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Get Thin

David Emerson


  • July 21, 2018
    4:00 PM
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Happy to be with you again today. So I talked about it yesterday we're going to talk about weight control it seems to be one of the. More prevalent topics today now this was at sea. And if you can see the slides they can OK my wife sent me this you might enjoy it. And anyway weight control. Many people ask you know what causes people to be too heavy and the common concept is well it's either too little exercise too few calories out or too many calories in. We are going to. Find out about the actually there is a group who. Has the same activity level as the American office worker same activity level but they weigh 20 percent less so they thought well if the activities are same and they weigh 20 percent last it must be because they're starving him but when they measure the calories they were eating 30 percent more calories so Joe like to know what their secret is OK Stay tune get there. OK. So how is obesity defined. It's actually the fine by the body mass index it's your weight in kilograms divided by your height in meters squared This compensates for people of different heights. A normal weight or healthy weight is B.M.I. of $20.00 to $25.00 overweight is $25.00 to $30.00 obesity $30.00 to $40.00 morbidly obese to be over 40. You have to if you want to figure out your body mass index you have to have a calculator to do it actually know they have tables in them on the internet here's one you can go across the top and find your weight and then go down to find your height and you find out that you're too short for your weight OK that's one way to find out what your body mass index says how big a problem is that in America it costs. Us our nation about $17000000000.00 a year in the year 2001 in 4 adults is obese in America causes death or contributes to the death of $300000.00 Americans each year and it's associated with other problems like diabetes heart disease and hypertension. In the Framingham States was a study done sometime after World War 2 They looked at the town of Framingham and they were looking for risk factors things that increase your risk of illness heart attacks strokes and death this is where they found that say your serum chloride had nothing to do with whether you got a heart attack or not but sure serum cholesterol did high correlation this is where we started understanding about risk factors risk factors like high blood pressure increasing the risk of heart attacks and strokes and they found that obesity was a significant risk factor for premature death conferred a 50 to 100 percent increased risk of premature death now. Who wants to know about your risk factors in other words who wants to know if obesity is going to shorten your life or not does your doctor want to know well maybe but is sort of kind of passing interest who does it affect financially with said Life Insurance exactly now they want to ask you if you're obese or not they will just ask you what your height what your weight and then they'll calculate your body mass index and based on that they know how much to charge you hope that they can cover your death benefit when you die. Now aside from of course the to the health risks there's social problems. And it's fine if I want to be 1st in a hospital or want to talk to a group of nurses all I had to do is talk to one about weight control and boom my shirt I surely had a crowd of nurses there wanting to know about way control so what do I tell them Well it's been around for a long time why the concern now it's on the increase. Based on. The surveys done in 2000. Obesity went from the prevalence one from about 23 percent in 1930 percent in 2000. Here's a graph. Usually like to point out that if you look under $1901.00 on the West Coast the light blue very light blue that is 10 percent of population or less had obesity on the East Coast the slightly darker blue. Was 15 percent or less in less than 5 years the West Coast went from 10 to 15 the East Coast went 215220 then in another 2000 the West Coast went from 15 to 20 the East Coast went from 20 to 25 percent and then in the little inset on the right lower corner it jumped another 5 percent on the West Coast and another 5 percent on the East Coast it's on the rise I recently were some time I took an airplane flight and sat next to a lady who designed airplane seats for airplanes and for commercial airlines and they had to make them larger because people aren't fitting in the old seats and southwestern airlines got upset at one point and they said and put their foot down they said if you can't fit in one seat we're going to so you tickets for 2 seats and so I saw this little cartoon show this beanpole of a guy really then guy going up the Southwest ticket agent and she's saying No sir I can't say you half a ticket. That's what he wanted. Obesity is a problem what can we do about it well the newstands have a new date every month. And why can they get away with doing this every month because last month didn't work so they have a ready supply of customers too for to sell their magazines one example McCall's 1992 issue. Showed how Oprah how 2 years earlier had lost $67.00 pounds and all the world rejoiced and then when this article came out she had gained all the weight back plus then all were saddened because of this however on the next page there was an interview with Dr Calloway telling showing that her failure was predictable and someone with her resources should have been able to get the counseling to tell her not to do the low calorie diet because it will cause a rebound effect and. Here's a picture of Oprah again the caption reads slender or starved the implication is gee have to be starved to be