When I have an obese patient in their 300 pound state, many times they come to me for advice and to clear them for gastric bypass surgery. Some insurers require these patients to undergo 6 months worth of diet and psychological counseling before undergoing the surgery, some just require that they have a primary care doctor like me to look after them around the perioperative period (the time surrounding the surgery) because of all of the complications involved with a risky surgery. I am usually the person who says whether it is safe to move forward with surgery.
However with my obese patients I hate giving this clarification because I have seen so many of my patients end up with complications … including death. I had one patient die from sepsis after the surgery. One patient ended up going the opposite direction from obesity and become bulemic. One patient constantly gets transfusions due to iron deficiency anemia and yet another has b12 deficiency because the part of the stomach that absorbs vitamin b12 is blocked from absorbing now. And I have countless patients who lost weight … only to gain it back. For every successful patient after the gastric bypass, I have 8-9 other patients who have had major complications that will go on for the rest of their lives because of the permanent change made to their stomach.
But I am having less and less patients experiencing these issues, yet STILL having the weight loss similar to the gastric bypass. The reason is because of my new understanding of the "Hungerstat," the thermostat for hunger in our bodies. I give my patients an alternative weight loss method that is free and does not require surgery and most of them have avoided bypass with this system of weight loss. Let me explain the hungerstat before I get to this diet.
The hungerstat is in all of us and is controllable. Our satiety levels can be forcefully changed by surgery and gastric bypass. That's a given or else we would not give our most unhealthy patients such a dangerous option for treatment. However Alwin Lewis, MD, MPH and I have been using our bodies' natural hungerstat control system to divert our patients away from gastric bypass to allow them to lose weight at the same rate WITHOUT SURGERY.
How do we do this? We use our bodies' natural system for losing weight and maintaining health. When we were hunter-gatherers before the ice age, when famines or winters came along and food was scarce to hunt or gather, our bodies would get hungry … for 3 days. After 3 days, the hunger goes away because the body goes into catabolic mode: a mode that allows it to burn fat. When you eat 10 or less bites of food per day, this mode is automatically turned on after 3 days.
So to be specific, if you eat five bites twice a day, after 3 days of hunger, and tiredness, your body turns off the feeling of hunger and is satisfied with minimal food! The body becomes satisfied because it starts burning fat to keep you alive. It's how we were designed. Your hunger thermostat, or hungerstat, tells the body to not feel hungry anymore.
Let's look at kids in those poor countries, in those commercials asking you to sponsor them for a few bucks a day. When you see them, they are sleeping. Even though they are malnourished, believe it or not, they are not feeling hungry. They look terrible, do not get me wrong, to be in that situation. But nature was nice enough to design us to not feel that hunger after 3 days so we do not have to suffer. Those kids are using their fat reserves to survive and their hungerstats are fully turned off.
So the amazing thing is if you eat five bites twice a day only, in 3 days you will feel absolutely no hunger. You will feel just like you had a gastric bypass.
However here is the second amazing thing. After 14 days of easily taking in only 5 bites twice a day, the stomach naturally shrinks down. In other words, after 14 days of eating only 5 bites twice a day, the stomach shrinks to a point where eating more than 5 bites makes you feel drastically full. Your thermostat for hunger goes down to a point where it feels satisfied with smaller amounts of food. Your portion sizes, from that point forward, are naturally controlled as if your stomach had gone through a gastric bypass. My patients that are on this diet end up having a portion control for the rest of their lives because they have naturally controlled their hungerstat so they no longer feel the need to go to the buffet with a full plate for 3 visits, they no longer overeat, and they no longer have the capacity in their stomachs to overeat (unless they blow it all and eat huge amounts of food and overstretch their newly-shrunken stomach's capacity).
If you've ever seen a friend after surgery, many a time their appetites just will not allow them to eat more than a few bites off their plates. Hospitals regularly have people with full plates on the table even though the surgeon has given the person the OK to eat as much as they want. But many people just can not get their appetites back up after a few days of not eating due to abdominal surgery or abdominal conditions. These people are having the same exact effects on their hungerstat. So the question is … is it really the gastric bypass helping people lose weight, or the post-surgical period creating a lower hungerstat?
So with a drastic proportion reduction and only eating 5 bites twice a day, in 3 days you feel no hunger, and in 14 days you feel like you are satisfied after only 5 bites. Sounds like a person who has had a gastric bypass does not it? But instead, you are using your body's natural hungerstat to make the same exact changes.
After a gastric bypass, you end up eating 3 bites 3 times a day. When my patients come to me for pre-operative counseling, I put them on Dr. Alwin Lewis's "Five bite diet" and they lose the same amount of weight, have the same effects on their hunger, and avoid the surgery altar. While on this diet, they lose 1 pound a day. And best of all, the diet costs NOTHING. You save from the surgical costs, and the costs to your body as you avoid life-threatening surgery.
Many surgeons are starting to get mad at me because when they send these patients to me for pre-operative counseling, they rarely ever go back, because this diet has allowed them to lose 1 pound a day as if they had the bypass. They finally see weight loss success when they thought their only option was surgery. And they smile that they avoided such a heavy risk. And it's all thanks to this new knowledge on the hungerstat.