​Patients often tell me they heard that “processed foods” make you fat, or  white foods make you fat, or any number of crazy ideas. Really people just repeat whatever they hear.
                                                                                
What are processed foods anyway? People say these new words as if anybody would know what they mean. But what does “emotional eating” mean? What does “woke” mean?  “troll”,  “hack”, etc. The older I get, the less I understand the English language. 
 
I googled (another new word!) “processed foods”. Here you go. From the National Health Service in Britain . . .
 
breakfast cereals
cheese
canned vegetables
bread
savory snacks such as potato chips, sausage rolls, pies and pastries
meat products such as bacon, sausage, ham, salami
microwave meals
cakes and biscuits
drinks such as milk and soft drinks
 
I’d like to know, how are you going to eat anything at all if you live in an urban environment? Really?  canned vegetables make you fat?
 
People get fat for different reasons–let’s be honest–but the most common reasons are sugar and gluttony. Tell it like it is.

Years ago I wrote a Message of the Week listing ideas for new diet books. I wasn’t serious. It was a joke. I noticed there were so many diet books that made no sense, diets that didn’t work. Publishers publish such books because Americans buy them. The crazier and sillier the better. Americans have no background, understanding or taste for evidence or truth. You might notice that in some of our current politics.
​
One of my funny suggestions became an actual book, even a short-lived craze. The Cookie Diet. I would love to know if the author Sanford Siegal D.O. got his idea from my Message of the Week.  Possibly, but not likely. I bet he thought of it himself, and I’m sure he sold more copies than I ever sold of my serious books.

Without further ado, here is the 2019 list of silly ideas for diet books.

The Move to France Diet Book. The average French non-smoker weighs 30 lb less than the average American. Among the reasons is that the French never snack, eat more lunch than dinner, smaller portions, don’t work hard and don’t exercise. Easy enough in France, but a little harder here--but you could still do it.

The Concentration Camp Diet. Ever notice how people in concentration camps are so lean?  How do they manage it? I will tell you.  Recipes included.

The Blue Food Diet. Eat only foods that are blue. All I can think of is blueberries, blue corn chips and blue cheese, but if you can think of anything else, please call me.

The Alien Diet. What do aliens eat? You got me, but it’s in this book.  I never saw a fat alien except except Jabba the Hut. I kid you not, if someone wrote this book, some American publisher would publish it and it would sell.

The Cocaine Diet. Comes with samples.

People are so confused about the meaning of a low-carb diet. They come in, puzzled, having lost no weight after cutting out rice, bread, potatoes and spaghetti. But think about it. The Chinese eat rice at every meal–the same word “fan” means both meal and rice–yet they are the second skinniest country. The Italians in Italy eat spaghetti; the Irish ate potatoes, the French bread, all without getting fat. Think. Always think.
 
The only fattening carbs are sweet carbs. because they raise insulin steeply and quickly. Non-sweet carbs raise insulin a little, but not so dramatically.  In spaghetti the flour is combined with egg, slowing the absorption, lowering the glycemic index. Rice and whole wheat have a husk that has to be broken down.
 
Insulin matters more than calories. On my wall and in my books there are seven reasons why. Order #3 of the Ten Orders says “eat less sugar, sweeteners, sodas and baked white flour”. There is a reason or evidence for everything I say. Amazing how people struggle to give up candy and cake. Rice and potatoes easy. But pie?

 Today standing in a long line at the CVS drugstore, I noticed that all the people in front of me bought the items they came for, but also at the last moment, grabbed candy. At the counter there is a long shelf of every kind of candy. I stayed for a while, hid behind a counter and watched. Fully 90% of the customers bought candy. If you are trying to lose weight and such nonsense goes on, you will never lose weight!
​Order #9. Stop snacking.
It is high insulin that makes people fat. Not calories. Between meals you have to let your insulin come down and stay down for a while. Even a little candy or a soda messes up that plan.  I don’t mind a small dessert after a meal–your insulin goes up after the meal anyway–but not a snack between meals.
And reminding you that just because a Coke is a liquid, does not mean it is not also a snack. 

