Judith J. Wurtman - The Serotonin Power Diet: Eat Carbs—Natures Own Appetite Suppressant—to Stop Emotional Overeating and Halt Antidepressant-Associated Weight Gain

To Dick, my husband

Judith J. Wurtman, PhD

To Camille, Zeno, Hugo, and my husband, Andre

Nina Frusztajer Marquis, MD

Thou shalt eat and be satisfied.

Deuteronomy 11:15

Just as a stool needs three legs to stand on, so too did this book need three writers. The third leg of our writing enterprise was Susan Suffes, who, in a seemingly effortless manner, fused our two writing styles, added her own wisdom and insight to our advice and recommendations, and combed through details and organizational puzzles with endless patience. Her many years as an editor and writer made her an indispensable source of advice and comfort when it looked as if a chapter would drown under the weight of suggested revisions. And her good humor seemed to come from a bottomless supply, which we dipped into without restraint.

The insightful and critical reading of our manuscript by Amy Super, our editor, enabled us to strengthen the book quickly and efficiently. Thank you, Amy, for your constant support and enthusiasm.

We were also amazingly fortunate to work with our agent, Regina Ryan, who, in addition to doing the agent thing, turned out to be a wonderful writer and editor as well. The book benefited substantially from her editorial recommendations and her willingness to try our diet recommendations herself.

Our domestic support was also unfailing: husbands, children, even grandchildren told us constantly how proud they were of our endeavor and gave us the time and support to carry it out.

This book would not be what it is without our many clients, who have given us insight into the complexity of weight gain and the joys and struggles of weight loss. Thank you for your dedication to our program, your faith in us, and the personal connections we have developed over the years.

Finally, we should thank whoever invented e-mail. We could never have managed our bicoastal collaboration so effectively and painlessly without it.

T he Serotonin Power Diet started in a health club in 2001. That's where we met, side by side on elliptical trainers. Between panting and puffing, we learned of our mutual interest and experience in health, weight loss, exercise, and diet counseling. Judy was directing a large Harvard-affiliated, hospital-based weight-loss clinic, which she had developed, and was contemplating leaving to start a private practice. Nina, a physician who had moved recently to the Boston area, was deciding how to best tie together her experience as a physician, nutritionist, lifestyle coach, and yoga instructor (and was soon to be a mom).

Our conversations continued beyond the gym and eventually resulted in a private practice called Adara, a Greek name that means beauty. It came from a baby-naming book that Nina was carrying with her at the time.

Adara's mission is to help each client lose weight with the most scientifically advanced program possible, along with emotional comfort and support. The scientific basis of the Adara program was founded on years of laboratory research at MIT, followed by reports on hundreds of volunteers who participated in clinical studies carried out at the MIT Clinical Research Center. These clinical studies led to the development of a weight-loss plan that included the use of carbohydrate snacks or a carbohydrate drink. After the program was tested as completely as possible, it became the foundation for a hospital-based weight-loss clinic on the grounds of McLean Hospital, which opened in 1996. That program is the one we present to you here, in the Serotonin Power Diet.

Initially most of our clients had a typical weight-gain history. They put on weight because of lifestyle changes due to marriage, children, jobs, travel, and situational stress. These clients responded successfully to the weight-loss program, which at that time not only included private or group support sessions but also workout time in an on-site gym supervised by the clinic's trainers.

Soon clients began to arrive with an entirely new cause of weight gain. These individuals had been thin all their lives until they were treated with antidepressant and mood-stabilizing drugs. They found themselves gaining weightin some cases, up to 150 pounds!

At the time, there was relatively little known about the potent effect of such drugs on weight gain, and even less was known about how to treat it. The clinic's diet program, which increased the brain's ability to control appetite, was found to be effective for these clients. They found an almost immediate relief from the incessant carbohydrate cravings induced by the drugs, and they also found they were less tired. Better yet, they began to lose weight and return to their pre-treatment size.

The Serotonin Power Diet and our Adara centers benefited greatly from the hundreds of clients who attended this hospital-associated clinic. We have treated clients ranging in age from 16 to almost 90. Their weight-loss goals varied from shedding 15 pounds to that of two clients who weighed more than 500 pounds each before starting the program. Both of these clients lost almost 200 pounds and went from being nearly unable to walk to exercising regularly.

Through our work with these clients, we learned how important it was to combine the effects of the diet program on the brain with weekly coaching to make people mindful of their personal eating triggers and to teach them strategies to decrease and eliminate these triggers. In addition, we also stressed the essential role of exercisenot only for their weight loss but also for their general health.

ADARA IS NOW LOCATED ON BOTH COASTS. The original office is still in Boston and the new office is in Palo Alto. Because of physician referrals around the country and our Web site, we also treat clients around the country through telephone consultations and e-mail.

We were pleased to find that, as our clients went through the program, they identified situations that in the past would have caused them to reach for food and found themselves able to get through them without eating. Eventually they learned how to reduce the stresses in their lives and increase their pleasure and enjoyment. They planned meals, ate healthily, and exercised frequently and enjoyed their newly toned bodies.

Did they ever gain back some weight? Sure. A trip to Paris, a week of celebrations, a difficult illness, and many of the other events of living often caused them to overeat after the diet was done. But they learned that appetite and stress relief was only a snack away, a very easy way of losing the weight they had gained.

The Serotonin Power Diet is the same as that followed by our Adara clients. You will be using the same diet plan and experiencing the almost immediate ability to control your appetite and lose your cravings. Those of you who have suffered from emotional overeating will find yourself feeling calm and able to cope with your problems without resorting to eating.

Although we cannot talk with you personally and coach you through the problems that might be causing you to overeat, this book will give you the support you need to stay on the dietregardless of the stress in your life.

And while we can't exercise with you, we hope that you will take seriously our insistence on the importance of physical activity for weight loss and for your basic health and follow our recommendations.