If you are desperate to lose weight but nothing works, the diet you follow doesn’t matter. Perhaps this sounds funny. But there are many good diets that work. Fundamentally, the problem is one of attitude rather than a diet.

I have been fat. I have also treated fat people. I have helped myself, and I’ve helped them. I would like to help you. I believe I can.

Fatness is sickness

Being fat is a sickness. The affliction is fat – extra fat that strains the heart, blocks the arteries, and raises the blood pressure.

Mainly, though, it makes you look old and clumsy and ugly. Worse still, all fat people look alike because fat has a way of ironing out features.

This sickness, perhaps like no other, is terribly destructive to the personality and to social life. Nobody loves a fat man, including himself.

I hope I’ve piqued your vanity. Being destructive, that will probably have more effect than an appeal for concern for your health.

All right, you are sick. If you feel sorry for yourself, that is good. You have every reason to feel sorry for yourself. You are a sick person. Step one is to admit that you are sick. This is crucial.

Ask yourself how long you have been fat, how fat, through how many diets and promises. Ask yourself what it’s done to you, how it has affected your life and your relationships with other people.

If you’re ready to admit that overeating and being fat are an obsession, a compulsion, that you are addicted to eating too much food – you are on your way.

Hopelessness

Do you want to get well? Of course, you do. But can you? If you are a chronic case, you probably think you can’t. Chronically fat people really feel hopeless about the possibility of change.

This hopelessness is the second-best way to maintain the status quo: “Why try? It won’t work, anyway. May as well eat. I’m 30 pounds overweight; another couple of pounds before I diet won’t matter.

The rationalizations are endless. You will attempt to use them again and again as justifications for over-eating.

The fact is that your illness can be cured. Other people have made it and so can you. But you must be realistic about this struggle. That is just what it’s going to be a long, hard struggle for which you must be thoroughly prepared.

Working units

Fat people tend to be expansive, to operate in an all-or-nothing way. Therefore, you are very likely to set exorbitant goals. This can be very dangerous, as discouragement – especially early in the game – can be completely devastating.

Now, I’m not suggesting that you minimize the problem. Being 70 pounds overweight is being 70 pounds overweight. But thinking in terms of 70 pounds – from the beginning – is also unrealistic.

Goal One is to indicate to yourself that it can be done. This is why I recommend an immediate crash diet designed to lose 10 percent of the total weight you want to lose.

Your doctor can advise you about a crash diet. Do not starve! There are crash diets in which you can eat. Your doctor will probably recommend a high-protein, low-carbohydrate diet. This is fine.

Remember to drink lots of water. Constipation is often an initial response to serious dieting and can be both painful and demoralizing.

After this initial goal has been achieved, you may feel, “What is seven out of 70? Practically nothing …”

But seven out of 70 is ten percent – a wonderful accomplishment.

Later on, 20 percent is a good goal. For example, let’s say your overweight is down to 30 pounds. Six pounds is then the next good goal to contemplate.

Prepare to fail

If you expect perfect dieting, you are already on your way to a massive failure. So you will have failures. Be prepared for them.

Let us say you are breaking your diet. You are on an eating binge. Now, to any extent – and I mean to any extent whatever – that you can limit this binge, you are fighting failure and later despair.

Even in failure, keep success in mind. Three-quarters of a milkshake is better than a full one; half is better still. It’s hard. All your past conditioning implores you to go on. But settle for what you have had; then stop.

And once the binge is over, do not hate yourself, or even feel guilty.

You did it. Now what can you do about it? Isn’t this an old habit: depression, eating, then even more depression? Learn what you can from this.

Ammunition foods and emergency foods

Ammunition foods are foods to help prevent failure and to limit it.

It is too much for you to hope to succeed in eating your three diet meals and nothing else. This is not realistic or in keeping with a long-standing way of life.

But there are ways of eating between meals. Cheese, nuts, and crackers are very tasty – and extremely destructive to a diet. Ammunition foods, on the other hand, satisfy both appetite and diet. These are foods which you must prepare and always keep in the house.

Let me list just some: sour pickles (not sweet-and-sour), tomato juice, celery stalks, cooked mushrooms, sauerkraut, strawberries, tomatoes, brussels sprouts, carrot sticks, lettuce leaves, cucumbers, and cauliflower.

There are also emergency foods.

You must have something sweet? Have some low-calorie chocolate pudding or half a melon or, if more solid food is necessary, a small steak.

See: Fruit and Vegetable Diet for Weight Loss

Time

Taking your time in getting thin is most important.

First, it gives your body an opportunity to get used to its new dimensions. The stomach has a chance to shrink. The skin has a chance to tighten.

More important, your psychology regarding yourself and yourself in relation to food will have had a chance for healthy, permanent change.

It takes time to substitute other interests and activities for eating.

Goal units

Taking time involves units again – not the practical working units I spoke about before but much larger “goal” units. I feel that goal units can be from 10 pounds to not more than 20 pounds.

