The Lap Band Still Plays On

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I received this email today from fellow comedian and blogger Josh Goguen:

Hey, Tom –

I have satellite radio and they have a channel called Doctor Radio. I happened to be listening when they had a LAP BAND/Gastric ByPass doctor on and I couldn’t believe the things they were saying. She made it sound like something that’s just so great and easy and, aww come on, you’re not going to diet, who are you kidding?

Then she rattled off all these benefits of losing weight (diabetes relief, lower cholesterol, etc.) while completely glossing over how restrictive the diet is or how risky surgery itself is. It almost seemed sadistic. I could almost picture POWs being returned, emaciated while their captors say, “Yes, we did starve our prisoners, but if you look at their triglyceride levels, you’ll see they’ve benefited tremendously.”

Not one person who called in compared it to a forced diet and asked if a person skipped the surgery and just ate the post op food if they’d lose the same weight. It was recorded early in the week, so the opportunity wasn’t there for me to do so.

It seems as if a segment of the medical community isn’t interested in actually educating and helping people help themselves but rather just devising new means to “effortlessly” fix a problem. I wonder what will happen to these people should government healthcare takes effect.

Honestly, if that happens, I believe we can say good bye to the hopes of the lipid hypothesis overturned. I wrote a blog based off of it, but I couldn’t help but share this with you via e-mail.

Josh Goguen

Josh Goguen

Josh’s blog post on the topic, in which he creates his own miracle diet plan, is spot-on.  (And I recommend adding his blog to your reading list, because he covers a nice variety of topics and makes a habit of being spot-on.)

In my previous post about the Lap-Band surgery, I mentioned that a friend of mine had gastric bypass surgery and now regrets it.  So imagine my surprise when I poked through some bariatric-sugery literature available at our family doctor’s office and found that this same friend is mentioned as a surgery success story.  This is what the literature said about her:

[Her name] is a size 4 today after losing more than 100 pounds from her peak weight of 230.  A mother of three, her drive was to be able to be active with her youngest, the way she used to be.

Before her surgery, she had diabetes, sleep apnea, and was on heart medication.  That’s all in the past.  Today she and her husband and the kids play golf and tennis together.

Why, doesn’t that just sound fantastic?  So I emailed her to ask if she knew she was being used as an example of the wonders of weight-loss surgery.   Her reply:

Had I done it your way, I truly would have been a success story. Glad they’re excited about cutting out 20 feet of intestines and subsequently yanking out my gallbladder and keeping me in a constant state of vitamin deficiency.

But gee whiz, she can play tennis now and wear size 4 clothes …


It’s the Carbs, Not the Calories

A new study presented this week at the European Congress on Obesity concludes that Americans have gotten fatter as the result of eating too much, and not from exercising too little.

I expect most people and nearly all of the media will file this under “Duh, do you think?” I can already hear Conan O’Brien or Jimmy Kimmel delivering a punchline along the lines of, “So we’re fat because we overeat? Well, thanks for explaining that to us, Doctor Obvious.”

But this is one of those cases where the “obvious” explanation doesn’t actually explain much of anything. Read this statement by Boyd Swinburn, the lead researcher:

“There have been a lot of assumptions that both reduced physical activity and increased energy intake have been major drivers of the obesity epidemic. This study demonstrates that the weight gain in the American population seems to be virtually all explained by eating more calories.”

If that’s true, then it certainly supports Gary Taubes, who raised quite a few academic eyebrows (and some well-toned hackles among fitness gurus) when he said exercise has little effect on weight loss.

But it also raises a hugely important question that the high priests of The Holy Church of Accepted Advice For Living A Long and Healthy Life can’t seem to answer:  Why, after so many generations, did Americans suddenly decide to start eating too much in the 1970s?

Or, asking the same question from another angle, why didn’t our grandparents eat themselves into obesity? The word “leftovers” certainly existed back then, so it’s not as if they didn’t have enough food to make pigs of themselves.  Were they blessed with some kind of Greatest Generation self-discipline that enabled them to leave the dinner table while still hungry? Given what I remember about my grandfather’s smoking and drinking habits, I’m going to guess “no” on that one.

