Health

Fighting off cancer with food

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Is there really an anticancer diet? Right now, the answer seems to be a definite
maybe. The problem is that cancer isn’t one disease; it’s many. Some
foods seem to protect against some specific cancers, but none seem to protect
against all. For example:
Fruits and vegetables: Plants contain some potential anticancer substances,
such as antioxidants (chemicals that prevent molecular fragments
called free radicals from hooking up to form cancer-causing
compounds); hormone-like compounds that displace natural and synthetic
estrogens; and sulfur compounds that interfere with biochemical
reactions leading to the birth and growth of cancer cells. (For more
about these protective substances in plant foods, see Chapter 12.)
Foods high in dietary fiber: Human beings can’t digest dietary fiber, but
friendly bacteria living in your gut can. Chomping away on the fiber, the
bacteria excrete fatty acids that appear to keep cells from turning cancerous.
In addition, fiber helps speed food through your body, reducing
the formation of carcinogenic compounds.
For more than 30 years, doctors have assumed that eating lots of
dietary fiber reduces the risk of colon cancer, but in 1999, data from the
long-running Nurses’ Health Study at Boston’s Brigham and Women’s
Hospital and Harvard’s School of Public Health threw this into question.
By 2005, several very large studies — one with more than 350,000
people! — confirmed that dietary fiber has no protective effect against
colon cancer. But even if dietary fiber doesn’t fight cancer, it does prevent
constipation. One out of two ain’t bad.
Low-fat foods: Dietary fat appears to increase the proliferation of various
types of body cells, a situation that may lead to the out-of-control
reproduction of cells known as cancer. But all fats may not be equally
guilty. In several studies, fat from meat seems linked to an increased risk
of colon cancer, but fat from dairy foods comes up clean. In the end, the
link between dietary fat and cancer remains up in the nutritional air . . .
so to speak.
The American Cancer Society Advisory Committee on Diet, Nutrition, and
Cancer Prevention issued a set of nutrition guidelines that shows how to use
food to reduce the risk of cancer. These are the American Cancer Society’s
recommendations:
Choose most of the foods you eat from plant sources. Eat five or more
servings of fruits and vegetables every day. Eat other foods from plant
sources, such as breads, cereals, grain products, rice, pasta, or beans,
several times a day.
Limit your intake of high-fat foods, particularly from animal sources.
Choose foods low in fat; limit consumption of meats, especially high-fat
meats.
Be physically active. Achieve and maintain a healthy weight. Be at least
moderately active for 30 minutes or more on most days of the week. Stay
within your healthy weight range.
If you drink alcohol, drink in moderation. Chapter 9 lays it out:
Moderate consumption means no more than one drink a day for a
woman, two for a man.

Examining Diets with Absolutely,

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Some foods and some diet plans are so obviously good for your body that no
one questions their ability to keep you healthy or make you feel better when
you’re ill. For example, if you’ve ever had abdominal surgery, you know all
about liquid diets — the water-gelatin–clear broth regimen your doctor prescribed
right after the operation to enable you to take some nourishment by
mouth without upsetting your gut.
Or if you have type 1 diabetes (an inherited inability to produce the insulin
needed to process carbohydrates), you know that your ability to balance the
carbohydrates, fats, and proteins in your daily diet is important to stabilizing
your illness.
Other proven diet regimens include
The low-cholesterol, low-saturated-fat diet: The basic version, known as
the Stage 1 Diet, is used as a first step in lowering a person’s cholesterol
level. The diet limits cholesterol consumption to no more than 300 milligrams
a day and total fat intake to no more than 30 percent of your
total daily calories (see Chapter 16).
326 Part V: Food and Medicine
A nifty bonus to this diet is that it’s a relatively painless way of losing
weight.
The high-fiber diet: A high-fiber diet quickens the passage of food
through the digestive tract. This diet is used to prevent constipation. If
you have diverticula (outpouchings) in the wall of your colon, a highfiber
diet may reduce the possibility of an infection. It can also alleviate
the discomfort of irritable bowel syndrome (sometimes called a nervous
stomach). Extra bonus: A diet high in soluble fiber also lowers cholesterol
(see the preceding section, “Defining Food as Medicine”).
The sodium-restricted diet: Sodium is hydrophilic (hydro = water; philic =
loving). It increases the amount of water held in body tissues. A diet low in
salt often lowers water retention, which can be useful in treating high
blood pressure, congestive heart failure, and long-term liver disease.
By the way, not all the sodium in your diet comes from table salt. Check
out Chapter 16 for a list of the sodium compounds used in food.
The extra-potassium diet: People use this diet to counteract the loss
of potassium caused by diuretics (drugs that make you urinate more frequently
and more copiously, causing you to lose excess amounts of potassium
in urine). Some evidence also suggests that the high-potassium diet
may lower blood pressure a bit.
The low-protein diet: This diet is prescribed for people with chronic
liver or kidney disease or an inherited inability to metabolize amino
acids, the building blocks of proteins. The low-protein regimen reduces
the amount of protein waste products in body tissues, thus reducing the
possibility of tissue damage.