This means, for example, that 60 pounds can be segmented into six 10-pound units or three 20-pound units.

The choice of unit size should depend on what is practically possible for you in terms of prolonged disciplined eating.

Therefore, you diet until you arrive at the end of a goal unit, a vacation from dieting for a month, then diet again.

This is hard. But, in learning that it can be done, your morale and your sense of self-control will improve.

Another reason is that a “vacation” from dieting after reaching a goal unit means going on a maintenance diet – the diet you will ultimately go on for the rest of your life to maintain your weight.

The scales

Compulsive use of the scales early in the game (and I’ve known people who jumped on them about 20 times a day) can be quite discouraging.

Regardless of the diet you go on, don’t expect big changes immediately. They just won’t happen, not even with complete starvation.

Oh, there will be changes shortly, especially with an early crash-diet, but not quickly enough to satisfy most people.

Also, initial significant-looking weight loss will probably be due to an early loss of water, because taking in less food means having less salt in the body to bind the water.

So in the very beginning the scales may indicate nothing at all. Don’t blame them, or yourself.

Exercise

There are people who will have you believe you can trim off your overweight with exercise. Massage treatments of all kinds are also advocated.

Exercise alone simply will not do it! Massage, while it may be pleasant, will have even less effect. You may achieve some small redistribution of fat through the exclusive use of exercise, but the chances are excellent that you will retain your weight within five pounds.

But there is another very important aspect of exercise for the fat man or woman.

The fat person has, to a great extent, lost touch with her physical self. Emotionally, she has put as much distance as possible between herself and her body.

How is this demonstrated? By no longer having a good feeling for your body. Exercise helps you enjoy the feeling of it again.

This is especially true when changes healthy, flattering changes – are taking place. As you get thin, you will feel better about your body, and your image of it will slowly change.

Exercise will enhance this change in feeling and will accelerate this process.

See: Exercise and Sport: The Pros and Cons

The diet I like best

First, I want to stress again: See your own doctor. Before dieting, it is important to equate your diet with any physical conditions that may exist.

I also feel it is very important that you understand the diet you will be on.

I don’t mean the simple “eat this” and “don’t eat that.” Get your doctor to explain what your diet is all about, what it consists of, and how and why it works. It is vital to your sense of responsibility that you understand what you are doing.

Now, the diet I like best is the high protein and low-carbohydrate one.

What is so wonderful about protein and so villainous about carbohydrates?

Protein is not just low in calories. It acts as a kind of metabolic catalyst; it burns itself up very readily and also stimulates the rapid metabolizing of other foods.

Carbohydrates, on the other hand, are believed to have the reverse effect. Some researchers feel carbohydrates may be a factor in the retention of cholesterol in the bloodstream which eventually leads to arterial degeneration and heart and circulatory diseases.

So I recommend the high-protein, low carbohydrate diet with the accessory “emergency and ammunition” foods mentioned before.

For others

Motivating patients to do something about themselves in order to get well is still an item that defies doctors. Motivation must come from the patient.

But what if it just isn’t there?

Well, how about those around you? Is there anybody you feel something for? Do it for them until you see some results.

Results will encourage you to go on for them and for you as well.

When?

D-Day ought to be chosen with care. Important enterprises deserve the very best kind of send-off.

For several days now, you will have had your house cleared of excess fattening food, and you now have plenty of ammunition food, comfort food, and emergency supplies on hand and easy to reach.

Ideally, the next few days should be pleasant but well-organized – not weekends of unplanned “free” time with nothing to do but eat. Ordinary work-days are fine but guard against excess work and fatigue.

These should be busy days but take-it-easy days.

Do not undertake other large, self-interest tasks at this time. You will certainly fail, and you may become very depressed. Dieting is enough for now.

Auxiliary measures

Do not suffer unnecessarily. Use every means at your command to arrive at your goal healthily and comfortably.

You will find it most helpful to socialize, talk, be active in causes, visit museums, see plays, see movies. Do things. Be with people.

This is no time to give up smoking. I do not suggest that you establish this habit. But, if you smoke, expect a slight increase. Try not to let this get out of hand but don’t be hard with yourself if a temporary increase takes place.

If your diet and scruples permit, I also see nothing wrong with a cocktail in the evening. This can be something to look forward to.

In short, be kind to yourself. Try to increase pleasant activities. Do all you can to raise and sustain your morale. Your diet will take care of the weight; you must take care of yourself.

I like tea

I find it comforting to drink tea, especially during periods of fatigue and when pressured by the vicissitudes of dieting.

If you don’t like tea, choose clear broth or sugarless coffee or bouillon – just as long as it’s calorie-free and comforting.

Help!

Emergency: you are about to go on a binge.

Quick! Drink two glasses of no-calorie soda, tea, instant coffee, bouillon, or plain water. It will blow you up inside. Then eat two pickles (large ones) and a whole cantaloup (a medium one).

Then … get out of the house and walk. Here you are, starving, fatigued, filled only by carbonated gas, water, and the equivalent of grass, and I ask you to go for a walk!

