HOW TO LOSE WEIGHT

AND KEEP IT OFF

Pamela W. Smith, M.D., MPH

Copyright 2004

Causes of Obesity

• Physiological factors

• Psychological factors

Certain Food Habits Are

Physical

• Chocolate has opiate effects.• Chocolate stimulates the release of

chemicals within the brain’s pleasure center that encourage you to be addicted.

• Chocolate stimulates the same part of your brain that morphine acts on.

Food Habits That Are Physical

• Cheese and dairy products have a similar affect on your body as chocolate.

• Mild opiates are released during digestion of cheese and dairy products.• Shah, N., et al., “Effects of milk-drived

bioactives: an overview,” Br J. Nutr 2000; 84(Suppl 1):S3-S10.

Food Habits That Are Physical

• PET scan shows that many overweight people have fewer brain receptors for dopamine (DRD2) compared to other people.

• This brain–rewarding chemical has fewer receptor sites to help the person feel good.

• People will try and overeat to get the pleasurable stimulation they lack. • Wang, G., et al., “Brain dopamine and obesity,”

Lancet 2001; 357:354-7.

Addiction

• These findings help explain why

alcoholism, drug abuse and food

compulsions often run in families.

Dopamine

• Healthy foods can turn on the dopamine

system also.

• So can exercise.

Rather have chocolate than

sex?

• The same part of your brain that appreciates chocolate is also responsible for libido.• Stahl, S., et al., “The psychopharmacology

of sex, Part 1: neurotransmitters and the 3 phases of the human sexual response,” J. Clin Psy 2001; 62:80-1.

Chocolate

• Chocolate is rich in a chemical called theobromine.• Theobromine is a stimulant similar to caffeine.• Chocolate also contains phenylethylamine which is

an amphetamine-like chemical.• Koehler, P., et al., “High pressure liquid chromatographic

analysis of tyramine, phenylethylamine and tryptamine in sausage, cheese, and chocolate,” J. Of Food Sci 1978; 43:1245-7.

Chocolate

• Chocolate likewise contains traces of

compounds similar to THC, the active

ingredient in marijuana.

• Brain cells contain a chemical called

anandamide, which is related to THC.

Chocolate

• Certain chemicals in chocolate delay

the breakdown of anandamide in the

brain so that the wonderful pleasant

brain effects last longer than normal.• Di Tomaso, E., et al., “Brain cannabinoids

in chocolate,” Nature 1996; 382:677-8.

Milk

• Contains a protein called casein.• Casein breaks apart during digestion to

release a group of opiates called casomorphins.

• A cup of cow’s milk contains six grams of casein.

• Skin milk contains a little more.

Milk

• Cow’s milk is high in casein and low in

whey.

• Human breast milk is low in casein and

high in whey.

Cow’s Milk

• Recent study found the following in cow’s milk: prolactin, somatostatin, melatonin, oxytocin, growth hormone, LHRH, thyrotropin-releasing hormone, TSH, vasoactive intestinal peptide, calcitonin, PTH, corticosteroids, estrogens, progesterone, insulin, epidermal growth factor, IGF-l, erythropoietin, bombesin, neurotensin, motilin, and cholecystokinin.

Reference

• Teschemacher, H., et al., “Milk protein-

derived opioid receptor ligands,”

Biopolymers 1997; 43:99-117.

Cheese

• Cheese contains far more casein than milk.• It also contains phenylethylamine which is an

amphetamine-like chemical also found in chocolate and sausage.

• Most of the fat in cheese is saturated. The kind that elevates your cholesterol level.

• Ounce for ounce, there is as much cholesterol in cheese as there is in steak.

Dairy

• Men who avoid dairy have a 30 percent

reduction in the risk of prostate cancer.• Chan, J., et al., “Dairy products, calcium,

and prostate cancer risk in the Physicians’ Health Study,” Am J. Clin Nutr 2001; 74:549-54.

Vitamin D

• Milk contains some added vitamin D, but it is in the inactive precursor form.

• Dairy consumption suppresses vitamin D activation.• Giovannucci, E., et al., “Calcium and

fructose intake in relation to risk of prostate cancer,” Cancer Res 1998: 58:442-7.

Sugar

• Sugar causes the release of opiates in the brain.

• Sugar also has an appetite-driving effect.

• Carbohydrate rich foods boost a brain chemical called serotonin.

• Serotonin helps regulate mood and sleep.

Wheat

• Wheat protein, called gluten, breaks apart

during the digestive process into compounds

that have a variety of mild opiate effects.

• Wheat derived opiates work within the gut

and do not appear to pass into the blood

stream.

Brain Serotonin

• Serotonin has a considerable influence on eating behavior.

• Diets low in tryptophan lead to low serotonin in which the brain senses that you are starving so it stimulates your appetite.

• Low serotonin levels result in a preference for carbohydrates.

• Serotonin levels decrease when dieting.

Food Addition

Psychological Factors

• Sometimes we use food to stimulate the

brain when what we really need is

friendship and love.

• Food becomes a friend.

How to Lose Weight And

Keep It Off

• Secret #1: Eat breakfast

Secret #2

• Choose foods that hold your blood sugar steady.

• Insulin sensitivity.• Increasing the body’s sensitivity to insulin

results in less insulin being secreted.• Insulin sensitivity establishes normal

thermogenesis (how the body burns calories).

Insulin Resistance

• Elevated lipid deposition.• Altered hepatic lipoprotein metabolism.• Blunted peripheral insulin

responsiveness and increased insulin levels.

• Altered insulin/glucagon/cortisol influence on gene expression.

Insulin Resistance

(Continued)

• Altered glycation of proteins.

• Altered mitochondrial function with

increased evidence of oxidative stress.

• Altered production of inflammatory and

adhesion molecules.

Secret #3

• Increase fiber.• Research has shown that you can

decrease your calorie intake by 10% if you add an extra 14 grams of fiber each day.• Howarth, N., et al., “Dietary fiber and

weight regulation,” Nutr Rev 2001; 59:129-39.

Secret #4

• Boost your leptin.

• Leptin is a hormone that helps you tame your

appetite.

• Leptin also boosts your metabolism.

• Dieting decreases leptin.• Cella, F., et al., “Effects of dietary restriction on

serum leptin concentration in obese women,” Int. J. Obes 1999; 23:494-7.

Leptin (Continued)

• High fat foods interfere with leptin.

• Exercise increases leptin sensitivity.

Secret #5

• Do not diet. Eat enough calories.

• Otherwise your body’s leptin system is

impaired.

• Your body goes into a “fight or flight

response” and burns no calories

Secret #6

• Get enough exercise.

• Exercise improves insulin sensitivity.

• Exercise increases mitochondrial

function.

Secret #7

• Decrease stress.

• Elevated stress increases cortisol

levels.

Secret #8

• Get enough sleep.

• Sleep is when you make growth

hormone which aids in weight loss.

Secret #9

• Take vitamins to keep your body

functioning well.

Secret #10

• CLA

Secret #11

• Carnitine

Secret #12

• Avoid fast food.

Secret #13

• Eat the right food.• 40% protein

• 40% carbohydrate

• 20% good fat

Secret #14

• No one eating program works for

everyone.

Secrete #15

• Important to have normal sex hormone

levels.• Normal DHEA for both men and women.

• Normal testosterone for men and women.

• Normal estrogen for women.

• Normal progesterone for women.

Secrete #16

• To lose weight you must have normal

thyroid function.

Good Books

• Breaking the Food Seduction by Neal

Barnard, M.D.

• When Food is Love by Geneen Roth

• Breaking Free from Emotional Eating by

Geneen Roth