holistic weight loss

the integrative approach to total well-being There are dozens of natural, healthful ways to get trim and stay that way; the more you use, the more you'll lose

nEED TO LOSE WEIGHT? Not a problem.

"Any fool can drop 20 pounds," declares Lynn McAfee, director of medical advocacy at the Council on Size & Weight Discrimination in Mount Marion, N.Y. "But if you don't address the bigger picture, your chance of keeping the weight off is slim to none."

In the United States, where more than 60 million people are at least 30 pounds overweight, many dieters turn to prescription drugs like Meridia and Xenical. But these "solutions" only deal with the symptom of weight gain, not the reasons behind it — and they often come with unpleasant and even dangerous side effects.

"Diet drugs work suppressively," says Amy L. Lansky, Ph.D., author of Impossible Cure. "People have learned to say, 'My appetite's too big; I'll take a pill to suppress it.' But there may be a medical or emotional reason why you want to eat more, and a suppressive pill isn't going to address that."

Neither will surgery, despite its growing popularity as a weight-loss option. "Some operations bypass a part of the intestines that absorbs iron, calcium, and other nutrients. The result is a lifelong need for dietary supplementation," notes McAfee. Procedures like lap-band surgery aren't malabsorptive, but come with other risks. "Some people think they don't have to eat healthy afterward," she says. "Others wind up with the nutritional loss and don't lose any weight."

Americans also love their quick dietary fixes. So what's wrong with eating only pineapple or no carbs if you can shed some pounds? "Diets don't stick," affirms McAfee. The weight virtually always returns, and you'll have harmed your health in the process.

Ultimately, drugs, surgery, and fad diets are radical approaches that backfire. To get (and stay) trim and healthy, you need to manage your weight with a program that combines psychological insights, behavior and mealtime modifications, and alternative therapies.

know thyself (and others)
THE FIRST STEP toward lasting, natural weight loss is to undertand why you eat what you eat. "We're programmed from childhood to connect food to emotion," observes Andrea Pennington, M.D., president of the Pennington Institute for Health and Wellness. "Mom says, 'If you get good grades, you'll get ice cream.' Or it's, 'I'm getting married, let's have a seven-course meal.' Or, 'I'm getting divorced, let's go have martinis.' Hey, one martini is 360 calories; that's a basic meal for someone who might be trying to manage a healthy weight."

Here are five suggestions for a little counterprogramming:

Keep a food journal. This will help you identify patterns in your eating habits, encourage responsible consumption, and pinpoint nutritional misconceptions, says Jay Ashmore, Ph.D., director of the weight management program at the Cooper Institute in Dallas. "I had a patient who was eating when he was tired, because he thought it would increase his energy. Of course, it can do the opposite, and he and I both learned about this problem via his food log," Ashmore recalls. "Logging what you eat increases your awareness of what you're putting into your mouth."
See the point. Once you determine what and why you're eating, it's time to transform your relationship with food. For a start, try one of Pennington's favorite mantras: "Food is only fuel," and not, she adds, something to rely on for comfort or diversion.
Check your ego. Many dieters are trying to shore up a sagging self-esteem. "If you want to lose 20 pounds to fit into a hot outfit and make people jealous at your class reunion, you'll almost certainly go back to unhealthy eating habits," says Pennington. "I ask people to dig deeper, to picture a goal that isn't about a quick fix, and work on weight management from there."
Recognize your enemies. Obesity leads to serious problems like heart disease and diabetes — but that won't stop people from offering you seconds. "When you're maintaining your healthy eating habits, you don't need to hear, 'Oh, you've been on that diet too long — have some more chicken wings,'" Pennington says. "Put people in your life on notice that you're serious about managing your weight — and to please leave the cream puffs in the kitchen." Instead of getting together over food, she suggests bonding with friends and family during caloriefree pursuits like jogging in the park or visiting a museum.
Recruit a friend. Identify a trust-worthy acquaintance and ask for the help you need. "Find someone who's willing to call each day to see how you're doing on your program, or who will walk with you to burn some calories," says Ashmore. "Some people want to be policed; others want gentler reinforcement. Be clear on what help you prefer."
change your habits
IN THE SIMPLEST SENSE, the key to weight loss is to burn more calories than you consume. But playing the numbers game can be discouraging (and misleading; see "Born to Gain," opposite). "People don't want to be obsessed with counting carbs and calories and spending hours at the gym," says Pennington. "Once you break free of that and focus on what really works for you, it's easier to maintain a healthy weight. Then you can obsess about your great new job or your wonderful romance — anything but whether you need to drop 10 pounds and how you're going to do it."