Shall I explain? During World War II the U.S. government paid farmers to grow as much wheat and corn as possible, to feed our army and devastated countries in Asia and Europe. Our farmers, mostly single family operations, responded vigorously.
 
By 1960 Europe had recovered and did not need as much grain, but our farmers  used to subsidies from the government were loath to give them up.  They continued to grow too much grain. Kennedy, the first Democratic president in a long spell, might have foreseen the outcome (below) and encouraged Congress to cut back the subsidies. He did not.
 
In the early sixties this nation was lean. On my desk is the 1966 yearbook of the University of Maryland. In this thick book there is only one fat girl and no fat boys. But at that time the most common breakfast was bacon and eggs; Americans snacked less, ate steak & veggies and did not eat from dinner until breakfast. At night they had conversations, played cards or read books. TV consisted of only four channels and the shows were pretty lousy.
                                                                                                                                
Enter the cereal companies. Desperate to move the extra cereal, they filled American ears with lies such as “fat and cholesterol are bad for you” or “breakfast is the most important meal of the day”.  All lies now exposed in current books, lectures and TIME magazine.  Watch “The Magic Pill” on Netflix, a documentary from 2017.
 
Since cereals are so bland, the food companies added sugar. From that decision our addiction to sugar sprang.  People started snacking on sweets–you  don’t see many snacking on beef jerky. The cereal companies sold their toxic ideas to children with Tony the Tiger and other cartoon characters.
 
Kennedy might have averted all this. But I don’t blame him; it’s hard to foresee the future. But come on! to this day we still give subsidies to farmers. And these are not family farmers any more–they are giant corporations like Monsanto.  We convert corn to alcohol and add alcohol to gasoline, No other country does that.  It costs more and it’s worse for the environment.
 
The rising curve of U.S. obesity began in the late sixties. It’s obvious why. If you want to lose weight, you should return to the behaviors of the sixties. Do not be a victim of advertising. For godsakes, people, think.

Effective today, restaurants chains with more than 20 restaurants are required to post the calorie count of each meal on their menu. A law passed under Obama. This goes ahead in the face of ample evidence showing that posting calories does not significantly help people lose weight. This was true for multiple reasons. (A) People don’t know how many calories they should be eating; they haven’t been told in a clear way. (B) Calories are not the important factor anyway; insulin is.
 
The fact that this measure went forward anyway, in the face of the evidence, suggests a problem with government, democratic government in particular, mainly that the appearance of action is more valuable to people in government than real action.
 
--You can get started with a phony solution right away, and get the credit right away.
 
--The mere appearance of action is sufficient to secure votes or funding.
 
--It takes time to find out if a real solution has been effective.
 
--By the time you find out, everybody has forgotten what the original problem was. 
 
--Having fixed the problem, the legislator must go on to learn about something new.
 
--Fixing problems for real can create enemies in the process.

Many of the overweight patients who come to me are taking a vitamin D supplement on their doctor’s orders because the doctor measured the vitamin D and said it was low. Many of the same patients have had kidney stones recently. There is a link.
 
Vitamin D does many things, but one thing it does is to encourage the absorption of calcium from the gut.
 
Most of the vitamin D in the blood is bound to vitamin D binding protein. Only the unbound free fraction is hormonally active. Most doctors measure only the total vitamin D. What they should do instead is to measure the free fraction, since that’s the only fraction that matters.
 
In fat people the liver makes less vitamin D binding protein, compared to lean people. So in fat people, the TOTAL vitamin D is always low. This does not need to be treated because the free fraction can be, and probably is normal.
 
Taking the unnecessary vitamin D supplement is not harmless. It can cause calcium kidney stones. Obese people are more prone to kidney stones anyway, and the vitamin D pill makes this situation worse.
 
Fortunately most of the vitamin D in the pills is not even absorbed. Vitamin D is a fat-soluble vitamin. If the pill is not taken with oil or fatty food, the vitamin D is not absorbed.  Maybe medical students should be required to take two years of biochemistry instead of just one.

