*119\186\4*

The first step is to return the patient to a healthier physical condition. The patient is not likely to benefit from psychotherapy if her starvation is too severe.

Let’s digress for a minute to look at the difficulties that starvation itself (that is, starvation not necessarily caused by anorexia) can cause. In a famous study by Ancell Keys at the University of Minnesota, thirty-six carefully screened normal males voluntarily decreased their food intake over six months. They each lost an average of 25 percent of their original body weight. The experimenters monitored their progress carefully.

The symptoms produced by starvation were the same we now know as the classic symptoms of anorexia. The men became preoccupied with food-reading cookbooks, collecting recipes, dreaming about food. They reported more depression and noticed that their ability to concentrate was impaired. They developed bizarre eating habits, such as mixing unusual types of foods together, creating superstitions surrounding certain foods, or stretching out their meals for extended periods of time. They noticed increased irritability, difficulty sleeping, a loss of interest in sex, and social withdrawal. After the experiment ended, a few of the men actually went on to become chefs.

The Keys study reveals why restoring weight is such a priority for treatment of anorexia. Extremely low weight, no matter what the cause, results in such severe disturbances in thinking and feeling that any form of therapy is unlikely to be successful until there is some degree of return to a healthier weight. Additionally, in some ways anorexia represents a phobia about mature body weight. As with other phobias, the fear won’t go away until the patient confronts the things she fears most.

Once weight increases to a healthier level, we can start to address other aspects of the illness. We now begin to resolve the underlying psychological issues that contribute to the disorder. The task involves showing the patient how to accept herself and like herself. We help her build a new identity that isn’t based solely on her ability to starve. In so doing, we loosen her grip on childhood and help her make the passage into adolescence and adulthood.

Through family therapy and social-skills training, we work to improve the patient’s relationships. Anorexic girls are so focused on themselves and on their condition that they lose the knack of dealing with other people. They are scared of reaching out for fear they’ll be rejected. As her peers grow and mature, the anorexic is left behind and now has a lot of catching up to do. Treatment focused on social-skills training can help.

*56/35/5*

“Desire wasn’t the problem. What I lacked was the belief that I really could lose weight,” recalls Sonia, a 43-year-old real estate agent from Timmins, Ontario. “I decided that before I could change my body, I had to change my way of thinking.”

In January 1997, when she weighed 285 pounds, Sonia started a scrapbook called My Dream Book. In it, she pasted images of people exercising, news stories of folks overcoming adversity, and, most significant, a photograph from her husband’s company newsletter showing a trim-looking, smiling couple at a Christmas party.

Sonia and her husband hadn’t gone to that party. “I wanted to stay home because I was embarrassed,” she says. “I cut out that picture and said, ‘Next year, we’re going.’

For several weeks, Sonia listened to motivational tapes and poured over the classic book The Power of Positive Thinking. Finally, she felt ready to address eating and exercise.

Sonia wanted a plan for life, not just a diet. She evaluated her eating habits and started making more sensible food choices. She took up walking, and as the pounds came off, she graduated to jogging. She also signed up for TOPS (Take Off Pounds Sensibly), which provides group support to its members.

By the time the holidays rolled around, Sonia had lost 135 pounds. She and her husband went to the company Christmas party and danced the night away.

Now, her sights are set even higher: She wants to run a marathon. “To be able to run is an unbelievable experience,” she says. “I just fell in love with it.”

Her dream book remains central to her motivation. Only this time, it’s packed full of pictures of runners crossing the finish line.

WINNING ACTION

Learn how to believe in yourself. Not ajl of us grow up with a positive sense of self or the belief that we can get what we really want. Sometimes, we have to learn those important lessons from others. Some of my favorite sources of motivation are Anthony Robbins’s Awaken the Giant Within, Oprah Winfrey’s Make the Connection, and Jon Kabat-Zinn’s Full Catastrophe Living. And like Sonia, we should go ahead and dream. After all, dreams do come true.

*110\89\8*

That’s not as tough as it seems. Three servings of 3 ounces of meat amounts to a nice chicken breast for lunch and another one for dinner. And you can throw in a cup of peas for your supper, plus (of course) a big baked potato. The reasonable dollop of butter or sour cream necessary to make the potato taste really good will be removed by a couple of grams of Chitosan.

All in all, not a bad meal. And, remember, if you eat a little more than you’re supposed to, it doesn’t matter. As long as you eat a little less than you did before starting the program, and take Chitosan as required, you will lose weight.

