Dr. Sekula on weight loss, fitness and nutrition

While in San Diego last week, the biggest highlight for me (other than my talk, of course) was the keynote, Malcolm Gladwell. Chris Berman of espn also gave a keynote, which I did not attend. But by all accounts, underwhelming would be a compliment.

Gladwell, on the other hand, was excellent. I furiously took notes on my Blackberry and emailed them to myself – see image below.

As you can see, I gave the email an appropriate subject line: “Gladwell Lessons.” As anyone can attest, typing on a Blackberry can be challenging, but done so like this is typos galore. This is without mentioning my Blackberry seems to have a mind of its own, or at least some of the keys do. The 1, 2 and A seem to only work when they want.

I’ve had many questions about his lecture and wanting to implement some of his ideas, I set about deciphering. So, here goes.

His talk was a combination of Blink and Tipping Point. In other words, if you want to have something spread throughout your world in a Blink, you need to identify the Tipping Point. Gladwell calls this a revolution.

To accomplish this, three things are needed. You need to:

1. Leverage your skill,
2. Frame your message and
3. Employ social power.

He made this point through an example with David Sarnoff and RCA broadcasting the first ever, live boxing match between Jack Dempsy and Georges Carpentier in 1921.

First, Sarnoff knew radio. He was working for RCA. He knew how to get the fight broadcast (even if he had to have help). It helped him leverage his skill.

Second, he framed his message. “See what else you can do with a radio?” “It’s not just for news.” “It’s for entertainment.”

Third, he used social power from every store selling RCA radios. He contacted each one of them and had every radio tuned to the station broadcasting the fight. He wanted as many people as possible hearing the fight.

Some estimates were as many as 300,000 people heard the live broadcast. Amazing, 300,000 people in 1921. Within six months, RCA radios were flying off the shelves.

So, if you are in the health/fitness industry, how are you going to create a revolution? One of the things mentioned over and over again (at the meeting and from others), is that we do a good job with those who seek our services. What about the other 60% of the population?

How can we connect with them? How can we draw them in?

How can you leverage your skill to help those that need it most? How can you frame your message so they hear it? That was one of the main points in my presentation. It’s not that the energy balance equation is wrong. It’s the pervasive mis-application of it. For those needing our help the most, we don’t see the problem.

They (patients, clients, customers, etc…) fail because we blame them. It’s all their fault. So we shift. Our focus now is the behavioral aspects of weight loss. They’re not motivated enough. They didn’t write their goals down correctly. They’re eating too many/ not enough meals per day. The list goes on…

It’s why someone like Dr. Phil, who doesn’t know ATP from ketchup can write a best-seller weight loss book.

It’s also why nearly 100% of weight loss books say the same thing, eat less and exercise more, while differing in their approach to behavioral strategies. If it weren’t so ridiculous, it would be funny. All the while, all of this has underhandedly laid the failure of weight loss at the feet of those trying to lose weight.

Finally, how will you employ social power to spread your message? Twitter? Facebook? Email? Local meetings? Local experts? I’ll tell you this, however you do it, you need to have a better understanding of why people fail at weight loss attempts before you use your social power. Otherwise, it will be more of the same.

The last things I want to point out are mavens and connectors. According to Gladwell, mavens are information deciphering machines. They take it all in and make sense of it. Connectors help mavens put it in the right place.

Are you a maven or a connector?

How are you going to start a revolution?

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On March 10, 2010, the Medical Wellness Association sponsored a Medical Wellness and Nutrition forum as part of the IHRSA convention in San Diego. As an aside, Sunny San Diego? Are you kidding me? It was sunny, but, man, was it cold! The wind was blowing. Hard. Felt it to my bones. Probably not cold to someone from Minnesota, but to a Texas boy it was. And can you do something about the homeless people? The only place I’ve been where it was worse was downtown Baltimore.