The explanation offered up by people like Morgan Spurlock and Kelly Brownell, author of Food Fight, is that we found ourselves living in a “toxic food environment.” The evil food producers and restaurants started offering us bigger portions and so, mindless sheep that we are, we ate more simply because we could.

But in order to swallow this load of bologna, you have to believe that eating and hunger are only somewhat related.  Sure, people eat when they’re hungry, but they also eat just because the food is available – in other words, because they’re gluttonous.

One of the insights Gary Taubes presented in Good Calories, Bad Calories is that hunger doesn’t begin in the brain or even in the belly – it begins at the cellular level, when our tissues run low on fuel. If you haven’t seen it already, check out this clip from Fat Head:

Now look at where we’re getting all those extra calories the experts are so worried about:

We don’t eat too much because we’re more gluttonous than our grandparents. We eat too much because in the 1970s the McGovern committee convinced us we need to live primarily on low-fat grains and other starches. We eat too much because our insulin levels are too high. We eat too much because we’re storing too many calories as fat.

In other words, we eat too much because we’re too damned hungry.

And we’ll stay hungry as long as we continue living on foods that spike our blood sugar several times per day. But as usual, the experts have the cause and effect confused:

From a public policy perspective, expectations regarding what can be achieved with exercise need to be lowered and emphasis should be shifted toward encouraging people to eat less, Swinburn says.

No, from a public policy perspective, emphasis should be shifted toward encouraging people to drastically reduce their consumption of carbohydrates; do that, and the “eating less” will take care of itself.  But in a country where sugar, wheat and corn are all subsidized by the taxpayers, I don’t expect this kind of policy shift to happen anytime soon.


Bonus Footage – Frankenstein Fats

You ever have someone make a suggestion that’s so simple and obvious, you find yourself having a serious “Duh!” moment?  As in, “Duh!  Why didn’t I think of that?”

I commented awhile back that I was pleased when our DVD distributor asked for bonus material, because that allowed me to include interview footage that wouldn’t fit into the film.  I explained how they asked for perhaps 20 minutes, I gave them 30, and wished I could’ve inlcuded even more.

A reader named Stephen, who lives in Northern Ireland, asked why I didn’t just post more interview footage on my blog.  That’s when I had the “Duh!” moment. 

So periodically, when the mood strikes me, I’m going to go back through my old interview footage and put together clips on various topics.  This will give you all more opportunities to hear from people like Drs. Mike & Mary Dan Eades, Sally Fallon, Dr. Al Sears, etc. 

I’m not going to edit these too tightly because, unlike in the film, we don’t need to keep the comic timing going, so I can just let my experts have their say.  You may hear bits and pieces that you already heard in the film, but with more of the original interview included.

Today’s clip is about how the misguided fears over saturated fats gave us the Frankenstein fats we consume today.  Enjoy.


More 100-Calorie Nonsense

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I found this video on the MSN health channel. It’s obviously sponsored by Nabisco, and is really nothing more than an infomercial meant to promote their 100-calorie snack packs. I hope people recognize this for what it is and take it with a grain of salt.

Nonetheless, viewers are treated to the usual bologna about diets (in a convenient snack size, naturally), so I wanted to comment on it.

Now, notice the overall message: weight control is all about limiting your portion sizes. Eat what you eat now, but a little less of it, and you’ll lose weight.

This is a convenient message for Nabisco, because it would mean you could still eat Oreos and lose weight, as long as you just eat a few of them. And Nabisco will help you, bless ‘em, by putting 100 calories’ worth of cookies into a to-go package for you.

This will save you the trouble of reading the label on a box of Oreos, noticing that each cookie provides 53 calories, and dropping two of them into a baggie before you leave for the gym. If you’re willing to pay a higher per-cookie price to avoid this kind of simple math, I suspect being overweight isn’t your biggest problem in life.