Protecting the Nutrients in Cooked Foods

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Myth: All raw foods are more nutritious than cooked ones.
Fact: Some foods (such as meat, poultry, and eggs) are positively dangerous
when consumed raw (or undercooked). Other foods are less nutritious raw
because they contain substances that destroy or disarm other nutrients. For
example, raw dried beans contain enzyme inhibitors that interfere with the
work of enzymes that enable your body to digest protein. Heating disarms
the enzyme inhibitor.
But there’s no denying that some nutrients are lost when foods are cooked.
Simple strategies such as steaming food rather than boiling, or broiling rather
than frying, can significantly reduce the loss of nutrients when you’re cooking
food.
Maintaining minerals
Virtually all minerals are unaffected by heat. Cooked or raw, food has the
same amount of calcium, phosphorus, magnesium, iron, zinc, iodine, selenium,
copper, manganese, chromium, and sodium. The single exception to
this rule is potassium, which — although not affected by heat or air —
escapes from foods into the cooking liquid.
Those volatile vitamins
With the exception of vitamin K and the B vitamin niacin, which are very
stable in food, many vitamins are sensitive and are easily destroyed when
exposed to heat, air, water, or fats (cooking oils).
To avoid specific types of vitamin loss, keep in mind the following tips:
Vitamins A, E, and D: To reduce the loss of fat-soluble vitamins A and E,
cook with very little oil. For example, bake or broil vitamin A–rich liver
oil-free instead of frying. Ditto for vitamin D–rich fish.
B vitamins: Strategies that conserve protein in meat and poultry during
cooking also work to conserve the B vitamins that leak out into cooking
liquid or drippings: Use the cooking liquid in soup or sauce. Caution: Do
not shorten cooking times or use lower temperatures to lessen the loss
of heat-sensitive vitamin B12 from meat, fish, or poultry. These foods
and their drippings must be thoroughly cooked to ensure that they’re
safe to eat.
Do not rinse grains (rice) before cooking unless the package advises you
to do so (some rice does need to be rinsed). Washing rice once may take
away as much as 25 percent of the thiamin (vitamin B1). Toast or bake
cakes and breads only until the crust is light brown to preserve heatsensitive
Bs.
Vitamin C: To reduce the loss of water-soluble, oxygen-sensitive vitamin
C, cook fruits and vegetables in the least possible amount of water. For
example, when you cook 1 cup of cabbage in 4 cups of water, the leaves
lose as much as 90 percent of their vitamin C. Reverse the ratio — one
cup water to 4 cups cabbage — and you hold on to more than 50 percent
of the vitamin C.
Serve cooked vegetables quickly: After 24 hours in the fridge, vegetables
lose one-fourth of their vitamin C; after two days, nearly half.
Root vegetables (carrots, potatoes, sweet potatoes) baked or boiled
whole, in their skins, retain about 65 percent of their vitamin C.