So back to the forum. There were four speakers (including me), each presenting on a topic related to nutrition and wellness. I think the forum was well-received. I listened to all presentations and only one other excited me. Amy Blansit works with obese people in Missouri and she gets it. Her presentation was excellent and she’s doing a bang-up job. The other talks seemed rather fluffy.

In order to gain more attention, I badly titled my talk: “How to increase revenue with weight loss programs.” IHRSA is not the most scientifically rigorous organization. A more appropriate, but boring, title would have been: “Misapplication of the energy balance equation.” That was the focus of my talk, but no one would have attended. I spent nearly half of the two hours building this up and why weight loss programs fail (or, the misapplication idea).

For more on this, check out Dr. Eades’ blog, Protein Power, more specifically, this recent post. You can also read this post by Robert McLeod on energy balance, it’s at the bottom of the post.

The gist of the talk centered on the pervasive notion of eat less, exercise more. For overweight and obese, hyperinsulinemia equals metabolic domination, efficiency at fat storage and feeble efforts in fat mobilization. Simply eating less does not fix this and leads to failure.

Oh, and before you chime in with ASP, leptin and all the others, don’t bother. ASP is a toothpick to the bat of insulin. While the research on leptin and leptin resistance is fascinating, I have yet to work with someone where it was a problem. I know it’s there, somewhere, and I know it exists. Just haven’t run across it in my day-to-day business.

You can also view the presentation at slideshare.net.  Don’t know why, but the embed code has jacked up the first slide. It’s normal at slideshare. Below the presentation are links to a reference list and white paper.

Click here to download the references.

Click here to download the white paper. Note: I can’t find my white paper. It’s somewhere on my laptop. I’ll hunt it down and post the link in the next day or so. 

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Jeff Garlin, co-star and executive producer of Curb Your Enthusiasm, has written a memoir about his lifelong struggles with weight. In an interview for ABC news, Garlin talks about his addiction to food and his new diet. You can read the interview and watch a video here.

This is sad. Really sad. He said he’d eat and eat and eat and never feel full. Stand-bys included gourmet sandwiches, pop-tarts and Cap-n-Crunch cereal. In the video, he talks about donuts and milkshakes. Also, knowing that a single donut or any sugar-filled food would send him over the top, meant these foods were forbidden and that moderation was not possible.

He alluded to his lifelong struggle with weight. Although not prominent, I’m sure there were never-ending attempts to lose weight. Well-wishers like Larry David, his wife and others, I’m sure, encouraged him to lose weight. I’ve never met a person that was overweight who didn’t want to lose weight. Really, I’ve never known an overweight person that hasn’t tried every diet under the sun.

At age 37, he suffered a stroke. At his heaviest, he weighed 320 pounds. Through various changes he’s down to the upper 260’s. I’ll talk about those changes in a second. 

So what’s going on? What’s the problem? Why can’t Jeff Garlin, et al just buckle down and lose weight? The answer lies in the ubiquitous message of energy balance. Accordingly, you can eat what you want, just eat less and the weight will disappear. Not in Jeff Garlin’s case.

Despite the fact he’d eat a half-dozen donuts and a milkshake, he was never full. He talks about stopping at In-N-Out Burger on the way home from work to get two double cheeseburgers because dinner at home would not be enough. He also mentions the ability to eat an entire pizza and wash it down with five boxes of instant pudding, topped off with graham cracker crust. I wouldn’t be surprised if that didn’t fill him up, either. 

The problem with the energy balance equation is that it assumes we can simply restrict calories and lose weight. Completely ignoring the real issue, insulin, of which Mr. Garlin could not be a more perfect example

As Gary Taubes eloquently pointed out in Good Calories, Bad Calories, hyperinsulinemia  drives fat storage and dictates cellular starvation, regardless of food intake. This is spelled out specifically in Chapter 22, The Carbohydrate Hypothesis. More specifically, on page 399 (paperback), he discusses the role of lipoprotein lipase (LPL) and fat storage. As insulin levels rise, triglycerides are preferentially stored in adipose tissue.