And of course, there’s a teensy little problem with this whole theory: nutritionists, dieticians, doctors and other priests of The Holy Church of Accepted Advice For Living A Long and Healthy Life have been telling people for decades to lose weight by restricting calories. This sage advice has been demonstrated to have a long-term success rate of about 1 percent, otherwise known as a failure rate of 99 percent. If I want advice that’s useless 99 percent of the time, I’ll take golf lessons.

There’s a good reason this advice rarely works: it isn’t based on real science. As Gary Taubes recounts in Good Calories, Bad Calories, if you restrict calories without lowering your insulin level, the insulin will tell your body to continue burning sugar while storing fat. You’ll take in less fuel, but the fuel in your fat cells – which is what you want to burn on a diet – will be released slowly or not at all.

So after perhaps losing a bit of weight, you’ll simply start running out of fuel for your cells. You’ll get hungry. If you ignore the hunger, your body will slow down your metabolism to compensate – exactly what a fat person doesn’t need. And the reality is that most people can’t ignore hunger week after week. It goes against our deepest survival instincts. So once you start eating more again, the slower metabolism means you’ll gain weight even faster.

So what you could keep your insulin elevated even as you cut calories? Hmm, let’s think about this … well, 100 calories’ worth of Oreos could probably do it.

The section of the video that prompted me to yell at the screen, however, was when the dietician explained that the proper size for a serving of meat is three ounces. If I consume three ounces of meat at a meal, it means one of three things:

  • I need to go shopping.
  • It’s an appetizer.
  • I’m at a restaurant that I won’t be patronizing again.

Whenever I hear one of these blanket pronouncements, whether it’s on a health topic or not, I like to ask myself a question: says who, and how do they know? Which gold-standard research study concluded that the proper size for a serving of meat is three ounces … as opposed to 2.5 ounces, or 11 ounces?

The answer always seems to involve some kind of tautological explanation: Three ounces is the proper size because it’s what experts recommend.  Okay, so why do they recommend that size? Because it’s the correct amount. Yeah, but why is that the correct amount? Because experts say so.

This is the same kind of iron-clad logic we saw in that stupid Reader’s Digest article that slammed low-carb diets. You can’t eat that all that fat because experts say it’s a bad idea. And you shouldn’t restrict your carbohydrates because experts say you need them. How do the experts know this? Because they went to school and were trained by experts.

And if I’m supposed to limit my meat to three ounces per meal – which wouldn’t provide nearly enough calories to get me through the day – where am I supposed to get the rest of my calories? From starch?

Uh, yes, apparently. According to the video, I should consume either pasta or a potato, but limit my portions. Portion control is definitely a good idea when it comes to starch, so I follow a modified version of what the nutritionist suggests: I cook up some pasta, then disconnect the mouse from my computer and take it to kitchen to use as reference for selecting a potato. I bake the potato and squeeze the pasta into a tennis ball shape. Then I throw them in the garbage where they belong. Oh yes, then I put more meat on my plate.

Finally, we learn from the video that those 100-calorie snack packs are a great idea. Yup, when you’re on a diet, nothing keeps you on the straight and narrow like a convenient bag of sugar. After your blood sugar spikes and then drops, you’ll feel famished.  All you’ll think about is your next meal.

Too bad it’s portion-controlled, or you might really look forward to it.


The Caveman’s Valentine – a radio play

(SFX:  A boulder rolled away)

GROK:  Honey, I’m in da’ cave!

MANA:  Home.  We call it home now.  “Honey, I’m home.”

GROK:  Right, right.  Sorry, I – Wow!  You made animals on the wall!

MANA:  I call it “painting.”  Hope you don’t mind, I used up the berries.

GROK:  No, it’s a lovely surprise.  And I have a surprise for you, too.  Here!

MANA:  What are those?

GROK:   Flowers.  

MANA:  Flowers? 

GROK:  All the men are doing it now.  I didn’t want to be the last man to catch on,  you know, like when everyone around here started  … aaah, what’s that thing we do sometimes now?  You know, before we —

MANA:  Kissing?