Refueling: The Cycle of

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Your body does its best to create cycles of activity that parallel a 24-hour day.
Like sleep, hunger occurs at pretty regular intervals, although your lifestyle
may make it difficult to follow this natural pattern — even when your stomach
loudly announces it’s empty!
Recognizing hunger
The clearest signals that your body wants food, right now, are the physical
reactions from your stomach and your blood that let you know it’s definitely
time to put more food in your mouth and — eat!
Growling and rumbling: Your stomach speaks
An empty belly has no manners. If you do not fill it right away, your stomach
will issue an audible — sometimes embarrassing — call for food. This rumbling
signal is called a hunger pang.
Hunger pangs actually are plain old muscle contractions. When your stomach’s
full, these contractions and their continual waves down the entire
length of the intestine — known as peristalsis — move food through your
digestive tract (see Chapter 2 for more about digestion). When your stomach’s
empty, the contractions just squeeze air, and that makes noise.
This phenomenon first was observed in 1912 by an American physiologist
named Walter B. Cannon. (Cannon? Rumble? Could I make this up?) Cannon
convinced a fellow researcher to swallow a small balloon attached to a thin tube
connected to a pressure-sensitive machine. Then Cannon inflated and deflated
the balloon to simulate the sensation of a full or empty stomach. Measuring the
pressure and frequency of his volunteer’s stomach contractions, Cannon discovered
that the contractions were strongest and occurred most frequently
when the balloon was deflated and the stomach empty. Cannon drew the obvious
conclusion: When your stomach is empty, you feel hungry.
Getting that empty feeling
Every time you eat, your pancreas secretes insulin, a hormone that enables you
to move blood sugar (glucose) out of the blood and into cells where it’s needed
for various chores. Glucose is the basic fuel your body uses for energy. (See
Chapter 8.) As a result, the level of glucose circulating in your blood rises and
then declines naturally, producing a vague feeling of emptiness, and perhaps
weakness, that prompts you to eat. Most people experience the natural rise
and fall of glucose as a relatively smooth pattern that lasts about four hours.

Why Fast Weight Loss Leads to Failure

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If you’ve tried “quick weight loss” diets, you know the truth: when you lose
pounds quickly, you put them back on just as fast. Worse yet, when you end
a diet, you usually gain back more weight than you lost. That’s because your
body reacts to an intense period of semistarvation by making you crave large
amounts of “forbidden” high-calorie, high-fat, high-carbohydrate foods.
Thousands of years of evolution have taught your body that starvation is
dangerous. Because of this, you react to a restricted diet in the same way as
your Neanderthal ancestors did: you grow ravenously hungry, because your
body wants you to store extra fat. Worse, your body goes into survival mode,
slowing your metabolism, hoarding fat, and even putting on water weight to
make weight loss harder. Your body doesn’t know that your food shortage is
artificial; it thinks there’s a real danger that you’ll starve to death, and it pulls
out all the stops in an effort to save you.
Even when you “wise up” and stop dieting, it takes time to reset your
metabolism so you can burn calories more easily. Chronic dieting sends your
body the message “Conserve body fat at all costs!” To reverse this process, you
need to convince your body that the danger of starvation is over—and that
won’t happen overnight.
In addition, you need to allow time for both your body and your mind to
recover from the stress of dieting. New research shows that stress itself can
put on pounds, which is another reason the ordeal of dieting usually results,
ironically, in added weight and inches. To understand this pattern, let’s look
at how stress changes your body in ways that promote weight gain—and why
it takes time to reverse this process.

Truth in Dieting Analysis

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1. Take several sheets of paper. At the top of each sheet, list the name of
a diet you’ve tried. This should include any plan that imposes limits on
what you can eat. (For instance, Dean Ornish’s book Eat More, Weigh
Less contains a section on what you should and shouldn’t eat, making
it a diet plan.) On additional sheets of paper, list diet pills or diet foods
you’ve used.
2. On each sheet, list your recollections of how you felt before beginning
the diet or using the diet product. Did you buy a book promoting the
diet? Did the book list many impressive-sounding scientific reasons why
the diet would work? (For instance, did it promise that the combination
of foods it allowed contained special chemicals that would “melt off”
your fat or say that you would lose weight by putting your body in a
state of ketosis?) Did the pills or diet foods promise miracle results in a
convincing way?
3. Describe how you felt when you began each diet or started using each
diet product. Were you hopeful, excited, optimistic?
4. Describe what happened during the first few weeks that you dieted or
used the diet product. Did you lose weight quickly? Did you enjoy the
compliments of friends and family? Did you believe that the diet would
solve your weight problems—perhaps all of your problems—for good?
5. Describe what happened as you continued to diet or use the diet pills or
foods. Did the diet or diet product continue to work, and did you lose
the weight you had hoped to lose and keep it off? Or did you regain the
weight and possibly even more? If so, how did you feel, physically and
emotionally, when your diet failed?
6. Now look at your list and make several estimates. First, calculate how
much time you invested in each diet or diet product and how much
weight you lost over the long term as a result. Second, calculate the
amount of money you spent on each diet or diet product. In addition,
note the emotional effects of each diet you tried.
If you’re a typical “serial dieter,” your results will show that you’ve invested
a tremendous amount of time and hundreds if not thousands of dollars for
no long-term benefit at all. In fact you probably weigh more now than you
did when you first decided to lose weight! In addition, your list will reveal the high emotional price of the diets that failed you. Typical postdiet emotions
that dieters list in point 5 are “sadness,” “tiredness,” “a sense of failure,”
“a feeling of hopelessness,” and “self-loathing”—a poor reward for weeks or
months of deprivation.
What does this mean? It means that unnatural cultural expectations have
suckered you into becoming a perpetual dieter and that the diet industry is
benefiting by taking you for hundreds (or possibly thousands) of dollars—
while you wind up feeling overweight, ugly, and defeated. You’re a victim of a
one-two whammy: a society that holds up impossible images of beauty and a
profit-crazed industry that uses those images to sell you modern-day snake oil.