During caloric restriction (as I’m sure Mr. Garlin tried, you know, eat less, exercise more?), weight loss becomes more difficult and even problematic. Fewer calories lead to decreased muscle mass and smaller organs (brain and kidneys, for example), in the face of hyperinsulinemia. It’s a feedback loop, driven by insulin, that works to maintain body fat levels, even in the face of decreased organ systems.

So Jeff Garlin likely went on a typical diet of eat less, without changing the types of food he ate. Since his insulin levels were still high, it only made him hungry. Probably hungry as hell. And he could only hold on for so long.

One thing those foods will do is elevate insulin. All that glucose has to go somewhere. I’m sure he Jeff wasn’t exercising. Even if he was, there’s no way in Hades he was depleting his glycogen stores, so that glucose went somewhere. It got converted to fat and stored.

All of this brings me back to his new approach. I wish him well, but I have my reservations. Here’s what he’s doing. He meditates daily, 5:30am. He cut out sugar, fast-food and binge-eating. He doesn’t eat salt, chicken, turkey, red meat or ham, although he does still eat fish. He eats fruit, vegetables and whole grains. “It’s all very boring,” he says. Giving up sugar was, “really, really hard.”

He’s done pretty well. Lost about 50 pounds. Gave up sugar, salt and most forms of protein and he meditates. I think he’s been successful so far because of sugar elimination. I have no idea how much sugar he was eating, but with milkshakes, pizza, cereal and donuts, it had to be a boatload. I’m guessing 400-500 grams, minimum.

The problem I see, however, is the whole grains and fruit. His insulin is down, which helps the cravings. For the long run, however, it’s not down enough. He’ll find caloric balance soon and will get stuck, probably several pounds away from his goal weight. Then what? Probably try to eat less, again.

What will be the culprit then?

*Photo courtesy of abcnews.com.

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Most people I work with are significantly overweight – average weight > 300 pounds. As you might expect, all have a cluster of metabolic disorders. Coincident with their condition,  they take a laundry list of prescription medications. In general the lists are nearly identical and include prescriptions for hypertension, diabetes, cholesterol and digestive disorders.

Given this, I assumed their laundry list was similar to that of the general public. So I went looking for the top 10 prescription drugs of 2008 to see if my thoughts would be confirmed.

Finding the Data.
I scoured the FDA website and could find nothing (for some reason, I thought the organization in charge of controlling this industry might track this stuff – go figure). I decided to contact them by phone and the person I spoke with (after about 3 minutes of menu clicks – seriously), directed me to drugtopics.com – here is their about page.

Table 1 shows information for 2008 (1), including the top 10 prescriptions, the number of prescriptions (millions) and retail sales (in billions) (2). Note: the list is for non-generic drugs only. Additionally, drugtopics.com separates their publications by top prescriptions and top selling. Table 1 is a combination of the two. The Sales column includes rank information.

 Table 1. Top 10 Prescribed Drugs in 2008.

Confirmation and Surprise.

So what was the confirmation? Cholesterol, hypertensive and digestive (GERD) disorder medications occupy spots #1, 2, 7 and 10 (italicized in table). They represent 110.2 million prescriptions and $15.3 billion in retail sales. It’s 40% of the top 10, 45% of all prescriptions and 49% of total retail sales. Lipitor by itself is 20% of all prescriptions and 19% of all retail sales for those in the top 10!

What surprised me? For starters, no diabetes drug in the top 10. Actos was the highest rated and it was 18th, with 12.5 million prescriptions. The $2.4 billion in sales would have been good enough for 10th on the sales list. This piqued my curiosity and led to another visit to drugtopics.com.

Thankfully they track prescriptions and sales of generic drugs too. Guess what was in the top 10? I’ll give you a hint. It starts with “M” and ends with “M.” This list too is dominated similarly and I’m working on a follow-up post.

