Obesity is defined as a body-fat percentage greater than 30 percent for women and 25 percent for men (measured by various instruments), or as weighing 20 percent more than your ideal body weight (based on insurance charts). At present, the most reliable definition uses the Body Mass Index (BMI), a calculation using your height and weight (see below for calculation). A BMI of 25 to 29 is considered overweight, and greater than 30 indicates obesity.

The major reasons for obesity are diets high in fats and sugars, and lack of exercise, Obesity places you at much greater risk for developing a variety of diseases, including cancer (especially of the pancreas, breast, uterus, gall bladder, and colon), heart disease, hypertension, gallstones, stroke, and diabetes, not to mention a premature death.

What You Need to Know

All diets that reduce calories, regardless of their composition, result in weight loss. What matters more is that you maintain the weight loss and establish eating habits that are healthy for you in the long run. There are three important considerations that you must incorporate into your life if you want to lose weight and maintain that loss, and be healthy for the rest of your life.

• Make a long-term commitment to change your lifestyle. Short term dieting (”yo­yo” dieting) not only doesn’t work for long-it is also unhealthy for the body. Also, you regain lost weight quickly and usually put on even more. The only proven way to lose weight and keep it off is to make permanent lifestyle changes.
• Focus more on calories than categories of food. The bottom line is that if you eat less, you’ll lose more. It’s really that simple.
• Set realistic goals. Losing one to two pounds per week is the best way to lose weight and keep it off.

Although obesity results in various diseases and increased mortality, it is not the extra fat cells alone that are harmful to your body. It is what you eat or don’t eat and what activity you do or don’t do that determines whether your body’s tissues are harmed. Those are the factors that not only cause you to gain weight in the first place, but that also damage your body at the same time. Just losing weight, without changing those lifestyle factors, does not protect your body from damage.

General Recommendations

Diet: The balance of foods you eat, both in quality and quantity, affects whether you will lose weight. The Balanced Healing basic weight-loss plan makes these recommendations:

• Follow the Healthy Eating Pyramid, a guide to balancing your meals developed by Dr. Walter Willett at the Harvard School of Public Health. When you follow a food pyramid as a guide to eating, you eat more foods from the bottom of the pyramid and less as you go up to the top. In the Healthy Eating Pyramid, equal weight is given at the bottom level to whole grain foods and plant oils (including olive, canola, soy, com, sunflower, peanut, and other vegetable oils), which you can eat at almost every meal. The next level of the pyramid includes vegetables and fruits, which can be eaten 2 to 3 times a day. Above that level are nuts and legumes, which can be eaten 1 to 3 times a day, followed by fish, poultry, and eggs, which can be eaten no more than 2 times a day. The next level of the pyramid includes dairy products, which can be eaten 1 to 2 times a day. At the top of the pyramid, you’ll find red meat, butter, white rice, white bread, potatoes, pasta, and sweets­which should all be eaten sparingly. For more information about the Healthy Eating Pyramid, read Dr. Willett’s book, Eat, Drink, and Be Healthy.
• Women, restrict calories to 1,200 per day, and men, to less than 1,500 per day. Get a good calorie-counting book and use it!
• Of total calories, for the best balance, less than 30 percent should come from fat, 20 percent from protein, and 50 percent from carbohydrates.
• When eating fat, use monounsaturated, which does not elevate your cholesterol levels. You should not exceed 10 percent saturated fats, because these elevate your blood cholesterol level. Also, avoid trans fats, which are contained in processed (packaged) and fried foods. Trans fats are even worse for your health than saturated fats. In fact, the Institute of Medicine reported that NO level of trans fatty acids is safe to consume.
• When eating carbohydrates, fresher is better. Fresh fruits and vegetable and whole grains are absorbed better into your system, are more nutritious, contain more fiber, and do not put more weight on you.
• When eating protein, restrict animal fats, which increase cholesterol. If you eat animal protein, consume more fish, chicken, and turkey than red meat. Eat more plant protein (legumes, beans) than animal protein.
• When eating grains, choose whole rather than refined grains. The refining process removes most of the beneficial nutrients and vitamins in the grains. If you eat refined grains, make sure they are enriched.
• Consume 30g to 40g of fiber daily. You can obtain this amount by eating lots of fruit, vegetables, and whole grains.
• Total cholesterol intake should be less than 300mg per day. Use vegetable spreads (such as Benecol or Take Control) instead of butter or margarine.
• When using oils, use olive preferably, with canola oil second. These oils are monounsaturated so they don’t elevate cholesterol levels as other oils do.
• Take a multivitamin while dieting, to make sure you are receiving all the essential nutrients.