Phentermine-Prozac helps people lose weight by (1) reducing hunger, (2) helping people focus & not make sleepy mistakes and (3) helping fight off food-cravings. You can guess from the last two items that phentermine-Prozac might help with other conditions, too. For instance . . . 
 
Phentermine-Prozac is very effective for attention deficit disorder (ADD). When a fat patient with ADD comes in, they have to stop their ADD medicine before they can take phentermine-Prozac. There’s nothing lost because phentermine-Prozac works as well or better than their ADD medicine. And phentermine-Prozac is cheaper, and I can prescribe it for longer periods of time.
 
Phentermine-Prozac works well on obsessive compulsive disorder (OCD). One of my patients, a lean woman who has never been fat, has taken phentermine-Prozac for years for trichotelomania. Without the medicine she plucks out her eyebrows. With the medicine she grows hair back. I don’t have to be a psychiatrist to do this. Just give phentermine-Prozac and the problem goes away.

Phentermine-Prozac helps people stop smoking or stop using other drugs.
 
One of my patients takes phentermine-Prozac for social anxiety. Another patient, a policeman, takes the combination for irritable bowel syndrome. All successfully on a long-term basis. If the patients stop the medicine, the bad symptoms return, so this is not just a placebo effect. The effect on OCD was published, I think, by Dr. Rothman and others. I am not aware that the rest of these effects have been published.

Fast food has a reputation for being fattening, but it doesn’t have to be like that. You can eat at fast food restaurants without getting fat. Why is fast food fattening? Let’s look at the reasons.
 
Eating fast food fast raises insulin more than the same burger and fries eaten slowly. Obesity is all about insulin; it has little to do with calories. If you eat even cake very slowly, it is less fattening, even though the same number of calories is taken in.
 
Burger and fries are a bad combination. The burger has lots of calories, but it’s a weak stimulus to insulin. The fries, being a starch, have fewer calories, but they are a strong stimulus to insulin. If you eat the burger and skip the fries, or eat the fries and skip the burger, you will be a lot better off.
 
At most fast food places the burger and fries are grotesquely huge, and men especially tend to eat the whole thing simply because they bought it.  But you don’t have to do that. You could eat part of the burger and let the rest go. You don’t have to eat every last fry. You could be smart.
 
Most people eating fast food get a very large soda. A little 12 oz Coke can has 8 tsps of sugar. How much sugar d’ya think is in one of those giant cups? And “diet” soda is no better, as has been published in so many places.  Anything sweet drives up insulin.
 
The soda thing is really ridiculous. I ate a burger (no fries) at Five Guys yesterday. It is really cold here in Maryland, 11º F outside. But all the beverages on sale at Five Guys, all of them, had ice! What a bizarre country, the U.S.

 I don’t understand the holidays. To me they seem like an excuse for severe overeating and snacking on candy. What is Thanksgiving all about? Thanksgiving was first proclaimed by Abraham Lincoln in 1863 to give thanks for the Union victories at Gettysburg and Vicksburg. It had nothing to do with pilgrims or turkeys. (I looked it up on my cell phone.) The pilgrims and the Indians didn’t eat together. They committed repeated mutual genocide.  Read the American Nations by Colin Woodard.
​And what is Halloween all about? 
How about Christmas? Luke 2 recounts that Joseph and Mary went to Bethlehem to be taxed. We know that occurred in April, for the same reason that we collect taxes in April. So Jesus must have been born in April. The reason the persecuted Roman christians celebrated Christmas in December was to coincide with the Roman holiday of Saturnalia, so the christian celebration would not be noticed. During Saturnalia the Romans lighted candles and played a game where the masters were temporarily the servants and the servants temporarily the masters–you can see the appeal to the christians. The lighting of candles around Dec. 21 was universal, to bring back the sun. Dec. 21, the winter solstice, is the longest night of the year.
I will see a wave of patients who regained a lot of weight during the holidays. It shouldn’t be. The Ten Orders are in force all year.