Turn off the Hunger Switch: Reset Your Brain to Change Your Weight

Turn off the Hunger Switch: Reset Your Brain to Change Your Weight

by Paul Rivas


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Product Details

ISBN-13: 9780130605634
Publisher: Prentice Hall Professional Technical Reference
Publication date: 02/28/2002
Pages: 216
Product dimensions: 60.00(w) x 90.00(h) x 1.25(d)

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Doctors call the state of being overweight obesity. Over 58 million people in the United States fall into that category, and the numbers are increasing.

The health risks of obesity are well documented. As noted in an editorial in the New England Journal of Medicine (vol. 335, pp. 659–660, 1996), "Obesity is the second leading cause of preventable death in the United States exceeded only by cigarette smoking." Obesity is a major risk factor for cardiovascular illnesses such as hypertension, elevated blood cholesterol, and coronary artery disease. Obesity is also a major risk factor for developing diabetes and certain cancers.

Many informed members of the public already know these facts. Less well appreciated is the strong association of obesity with the development of low back pain, joint pain, and fractures of the hip, especially in the elderly, and, as reported in a 1995 study published in the New England Journal of Medicine, even modest degrees of obesity increases the risk of premature death.

The benefits of weight reduction are documented by careful medical research. Blood cholesterol comes down, blood pressure begins to normalize, and blood sugar improves with even small amounts of weight loss.

Many people, including health professionals, think of obesity as being a "willpower" disease. These people believe that if overweight individuals would only control their appetites, then they would most certainly reverse their weight problems. The fact that many obese patients cannot, despite great effort, control their appetites, or do not lose weight even when they do, is taken as evidence that obese individuals lack the willpower possessed by thinner people. This conceptualization of obesity, which blames the victim of a disease for having the disease, is not supported by scientific and medical research. In fact, it's simply wrong.

Traditional approaches to weight reduction include a changed diet, increased aerobic exercise, and behavioral modification. Unfortunately, they just don't work for many patients, and over long periods of time, they seem to work for very few. For these patients, treatment with anorectic agents (substances that can help you lose or control your weight) can be helpful.

In this book, Paul Rivas, M.D., delves into this complex area with expertise and astute insight. Building on his extensive clinical experience in treating obesity, his acute clinical acumen, and his broad knowledge of the medical literature, Dr. Rivas makes this complex subject understandable to the lay person. He provides useful examples and helpful advice for people trying to lose weight.

I highly recommend this book not only to people embarking on a weight-loss program, but also to anyone who seeks a deeper understanding of obesity, its causes, and its treatments.

Richard B. Rothman, M.D., Ph.D.

Table of Contents

1.Hard Facts About Soft Tissue1
2.Hunting the Elusive Fat-Storing Switch11
3.From Switch to Switchboard21
4.N-Profile: The Universal Type35
5.S-Profile: The Depression Connection51
6.D-Profile: The Root of All Pleasure61
7.C-Profile: When Pasta Is the Problem69
8.Guess What Doesn't Work!75
9.The Uncooperative Doctor89
10.Keeping the Switch in the Off Position97
11.Choosing a Healthful Diet107
12.Exercise to Feel Great115
13.Our Kids and Our Parents125
14.Special Advice for Men133
15.Common Questions with Uncommon Answers141
Author's Note155
Afterword: How Safe Is Ma Huang?157
Appendix A.Programs at a Glance187
Appendix B.Manufacturers of Medications and Supplements191
Appendix C.Weight-Loss Doctors Near You193


I am a bariatrician, a doctor who treats people who find it difficult to control their weight—and today, I am a successful bariatrician. My patients actually lose weight and keep it off. But it hasn't always been so.

Like most weight-loss doctors, when I first began my practice, I immediately ran up against a brick wall. I had gone through standard medical training at a good medical school, so I offered everyone who came to see me the standard medical advice I had learned: Eat less and exercise more. The problem was that my advice didn't work. Most of my patients weren't getting any thinner, and those who were didn't stay that way for long.

Then one patient, Roy M., came in one day and did something that would forever change the way I practiced medicine.