slender we want to share no you don't have low calorie diets worked in the past this was a question asked as far back as 1959 stunk and in the clear noon they did a survey of the previous low calorie diet studies over the past 30 years they found only 7 were considered well designed and well documented with the exception of one a maximum of only 29 percent of the patients lost 20 pounds or more. Less than 8 percent lost 40 pounds or more and then they question is why the failure why didn't this work well he did his own study to find out he looked at the next 100 patients coming to the clinic for a low calorie diet and they put them 188-5800 calorie diet to get a perspective a normal intake would be 25023000 calories per day so this was about a 3rd to half as many calories as you would normally take in. What happened well at the end of treatment up there you see the circle there only 12 percent 12 out of 100 last 20 pounds or more a large number had dropped out by the end of one year right under that 12 Mark only 6 were successful in maintaining it and at the end of 2 years only 2 out of $100.00 were able to maintain the weight loss why the failure well they noted some problems they noted nervousness weakness irritability fatigue and Nazia some of the side effects one man who had lost the most weight noted increasing tension he developed acute schizophrenia reaction ended up in the hospital and gradually regained most of the weight that he had lost why does a low calorie diet not work well. The reason is because your Creator actually has created it to protect you from a low calorie diet or from starvation for an example what's this guy doing with that pushups right what does that stress in your body muscles right triceps and all. Pectoral muscles it stresses those muscles after the exercise what are the muscles do to prepare for the next exercise if he keeps doing this what's going to happen to his muscles to get bigger right they're going to get ready for the next exercise session so your body is adapting to the stress that you put it under our God created is that we it's a wonderful design. Let me ask you this does. Does a low calorie or starvation diet put the body under stress. Yeah anybody who's tried it knows it's stressful but a metabolically you put your body under stress. And the there was a study they asked the question what how does the body adapt to the stress you're putting it under while the Carnegie nutrition laboratory did a study in 1900 to find out they put a group of men 181400 calorie diet again it's about half of the normal calories they would take in and they noticed what happened in the metabolism. The temperature dropped body heat released drop oxygen consumption dropped pulse rate dropped and they had decreased energy What does it mean decreased energy well means if if I'm Ana a low calorie diet and I see a bird out there when I was in Iowa that's an interesting bird I think I get a closer look and then I think now I think I'll walk I watch the bird from here OK You just don't have any energy to do anything. Above the minimum. So the body was turning down its metabolism it was conserving calories it was burning calories slower to conserve calories because you're taking in the last it's like if you're trying to conserve energy in a house you turn the thermostat down and that's what's happening in your body. There's a 2nd study done at the end of World War 2. They wanted to study starvation because they were going to beef freeing starvation victims in concentration camps and they found that if they fed them too fast they died. It when they did further studies they found that when you feed starvation victims you change the A Denson triphosphate in 3 foster or 2 phosphate she's made denizen by phosphate goes into a dense and triphosphate such stuff all the free phosphorus phosphorus level goes down your heart was in the arrhythmia and you die so you have to be very careful to watch the phosphorus levels when you're receiving these people but that's not what we want to look at we will look at what happened during the 6 months starvation period that they put $32.00 conscientious objectors in the study this. These $32.00 conscientious objectors were put on a semi starvation diet for about 6 months now their weight predictably dropped and that was not unexpected. At the end of the 6 month period their muscle mass or the total body way to drop to about 75 percent of normal muscle mass a drop to 60 percent of normal body fat had dropped down to about 33 percent of normal that wasn't too unexpected but what was a little unexpected was what they found when they referred them. If you look at the bottom there is 0 you see it 0 and then as 12 an S. $24.00 that's the starvation starvation weeks going from left to right and what you find in the little circled areas there that's body fat now what you don't see is. Now the body fat dropped to a minimum it S. of $24.00 starvation $24.00 at $24.00 weeks they re fed them they gave them normal calories again and what happened was the metabolism rose over the next year but at the end of year it was still below normal muscle mass rose toward normal again but at the end of year was still below normal but if you look a little clear circles there that jumped up the body fat jumped up and at $33.00 weeks was actually 10 pounds above what it was before they started the diet for the fast or the starvation and at the end of the year it was still 2 to 3 pounds above what it was before the starvation diet they thought what is going on why is this happening or what happened was when the body came off the fast it has 24 on the bottom there the body says whoa OK now we have calories because they started be feeding him by said we'd better get ready for the next starvation so how are we going to do that