Friday, August 17, 2007

The Commandments in a Nutshell

The Thin Commandments - A diet expert offers a 10-point behavioral strategy for losing weight and keeping it off.
By Leanna Skarnulis
Reviewed by Louise Chang, MD

Wonder why you lose weight only to regain it and then some? "You've lost the weight but not the vulnerability," says Stephen Gullo, PhD, author of The Thin Commandments: The Ten No-Fail Strategies for Permanent Weight Loss. He maintains that losing weight and keeping it off is about adopting new strategies and changing your thinking about food. "If you go back to foods you have a long history of abusing, it's Psychology 101: Do what you've always done, and you'll get the result you've always gotten."

Although he disavows "the theology that you can have all foods in moderation," this book isn't the bible of faith-based weight loss programs. It preaches strategy, not prayer, as the path to lifelong weight control. Nor is the book related to The Thin Commandments written by Carolyn Costin, MA, MEd, MFT, for people with eating disorders. Her tongue-in-cheek commandments aren't meant to be followed but to illustrate beliefs that lead people astray -- maxims such as "Thou shalt not eat without feeling guilty" and "You can never be too thin."

Gullo's book presents 10 commandments or behavioral strategies plus his ABC Eating Plan and recipes. WebMD talked to him about why most diets fail and about his approach to permanent weight loss.

Successful Dieters Know Their Food History
Gullo says "the thin commandments" represent a new paradigm because they place a person's food history first and calories second. For example, seven almonds don't have a lot of calories, but someone whose weakness is nuts may stop at 70, not seven. "I'd rather my patients had a higher-calorie food at a dinner party than to start with the bread basket they have a long history of abusing. And I'd rather they'd have a crème brulee than a cookie, because the crème brulee doesn't translate to their daily lifestyle, but cookies they see every day."

He says the field of weight control is the only area of health care in which the importance of the patient's history is ignored. "The same people gain back the same weight with the same foods again and again. That's a major reason the field of weight control has produced a 90%-95% failure rate." He says his program has a success rate 15 times higher than the national average and has helped thousands of people maintain their weight for more than five years.

Successful Dieters Have Strategies for Controlling Their Eating
Gullo, former chairman of the National Obesity and Weight Control Education Program at Columbia Presbyterian Medical Center, says no diet can change decades of eating habits. "Changing habits of a lifetime takes strategy."

He maintains that once you know your food history, you should banish problem foods from your home. It almost feels as though he's been peeking into our kitchens when he says, "Every woman and most men have a counter with food, that as soon as they walk in their eyes and hands automatically go there. Throw out the kitchen-counter food."

That doesn't mean you can never eat those foods, but he says to manage them you must "box them in." "Don't eat them at home; limit them to a fine restaurant on Friday night. If you buy them for the home, only buy small bags."

Watch Out for Irregular Eating Patterns
Irregular eating patterns also sabotage weight control, so structure your meals and snacks. "If you go longer than three to four hours without a healthy snack and your blood sugar falls, you're more likely to have cravings," he says.

Arriving at a restaurant or dinner party hungry is another mistake. "The first thing they put in front of you is the bread basket," he says. "Frito-Lay had it right when they said, 'Bet you can't have just one.'"

He often tells his patients, who pay him $1,000 an hour, to get over feeling deprived and to grow up. "For the first time in history, people pay someone because they eat too much. We live in a world where there's cancer and AIDS. How can we feel deprived if we can't have an M&M? I can't eat pizza. I don't think I'm deprived at all. It's an adult decision. The only real deprivation is to trade off your life for a cookie, an M&M or a chip."

Although his degree is in psychology, he has no tolerance for psychobabble. "I realized when I was a student at Columbia, I wasn't even hungry, but if I took one cookie I wanted five or six more. I never thought it was because my mother didn't buy me a bicycle or because I was afraid to be thin or wanted to sabotage myself. You don't have to be crazy to be crazy about a cookie."

Successful Dieters Pay Attention to Food Neurochemistry
Ever notice that whatever you eat when you're starving tastes terrific? Gullo says neuropeptide Y, a brain hormone, rises when you go too long without eating and causes cravings for carbs to get accentuated. "If you want to eat sweets, and that's what you have a history of abusing, don't eat them on an empty stomach. The best snack might be a protein, or low-fat cheese and fruit."

He advocates combining foods and supplements -- seafood, cinnamon, calcium-rich foods, and high-fiber foods -- that have what he calls a "synergistic effect" in their ability to melt off pounds. He presents a 10-day Turbocharge Diet he says can safely take off from 10-14 pounds. The diet is limited to an A list of foods that include certain fast-food selections as well as meals you prepare at home. Next he has a B list of foods for continuing the diet and a C list for maintenance.

The Commandments in a Nutshell
1. Strategy is stronger than willpower.
2. Think historically, not just "calorically."
3. The problem may be in the food, not you.
4. Structure gives control.
5. Separate mood from food.
6. Take control of your favorite foods.
7. Slips should teach you, not defeat you.
8. Stop feeling deprived.
9. Treat your calories like dollars.
10. Losing weight is half the job. Keeping if off is the other half.


Another Point of View
Cindy Moore, MS, RD, spokeswoman for the American Dietetic Association, reviewed Gullo's book and enthusiastically endorses his strategies. She tells WebMD, "He's very motivational. He puts people in touch with the reasons they do what they do, helps them identify their food histories and food triggers, and gives specific examples of what they can do to change their behaviors."

She appreciates his understanding of the pitfalls that occur at the various stages of dieting and the strategies he presents for overcoming them. "He writes in a manner that people can identify with and takes them through what they have experienced in the past when they've fallen off diets."

But Moore, who is director of nutrition therapy at The Cleveland Clinic, has problems with the second half of the book. "He goes over the edge a bit when he talks about how his diet 'turbocharges' the body's capacity to lose weight." She says there's nothing harmful in the foods or in adding cinnamon and calcium to the diet, but she believes they're overused and their benefits overstated. "As with most popular diets, there's no science to prove his claims. He can't prove the turbocharging effect of his diet or that the combination of foods he uses can have a greater effect than if you happened to eat them on occasion."

She also believes most people would have problems adhering to the diet and following the recipes. "The 10-day Turbocharge diet is very limiting, and you really have to like fish. And the recipes aren't very reader-friendly. Sometimes you have to refer back to another place in the book, and there could be a lot of flipping back and forth."

Her advice: "Read the book for the excellent behavioral strategies, and skip the diet and recipes."


SOURCES: Stephen Gullo, PhD, author, The Thin Commandments Diet: The 10 No-Fail Strategies for Permanent Weight Loss; president, Institute for Health and Weight Sciences, New York. Cindy Moore, MS, RD, director, nutrition therapy, The Cleveland Clinic; spokeswoman, American Dietetic Association. Eating Disorder Referral and Information Center.

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