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The No-Beach, No-Zone, No-Nonsense Weight-Loss PlanA POCKET GUIDE TO WHAT WORKS
By Jim Johnson
Hunter House Inc., PublishersCopyright © 2005 Jim Johnson, Inc.
All right reserved.
Chapter OneSave Yourself Some Time-Know These Basics Before You Begin
When you're armed with the facts, your journey becomes easier
As I remember, it was about two in the afternoon that day. Through its twists and turns, life had led me to a gross-anatomy class where I was put into a small group and assigned to a cadaver, a human corpse that is cut apart for scientific examination. I had beaten out stiff competition to get into physical-therapy school-some four hundred-plus applicants for a mere thirty-eight slots-but today I would have traded places with any of them.
The instructor told us to begin. We all stood there quietly, just staring at the cadaver lying face up on the table, nobody really wanting to make the first cut with their scalpel. After what seemed like a lifetime, someone finally spoke up and said, "Alright, I'll do it."
The rest of us just watched (well, most of us anyway) as the action began and the skin separated, instantly revealing a yellowish substance underneath. It was a fine layer of fat, or what I later learned to calladipose tissue.
HERE'S WHAT THE FUSS IS ALL ABOUT
I have yet to pick up a book on weight loss that gives the reader a basic understanding of the very problem it's trying to tackle: fat! As I see it, the more you know about this annoying little substance, such as what its purpose is and how it works, the more successful you're going to be at getting rid of it. It's kind of like that old Chinese proverb-you know, the one that goes "Know thine enemy."
Doctors call fat adipose or adipose tissue. The story of your adipose tissue began some time ago when you were only in your second trimester of life, still in your mother's uterus. It was around then that fat cells, known as adipocytes (that's pronounced add-i-poh-sites), began to form.
By the time you were fully grown, you probably ended up with somewhere around thirty to thirty-five billion of these adipocytes. Highly controversial, however, is the question of whether the number of adipocytes you have as an adult remains the same, or if it can actually increase. According to the latest research, the jury's still out on this one.
If you reach down and pinch a little bit of fat from around your stomach area, the following picture (Figure 1.1) is a close-up look at what the fat, or adipocytes, that you hold between your fingers looks like:
They sort of look like tiny balloons, don't they? As a matter of fact, they work a lot like balloons too. You see, if you happen to eat more food than you need on a given day, your body says, "Hey, I don't need all this food right now, so I'd better save it for when it might come in handy." And so your body efficiently converts what you don't need into fat and stuffs the fat into (you guessed it) the adipocyte cell. It's all basically a survival kind of thing and really comes in quite handy. For instance, just think of the last time you were sick and didn't really feel like eating very much. You can thank the stored fat in your adipocytes for keeping your body running until you got back on your feet.
Normally, fat makes up about 10 percent of your total body weight, giving you about a forty-day backup supply of energy-and that's definitely a good thing. The downside, however, is that these adipocytes, just like balloons, can "blow up" and hold an amazing amount of fat. Therefore, the more surplus food you eat, the more surplus fat your body has to stuff into your fat cells to save for a rainy day. Problem is, the bigger the fat cells get, the bigger you get.
Don't get too discouraged, though, because the whole process described above can also be reversed-if you know how. The trick is to make your body want to take the fat out of the adipocyte, which it will be more than happy to do when it runs out of energy. Question is, how do we make your body run low on energy?
There are two good ways. You can either give your body a smaller supply of energy to run on than it needs (a diet strategy) or you can burn up more energy than you've given it that day (an exercise strategy). Using either one of these two strategies, or preferably both, forces your body to reach into your adipocytes to get some fat for energy. This, of course, makes the adipocytes smaller, and the smaller they get, the better you look in the mirror. As you can see, losing weight in principle is really no different from letting the air out of a balloon. It's finding the easiest and most effective way to "let the air out" that becomes the hard part.
The last thing you will want to know about these adipocytes is that as you get thinner, your fat cells never disappear; rather, they just shrink in size. The only way to actually get rid of the fat cell itself is to physically remove it, liposuction being one such method.