Using supplements as insurance

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Healthy people who eat a nutritious diet still may want to use supplements tomake sure they’re getting adequate nutrition. Plenty of recent research supports
their choice.

Protecting against disease

Taking supplements may reduce the likelihood of some types of cancer and
other diseases. After analyzing data from a survey of 871 men and women, epidemiologists
at Seattle’s Fred Hutchinson Cancer Center found that people
taking a daily multivitamin for more than ten years were 50 percent less likely
to develop colon cancer. In addition, selenium supplements seem to reduce
the risk of prostate cancer, and vitamin C seems to lower the risk of cataracts.

Supplementing aging appetites

As you grow older, your appetite may decline and your sense of taste and
smell may falter. If food no longer tastes as good as it once did, if you have to
eat alone all the time and don’t enjoy cooking for one, or if dentures make
chewing difficult, you may not be taking in all the foods that you need to get
the nutrients you require. Dietary supplements to the rescue!
If you’re so rushed that you literally never get to eat a full, balanced meal,
you may benefit from supplements regardless of your age.

Meeting a woman’s special needs

And what about women? At various stages of their reproductive lives, they,
too, benefit from supplements-as-insurance:

before menopause: Women, who lose iron each month through menstrual
bleeding, rarely get sufficient amounts of iron from a typical American diet
providing fewer than 2,000 calories a day. For them, and for women who
are often on a diet to lose weight, iron supplements may be the only practical
answer.
Iron is a mineral element, so it may be called “iron” or “elemental iron”
on the label. Iron pills contain a compound of elemental iron (“ferrous”
or “ferric,” from ferrum, the Latin word for iron), plus an ingredient such
as a sulfur derivative or lactic acid to enable your body to use the iron.
On the label, the combination reads “ferrous sulfate” or “ferrous lactate.”
Different iron compounds dissolve at different rates in your stomach,yielding different amounts of elemental iron, so supplement labels usually
list the iron this way: Ferrous sulfate 325 mg/Elemental iron 65 mg.
Translation? This pill has 325 milligrams of ferrous sulfate, yielding 65
milligrams plain old iron. Sometimes the label omits the first part and
simply says: Iron 65 mg.
If your doctor says, “Take one 325-milligram pill a day,” she means 325
milligrams iron compound, not plain elemental iron.

During pregnancy and lactation: Women who are pregnant or nursing
often need supplements to provide the nutrients they need to build new
maternal and fetal tissue or to produce nutritious breast milk. In addition,
supplements of the B vitamin folate now are known to decrease a
woman’s risk of giving birth to a child with a neural tube defect (a defect
of the spinal cord and column).
Never self-prescribe supplements while you’re pregnant. Large amounts
of some nutrients may actually be hazardous for your baby. For example,
taking megadoses of vitamin A while you’re pregnant can increase
the risk of birth defects.

Through adulthood: True, women older than 19 can get the calcium
they require (1,000 milligrams/day) from four 8-ounce glasses of nonfat
skim milk a day, three 8-ounce containers of yogurt made with nonfat
milk, 22 ounces of canned salmon (with the soft edible bones; no, you
definitely should not eat the hard bones in fresh salmon!), or any combination
of the above. However, expecting women to do this nutritional
balancing act every single day may be unrealistic. The simple alternative
is calcium supplements.

Don’t Put Your Child on a Diet!

