Philip J. Goscienski, M.D.
June 2010
The fight against obesity isn't getting anywhere. More Americans are overweight, obese or morbidly obese than ever.
Stop thinking about weight loss. Think fat loss. Normal body weight includes muscle, bones, blood, skin and all the organs in the skull, chest and abdomen as well as the small but necessary protective layer of fat under the skin. It does not include a bulging belly, double chin, lumpy bottom or droopy arms and chest. Most of all it does not include the accumulation of fat inside the abdomen known as visceral fat.
Fat is not inert. It produces chemical substances that promote inflammation and that play a role in problems that range from coronary artery disease to type 2 diabetes. The estrogen-like hormones released from fat stores may play a role in breast cancer. One thing is certain: these chemicals are not good for us.
The solution to obesity is fat loss, not weight loss. The weight that is usually shed in the course of a severe reduction in calories includes lean body mass, most of which comes from muscles. No wonder successful losers feel weak! Lean body mass can be nearly half of the total pounds lost.
In their eagerness to lose weight most dieters ignore three healthy principles. The first is to lose fat slowly, no more than about two pounds per week after the first week. (The pounds lost in the first few days, especially on a low-carbohydrate diet, consist mainly of water and stored energy in the form of glycogen.) More rapid loss is usually accompanied by weakness, fatigue, cravings and a risk of a gallbladder attack.
The second principle is to exercise with moderate intensity almost every day. Walking and running are good but they are not adequate. Lifting weights or using weight machines encourages muscles to retain strength and tone and minimizes loss of muscle tissue. The third factor supports the second: maintain adequate protein intake. The calories cut from a diet should consist mostly of fat and carbohydrate; the body requires a minimum protein intake.
The scale will not tell you how much fat you have lost but an impedance analyzer will. These don't cost much more than a bathroom scale but they measure body fat, which is what you really want to lose. These instruments are fairly consistent as long as conditions are the same (after a morning shower and before breakfast).
Philip J. Goscienski, M.D. is the author of Health Secrets of the Stone Age, Better Life Publishers 2005. Contact him at drphil@stoneagedoc.com.