Here are seven simple ways to establish positive eating and exercise behaviors:

Find the right workout. "If you hate running, don't head for the treadmill," advises Julie Funderburk, M.S., an exercise physiologist for the Johns Hopkins Weight Management Center. "Do something that you're not going to dread and therefore eventually abandon. If you don't like calisthenics or aerobics or weightlifting, walk rather than drive and take the stairs instead of the elevator. Those extra steps add up, and all body movements burn calories."
Change direction. Does your local grocery have a potentially diet-sabotaging bakery at its west entrance? Use the east door. Better yet, shop farmers markets, where veggies are plentiful and Tasty-kakes nowhere to be found. (No matter where you shop, don't do it while you're hungry.) And if your co-workers habitually leave platefuls of brownies in the break room, don't go in there without an escape plan: Occupy one hand with an apple, the other with a cup of tea, and beat a hasty retreat.
Keep yourself satisfied. Meal skippers end up bingeing on junk food. Have a high-fiber, low-fat breakfast of oatmeal and fruit to stay sated and energized. Enjoy small meals throughout the day to keep your metabolism humming, and stave off occasional hunger pangs with a glass of water or iced tea.
Water down your menu. Foods with a high H2o content satisfy hunger without excess calories. In a study at Pennsylvania State University, women who began a meal with a bowl of soup ate fewer calories overall.
Spice up your diet. Improve the taste of low-calorie dishes and boost your metabolic rate at the same time with hot seasonings like horseradish, ginger, cinnamon, cayenne, or mustard.
Shortchange your plate. People tend to overeat by about 25 percent, so downsize your portions accordingly. "Three-quarters of the way through a big bowl of pasta, you may be perfectly satisfied. But if there's more in the bowl, you'll eat it," warns James O. Hill, M.D., coauthor of The Step Diet Book.
Deal yourself a flush. Wash down your meals with dandelion tea to flush out the kidneys (without potassium loss), protect the liver, and offset cravings for sweets.
consider the alternatives
WHILE YOU'RE LOGGING, jogging, and flushing, consider augmenting your weight-loss plan with these complementary practices:

1. Lend an ear to acupuncture. This ancient art has a strong track record for relieving stress, one of the main reasons that people dip into the cookie jar. "Lowering stress hormones that trigger the craving of naughty treats keeps the body from going into a fat-conserving mode," says Pennington.

Auricular therapy, a type of acupuncture that's performed on the outer-projecting portion of the ear, suppresses the appetite by stimulating the auricular branch of the vagal nerve and raising serotonin levels. Pennington suggests four to seven months of weekly sessions as part of a comprehensive behavior-modification program that may include other stress-management techniques like yoga or meditation.

2. Follow your nose to aromatherapy. Essential oils of bergamot, fennel, and patchouli may help decrease appetite. Try them separately or in combination using a diffuser; alternatively you can place a couple of drops on your pillow, in a handkerchief, or in a warm bath.
3. Bring home the homeopathy. There are several homeopathic options that may potentially reduce your cravings, especially for sweets; these include Argentum nitricum, Ignatia amara, and Lycopodium clavatum. Discuss their use with your practitioner.
supplement your efforts
USED SEPARATELY or in conjunction, natural supplements can help you manage your weight in a healthy way (after you check with your physician). These are 10 of the most effective:

Milk thistle. "The liver is your body's chemical plant for fat metabolism," says Linda Page, N.D., author of Healthy Healing. Fend off multiple toxins and support liver function by taking 200 milligrams of milk thistle extract every day.
Green tea extract. Useful as an antioxidant, green tea also seems to have thermogenic boosters that raise metabolism and aid in burning fat more quickly. A post-meal cup of tea has numerous health benefits, but for weight control the American Botanical Council Clinical Guide to Herbs recommends two 250 mg capsules of extract taken three times daily with meals.
PGX. Any fiber supplement (like Benefiber) absorbs fat from foods and lets you feel fuller, longer. Mark Hyman, M.D., suggests PGX, also known as PolyGlycopleX or konjac root. "This special superfiber is very viscous and soaks up fat, sugar, and water in the gut," says Hyman, author of Ultrametabolism: The Simple Plan for Automatic Weight Loss. "It's a uniquely powerful, safe way to promote weight loss." Hyman advises taking two to four capsules before every meal.
Calcium. Researchers at the University of Tennessee found that dieters who consumed dairy products and calcium enjoyed accelerated weight loss. Take 1,000 mg of calcium citrate daily. (Calcium can deplete magnesium, so add 400 mg magnesium citrate for mineral balance and better sleep.)
ALA. "Alpha-lipoic acid is a powerful antioxidant and metabolic booster that has been shown to reduce blood sugar and prevent diabetic complications," Hyman says; he recommends 100 to 300 mg twice a day.
L-carnitine. The amino acid acetyl-L-carnitine "helps transport fat into the mitochondria for burning," notes Hyman, who finds it especially useful for people with insulin resistance. A common dosage is 500 to 1,000 mg, sometimes up to 2,000 mg.
5-HTP. Its complete name is 5-hydroxytryptophan — which is why everyone calls it 5-HTP. This nutrient is converted into serotonin, a neurotransmitter that enhances mood and promotes weight loss by decreasing carbohydrate cravings. Begin with 50 to 100 mg once or twice a day, working your way up to 400 mg daily.
Gymnema sylvestre. Insulin released as a result of high blood sugar tells the body to store fat. Curb your sugar cravings with 300 mg of Gymnema sylvestre; this herb binds to taste receptors and reduces sugar's sweetness, according to Page.
HCA. In animal studies, fruit-derived hydroxycitric acid suppressed appetite and reduced calories stored as fat. Human research is less clear, but side effects are essentially unknown. "HCA has a number of years of safe use," says Evan Fleischmann, N.D., who recommends 750 to 1,000 mg a day.
Chromium picolinate. This trace mineral helps keep blood sugar steady, which allows for easier weight loss. It's difficult to get from food, so supplementation of 200 to 400 micrograms daily is often advised. (The amount found in multivitamins is usually 120 mcg.) Chromium is sometimes paired with HCA (as in Twinlab Mega Citrimax) or L-carnitine (as in Clinician's Choice Weight Guardian).
BORN TO GAIN
"Our DNA evolved in an environment of food scarcity, not overabundance," notes Mark Hyman, M.D., author of Ultrametabolism. "Ignoring that fact is hazardous to our health and our waistlines. When you limit calories, this signals your body to go into starvation mode and pack on the weight."

All calories are equal, says Hyman, but only in the lab. In the body, they're absorbed at different speeds and have different nutrients, triggering different metabolic signals that control your weight. For example, 100 calories from a soda will enter your blood-stream so rapidly, they'll usually be stored as fat, while 100 calories from kidney beans are digested more slowly, making it likelier the body will burn them off.

In other words, eating mostly whole foods (fruits, vegetables, legumes, whole grains) and lean animal protein kicks fat-burning cells into action. "Unlocking these metabolic keys — and not more exercise and fewer calories — is the real answer to healthy weight loss," Hyman claims.

PHOTO (COLOR): NO MO' YO-YO: Diets and drugs backfire, but a mind-body program will keep you svelte and centered.

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By Robrt L. Pela

CONTRIBUTED BY David Van Ness; Illustrations by Eili-Kaija Kuusniemi

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