well we'll increase some towels a little bit but we'll want to keep it as high as it used to be well increase the muscle mass a little bit but not as much as it used to be because then we'll have less muscle to feed in the next starvation and we'll increase the body fat above what it used to be so that we'll have more fat to feed less muscle during the next starvation and in countries where they have annual starvations crops run out they become really like skin and bones and across come in they become obese and the crops are not they become skin and bones and crops come in the can obese and they just do the cycle to survive those conditions. Wrestlers wrestlers have made a study with wrestlers they found that. Wrestlers wait cycle their metabolism drops what weights cycling that's where they starve themselves to make Wayans and then they eat they starve and eat starve any when they do that the metabolism drops to rest was one moment. No no no of course not they want a higher metabolism so weight cycling is again not a good idea for wrestlers. Women dieters they looked at women dieters and they wanted to see how repeated low calorie diets affected their metabolism they looked over the past year and if they had gone on a 1000 calories a day or less for 7 days or more 4 times over the previous year the metabolism was a lot less than what it was in those that hadn't what happens on repeated starvations or low calorie diets they did a study to find out how the body adapts on the right there that bar they put you see a 1000 obese patients and they put them on a. A low calorie diet $600.00 to $800.00 calories a day and the bar on the right shows that the 1st time they did this they lost point 1000 kilograms per day that was the rate at which they were losing weight then they came off the diet and they gained all the weight back plus an extra 20 percent that was the weight rebound which we understand why that would have happened so I said no no problem we'll just do that diet again so on the bar on the right is their 2nd trial but this time under the same conditions they only last point 15 kilograms per day thought how come they're losing weight at a slower rate. So they say well maybe they're cheating maybe they're not following the diet at home so we'll put him in the hospital so they put him in the hospital and sure enough 1st time they did it on the blue bar on the right you see that they lost point 47 kilograms per day very fast rate of weight loss then they came off the diet they gained all the weight back plus another 15 percent so they had the weight rebound and they said oh no problem just put him back in hospital but the 2nd time they put him back in the hospital they only last point 37 kilograms per day they were losing weight at a slower rate and said How come what's going on well what was going on is the 1st time this happens the 1st time they have the weight the low calorie diet the body says we're not getting as many calories today I wonder if this is a pattern and sure enough after a couple days of ice up this is a pattern we better turn down the metabolism to conserve calories and so everything slows down that's the protective response to protect you from the starvation when they came off the diet of course advice is OK we better get ready for the next starvation so they gain all the weight back plus on the 2nd time it happened the body says. We're not getting as many calories today I wonder if this is a pattern and says nope I'm not going to wait to see if this is a pattern we're going to we've learned our lesson we're going to turn down the metabolism today immediately it responds much more aggressively and considers calories much more efficiently the 2nd time around the body is being trained to protect you from the starvation and that's why. People going on a low calorie diet can lose 10 pounds the 1st time they try it next time they try it maybe only 5 pound loss next time only 2 or 3 pound loss and they are frustrated they don't understand why this isn't working like it used to were heard and this is this is why your body is adapting so what have we seen so far low calorie diets don't work and they cause a weight gain in the long run their tolerated poorly it slows your metabolism so you're not going to have the energy that the Holy Spirit's wanting it to the energy to do the things the Holy Spirit is calling you to do it will produce a weight rebound when you come off a low calorie diet and on repetition you'll have a slower rate of weight loss OK So this is a very difficult concept to get across to patients because the natural tendency is on gaining weight I've got to cut down on my calories and when they do that they're setting themselves up for a weight rebound I will tell this to patients that come in one time then I'll see him 3 months later and they're still trying the low calorie diet so it's a very difficult thing to to reeducate on but it's important if they want to be successful OK Has anyone heard about it OK Some of you have what is it does it work is it safe Actually it's not new is introduced in the 860 S. by William Banting its effectiveness and safety are still questioned in 2004 the food industry began to capitalize on low carb craze by selling these low carb options. What is a low carb option Well I remember my wife asked me to pick up something in health food store on the way home. It was lunchtime I'd missed lunch and so on the way out I said I'll get some of these health health bars they're always good so I got a couple of those for lunch and when the car and I took a bite out of one and I said Yeah what is this This tastes like straw and I read the list I will this is a low carb option that was my introduction to low carb options. What is a low carb diet actually there is no definition of a low carb