GROK:  Right, kissing.  Anyway, after we killed the mastodon, Old Baka said, “It’s been a long hunt, men, and we don’t smell so good.  Better bring the women some flowers, or there won’t be any children next year.” 

MANA:  That’s nice.  But they don’t really look like flowers. 

GROK:  Well … no.  When Old Baka said that, I was squatting behind a bush, and the other men picked all the flowers.  So I grabbed some of this tall grass the birds were eating.  See, there’s a little bit of a flower on the top.  I call it a “what.”

MANA:  What?

GROK:   Yes, that’s right.

MANA:  No, I mean, you can’t call it “what.”  We use that word already … what’s this, what’s that, what’s for dinner.

GROK:  Oh, I see.  Uh … How about “wheat”?

MANA:  You have a wonderful mind.  Should I put the wheat in some water?

GROK:  I was thinking maybe we could eat some of it.  Like the birds.   They sing really nice.

MANA:  Well, mastodon takes forever to cook, and I am a little hungry.  

GROK:  And you used all your berries to paint. 

MANA:  Yes.  I call myself a “starving artist.”  It makes me feel special and gifted beyond my actual abilities.

GROK:  Uh … right … so you still want to eat what? 

MANA:  Wheat?

GROK:  What?

MANA:  Never mind.  Yes, let’s try the wheat.

(SFX:  munching, then gagging and spitting)

MANA:  Yeeeuk!  Birds are stupid!  Wheat tastes terrible. 

GROK:  And  it made my belly hurt!  Stupid wheat!

(SFX:  A club pounds away, BAM!  BAM!  BAM!)

MANA:  Look at that.  You beat it into a pile of dirt.  I mean, it’s sort of like dirt, except it’s kind of pretty.

GROK:  It is, now that you mention it.  I think I’ll call this wheat-dirt “flower.”

MANA:  I have an idea!  Let’s mix the flower with some water and a little bear fat.  Maybe it’ll taste better.

GROK:  I’ll get a bowl.

(SFX:  pouring, stirring, then swallowing)

GROK:  Mmm!  That’s not bad!

MANA:  It’s delicious!  Ha-ha-ha-ha-ha-ha-ha!

GROK:  Why are you laughing?  Ha-ha-ha-ha-ha-ha!

MANA:  I don’t know.  I just feel all happy and silly!  Like after eating honey!  Ha-ha-ha-ha!

GROK:  So do I!  Ha-ha-ha-ha! 

MANA:  Ha-ha-ha-ha-ha! – oh …  Wait a minute.  I don’t feel so good.

GROK:  Me neither.  I feel kind of sleepy.   Like after the kissing.

MANA:  What should we do?

GROK:  We probably should eat more flower.

MANA:   Okay! 

(SFX:  Pounding, pouring, stirring, then swallowing)

MANA:  Mmm!

GROK:  Mmm-mmm!  That’s better!  I feel good again.

(SFX:  two small pings, off the stone floor )

GROK:  What was that?

MANA:  Two of your teeth fell out.

GROK:  Hmmm…  How do I look?

MANA:  Somewhat less intelligent.  I’m not sure why.

GROK:  Good thing the flower is soft and easy to chew.  Get me a little more, would you?

MANA:  Sure, why not?

(SFX:  shuffling, creaking)

GROK:  Why are you moving like a turtle?

MANA:  It’s strange … my bones hurt.  Like that old man, Artur.

GROK:  Well then, we should call what you’re feeling “Artur-itis.”

MANA:  Call it whatever you want, but get your own flower.  I need to sit down. 

GROK:  Okay.

MANA:  And get me some, too.  I want to feel happy and silly again.

GROK:  Right.  Good idea.  We should eat more  flower and feel silly and happy.

MANA:  So stand up and go get the flower, already!

GROK:  I am standing up!

MANA:  Oh!  Uh … Grok … you’re not as tall as I remember.

GROK:  I kind of thought my deerskin was dragging on the floor.

