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Tuesday, August 18, 2009

Break Through Your Set Point: Introduction

You know the feeling: cranky, tired, and hungry—the telltale signs of another diet attempt gone awry. Whether you’re dealing with a recent middle-age spread or a lifetime of being too heavy, chances are you’re desperate to lose weight to look and feel better. But despite your best efforts, you aren’t succeeding. Perhaps you’ve hit a plateau and can’t seem to nudge down the number on the scale. Or maybe you’ve managed to reach your goal weight only to regain the pounds.



Failing at weight loss isn’t due to a lack of awareness, money, or effort. We know that being overweight can lead to health problems. Dieters join weight-loss groups, start and abandon diets out of frustration, and buy the miracle products pitched in magazines, on television, and on the Internet. Each year, Americans spend an estimated $50 billion on weight-loss products and services. Despite this enormous cash outlay, two out of every three people in the United States are overweight, and about half of those are seriously overweight or obese.

In our convenience-driven society, abundant food and fewer opportunities for physical activity make it easy to gain weight. Some of the blame also lies with the overhyped marketing of fad diets and dietary supplements that promise to melt fat away. Infomercials and Internet ads imply that you can lose weight with little effort. It’s hard to abandon all hope of a quick fix when new products and new diet plans continue to promise amazing results. If you’re reading this book, you may already know those claims aren’t true. And with more than thirty years of clinical experience in helping patients lose weight, I can say with certainty that there’s no such thing as a magic bullet.

I tell my patients that while it isn’t easy, it is simple. You don’t need to give up any of your favorite foods, and you don’t have to count calories. To lose weight and keep it off, you need to follow three steps:

1. Eat less food.
2. Eat healthful foods.
3. Be physically active.


Here’s the novel part: Set a reasonable goal to lose about 10% of your initial body weight. Then hold steady at your new weight without regaining any weight for at least six months, which will reset your body’s set point (or typical body weight). Once you’ve reset your set point, you can repeat the cycle to lose even more weight. Following this advice in the context of a structured daily routine will reap positive changes in your health, well-being, and appearance and prevent those extra pounds from coming back. I’ll show you how managing your time more effectively and getting more sleep can help you accomplish these goals.

I know you’ve heard the basic message many times before: eat less and exercise more. What’s different about Break Through Your Set Point is that it gives you specific tools and targeted advice to effect and sustain those changes. The book you’re holding includes all the tips and tricks I’ve prescribed to my own patients to help them restructure their eating and exercise habits and lose weight. Most importantly, I never give any weight-loss patient the exact same advice, because each person has unique reasons for gaining weight and making lifestyle or behavior changes. But whether you’re a busy parent with kid-food syndrome (you eat chicken fingers and sugar-coated cereals on a regular basis) or you’re a former athlete-turned-couch-potato (your exercise routine fell by the wayside after you left school), this book will help you devise a plan that works for you.

One of my mantras is find your own path and take the journey slowly. This easy-does-it approach isn’t a concession to laziness. My program is based on the proven scientific fact that the body resists losing weight after a certain point, which stems from the body’s innate tendency to protect itself against starvation.

This book is based on three decades of my own research and clinical practice, coupled with innovative findings from other experts in the field. My doctoral studies at Massachusetts Institute of Technology (MIT) identified the twenty-plus essential nutrients required in special formulas used to deliver nutrients through a vein. This type of feeding, known as total parenteral nutrition, nourishes and sustains people who are unable to eat normally because of gastrointestinal surgery or other problems. My expertise in this area prompted a request from a physician and a businessman to develop a formula for a good-tasting, nutritionally sound meal replacement that people could buy over the counter to help them lose weight. This became the SlimFast shake, which has proven to be a safe, effective weight-loss aid not just in clinical trials but also in a long-term study.

During my surgical training at Kansas University, I witnessed and studied the dire complications of early weight-loss surgeries. With the help of Dr. Edward Mason, who developed the Roux-en-Y gastric bypass procedure—a vast improvement over the previous surgeries—I introduced this technique to the Boston area in 1975. It is now the most commonly performed surgery for treating severe obesity.

The most meaningful discoveries I’ve made deal with the range and rate at which people lose weight and how those factors affect their regaining the weight. My studies were the first to discover that most people can change their body weight by only 15 to 20 pounds at a time. I demonstrated that this modest loss will improve health, helping people to recover from weight-related problems such as diabetes, high blood pressure, and high cholesterol. Countless other studies by researchers around the world using a variety of different diets confirmed the same phenomenon, which has formed the basis for national guidelines now promoted for the treatment of overweight and obesity.

We know that the body imposes a natural limit on how much weight you can lose. It is governed by an internal balancing mechanism that works to keep your body weight at a stable point—or set point. My studies documented that people failed at weight loss only when they tried to lose too much weight too quickly and without long-term goals. They also showed that diet was only one facet of enduring weight loss. It took a multidisciplinary team approach with dietitians, behavioral therapists, and health care providers to enable patients to eat less, choose healthy foods, become physically active, and achieve a lifelong healthy body weight.

As you are introduced to the set point theory, you’ll learn how your genes affect your set point and explore the myriad of environmental influences that have caused Americans’ set points to creep upward over the past few decades. You’ll see how the 10% solution is governed by your set point, and more important, why this modest weight loss is enough for most people to become healthy and stay healthy for years. I will lead you through the lifestyle changes that will help you realize the three simple steps of eating less, eating healthy, and exercising more. The case studies will help you identify your own challenges around food, activity, time management, and sleep. By mastering a simple journaling technique that allows you to track your progress, you can figure out which areas to target and adopt strategies that resonate for you. In essence, this book provides the pragmatic program that will get you lasting results.

I’ve spent decades investigating the treatment of the diseases linked with both starvation and excess weight. I’ve helped thousands of patients. But there’s another reason you can trust me, which is that I really do know how you feel. I used to be 20 pounds heavier. I was not blessed with a naturally fast metabolism. I make choices every day that help me stay at a healthy weight. Nearly every morning, I take a brisk 2- to 3-mile walk around the pond near my home. Afterward, I leisurely spend twenty minutes enjoying a healthy breakfast of cereal, fruit, and skim milk, eating slowly to give my stomach time to tell my brain that I’m full and satisfied. My office is on the eighth floor of the hospital, and I walk up those flights at least once a day, often twice. My lunch usually consists of a big salad with dark, leafy greens topped with vegetables, nuts, dried fruit, and raspberry vinaigrette. These choices are now second nature for me, like brushing my teeth. I stick with these patterns not just because they prevent me from gaining back that 20 pounds but also because I know they’ll keep me healthy, fit, and feeling great.

Society as a whole—and doctors in particular—have become keenly aware of the need to prevent many diseases linked to excess weight. This book offers a holistic, lifelong prescription to address this need. Given today’s environment, resetting the average American’s inflated set point is a tall order. But by working with our families, workplaces, and communities, we can do better. I hope this book can help incite this transformation—one that I’m confident will lead to successful weight loss, better health, and happiness for all those who try it.

Source: George L. Blackburn, M.D., Ph.D., "Break Through Your Set Point: How to Finally Lose the Weight You Want and Keep It Off," 2008

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