Substitute. Some are made from carbohydrates and protein, whilst others are derived from other food components (e.g. Cellulose), or are completely synthetic compounds. Fat substitutes must be safe to use, must not affect the organoleptic properties of the food and provide some of the attributes of fat.

The biggest question is whether they provide dietary assistance for body fat management’ The answer appears to be yes when all high-fat foods are substituted for reduced-fat varieties or fat substitutes. If only a portion of high-fat foods (e.g. Only ice cream and biscuits) are modified, there is likely to be compensation in the form of extra fat or energy intake at other times in the day.

Based on current evidence it seems that a complete dietary overhaul to include low-fat options will be most effective for fat loss.

On a practical level, the use of the recently approved (though only in the US) fat substitute Olestra has been found to reduce feelings of deprivation associated with low-fat diets, as well as reducing the number of high-fat foods that were considered tempting’. Even so, Olestra has serious nutritional implications, as it has also been found to decrease the absorption of antioxidant carotenoids, vitamin E and other fat-soluble compounds. Oelstra is not yet available outside the US and its potential introduction to other countries will receive fervent opposition from dietitians.

It will be important to monitor a client’s use of fat substitutes, artificial sweeteners and reduced-fat foods to see if these dietary modifications are effective.

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Rodney Dangerfield, the comedian, tells about the time he went to his doctor with a sore shoulder. Raising his arm, he said, “It hurts when I go like that.” The doctor replied, “Don’t go like that.”

Unfortunately, breaking the binge-purge cycle is rarely that easy. Instead of just telling the patient, “Don’t go like that,” one must reduce the forces behind the urge to binge and purge. These forces include the physical effects that are caused by an irregular pattern of eating or trying to maintain a weight that is too low.

Another goal of treatment is to change the patient’s characteristic cognitive distortions and disturbed emotional responses. For example, learning how to be more assertive can be a key element in recovery. A binge is frequently triggered by anger that the patient feels powerless to express. One woman told me her boss demanded that she work on a Saturday when she had made other plans. She suppressed her fury, telling herself that “I’m lucky to have this job, no one else would hire such a worthless person.” She worked that Saturday, then went home and pigged out for two hours. After assertiveness training, such patients find it easier to “just say no” without feeling guilt or self-hatred.

Finally, improving family relationships can be very helpful, especially for patients living at home. But because bulimic families can vary widely in their dynamics, therapy must address the particular family pattern involved.

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He didn’t recognize her. He’d never seen her so svelte.

“It was a big motivator for me, to try to shock him,” Hope says. And shock him she did. “He didn’t know who I was at first,” recalls the 31-year-old Leavittsburg, Ohio, resident. “After he hugged me, he stepped back to look at me and said, ‘Oh my gosh, how did you get smaller than me?’ That whole day, he kept touching me now and then, saying, ‘I just don’t understand where it all went!’

Hope had set out on her secret weight-loss mission after watching her obese grandmother struggle after breaking a rib. “She was so overweight that it took two people to move her out of bed,”

Hope recalls. “And she was so independent. I could see what it was § doing to her pride. I didn’t want that to be me one day.” So at 6 feet and 306 pounds, and with her husband far away, © s Hope joined TOPS—Take Off Pounds Sensibly Through the program’s sound diet-and-exercise program, she whittled her way to 185 pounds in just over 11 months.

Months later, still jazzed by her weight-loss success, Hope bought herself a sexy velvet dress. Her husband was on the phone with a relative when she walked downstairs to model it. He paused to lavish her with compliments, then described to the caller how fabulous his wife looked. “The reply was, ‘She’s not as thin as your brother’s girlfriend,’ Hope recalls. “I was devastated.”

Hurt and angry, she headed to the kitchen for some solace. But she stopped in her tracks, then went outside for a walk instead. Thirty minutes later, she returned home, calm and enlightened. “I let go of those hurtful words by focusing on the kindness that I received from others who supported me,” she says.

Eventually, Hope began strength training to shape and tone her body. Now a Zena-esque size 10 and 195 pounds, she no longer turns to food to heal those emotional blows. If she feels down, she bypasses the kitchen and heads out for a walk.

WINNING ACTION

Realize that you have weight-loss friends and foes.

When hurtful words hit you, consider the source. Understand that there will always be negative people in your life, but don’t accept their perception of you. Remember the title of the book written by Saturday Night Live character Stuart Smalley: I’m Good Enough, I’m Smart Enough, and Doggone It, People Like Me!

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In recent years, the dairy group has received a lot of undeserved bad press. It’s been called everything from mucous producing to unnatural to health threatening. I’ve found none of these claims to be scientifically substantiated. In fact, the lack of dairy products (and resulting lack of calcium) seems to be a lot more threatening to the health. Adequate amounts of calcium are vital for children and adolescents who are actively building bones and for pregnant women who are supporting the growth of the fetal skeleton. Without it, the quality of the bone suffers, paving the way for osteoporosis later in life. In my 40 years of medical practice, I’ve seen many patients suffering from this disease. Their brittle, easily broken bones are constantly wracked with pain, making it extremely difficult to get around. Eventually, the victim is confined to bed. The confinement, in turn, brings on complications such as pneumonia and other diseases that prey on the inactive. Not only do osteoporosis sufferers tend to die more quickly than their peers, the quality of their lives is severely lessened by the disease. So remember what your mother used to tell you: “Drink your milk!”