MANA:  And my deerskin feels tight around the middle.

GROK:  Yes, I noticed.  I was afraid you were hibernating.

MANA:  You’re getting shorter, and I’m getting fatter.  What should we do?

GROK:  Well … let’s have some flower so we can be happy while we think about it.

MANA:  Good idea.

(SFX:   Pounding, pouring, stirring)

GROK:  Here!  I made extra!

MANA:  Mmm!  So good!

GROK:  Mmmm!  Mmm-mmm – aaaah!

MANA:  What’s wrong?

GROK:  My eyes and my throat hurt.  They’re dry, like dirt! 

(SFX:  Grok taking short, painful breaths through clenched teeth.)

MANA:  Ha-ha-ha-ha-ha!

GROK:  Why are you laughing?!  This hurts!

MANA:  I can’t help it; it’s funny.  You’re in pain, but  it looks like you’re grinning.  We should call this “Show Grins” disease.

GROK:  Call it whatever you want, just get me some water! 

MANA:  Okay, already!

GROK:  And more flower!  I need more flower!

MANA:  I’m moving as fast as I can.

(SFX:  shuffing, creaking)

GROK:  Why are you all bent over like that?  Your back looks broken.

MANA:  I call it a “window’s hump.”

GROK:  How can it be a “window’s hump”?  I feel awful, but I’m not dead.

MANA:   No.  But if you bring home any more of this bird food, I’m pretty sure I’m going to club you.


Primal Body, Primal Mind, Primal Tools

There’s an old saying that when you’re holding a hammer, everything looks like a nail.  If you’ve got a malfunctioning pancreas, a surgeon is likely to decide you need surgery, a medical doctor will decide  you need a prescription drug, and a therapist will suggest you heal your inner child so it will stop taking its emotional wounds out on your pancreas.

Sometimes these modern therapeutic tools are exactly what we need.  But sometimes they’re not.  Sometimes what we really need is a good, old-fashioned, stone-age tool … such as a hunter-gatherer diet. 

Here’s an example: some years ago, as I’ll explain shortly, I thought I needed a 12-step program, and perhaps some therapy to go along with it.  Turns out I actually needed a medium-rare steak.

I thought about that while reading Primal Body–Primal Mind, by Nora Gedgaudas.  The book covers a wide range of health topics – nutrition, metabolism, exercise, weight loss, vitamins and supplements, depression and other emotional issues – but ties them all back to one central idea:  physically, we are virtually identical to our Paleolithic ancestors.  We may drive minivans and listen to modern jazz on iPods, but our bodies and brains haven’t really evolved past the stone-tools era.  Your great-grandfather to the 10th power thrived on particular nutrients, and so will you.  The reverse is also true:  you probably won’t thrive if you fill you belly with foods he never ate.

Nora obviously ploughed through an enormous amount of research to write this book, and she summarizes it quite nicely.  She explains biochemical concepts clearly, while managing to sneak in a bit of humor here and there – always a plus with me.  I enjoy a book when the information is dense, but the writing style isn’t.

But what I especially liked is the reason she wrote the book.  Nora is a clinician who helps address brain malfunctions with a technique called neurofeedback, a kind of biofeedback for the brain.  With electrodes attached to your head, you play something akin to video games on a computer, and retrain how your brain responds to stress.  She’s used this high-tech tool to help clients with everything from depression to autism with impressive results.

Nora Gedgaudas

Nora Gedgaudas

And yet, she sometimes found that clients would make minor improvements, then stall.  Since she’s been studying nutrition for 25 years, she recognized that the neurofeedback treatments were being stymied by brain malfunctions that were rooted in a lousy diet.  As she explains in the preface:

“The brain and the body simply have to have certain raw materials to work with in order to function properly.  It is abundantly clear that all the brain-training in the world cannot create a nutrient where there is none, or remove a problematic substance which does not belong.”