diet but the new Food and Nutrition Board has established a minimum requirement for carbohydrates because your brain in your spinal cord your nervous system can only burn sugar you need about 130 grams of carbohydrates a day to supply your nervous system. Also just to get the nutrients you need those nutrients come with carbohydrates and so if you're getting the carbohydrates from plants you'll get the nutrients you need to protect you from degenerative diseases and so they say you need 225 to 325 grams of carbohydrates per day for that now the meat in the dairy those are the high protein high fat foods that are very low in carbohydrates those don't have the nutrients that you need and so and they also don't have the carbohydrates you need and so that's why they're saying you need these carbohydrates if you get into carbohydrates then you're be pretty much assured of getting the nutrients with those. What does the Akon stat allow does it meet either of those requirements now they they start out at getting 20 grams of carbohydrates per day and then slowly increasing it to a maximum of 60 grams per day which meets neither of those recommendations. Does the AK in this diet work does it cause weight loss because people are willing to risk the new shin deficiency if it can get rid of their weight there is a weight loss initially. And the question is why when they're also does it last. Well they they did a study to find out why the weight loss and what they observed as a people that were taking the Atkins diet when they measured the calories intake they were only getting 66 percent of the calories they would normally eat and so they asked them why are you eating 100 percent of calories you would normally eat they say well we have no appetite for the foods that are available on the study it so I thought oh well in Astra eating those low carb bars I understood why OK And so they thought well maybe the Atkins program is working because of decreased calorie intake because of suppressed appetite for the foods that are available so they said well let's test this so they had 2 groups of patients they had one group of patients OK you're on the Atkins group are low the low carb group and. You can have as many calories as you want but you can only have so many carbohydrates they limited their carbohydrates to 20 grams per day for about 6 weeks well the other end when they ate their foods they were only eating 66 percent of the calories as expected. The other group they said OK you can have as many carbohydrates as you want but your total calories has to match the Akron's group so they were limiting their calories so the calorie intake was the same in group both groups but one group was getting their calories from protein and fat the other group was getting their calories from carbohydrates mainly And when they looked at them at the end of 6 weeks both groups lost 11 pounds from this and several other studies they found that they had actually 2 extensive reviews 5 more recent studies showed that the actions that worse by suppressed appetite for the foods that are available it's essentially a variation of a low calorie diet what's going to happen then when you come off the local this program you're going to get the weight rebound that you get with any low calorie diet that's that's the problem. And let's see if I get OK Is is the diet risky Well yeah in order to get the eigenstate you have to have high protein high fat where you get protein and fat without carbohydrates it's mainly the animal products the meat the dairy and when you do that you're going to increase your cholesterol level that's the L.D.L. the bad cholesterol and that rose significantly on the Atkins diet there's also a risk of vitamin A mineral deficiencies because the mean the dairy don't have all the minerals and vitamins and phytochemicals the nutrients you need and so you're required on the Atkins program to take in minerals and vitamins to supplement that because you're not getting them if you don't take them they've had actually people die of the program because they're they're not getting the nutrients. There is a high dropout rate in the Atkins group how come well weakness was a common symptom why are they weak they're only getting 66 percent of calories they would normally get constipation or the cost of pated well they get that yeah the from animal products meat and dairy there's no fiber in those and so you're going to have a low fiber diet which causes constipation they also have bad breath that's how it goes as muscle cramps diarrhea rashes and you had to have vitamins and minerals supplements and there's a high dropout rate and. There. There was a very. The average weight loss. After a year or 2 was very it was very low not just a few pounds. Has anyone heard of Weight Watchers you know it's it's publicized it's promoted I mean everywhere it's. Going to shopping centers and they'll have a Weight Watchers. Center there. What is it it's it's. Similar to a low calorie diet you have points for calories you also have points for fat and limiting the fats not a bad idea but again it's based on a low calorie diet and because of that it's it has the same problems any low calorie diet has. They they did a 2 year randomized controlled trial and the average weight loss after 2 years was only $6.00 pounds which is well for most people that are trying to lose weight that's that's not enough anywhere near enough only 16 percent maintained and achieved and maintained a weight of weight loss of 10 percent or more so again not not to be promoted. Low calorie diets so what we're we've seen so far low calorie diets don't work low carb diets don't work OK So what are some things that help well I'm going to talk about some things that will contribute to weight loss and then I'm going to talk about