My thoughts…

Insulin resistance is big business in this country, playing a small or large role in nearly all of these on the list. And the Standard American Diet (SAD) is being pushed down our throats by so many factions, I don’t even know which way is up sometimes.

With all the healthcare debate going on, it’s amazing to me those in charge can’t see what’s right under their noses. I’m blaming cognitive dissonance and the powerful sugar, corn and wheat lobbies.

My advice, trash the food guide pyramid. Ignore nearly all advice from registered dieticians and your doctor – they’re part of the cognitive dissonance crowd. Eat quality protein and healthy fats (including naturally saturated ones) at every meal, along with vegetables and exercise vigorously 2-3 days per week. That and keeping your stress levels down will go a long way to keep you from being on this list.

This post is part of the Kathleen Show, Prevention not Rx.

References (both are pdf documents).

1. 2008 Top 200 branded drugs by total prescriptions.

2. 2008 Top 200 branded drugs by retail dollars.

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CSPI has released their 2009 Xtreme eating awards. The press release is here and their website announcement is here. 

Should I laugh? Should I cry? Or should I get pissed off? There hasn’t been much sleep this week, pissed off is leading down the stretch. 

CSPI does not have the public interest at heart (watch the first video).  They think you can’t make a decision on your own. You’re too dumb to decide, so they should decide for you.

This whole idea that I, you or anyone else will suddenly change our mind on what to order at the counter when presented with caloric content is silly. And to blame restaurants and fast food on obesity is further destruction of personal responsibility.

And I’m not so sure McDonald’s is responsible. Sure, there’s Spurlock and Supersize Me. But there are major issues with Spurlock, which I won’t completely detail here but he has refused to show his food logs – raising questions on the 5,000 daily caloric intake.

Next, he gained 10 pounds in one week. If the obesity argument is all about calories in versus calories out, how do you explain that? That’s an extra 35,000 calories in one week. That’s an extra 5,000 calories per day, with emphasis on extra! So if we take him at his word, that he was eating 5,000 calories per day, where does this extra fit in?

Which brings me back to CSPI and their Xtreme awards. If they really stood by their name – Center for Science in the Public Interest, they would promote what we’ve learned from science and not personal dogma. Science has taught us a significant reduction, if not complete elimination of bad carbohydrates from the body leads to a multitude of positive health benefits.

Now that I got that off my chest, it was a photo finish and feeling better won by a nose.

Brian

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Props to Heather Davis. She has lost 110 pounds. It’s a story many would like to live. She didn’t follow a gimmicky diet or or sign-up for a quick fix fad. She did it with a good plan, hard work and perseverance.

Here are ten tips she offered in a CNN story that you can use to help you on your journey.

I like all of these tips. I use variations of nearly all of these in my weight loss program. One that I haven’t used but will incorporate immediately, Tip #8, keep an item of your “big” clothes as motivation. That’s a great idea!

Congratulations Heather!

1. Never let anyone tell you “You can’t.” Yes, you can.
2. Get as much social support as possible. Going to the gym with others is fun and motivating.
3. You will not be the biggest person in the gym and everyone will not be staring at you.
4. Some thin people in the gym used to be really heavy and they will applaud you.
5. Lose weight for you. Not because someone else tells you to. Also, know when to stop losing.
6. If you lose your way (fall off your diet), get right back into the saddle and try again.
7. Keep a calendar. Mark off every day you exercise and eat right. You will see the days rack up, and it will make you proud.
8. When you do lose weight, save one item from your heaviest weight. Look at it when you feel discouraged and you’ll see how far you’ve come.
9. Don’t let friends or family derail you. If you don’t want to eat something, it is OK to politely decline, but don’t go crazy. You don’t want to be “that person” at the lunch table.
10. If you want cheesecake or a sweet treat — eat it in moderation. Don’t deprive yourself of anything or you will get discouraged.

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First, you need to get into my boot camp. Today is the last day of the first week, but you can still register – right up until next Friday!
Second, If you’re skeptical of the results you can get from a Boot Camp, read this article.here.