THE TRUTH ABOUT CELLULITE
Just about everyone has heard the word cellulite, usually from women who are talking about that lovely "orange peel" or "cottage cheese" appearance frequently seen on their thigh and buttock areas. Since there seems to be a lot of mystery and misunderstanding going around about this cellulite stuff, let's just stick to some of the known medical facts (Rosenbaum, 1998):
* The layer of connective tissue that is right below the skin has a more irregular and broken-up pattern in people who have cellulite. * Fat pushing up into this irregular pattern of connective tissue causes the familiar dimpling effect that you see. * This irregular pattern of connective tissue is much more common in females, which explains why cellulite is mainly seen in women. The same layer of connective tissue in men is usually smooth and continuous. * Interestingly, studies of men who do have cellulite show that they have the same irregular connective-tissue patterns as females. * Cellulite can affect someone whether they are overweight or not, because the main reason for it is the irregular pattern of the connective tissue. Excess weight, however, does makes it more visible.
It would appear, then, that cellulite is really nothing more than just your run-of-the-mill kind of fat. The real culprit seems to be an irregular pattern of connective tissue that lies right beneath the skin and gives ordinary fat the ability to bulge out and change the appearance of your hips and thighs. While the stuff may look awful, it is good to know that it isn't harmful in the least.
Losing weight can have some effect on cellulite because it effectively shrinks the fat cells that are pushing up on the skin and causing it to dimple. However, losing weight may not be enough to totally get rid of the cellulite "look" (remember, cellulite can be seen in thin women as well), because losing weight does not physically change the underlying structure of your connective tissue. Therefore, to really eliminate cellulite, one would have to use a treatment that somehow changes the irregular pattern of tissue under the skin.
WHAT YOU NEED TO KNOW ABOUT SPOT REDUCING
While we're discussing hot weight-loss topics, we might as well cover one of the biggest of them all: spot reduction. For some reason, probably based less on reason and more on hope, there is a widely held opinion that you can selectively reduce the amount of fat over a particular part of the body by exercising it. Believers in this theory, for instance, do sit-ups to lose stomach fat or leg raises to get rid of thigh fat. If you think about it, there is a bit of logic to it. But what's the real story?
The answer to this question lies in the results of several studies, such as one conducted at the University of Massachusetts twenty years ago (Katch, 1984). Researchers had a group of subjects do over five thousand sit-ups in a twenty-seven-day period. Changes in the size of fat cells and body composition were checked before and after the study and compared to those of a control group that did not exercise. The results? Sit-ups did not selectively reduce the size of the fat cells in the stomach or significantly change the thickness of the abdominal layer of fat.
Other, less complicated studies have also reached the same conclusions. For example, one looked at the size and fat thickness of the arms of tennis players (Gwinup, 1971). The thinking here was that if spot reduction really worked, then the "working" arm of tennis players should have a lot less fat on it than their other, "inactive" arm. Once again, the theory of spot reducing was not supported, as no significant differences were found in the thickness of fat over the muscles of the players' racquet arm, the one clearly getting more exercise.
In light of the research, the real story about spot reduction is that this most appealing idea is clearly just a myth. One of the best ways of getting rid of body fat in certain areas is by making your body reach into that fat cell for reserve energy by using diet and exercise strategies. Over time, many different areas on your body where you store fat will get smaller-which will more than likely include the area you want to reduce the most!
HOW TO TELL IF YOUR WEIGHT IS PUTTING YOUR HEALTH AT RISK
Of course you know that putting on too many extra pounds is a bad thing; everyone knows that. It's here that we need to take the discussion a step further. What we really need to know is how much extra fat is too much and at what point it starts putting our health at risk.
In order to get answers to these questions, we first need a good way to determine just how much total body fat we're actually carrying around. Some of the best methods for figuring this out include total body water, total body potassium, bioelectrical impedance, and dual-energy X-ray absorptiometry.
I already know what you're thinking: Yeah, right. While it is true that these are all good methods, they are often expensive and not very practical for you or me to use on a regular basis. That's why the next best thing is what is known as the body mass index, or BMI for short. While the BMI does not directly measure fat, it succeeds quite nicely in giving each of us a number that does significantly correlate with our total body-fat content. You also might be interested to know that the CDC, Surgeon General, and the National Institutes of Health all promote and endorse the use of the BMI. The following are some very good reasons why just about everyone likes to use the BMI:
* It's simple, rapid, and inexpensive. * It's a more accurate measure of total body fat than relying on weight alone. * It works for adult men, adult nonpregnant women, and generally all racial/ethnic groups. * It is more highly correlated with body fat than any other indicator of height and weight. * It has been shown to correlate with a person's risk of health problems. As an example, your risk of getting heart disease increases as your BMI number increases above a certain range.