Roy had been coming to my office for years, desperately looking for a way to control his weight, but he just couldn't seem to make any progress. The problem was that he loved Italian food, craved it so much, in fact, that he felt completely helpless to resist when in the presence of a beckoning bowl of pasta. Finally, at my wits' end, I accused him of being a bad patient. He didn't bother to point out my failure as a doctor. He simply asked me for pills to control his appetite.

If you have ever gone to your family physician, or even a bariatrician, and asked for diet pills, you already know this story. Pills are precisely what you do not get. What you probably do get is a stern look (or if you're lucky, a benevolent one) and a pamphlet that tells you to count your calories, cut down your fat intake, and do more exercise. What you probably also get is the feeling that your doctor does not take your problem seriously. You are not like his or her other patients, patients who are genuinely sick.

So it was with Roy. I told him I did not believe in diet pills and had never prescribed them in ten years of practice.

Why not?

Until recently, most diet medications came from the amphetamine family. These drugs are powerful appetite inhibitors, but they are also dangerous and addicting. People who use them over an extended period of time often become restless and nervous. Many develop the "shakes," a chronic and noticeable trembling of the hands. Insomnia is common. Overdoses can cause depression, psychosis, and death. These were not drugs I would give to people I care about—and I care very much about my patients. I didn't realize at the time that science was already discovering new tools—many of them natural supplements as powerful as medications—in the fight against obesity.

As for Roy, I was convinced that, for some odd reason, he was choosing ravioli over self-esteem and good health. Losing weight, I thought, was simply a matter of making better choices and keeping one's self under better control. Not such a difficult thing for a person to do. After all, I controlled my eating habits, didn't I? Surely his temptations were no worse than mine.

Or were they?

Finally frustrated and out of patience, Roy handed me a copy of a report by Dr. Michael Weintraub. That moment was the beginning of a revolution in my thinking that has changed Roy's life, those of my patients, and perhaps most of all, my own.

In my years of practice since then, I've treated nearly 12,000 patients for their overweight condition, with close to a 95-percent success rate. All of those patients have driven home one fact for me that may contradict everything you have ever heard on the subject: Dieting and exercise have nothing to do with weight loss.

I know it sounds unlikely. I know it goes against common sense. But it's true. Don't take my word for it. Just look at the world around you.

Diet books are perennial bestsellers, even though they very often contradict one another. One proposes high carbohydrates; another, high proteins; still another, high fats. Some claim that simply balancing your meals will do the trick. Others suggest changing your eating habits according to your blood type or the season of the year. In the meantime, we spend millions of dollars on treadmills, tummy-toning exercise machines, and health-club memberships.

Unfortunately, despite all this effort, we don't seem to be losing any weight. Nearly everyone who loses weight through diet and exercise gains it back within five years.

In my own practice, patients often come to me in utter confusion and despair after years of exhausting exercising and restricted eating with little or no weight loss to show for it. In fact, many have watched in horror as the needle on the scale actually moved upward when they cut their calories back. They feel weak and out of control.

"What's wrong with me?" they'll say. "What diet should I be on and how much should I exercise?" Or "Maybe I should just give up and accept myself as I am."

My answer is usually not what they expect to hear. In fact, it's something that most people have never heard before: The sizes of your meals don't matter, but the size of your appetite does. It's not the degree to which you consume food, but the degree to which you crave and desire food that controls your weight. It's not so much the steaks, chocolate, and fries, but rather the obsessions with them that ultimately add fat to your frame.

Why? Insatiable hunger tells your body to go into its fat-storing mode.

Your system feels the symptoms of starvation, so it stops "wasting" precious calories by burning them and stockpiles them instead.

So, I tell my patients, don't worry about eating that piece of chocolate, but rather how much you crave it.

What controls how much you crave and obsess over food? It has nothing to do with your diet; it has to do with your parents. It's not your exercise program that matters; it's your genetic program. The solution to your problem doesn't lie in willpower, self-control, or pushing away from the table. It lies turning off your appetite, and your appetite center is located in your brain.

Once you do that, chocolate and sweets will instantly lose their appeal. You'll feel full after eating only a small portion of a meal. Food thoughts and compulsive eating stop. It's instant, dramatic, and works exceptionally well.

So put away your weight-loss books, throw away your tummy toners, and learn how to turn off your hunger switch. The day of the diet is over.

Paul Rivas, M.D.

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