Finally, the best Boot Camps are fun, challenging, rewarding and most importantly, get results. Exactly what you get.

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January 07, 2008.

From a recent article posted in the San Jose Mercury News by Melinda Sacks…

I took the liberty of highlighting important benefits in each of the points. The benefits of weight training are numerous and this article does a good job of highlighting some of the more
important ones.

Even though this article is geared toward women, the same benefits listed apply to men. So you guys don’t get off that easy.

Researchers say that most women who exercise still spend the majority of their time doing cardio, often ignoring the benefits of weight lifting. But unless a doctor advises otherwise, weight lifting can provide enormous advantages for most women, according to studies from such institutions as the Mayo Clinic, Harvard and Stanford universities. As with any new physical activity, check with your doctor if you have any health issues.

Here are the top 10 reasons sports medicine doctors and fitness experts agree weight lifting is good for you:

1. By becoming physically stronger, you will make routine tasks easier and safer to perform, from carrying heavy groceries from the car to picking up the kids.
2. Weight lifting will help you lose body fat and gain lean muscle. As this happens, your body mass decreases, your resting metabolism increases, and your clothes will fit looser. For every additional pound of muscle you gain, you will burn 30 to 50 more calories a day. Weight lifting is often touted as a proven way to keep weight off as women age.
3. Women don’t need to worry about bulking up as they get stronger. Unlike men, women do not have enough testosterone to build bulky muscles. Men have 10 to 30 times more of the hormone than women.
4. The risk of osteoporosis goes down as you gain muscle strength. Weight training can increase spinal bone density significantly in just six months.
5. Risk of injury decreases when you are stronger. You will be less prone to everything from back pain to arthritis to depression.
6. It’s good for your heart. Lower blood pressure, improved cardiovascular health and higher levels of “good cholesterol” have been found to be the side benefits of regular strength training, according to numerous studies.
7. The risk for diabetes declines because weight training has been found to improve the way the body processes sugar.
8. You can start weight training at any age. Research has shown that even women in their 80s can still build muscle strength.
9. Weight lifting can improve mood and fight off anxiety and depression. One Harvard study found that after weight training for 10 weeks, those suffering from clinical symptoms of depression felt better than those who received only counseling.
10. For women in middle age, strength training can help prevent the predictable metabolic sluggishness that often occurs. Many say it is not dieting, but weight lifting that is the true secret to keeping off middle-age pounds.

 

I will comment on one thing. In the opening paragraph, the author suggests that a majority of women spend their time doing cardio. I believe this is true. In my humble opinion, walking on a treadmill for 30- to 60-minutes is like Chinese water torture. You’re better off cranking up the intensity and going for a shorter period of time.

And don’t get me started on the benefits of slow-cardio and fat burning.

It simply isn’t a good use of time in a world where we’re all busy.

Off the soapbox…

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On Friday I mentioned a new service debuting today. You can find more info on that and other services we offer guaranteed to help you achieve your weight loss goals.

• Looking for a trainer? You found one here. But what if you don’t live in or near Sugar Land. What if you are really serious about achieving your goals this year but are hesitant to just hire any old trainer? I don’t blame you! What if you’re nervous about joining a gym and just want to workout at home?
  The answer to all of those questions and more is my newest service, BSFC Remote. When you sign-up, I’ll design a workout program specific to you. It will be based on your current abilities and the goals you want to achieve. It will include a daily schedule for weight training, cardio and stretching. Every activity I give you will have illustrations showing you the exact beginning and ending position. Additionally, each activity will have a text description “talking” you through performing it. These two things ensure you will perform the exercises safely and properly – leading you right down the path of success. It’s a step-by-step guide to reaching your goals. As if that weren’t enough, you’ll have unlimited email support throughout your program. Have a question? No problem, shoot me an email and I’ll get back to you. I know it sounds good and you’re ready to go. That’s great, but you better sign-up today. I’m having a serious special on this program. A limited number of spots are available and when they are full, I’m raising the rates. So get yours today for an amazingly low price!