Do you think that eating low-fat products will help you lose weight? Not always! In fact, they may have the opposite effect. Many low-fat products contain as many calories as their regular-fat counterparts. People tend to eat larger amounts of low-fat products, thinking they won’t do any harm, yet again adding to their weight problem. In addition, beneficial fats (primarily fatty acids, such as omega- 3) are eliminated in low-fat products. Be sure to read the labels on low-fat products to check the calories, added ingredients, and serving size.

Other Lifestyle Changes: The manner in which you eat can also help you lose weight. Here are some additional recommendations:

• Plan your meals every morning.
• Eat more frequent meals. People who have been most successful losing weight and keeping it off average five mini-meals per day. This is because the more meals you eat, the less total fat is absorbed into your body.
• When you eat a meal, do not engage in another activity. Studies show that watching TV or reading while eating definitely increases weight gain, because your digestion slows down, allowing more fat to be absorbed into your body.
• Drink lots of water.

Exercise: Other than your diet, exercise is the most important factor in losing weight. If you are overweight but fit, you can often live longer than if you are normal weight but not fit. You will lose more weight and be much healthier if you combine exercise with diet. And without exercise, 95 percent of all people on weight loss diets regain the pounds they lose. I recommend aerobic and resistance exercise, at least four days per week, for 30 to 60 minutes. Resistance exercise (weight lifting) is crucial if you want to lose body fat.

Your balanced healing action plan for Obesity

• Many popular dietary aids and treatments can have harmful side effects. There are numerous products (pills, powders, and liquids) that may help you lose weight, but not in ways that are healthy. Many of these products contain a combination of ephedra and guarana, the herbal counterparts of the conventional drug combination ephedrine and caffeine. Most are effective at reducing weight using the “fat burner” approach (called thermogenesis) in addition to suppressing appetite.

I DO NOT recommend these products because they’re marketed with the false premise that you can lose weight without needing to exercise, reduce calories, or eat healthy foods. This is exceedingly dangerous because, as I mentioned before, eating unhealthy foods and not exercising causes long-term harm to your body tissues. Losing weight with these products gives you a false sense of security. In addition, they are all expensive, rebound weight gain is common once you stop them, and they may contain other ingredients that are harmful.

Of particular danger are these products:

• Conventional appetite suppressants such as phentermine, amphetamines, caffeine, or ephedrine, which can have serious side effects and provide only short-term weight loss.
• Thyroid-related weight loss aids, such as those containing tiratricol or triac, which can cause heart attacks and strokes.

Step 1: Recommended Diet Programs

The previous diet recommendations will help you safely lose weight and keep it off. However, it is often easier and more helpful to follow a designed diet plan. I recommend any of the following (your choice depends on which diet fits your lifestyle):

• The Balanced Healing Eating Guidelines
• Mediterranean Diet (Go to your local bookstore; there are numerous cookbooks on the Mediterranean diet.)
• The John MacDougall program (Buy the book The MacDougall Program for Maximum Weight Loss.)
• Weight Watchers

Fad diets, such as the high protein/low carbohydrate, Sugar Busters, and the Zone Diet, are not recommended because of potential harm and long-term ineffectiveness. For example, the latter two are semi-starvation diets. And the high-protein/low-carbohydrate diet can lose important nutrients that cannot be replaced by supplementation. Also, this diet may result in cravings for high-carbohydrate and high-fat foods, result in poor athletic performance, and cause kidney stones and/or long-term osteoporosis. Finally, the weight loss does not come from fat loss alone, but also from loss of salts and minerals. Again, balance is the key.