But do it. Get out and walk away from the house (where you got fat in the first place) and away from the refrigerator. Keep going!

Picture yourself and how you look now. Are you passing a store window? Look at it and your reflection. Look at the pretty clothes for thin people.

You are on your way, and who is responsible? You are.

By this time, that overwhelming urge to eat poison foods is disappearing. You have survived an acute emergency.

When you get back to the house, either get busy or go to sleep. Don’t subject yourself to more unnecessary risks. In the morning when you wake up, please be fully aware that you have scored a major victory. You have proved you have self-control, and you can do it again.

Not only that. From now on, it’s going to be easier.

Doldrums

There may be times in your regime when things don’t seem to be going well. You will be doing all the required things without visible change.

This is very likely to occur after a sharp, initial weight loss and also about two-thirds of the way to your desired goal. Be prepared for it, so you don’t get unduly discouraged.

What is usually happening is a reshifting of weight distribution and, particularly, rebalancing of your body’s tissue-water. Stick to the regime, and you will pass from this ”doldrum” state to a satisfactory period of measurable weight loss.

About the water business – to give an oversimplified explanation, what happens is this: Salt binds liquid, which means that it keeps water in the tissues. A depletion of food and salt results in a freeing of water, so the kidneys excrete more water through urination.

So initial dieting will result in a loss of weight due to water loss. However, as the diet proceeds, the salt will gradually be replaced, as will the water – unless, of course, you remain on a salt-free diet. This is not advisable unless specifically prescribed by a doctor.

If a doldrum period becomes interminable – and this despite faithful, formerly effective dieting – do see your doctor.

It is possible that your diet needs some modification, or that you are accumulating water for one reason or another. Your doctor may then prescribe medication.

But remember that taking pills indiscriminately on your own can be very dangerous. The hormonal balance of the body is a very important and delicate one and should be treated with respect.

See: Dash Diet: Low-Salt Diet for Hypertension

Evening evaluation

It is a good idea to spend a few minutes each evening evaluating the day.

Were there any difficult periods? How did you get through them? Are there any areas that can be improved tomorrow? Were there any significant victories? How is your morale? Is there any way to improve it tomorrow?

This evaluation should be helpful. Please don’t use it as self-punishment.

Your friendliest enemies

Beware of your well-meaning friends and relatives. Many of them will be serious deterrents to your goal.

There will be people who insist that you eat out. They will tell you that you can eat dieting food and then will guide you to restaurants offering the most tempting and fattening foods – all poison for you.

There will be the force-feeders, who will pressure you endlessly to eat something. “So go off your diet just this once.” “Don’t be so hard on yourself.”

The list could go on and on. Each of you will undoubtedly be in contact with your own particular kind of sabotaging specialist. Please remember that your first duty is to yourself.

Maintenance

You are at your goal. Congratulations! You’ve done it – you’re actually thin.

Well, now that congratulations are over – back to work.

Please remember that, as a formerly fat person (of several years’ duration), you are something like the former alcoholic. The fat is gone; this is not true of your susceptibility and addiction to food.

You just can’t eat wildly and indiscriminately – not if you want to remain thin. Now and then you may allow yourself tiny periods of freedom. But you must make sure these periods remain tiny.

Even more dangerous will be the tendency to slip gradually into a larger and larger eating habit, and to ignore or rationalize a small but steady weight gain.

The most successful maintenance diet will probably be based on the principles of your reducing diet. They have worked, so they are good.

Of course, the maintenance diet will have modifications, including greater leeway and occasional divergencies.

I would like to stress once again the value of having dieted slowly.

Because you have taken a considerable time to lose weight, both your psychology (regarding food) and your stomach have been considerably reduced. The maintenance diet should feel like enough.

Be especially careful – and this is most important – during periods of stress. Remember that, despite your recent victory, you have subjected yourself to years of conditioning in which stress and depression were handled with food.

Now, during your maintenance period – the rest of your life – the scales will be most important. Make sure your scales are good. Use them once a day, before breakfast and before dressing, and use them consistently.

Here is a suggested way:

Let us say your right weight is 135 pounds. Then bring your weight down to 132 pounds. If you continue to weigh between 132 and 135 – a fluctuation of three pounds – your maintenance diet is working.

If you drop below 132, an increase is in order. If you rise above 135, immediately begin your reducing diet again.

BUT to give you ample leeway, do not go back to your maintenance diet until you go down to 133 – two pounds below your desired goal. At 133, go back on a slightly reduced maintenance diet.

Follow this rule carefully and you will never get back into serious trouble. Eventually, you will become so well-stabilized that there will be practically no fluctuation.

Well, you are on your way. Again, I want to congratulate you. I won’t wish you luck. It’s not luck that brought you this far. It’s self and self-esteem, and you have proved that you’ve plenty of that.

And, by the way, welcome to the fraternity of thin people formerly fat!

The Thin Book By a Formerly Fat Psychiatrist © Theodore Isaac Rubin

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