   

If you’re like most Americans, you want to get in shape this year. I can’t think of a better option than BSFC Remote (unless you want to train with me in person).

• Don’t forget, the day after tomorrow (Wednesday) is the free webinar on living, looking and feeling younger. I’ll be covering all the keys you need to unlock a more youthful body. But, you can’t get those keys without registering. Click here to learn how to live, look and feel younger.
  
• Don’t forget #2. Next Monday (January 14, 2008) is the first day of class for my 6-week Boot Camp. Imagine reaching all of your weight loss goals by the middle of February! You can do it with this Boot Camp. In six weeks you will do more for your health and body than you ever thought possible. You’ll burn fat, get stronger and leaner, get rid of those aches and
  pains, have more energy, and more. Like I said last week, if you live within 10 minutes of the SW Freeway and Beltway 8, you are making a mistake by not signing up. There is an AM session and a PM session, so I’ve got your morning and afternoon workout covered. We start January 14 and spots are limited (and filling up fast) so if you’re ready to change the way you feel and the way your body looks, sign-up today!

 

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That’s all for today. Make it a great day. I’ll see you soon. Until then, break a sweat today. It will do your body good. Brian

Sign up here to receive regular articles like this.

Links for you:
Live, Look and Feel Younger
6-week Boot Camp
BSFC Remote

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11 Steps guaranteed to get you there!

How do you feel right now?

• tired?
• soft and mushy?
• sluggish?
• bloated?
• unable to focus?
• no drive?
  

Why do you feel this way? Is it just the natural aging process? Should you live through your 50′s, 60′s, 70′s and beyond feeling tired, taking prescription medication and feeling this way?

Is it acceptable to forget where you put your keys? Is it acceptable that as you age, you get soft in the middle and gain weight? Is it acceptable that as you age you wake up for 2-3 hours every night, exhausted but unable to fall back asleep? Is it acceptable that you take prescription medication to feel better? To stay more focused? To increase your sexual desires and appetite?

These things aren’t acceptable to me. But how many people do you know live this way now? What about you? Do you live this way now? Is everyday like this? Is it acceptable to you?

I know it’s not acceptable to you and that’s why you are here!

You can learn all the secrets to maintaining youth and vitality in a FREE web-based seminar I’m holding on January 9, 2007, at noon CST. Yes, I said absolutely FREE. You’ll also get great stuff just for sigining up.

How do you sign up?

Simple. Just go to this website and enter your first and last name and email address. I’ll take care of the rest.

See you there.

Don’t Forget: Wednesday, January 9, 2008 at noon, CST.

Sign-up here: http://www.briansekula.com/antiaginghouston.htm.

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Our new weight loss program can do exactly that for you. GUARANTEED!

Wouldn’t it be great to look and feel the way you want? Wouldn’t it be great to feel light, lean and strong? That is exactly what you will get with our new weight loss program.

It’s a 3-month program that includes everything you need to accomplish these goals. It’s also unique from your standard weight loss program. First, when you are done, you will have all the tools you need for lifelong success. That is a major disadvantage with other programs. When you’re done, you’re on your own. Not with us, you’ll have all you need for long-term success.

Secondly, we have teamed up with a local doctor and developed a blood test that is included with our program. This blood test looks at markers for cardiovascular disease, metabolic disorders and hormonal imbalances. We use the results to help shape your program. We also show you how our program has improved your profile – it’s powerful information. And you can’t get it anywhere but in this program.

Finally, we offer a 100% money-back guarantee. If you follow our program and don’t get results, we’ll refund your investment. Pretty simple!

So while you are trying to decide how to set your New Year’s Resolutions, why not invest in a program that is guaranteed to work? Why not invest in a program that has more than any other program you can find?

Why not sign-up? Do that here: www.briansekula.com/weightlosshouston.htm.

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