Step 2: Use Acupuncture and Hypnosis in Combination

Along with the diet plans, I recommend undergoing acupuncture and hypnosis; the combination is very helpful in decreasing your desire to eat unhealthy foods. Either method alone is not nearly as beneficial, and both must be combined with a good diet and exercise. For acupuncture, ear acupuncture using press tacks is usually the most effective and easiest form. Small needles are embedded in an adhesive bandage and then pressed in specific points in the ear.

The points generally used are mouth, esophagus, stomach, small intestines, point zero, Shen Men, and the hunger point (or Appetite control). These needles remain in the ear for as long as possible (on the average one week) and are replaced when they fall out. For better results, you can tap on the needle several times a day to stimulate the point. (For hypnosis, see Appendix A, under “Mind-Body Techniques,” for more information and how to find a qualified practitioner.)

Step 3: Take 5-HTP

If you still have trouble controlling your eating urges, I recommend taking 5-HTP, which reduces appetite and promotes weight loss, and reduces carbohydrate cravings. Dosage is 50mg to 100mg 30 minutes before meals. If you don’t lose one pound per week, increase the dosage to 200mg to 300mg. This supplement can cause nausea initially, but this side effect will resolve within six weeks. 5-HTP can be used with the above steps for better results.

Step 4: Take Appropriate Chinese Herbal Remedies

If you still have trouble losing weight, take Chinese herbal formulas (not those containing primarily ephedra), which can help curb appetite and improve digestion. According to Chinese medicine, obesity can be a result of Dampness, Phlegm, Qi deficiency, Heat, and/or food stagnation. I recommend Fang Feng Tong Sheng San. Consult a practitioner qualified in Chinese herbal medicine to determine which Chinese herbal formulas are the best for your particular condition. You should observe initial benefits within three weeks (sometimes sooner).

Step 5: Take Bupropion

An antidepressant used to help quit smoking has now been shown to help you lose weight. Bupropion (Wellbutrin, Zyban) can help you lose up to 10 percent of your body weight, when given with exercise and proper diet, by reducing the flow of certain hormones in the brain that affect behavior. I recommend taking it if the previous steps have not helped you reduce weight.

Step 6: Prescription Weight-Loss Medications

If you are still having difficulty losing weight, your doctor can prescribe an appetite suppressant. Sibutramine (Meridia) is the first choice and can be used long term. Because of possible adverse effects on blood pressure and heart rate, frequent monitoring is recommended. Intennittent use (weeks 1 to 12, 19 to 30 and 37 to 48) is just as effective as continuous use.

Orlistat (Xenical) can also be used long term. Unlike other weight-loss drugs, it works on the digestive tract, not the central nervous system, preventing about one-fourth of the fat you eat from being absorbed. However, it does have several GI side effects that occur if you eat too much fat. If you adhere to eating less than 30 percent fat, you are less likely to have the side effects, and you will lose more weight.

If your child is obese, your doctor can prescribe metformin, a drug normally used for people with diabetes. If your child has normal blood sugar, metformin will significantly increase weight loss if used with a low-calorie diet.

Step 7: Undergo Surgery

If you are severely obese and have failed to lose weight, or you have metabolic dysfunction, or your weight causes significant physical or health problems, you may require a surgical method to reduce your weight. The first way surgery promotes weight loss is by decreasing food intake. Gastric banding and vertical banded gastroplasty (VBG) are surgeries that limit the amount of food the stomach can hold by closing off or removing parts of the stomach. VBG is the most commonly used. Thirty percent of patients achieve normal weight, and 80 percent achieve some degree of weight loss. The second type of surgery causes food to be poorly digested and absorbed. Gastric bypass is the primary surgery that provides this malabsorption. Most patients undergoing bypass lose two-thirds of their weight within two years.

With surgery, most patients lose weight rapidly and continue to do so until 18 to 24 months after the procedure. Most patients then start to regain some of the lost weight, but few regain it all. Ten to 20 percent of patients require follow-up operations to correct complications, one-third develop gall stones, and 30 percent develop nutritional deficiencies (and must take vitamin and mineral supplementation).

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