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If your child is overweight, I can almost guarantee that your pediatrician
will prescribe a diet—but as a parent and a physician, I urge you to question
this advice. In some cases there are valid medical reasons for children to follow
restricted food plans; for instance, a diabetic child needs to avoid excess
sweets and follow regular eating habits. But diets rarely lead to long-term
weight loss, as the research cited in this book makes clear, and they’re usually
even more harmful for children than for adults. Because children’s bodies
are still growing, strict diets can lead to early osteoporosis11 and stunt
growth.12 They can also precipitate depression,13 and very-low-calorie diets can
interfere with thinking and learning, especially if they reduce iron levels in
girls and cause anemia.14 Remember this key rule: in a growing child, weight
maintenance, not weight loss, is the goal.
Moreover, all eating disorders begin with dieting, and even moderate dieting—
the kind that most doctors mistakenly believe is safe—puts teens at
risk for dangerous eating disorders. A 1999 study found that girls who go on
severe diets are eighteen times more likely than other girls to develop anorexia
or bulimia and that even those who go on “sensible” diets are five times more
likely than nondieting girls to develop eating disorders.15 In addition to the
psychological damage done by these eating disorders, they often are deadly:
one recent study followed up anorexic patients and found that two decades
after diagnosis 16 percent of the patients had died from anorexia-related
causes.16 Children who become trapped in the diet mentality are also at riskfor taking up smoking or using illegal drugs in a desperate attempt to take
off pounds.
In short, diets probably won’t help your child lose weight, very possibly will
jeopardize his or her health (possibly for a lifetime), and will dramatically
increase the risk of deadly eating disorders—not to mention creating body
image problems and a warped relationship with food that can lead to lasting
psychological problems. So don’t ask your child’s physician for any type of diet
plan unless it’s medically necessary. Instead, request a thorough checkup to
spot any medical conditions that could contribute to your child’s excess
pounds. Also tell the pediatrician if your child shows signs of anxiety or
depression, which can lead to overeating. If the checkup reveals that your
child is healthy, I recommend following the advice in this chapter to help your
child become fit naturally and healthily.
One more thing: throw out your scales or keep them where your child
doesn’t have to face them every day. You’ll be able to tell if your child is gaining
or losing weight, simply by looking. Asking a child to weigh in every day,
or even once a week or once a month, places an unhealthy emphasis on
weight.
Note: If your child is significantly overweight, always consult with a medical
professional to determine the causes of this weight problem. A number
of medical disorders (see Step Six) can cause obesity, and some affect children
as well as adults. Also, if a doctor recommends dietary restrictions for valid
medical reasons, be sure to follow these restrictions.

Dieting?What About Nutrition?

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If you’ve never paid attention to the nutritional content of what you eat, you
may find—once you gain the ability to sense hunger and satiation, and you
give yourself permission to eat any food at any time when you’re actually
hungry—that it’s helpful to educate yourself about nutrition.
If you do so, however, be sure not to make lists of “good” and “bad” foods.
In fact, as you do learn about nutrition, you’ll be surprised to learn that many
of the foods you’ve considered “bad” are foods that do wonderful things for
your body. For instance, canola oil—one of those “evil” fats you’ve been
taught to avoid—is rich in omega-3 fatty acids, which can help keep your
brain, eyes, heart, and other organs healthy. (Omega-3 fatty acids are particularly
crucial for early brain development, which is another reason that putting
very young children on diets can be dangerous.) Olive oil, too, can be
healthy for your heart and your mental health. And believe it or not, chocolate
is now gaining scientific praise because it’s packed with particular cellprotecting
antioxidants!
The more you learn about the foods that keep your body healthy, the more
you’ll be interested in eating them. But this time if you select a salad or an
apple, it will be because you want it, not to conform to externally driven eating guidelines that leave you feeling chronically dissatisfied. You’ll be amazed
at how much more tempting a cantaloupe is when you eat it by choice and
not because a diet plan orders you to.
The process of learning to trust your hunger takes time and patience, particularly
if you’ve dieted for many years. How will you know when you’ve
truly recovered from food preoccupations? You’ll find yourself leaving the
last piece of pizza in the box not because you can’t have it but because you
don’t want it. You’ll eat a scoop of ice cream for dessert after a nice dinner andfeel full. You’ll lick the spoon when you frost a cake, but you won’t feel
tempted to eat half the cake. You’ll eat one or two chocolate chip cookies
without feeling guilty and without the desperate urge to finish the entire
plateful of cookies. And you’ll enjoy healthy foods more than ever, because
you’ll eat them by choice.
When you reach this goal, you will have the tools you need to achieve
and maintain your personal ideal weight. With your body dictating how
much food you desire, and diet-induced bingeing no longer sabotaging your
efforts, your calorie intake will adjust to your calorie expenditure. With time,
the extra pounds will melt off, as your body no longer lowers its metabolism
in response to recurrent episodes of starvation—the very mechanisms that
made you gain weight when you dieted.
As you learn to eat without dieting, you will rediscover the relaxed, joyous
relationship with food that you enjoyed as a child. You will no longer feel
afraid to have food in your home, to order what you want from a menu, or
to enjoy an ice cream cone on a hot day. Using your newfound ability to
notice yourself and heed your body’s messages when you eat, you’ll be able to
recognize non-hunger-based eating and realize that you can wait to eat until
you’re truly hungry. You’ll be able to indulge in any food you love without
worrying about losing control—and as you free yourself from yo-yo diets
and chronic weight cycling, you will attain the fit, beautiful body that is your
birthright.

