noshing on more carbs than normal over the holidays, then start anew with us this January.  As I have discovered this first few days, the time I spent dallying with carbohydrates over the previous couple of weeks has reinvigorated my long dormant urge to eat even more carbs.  I’m sure I’m not the only one in this boat.  We all have to remember that this urge is one we have to overcome first by effort and ultimately by habit.  I’m back on track.  Hope you are as well.