So despite wielding a modern and effective tool, she knew these people needed a stone-age tool as well.  Tired of having to copy countless research articles on Paleolithic nutrition to give to her clients, she wrote Primal Body-Primal Mind so she could hand them a book instead.  It’s no surprise, then, that the book includes chapters detailing how the wrong diet can lead to depression, anxiety, ADD, bipolar disorders, and yes, alcoholism. 

Which brings me back to that medicinal, medium-rare steak.

Back in my starch-loving vegetarian days, I had a problem with alcohol.  The problem was that I craved the stuff.  If I drank a beer, I soon wanted another.  Then another.  Then another.  And if I didn’t have another, my brain would start to shut down.  I remember becoming sleepy and lethargic at parties, but feeling alert again after drinking yet another beer.  I even wondered how a supposed depressant could produce this effect.  (I never wondered for too long, because eventually I’d be drunk.)

Not wanting to be a lush, I swore off alcohol for long periods.  But I still craved the stuff and still got pretty drunk now and then, so eventually I started attending AA meetings. 

But a funny thing happened on the way to the 12th step:  I changed my diet.  After reading The Zone, I cut my carbohydrate consumption drastically and, for the first time in years, started stocking my refrigerator with meats.  I tossed the vege-burgers and the soybean mayo, and started cooking chicken and steaks.  I felt better, my overall mood improved, and I lost weight. 

I also lost the desire to drink.  I quit going to meetings because I didn’t see any point in continuing, and frankly, I have a limited tolerance for listening to people recount every stupid thing they ever did while drinking. 

(Before any recovering addicts decide to fire off an angry email, take note:  I’m not saying 12-step programs don’t have a place and don’t help people.  I’m saying I no longer needed one.)

A couple of years later, an immigrant waiter in a Lebanese restaurant served me a Lebanese beer instead of the non-alcoholic beer I’d requested.  I didn’t realize the mistake until I’d finished it.  I wondered what would happen.

What happened is that I enjoyed my lamb.  That’s it.  I didn’t want another beer.  The same thing happened when I intentionally ordered a beer a month after that, and again when I tried a glass of wine a few weeks later.

I still drink a beer, or a glass of wine, or a single-malt scotch now and then, but I don’t crave the stuff.   I’m not fighting the urge to keep drinking, because the urge isn’t there.  I literally can’t remember the last time I downed a sixpack, which I used to do quite easily … often as a warm-up for downing another one.

So why did changing my diet make such a difference?  I’ve wondered many times over the years.  Nora’s section on alcoholism offers a pretty good clue:

“Alcoholics are utterly dependent upon and regularly seek fast sources of sugar – alcohol being the fastest … the problem in alcoholism, in fact, really isn’t alcohol per se, but severe carbohydrate addiction … Once cravings for carbohydrates and dependence on carbohydrates as the primary source of fuel are eliminated, so are the alcohol cravings.  Training the body to depend upon ketones rather than sugar for fuel is key to this equation.”

I wasn’t addicted to alcohol; I was addicted to having fuel for my brain.  Thanks to my starchy, meatless diet, I was a sugar-burner. When I drank, I instantly became an alcohol-burner.  If I didn’t keep drinking, I’d run low on fuel and my brain would scream for more.  I didn’t need therapy, I didn’t need atonement, and I didn’t need to heal my inner child.  I needed to stop living on starch.

Which makes me wonder:   how many people are currently in therapy, when what they truly need is a Paleolithic diet?  How many people are sitting in some shrink’s office, feeling depressed and talking endlessly abut their mothers, because too many sugars and processed vegetable oils have screwed up their hormones?  How many kids are given a daily dose of drugs for ADD,  just before they finish up that big bowl of Cocoa Puffs and head off to school?

After reading Primal Body–Primal Mind, I’ve convinced that many (if not most) of these people don’t need drugs, and they don’t need therapy.  They need a stone-age hammer.

p.s. – Nora will begin hosting a show titled Primal Body-Primal Mind Radio on Voice America’s Health and Wellness Channel on May 20th.  In the meantime, you can read more about her work on her Primal Body-Primal Mind blog.