A Dangerous Obsession

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If dieting just wasted your time, it would be bad enough. But dieting is also
very dangerous—not just for anorexics and bulimics but also for average,
everyday dieters. Typical yo-yo dieting (what medical professionals call weight
cycling) doesn’t just damage your self-esteem; it can damage your body as
well. That’s why, unlike most doctors who call dieting a healthy activity, I call
it what it really is: a disease.
How does dieting jeopardize your health? Here’s a short list.

• Dieting hurts your heart and cardiovascular system. Studies of large
groups of people show that yo-yo dieting can increase your risk of death
from cardiovascular disease.6 Why? One recent study found that yo-yo dieting
significantly lowers levels of the “good” cholesterol HDL-C in women,7
and another study of rats showed that weight cycling disrupts levels of serum
cholesterol, triglycerides, glucose, and insulin in ways that could increase
heart disease risk.8 Yo-yo dieting is dangerous for men’s hearts as well as
women’s: one study found that men who experience at least one cycle of major
weight loss and regain are at increased risk of death from cardiovascular disease
compared to men who steadily gain weight or those whose weight
remains stable.9
• Dieting can break your bones. Yo-yo dieting reduces your bone mass
and increases your risk of hip fractures.10 Because we stockpile bone mass
during childhood and early adulthood, it’s particularly dangerous for preteens,
teens, and young adults to diet.
• Dieting can increase your risk of gallstones. Middle-aged women are
especially prone to this painful and sometimes dangerous medical problem,
which often requires major surgery called a cholecystectomy. According to a
recent study, “the risk for cholecystectomy associated with weight cycling [is]
substantial, independent of attained relative body weight.”11 For years, doctors
told patients that the highest-risk group for gallstones is “fat, female, and
forty,” but we’re learning that being overweight may be less risky than weight
cycling.
• Dieting can affect your immune system.When you reduce your calorie
consumption drastically, you also dramatically reduce the numbers of disease-
fighting cells in your body,12 putting you at increased risk for infections
and possibly even cancer.
• Dieting causes changes in the breast. Two recent studies link weight
cycling to DNA damage or abnormal cell changes in breast tissue, meaning
that yo-yo dieting may increase a woman’s risk of breast cancer.13
• Dieting may increase a woman’s risk of having a hysterectomy. It
sounds strange, but research indicates that yo-yo dieting is strongly linked to
menstrual problems serious enough to require removal of the uterus.14
• Dieting can ruin your teeth. Extreme dieting can deprive you of the
calcium you need to have strong, healthy teeth. If you purge after bingeing,
the stomach acids you bring up can cause the enamel on your teeth to erode.
Chronic purging can lead to cavities, tooth staining, and even the necessity
for tooth removal.
• Dieting makes you physically weak. Study after study reports that
physical fatigue is one of the primary side effects of dieting.
• Dieting is bad for your mental health. I’ll talk later about how dieting
can make you feel bad about yourself. But it can also make your brain feel bad.
As I mentioned, women who diet have reduced levels of tryptophan, the building
block of the brain chemical serotonin—and low serotonin levels are linked
to depression, hostility, impulsive behavior, obsessive-compulsive behavior,
and even an increased risk of suicide.
In addition, dieting appears to make you less smart—no kidding. A recent
study found that women had slower reaction times, exhibited poorer immediate
recall of words, and were less vigilant on cognitive tests when they were
dieting than when they weren’t.15
• Dieting can put you at risk for alcohol abuse. Canadian researchers
evaluated the dieting behaviors and alcohol use of nearly two hundred female
university students. They report that levels of food restraint correlated strongly
with how much the women drank and how often they engaged in “binge drinking.”
“Chronic dieting,” the researchers say, “appears to be related to a relatively
heavy drinking pattern that can be characterized as potentially risky.”16

