Louis J. Aronne - The Change Your Biology Diet: The Proven Program for Lifelong Weight Loss

This book presents the research, experiences, and ideas of its author. It is not intended to be a substitute for consultation with a professional healthcare provider. Consult with your healthcare provider before starting any diet. The publisher and the author disclaim responsibility for any adverse effects resulting directly from information contained in this book.

Copyright 2016 by Louis J. Aronne

All rights reserved.

For information about permission to reproduce selections from this book, write to trade.permissions@hmhco.com or to Permissions, Houghton Mifflin Harcourt Publishing Company, 3 Park Avenue, 19th Floor, New York, New York 10016.

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Library of Congress Cataloging-in-Publication Data is available.
ISBN 978-0-544-53575-6 (hardcover); ISBN 978-0-544-53579-4 (ebook)

Design by Alex Camlin
Illustrations by Josh McKible
Diagrams by Mapping Specialists

v1.0116

To our patients whose illness, frustration, and tears have inspired us to develop new ideas and more effective treatments. We believe you.

Dr. Lou Aronne has been my friend for thirty years. As a young man I was attracted to Lou, because he looked nice in a lab coat. A few years later, he saved me from a massive heart attack, forcing me to take a treadmill stress testwe discovered all of my arteries had turned to cement. Lou believes it was too many potato chips.

A year later, I had quintuple bypass heart surgery. In the middle of the operation the anesthesiologist brought me around and asked if I would like to hold my own heart. Of course this didnt happen. I think its illegal! But what if it had? Boy, that would be a book. If it wasnt for Lou, Id be dead, or certainly not in the top physical condition of my life. Which, if any of you have seen me lately, would be difficult to dispute.

Lou has devoted his life to helping the world understand food, obesity, and how to win BIG playing online poker! Lou has a wonderful wife named Janein her own right, a championship tennis player. Lou and Jane have two lovely grown children, whose names I can never remember.

This book will help you feel better, lose weight, and make you as smart as Alex Trebek.

Thanks to Lou I understand the connection between heart disease and blood sugar. For me its an on going projectand my only project since retiring from show business. (I used to be on television.)

Let Lou help how you think and eat. He might save your life as well.

Dave Letterman

Why dont people just lose weight? If losing weight were easy, two-thirds of adults in this country would not have weight problems. All it would take is cutting calories. Its more complicated than a matter of willpower. Obviously, something else is going on that makes weight management so difficult.

When I lecture new students at Weill Cornell Medical College, I explain the limits of willpower in weight loss with a simple demonstration. I ask a student to hold her breath for a few seconds, then for longer and longer intervals. I instruct the student to do this every day and to hold her breath for five more seconds every week. In a year, she should be able to hold her breath for an hour, right? At that point, everyone in the class laughs at the ridiculous notion. They know their classmates body wont allow her to hold her breath that long. Something tells her to breathe, because shes suffocating. Strong physical signals will communicate to her that her brain is starved for oxygen. The same thing happens with weight control. Something signals you to eat, because youre starving. Its not as immediate as breathing. Instead of reaching a crisis point in a matter of minutes, it might take days or weeks with eating, but its the exact same mechanism.

If I do anything in writing this book, my primary goal is to reassure you that having difficulty losing weight is a medical problem, not a lack of self-control. When you try to lose weight or hit a plateau on a diet, do you get the sense that you are struggling against something? In fact, you are. I call it weight loss resistance. Research has given us new insight into what is behind weight gain and how your body resists losing weight. We have discovered that eating too much highly processed, starchy, sweet, fatty food damages the appetite-control center in your brain and precipitates other changes in your body that contribute to fat production and storage. I want to share what we now know about breaking through the physical barriers to weight loss. With a greater understanding of how the body controls weight, we have been able to create diets that work better than ever. What does work better mean? It means that its easier to stick with the plan and that you can lose as much weight as possible. The Change Your Biology Diet offers you a science-based program and a set of strategies to help you alter the biological processes that are preventing you from losing weight and keeping it off.

How I came to specialize in obesity and weight management is a classic story of finding a calling. When I was a Fellow in Internal Medicine at Weill Cornell, funded by the Kaiser Foundation, in the mid-eighties, I became interested in cost-effective carein other words, the economics of health care. Increasingly sophisticated technology had made intensive care units an important part of hospital treatment by the mid-seventies. I set out to do a cost analysis of who should go into intensive care. I was intrigued to discover that patients who were obese cost two or three times more to care for than patients of average weight.

At the same time I was performing this study, I had a patient at the clinic in her late thirties, who needed a walker to get around. Her coronary arteries were severely diseased. She was about five feet two or three and weighed 250 pounds. I wondered how someone so young could be so sick and what we could do to help her. Being that overweight was not as common then as it is today. It seemed obvious that losing weight would be a good start. I found myself thinking about how we could solve her weight problem and whether losing weight would restore her health. At that time, there was no proven relationship between obesity and illness. We could not explain what fat cells had to do with overall health.

When I joined the faculty of New York Hospital-Cornell Medical Center in 1986 along with two other doctors, the chairman wanted each of us to set up a program. Dr. Orli Etingin, one new faculty member, worked on building the Womans Health Center; Dr. Jonathan Jacobs, the other, set up the Center for Special Studies, which focused on HIV. When I suggested an obesity program, the chairman, Dr. R. Gordon Douglas, had the foresight to think it was a good idea. At the time, being overweight was considered strictly a behavioral problem, but we suspected there was a lot more to the story. If it were simply a matter of cutting calories, overweight people would not have such a struggle dropping excess pounds. We were one of the first research and treatment programs in the country devoted to helping people lose weight.

Almost thirty years after we founded the program, I am the Sanford I. Weill Professor of Metabolic Research at Weill Cornell Medicine where I direct the Comprehensive Weight Control Center. We are making great strides in understanding what a complex disorder obesity is. What has become evident is that being unable to lose excess weight is not a question of willpower or motivationit is a medical problem that involves your genes, your brain, your fat cells, and your hormones. We now know that weight problems should be treated like a chronic disease in order to succeed at lifelong weight loss.