the core issue of obesity in America what is actually causing the epidemic. Does When we eat make a difference actually yes eating the main meal in the morning rather than the evening decreases weight the calories that you take in in the morning are tend to be burned the calories you take in at night tend to be stored so feeling the same number of calories but shift when you eat them. Shifted to the morning you can actually lose lose weight many people who are trying to lose weight will go on a 2 meal a day plan the biggest meal it breakfast moderate meal lunch and then they may even skip the evening meal or not cutting the total daily calories down to shifting when you're taking them in. In America I think that the tradition is when is what is the meal that we will typically skip when we're pressed for time practice OK what is typically the largest meal we be dinners it's the evening meal and that's the tradition and again many traditions in America set us up for for failures are OK Does exercise is actual size the answer exercise helps but exercise will bring a weight loss but then further exercise you're going to get a plateau. How does it work well let's look at some they did some studies with rats and they put them on a treadmill and they exercise them daily and some rats one group got 0 minutes a day and then if you look at the bottom there some rats got 20 minutes a day some 40 minutes and some an hour and if you see you know if I can point. I don't know if you can see it there a point or works. Here the weight dropped every 20 minutes until an hour exercise per day this is the weight dropped but going to 2 hours $34.00 there's a weight plateau until you get around 5 or 6 hours in the weight starts dropping again what happened out here was that rats went into total exhaustion they stopped eating maybe they were breaking their toes in the treadmill they basically said I give up let me die OK So you want to avoid this part of the of the exercise curve what you'd like to do is get in the active range but notice you don't have to be running marathons. Brisk walking can do this and get you in this in this is own so you want to stay out of center is zone into the active zone they also noted something very interesting with appetite and calorie intake. The calorie intake what they found is that as the weight dropped their appetite actually dropped as well they were taking in less calories until they hit this plateau and when they hit this plateau then with further exercise the calorie intake increased they want to Why is that why is there an initial calorie drop Well the reason is is that 75 percent of the calories you take in are burned just to keep you warm that's the major energy expenditure in normal people only 25 percent is needed to move and talk and do all the other functions you have. As the weight dropped the body surface area shrunk and they were radiating less heat there was less body surface area to lose heat with and that accounted for the initial weight drop for their little appetite drop once their weight stabilized that was no longer true tribute into their calorie need so once that plateaued then the thing that determined their appetite was actual size and increased linearly the more exercise they had the higher the appetite increased and that was that explanation that that was the explanation for the initial drop Well these are rats does this work in people while they went to India same researchers went to India and to find out and they looked at a mill they looked at different mill workers and they. Looked at the mill workers and they classify them according to how active they were these were the least active the clerks and the the office workers and then another group here were stallholders and they were a little more active and then each group was more active until you got the people that shoveled the coal and hauled hauled the grains in and then these are the most active here we see the way again the weight dropped as activity increased but then it hit a plateau beyond which there was no further weight loss. Just like in the rats and they didn't get into the exhaustion range like the rats did and that was good OK here we see the same thing happen with the appetite as the weight dropped the appetite dropped until they hit the weight plateau once the way plateau was reached the more exercise the more calories they took in and that's the normal V. that you would always see with with exercise. OK so. QUESTION And how do I get out of the sedentary range in the reactive range. And what type of exercise is going to give me the best response. They did a study to find out which was more likely to give a successful weight loss approach and so they they took about 34 patients and they said OK we want you to actually is 30 minutes a day and then we want you to increase your exercise time one minute per day and then record your weights over several weeks you and some shows walking some shows running some shows swimming some shows bicycling. What they found was 6 chose jogging 3 of those dropped out due to injuries other 3 could not tolerate long enough to produce the effect on their weight 3 chose cycling to chose winning but all of these 3 other tolerate the exercise long enough to be included in the study which is a 30 minute minimum. Only 11 of the initial 34 patients were able to maintain their excised period for over 30 minutes on a consistent basis and all 11 chose walking OK now I'm not saying you can't do these other exercises just if you want the biggest chance of success when you're starting on actually program your best chance to to sickly is going to be is going to be walking. Here were the results they found that this is kind of busy picture but. Here's the.


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