Ignoring Your Body’s Messages Won’t Work

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Diets don’t work for another reason: it’s dangerous to stop listening to your
body. Yet that’s exactly what you do every time you starve yourself.
Imagine what would happen if you ignored your body when it told you,
“I need to go to the bathroom” or “I need to sleep” or “I’m dehydrated—I
need water” or “I’m very cold—I need warm clothes” or “Ouch! Move your
hand—that stove is hot!”
Obviously, you don’t do any of these things—at least not on a regular
basis. More important, you don’t feel guilty about listening to your body
when it sends you these messages. You don’t feel guilty if you move your

hand away from a hot stove. You don’t agonize morally over whether or not
you should go to the bathroom. You don’t worry about whether it’s a sign of
weakness to stop at a drinking fountain. You don’t try to go for weeks without
sleeping and tell yourself if you fail, “I’m just so weak.” And if you’re too
cold, you dress appropriately. You don’t say to yourself, “You’re such a failure—
why can’t you handle a little frostbite?”
Yet when it comes to food, you ignore your body’s warnings all the time.
When you’re dieting, and your body says, “I’m starving—feed me,” you don’t
heed that message. Instead you say, “I can’t eat now.” You label your appetite
as bad or weak, and you pretend that you can make it go away.
An odd (and very destructive) thing happens when your eating is no longer
hunger driven, but instead becomes diet driven. When you’re forced to follow
an artificial eating schedule, you decouple your appetite from your eating.
That means that you don’t eat when you’re hungry, but it also means that
you binge or graze when you are not hungry.
“Chronic dieters do not compensate [for eating high-calorie foods] by
minimizing further eating, as non-dieters do after eating a large amount,”
researchers Janet Polivy and C. Peter Herman say. “Instead, dieters appear to
become disinhibited; after being preloaded with fattening food, they eat more
than similarly treated non-dieters or than dieters who have not [broken] their
diets.”
As I explained earlier, this is partly a biological response, because your
body wants you to eat high-fat foods when it’s starving. However, it’s also a
psychological response. As Polivy and Herman note, dieters who think they’ve
eaten “bad” high-calorie foods will continue to binge on other “bad” foods
at hand—even if the food that began the binge was really low in calories.
Why? Because dieting makes forbidden foods seem compelling and simultaneously
trains you to believe that you have no willpower in the absence of
external controls. The result: when you finally rebel against these external
controls, and give in to the urge to eat “bad” foods, you eat until you literally
are sickened, both physically and emotionally, by your bingeing.
Dieters are also more likely than nondieters to binge or graze when they’re
upset, when they’re drinking, or when they’re sick. Bingeing and grazing temporarily
soothe both physical and emotional starvation, but at a high price:
each binge or grazing episode makes the dieter feel more and more helpless
and out of control, leading to a vicious circle of intensified dieting and
increased bingeing. It’s a perfect recipe for weight gain and self-hatred.
Of course, a handful of people—that supposedly lucky 5 percent—do
succeed at overriding their body’s needs and maintaining the weight they’ve
reached on a diet. But most do so only by sacrificing, forever, a relaxed and
normal relationship with food. Every food-related family tradition becomes
an inner conflict (“How do I tell my mother I can’t eat her hamantaschen?”),
and every special occasion becomes a crisis (“Can I sit through the whole
wedding dinner without eating ‘bad’ food?”). Even a simple restaurant mealor a box of Valentine’s Day candy is transformed into a danger to be avoided,
a temptation to be resisted. We never realize how large a role food plays in
our heritage, our family life, our holidays, and our celebrations, until we
attempt to reduce eating to a mechanical, calories-in, calories-out process.