One serving of the dairy group is equal to 1 cup of milk, 1 ½ ounces of natural cheese, or 1 cup of yogurt. Of course, dairy products all suffer one disadvantage for dieters; they contain a lot of fat. For example, most cheese gets as much as 80 percent of its calories from fat, and cream cheese gets 91 percent. You can always try nonfat cheese, and for certain purposes (such as very spicy pizza where the taste and consistency of the cheese is largely masked), nonfat cheese can be quite acceptable. But to eat a chunk of the stuff plain may seem to you like eating soft plastic or candle wax. So, instead, eat a small amount of the cheese you really like, a little less than you usually eat, and pull out the excess fat with an extra gram or 2 of Chitosan.

The same approach applies to skim milk, which is my favorite, the only kind I drink. If you really dislike it, and even the low-fat 1 percent milk is too watery for your taste, try 2 percent and a little Chitosan.

I do recommend nonfat yogurt. It tastes almost as delicious as ice cream, and it lets you save Chitosan for when you really need it.

Average calorie amount per dairy serving. Nonfat: 90; Low fat: 120.

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You can do it!
This program has worked for many of my patients, whether they’ve been chubby, rotund, obese, or just plain big. It can work for you, too! The beauty of this program is that it never seems overwhelming. Unlike other weight reduction plans, I am not asking you to develop whole new eating and exercise regimens overnight. If you find that you can adopt the entire program all at once, begin simply by making a minor reduction in your fat intake. Gradually add in the other elements of the program as you feel comfortable. And remember, Chitosan can help you achieve your weight-loss goals. In no time at all, you’ll find yourself on the road to losing weight and gaining health!

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♦ Chitosan is a completely natural fiber derived from the shells of shrimp and other crustaceans.

♦ Chitosan acts like a magnet, its positive charge attracting and holding onto negatively charged fat from the food you just ate.

♦ The indigestible Chitosan/fat gel passes through the intestines and is eliminated from the body.

♦ By pulling fats and bile acids out of the body, Chitosan also helps to reduce your blood fats, total cholesterol, and bad LDL cholesterol, while increasing the good HDL cholesterol that can protect against heart disease.

♦ Chitosan has been tested and found to be safe and effective in scientific studies.

By taking Chitosan before a meal, you can block the absorption of at least 3—and up to

6—grams of saturated fat for every gram of Chitosan consumed. I’ve been using it as part of my Fat Blocker Program for years. When combined with a healthful diet and a program of regular exercise, Chitosan is a safe and effective key to opening the door to successful dieting. You can immediately and easily cut back on your fat intake without drastically changing your diet, thanks to Chitosan, the fat magnet. Even better, you can use Chitosan as part of the Fat Blocker Program to lose weight, improve your health, and maintain lifelong eating and lifestyle habits that will keep you in vibrant health. Chitosan is found under a number of brand names in health food stores.Program to lose weight, improve your health, and maintain lifelong eating and lifestyle habits that will keep you in vibrant health. Chitosan is found under a number of brand names in health food stores.

*47\29\2*

There are many painkillers used to treat arthritis, though none are completely effective. These medicines can help with pain and inflammation, but many of them have side effects. A much simpler approach that I’ve prescribed with a great deal of success is to slim down. Although obesity does not necessarily cause osteoarthritis, the two often go hand in hand. There is a definite link between gaining weight and developing osteoarthritis, especially in the knees and ankles, which bear the brunt of the extra weight with each step. A large percentage of patients had gained weight shortly before the osteoarthritis began, and some 50 percent of those with the disease had been overweight for 3-10 years before the disease struck.¹¹

The Fat Blocker Program has helped many of my arthritis patients get off their medicines while relieving pain and stiffness in their knee, hip, and ankle joints (as have the new

developments in arthritis treatment as described in The Arthritis Cure, cowritten by Brenda Adderly).

*29\29\2*

Bob made the rounds of doctors’ offices, trying one medicine after another for his chest pains and elevated blood pressure. Both of these conditions were caused by his high-fat, high-cholesterol diet, his completely sedentary lifestyle, and the 150 extra pounds he carried in his “belly bib,” chest, and rear end. Meanwhile, he continued gaining weight. “The medicines aren’t doing it for me, Doctor. I don’t want to die, so I’ve got to lose
weight.”

I put him on the Fat Blocker Program, not sure if it would really work for someone that morbidly obese. To be on the safe side I also had him continue with the medicines for his heart and blood pressure. But as the weeks passed and Bob steadily lost weight, I began to relax. The pounds seemed to melt away, his chest pains disappeared, and both his cholesterol and blood pressure dropped back down toward safe levels. As his health improved, I gradually began phasing out his medicines. Finally, even his belly bib disappeared and we could actually see his belt again! He had lost 130 of that excess 150 pounds, bringing his weight down to a relatively safe (if slightly pudgy) 190.

Two years later, Bob was still at a normal weight and still healthy. “I think I ate because I was scared of dying, like my father and grandfather,” he told me. “Now that I’m at a normal weight, I’m not afraid of dying anymore so I’m not scarfing everything in sight. And I feel like grabbing a candy bar occasionally, but well, the Chitosan helps take care of that”^.

*12\29\2*