As you can see, the BMI is a very useful and well-researched tool. To find out what your BMI is, grab any simple calculator and follow these three easy steps:
1. Multiply your weight in pounds by 705.
2. Divide your answer by your height in inches.
3. Now divide this answer by your height in inches again.
The result is your BMI.
Pretty easy, huh? Now here's a real-life example to make sure you're on the right track.
Let's say that you are 5' 6" (66 inches) and you weigh 185 pounds:
185 multiplied by 705 = 130,425
130,425 divided by 66 = 1,976.14
1,976.14 divided by 66 = 29.94, or a BMI of 29.9
Okay, enough math. Now that you've got your own personal BMI number, what does it really mean? Well first of all, researchers use the BMI number to classify people into different weight categories. So, according to the experts, this is how the cookie crumbles:
If your BMI is below 18.5 ... you're underweight
If your BMI is 18.5 to 24.9 ... you're in the "ideal" range
If your BMI is 25 to 29.9 ... you're overweight
If your BMI is 30 or higher ... you're obese
With your BMI number and the above list, you will now be able to look at your weight the same way doctors and dieticians do. Know also that the BMI does have a few limitations. It may overestimate body fat if you are pretty muscular (such as a bodybuilder), or it can even underestimate body fat if you have lost a lot of muscle mass (like an elderly person). Also, it may not be accurate for persons under five feet tall. Having said that, the BMI still remains a widely recommended and widely used tool by researchers and health professionals alike.
Using the very same classification system as the one above, researchers have taken large groups of people, determined their BMI numbers, and then looked closely at any health problems they might have. What the research has shown us (Stunkard, 1993; NIH, 1998) is that if you have a BMI of 25 or above, you are at increased risk for such problems as
* high blood pressure
* type-2 diabetes (non-insulin dependent)
* heart disease
* high cholesterol
* congestive heart failure
* sleep apnea
* colon cancer
* cancer of the gallbladder
* breast cancer
* endometrial cancer
* menstrual irregularities
Quite a lengthy list, isn't it? It appears that besides changing the way you look, carrying around a certain amount of extra fat can have a lot of serious health consequences as well. Know too, though, that having a BMI of 25 or above does not necessarily mean that you are unhealthy or will for certain get any or all of these health problems. This is because the BMI is not diagnostic in and of itself, but is rather just one of many risk factors that are used to predict your risk of getting a disease. Others that might enter into the overall picture include things such as your family medical history and habits such as smoking.
The main thing you need to be aware of is that there are many variables that need to be taken into account when deciding how likely it is that you will a get a health problem, but having a BMI of 25 or above is one of those important variables. This is because many studies have pointed out that as your BMI number increases above a certain range, so does your risk of getting many diseases.
IF YOU CARRY YOUR WEIGHT HERE, YOU COULD BE HEADED FOR TROUBLE
Have you ever seen a person with a huge, plump belly? Of course you have. How about a person with fat eyelids? Fat ears? Probably never. From these simple observations, it's quite clear that there are some places where Mother Nature has chosen to put fat, while others appear to be off-limits. Although this observation may seem rather trivial, there's really more here than meets the eye.
You have learned that high BMI numbers are linked to certain ailments. What you probably don't know, however, is that where you carry around this added weight also makes a mighty big difference when it comes to your health.
If you have a tendency to carry your fat on your upper body, waist, and abdomen, then you have what is sometimes called an "apple shape." On the other hand, if you lean more towards putting fat on your lower body, hips, and thighs, then you are more of a "pear shape." To make a long story short, "apples" tend to have more health problems than "pears" do (Pi-Sunyer, 1999).
We know this to be true because researchers, noticing these body types, began actively studying the following two particular areas of the body where people commonly store their fat:
1. the abdominal or "stomach area" and
2. the thigh or "upper leg area"
Just as with the BMI, researchers have analyzed large groups of people. After looking at both their health and where they carry their fat, it was found that people who store their fat more "centrally"-that is, in their upper body and stomach area (the apples)-were more at risk for
* high blood pressure
* diabetes, type 2
* heart disease
At this point, you are probably wondering if you are carrying too much fat around your stomach area and are at risk for getting these nasty health problems. Well don't worry, I won't leave you guessing.
Excerpted from The No-Beach, No-Zone, No-Nonsense Weight-Loss Plan by Jim Johnson Copyright © 2005 by Jim Johnson, Inc.. Excerpted by permission.
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