Dieting Causes Weight Loss? A False Belief

2008-01-01T09:50:00.000-08:00

As I write this, more than eighty million peoples are counting carbohydrates, cutting
calories, avoiding sugar, eating Craig meals, or living on cabbage soup
or canned weight-loss shakes. Glossy women’s magazines, TV fitness gurus,
weight-loss centers, and diet book authors tell us that all of this self-denial and
sacrifice is worthwhile—that diets work and that if we only spend a little
more money, invest a little more time, exhibit a little more willpower, the
perfect body is within our reach.
Their message is clear: if you’re not a size 6, it’s your fault. You’re weak.
You didn’t try hard enough. You’re a quitter.
It’s in the diet industry’s best interest, of course, to tell you this. Promoters
of diet products earn millions of dollars each year, simply by preying on
desperate dieters who believe their lives will change forever if they can lose
weight. But as a medical doctor who has studied dieting extensively (and,
perhaps more significantly, experienced dieting firsthand), I know that the
saddest thing about all of our starvation and self-deprivation is this:
It’s all for nothing.
In fact, for most people dieting is worse than useless. Somewhere between
95 and 98 percent of dieters fail to keep any weight off permanently, but sadder
still, many wind up gaining weight with each diet. (Perhaps that’s why
major diet programs aren’t interested in having their results analyzed scientifically.
2) We spend $30 billion a year on diet products, programs, pills, and
foods, and almost none of us loses weight permanently as a result.
Of course, that’s not what the people who run the diet programs and write
the diet books will tell you. Laura Fraser, author of Losing It: False Hopes and
Fat Profits in the Diet Industry, says, “The diet industry is a sort of perfect
business because it is the only business in the world where it fails 95 percent
of the time and blames the consumer. I mean, if you bought lightbulbs and
they went out 95 percent of the time, they wouldn’t say, ‘Well, you are not
screwing your lightbulbs in right.’ ”3
I’m reminded of the word delusion, which in psychiatry is defined as “a
fixed false belief.” I see a nation of people running themselves ragged, spending
more money on weight-loss products than some countries spend on their
national budgets, because of our delusion that dieting is the key to weight
loss—if only we can stop failing at it.
But in reality we haven’t failed at dieting—dieting has failed us. That’s why
almost every miraculous success story you read in ads for Jenny Craig or
Nutri/System says, in fine print at the bottom, “results not typical.” (A more
honest disclaimer for those I-lost-eighty-pounds-in-six-months stories would
be “results almost unheard of.”) A tiny number of lucky people, of course,
do succeed in losing weight on a diet and keeping it off—but for every one
of them there are fifty people who try every bit as hard, with no success.
Saying that dieting is a successful technique is much like saying that surgery
for pancreatic cancer is a rousing success because it cures two or three of
every hundred patients—or like saying that playing the lottery is a wise financial
strategy because two or three of every hundred people actually win more
money than they lose.
With millions of people suffering from the effects of failed diets, we should
find strength in our numbers—the strength to say that our lives are too valuable
to waste in an endless, unsuccessful battle with food. Unfortunately, the
diet industry, abetted by a culture that teaches us to value dangerously distorted
body images, has succeeded beyond its wildest dreams
in convincing us that we are failures if we look, feel, or eat like normal people.
We are brainwashed to believe that a woman with a slightly rounded
belly is grotesque, that a man without washboard abs is “soft” and weak, that
a teenage girl in size-10 jeans is fat. And we are brainwashed to believe that
there is only one path to personal fulfillment and an ideal body: constant
dieting, constant sacrifice, constant denial. It’s a lie—one that causes us enormous
suffering, guilt, and shame and offers us no reward and no escape.
If you are still playing the diet game, the most important step you must
take to achieve lasting weight loss is to stop believing this lie. You can’t win
at dieting, no matter how hard you try.
Before I explain why, it’s important to understand just what a diet is. By
dieting, I mean any eating pattern that entails replacing internally driven,
hunger-driven eating with externally controlled eating. Obviously, if you’re
counting calories or drinking Slim-Fast every day instead of eating lunch,
that’s a diet. But it’s also a diet if you tell yourself you can’t eat a dessert or
snack when you’re hungry—or if you restrict yourself to artificial sweeteners,
forbid yourself to put your favorite dressing on your salad, or deny yourself
certain foods because they’re “bad.” And it’s a diet if a doctor says “Eat
whatever you want, but just eat half as much as usual” or “Eat whatever you
want, as long as it’s healthy food.” In short, if you’re not eating what you
like, when you’re hungry for it, you’re dieting.
Why does virtually every diet fail? Three reasons. One is that when you
diet, your body outsmarts you. The second is that when you diet, you cause
a disconnection between your sense of hunger and eating, and that guarantees
that you will fail at dieting—unless you diet to the point of risking your
life. And the third is that while almost everyone can have an attractive,
healthy body, most bodies simply can’t be reshaped to look like Brad Pitt’s or
Cindy Crawford’s.