Nevertheless, it is desirable to cut down on protein. Do the best you can. Then do a little better . . . because, with my Fat Blocker Program you can do it. If you really try, you’ll see, your best is good enough! To help you cut down on protein to whatever extent you can manage, let me tell you that the average American eats more than twice the protein that he or she needs, which can put the kidneys and liver on overdrive as these organs struggle to excrete the excess nitrogen. Too much protein can also bind up much needed calcium, sending it out of the body through the urine, rather than into the bones where it is vitally needed.

But even though we don’t need much protein, it is vitally important that we get adequate amounts of it. Protein is necessary for the growth and maintenance of all body tissues, for production of enzymes and hormones, for manufacturing antibodies that fight off foreign invaders, and for maintaining proper fluid, salt, and acid-base balances. Without enough protein, the body will become more and more disease-prone, wasting away as it consumes its own tissues just to stay alive.

For healthy adults, the RDA for protein is .8 grams for each kilogram (2.2 pounds) of body weight. If you’re pregnant or recovering from a serious illness, the RDA is higher. And, believe it or not, athletes don’t need more protein than the rest of us. Their protein requirements are based on body weight, too, not on activity level. (To figure your own protein requirement, see the box above.)

The key here is to tailor the amount of Chitosan you take to the amount of fat you consume.

But there is even more to this approach. For, over time, another tremendously important benefit starts to appear. As your slight decrease in eating and your slight increase in exercise start to work together with the Chitosan to lower your weight, you will find that your energy starts to increase. Without even thinking about it, you will find yourself increasing your exercise. At the same time, because you are more active and less of a couch potato, you will find yourself snacking less. Gradually, what started out as a very mild exercise program will transform itself into a much more vigorous one—more than you could possibly have managed. In fact, you may even find that you can cut down on the amount of Chitosan you need to consume. Without really noticing it, you’ve formed new habits and patterns of eating and exercising.

caution: However, if you are allergic to shellfish, are pregnant or breast feeding, or are under the age of 14, it’s best to seek advice from your physician before
trying Chitosan. Also, discuss the use of Chitosan with your physician before using it if you are taking any medicines,
whether prescription or nonprescription, or have any diseases or ailments. As a general rule, it is best to consult your doctor before starting any diet program.

A Problem Solved some researcher have correctly pointed out that by pulling fatty acids from the body, Chitosan prevents us from using nutrients such as vitamins A, D, and E that are in those fats. Thus, it is theoretically possible for Chitosan to cause a nutrient deficiency.

I haven’t found this to be a problem for my patients. The average person gets 40 percent of his or her calories from fat. This is more than enough; the body only needs to absorb about 6 percent fat in order to take in all the essential fatty acids and nutrients it needs.

Still, my 8-Point Fat Blocker Program successfully deals with this potential problem by including generous amounts of these nutrients in supplement form in the daily regimen, scheduled so that they’re safely digested before Chitosan enters your stomach.

*46\29\2*

T-cells that grapple with invaders in fatal one-on-one combat, giant macrophages that engulf and destroy disease-causing entities, neutrophils that rush lightly armed into battle, B-cells that manufacture antibodies designed to search and destroy specific targets—these are just some of the parts of the mighty immune system.

Like all armies, our immune systems are prepared to operate in many different kinds of terrain. But when the body and blood are filled with fat, the immune system is hampered. Imagine that you’re a foot soldier or tank driver having to slog through sticky, knee-deep mud, or the captain of a boat crashing its way through an ice field. That’s something like the difficulties our immune system soldiers face when our bodies are filled with fat. Excessive amounts of fats, especially polyunsaturated fatty acids and cholesterol, have been linked to a weakening of the immune system.⁸ Excess blood fats directly interfere with immune system cells,⁹ the lymphocytes, T4 and T8 cells, B-cells, natural killer cells, monocytes, and giant macrophages. Fat also impairs the ability of the red blood cells to deliver oxygen to immune
system tissues that depend on a good supply of oxygen and nutrients in order to keep us healthy. Meanwhile, studies have shown that cutting your fat intake to lower levels may make your natural killer cells more effective, ¹⁰ all the more reason to keep our fat intake low.

“Why do you think you can’t stick with a diet?” I asked.

“I love chocolate too much,” she replied. “And I love the taste of ice cream, cake, pie.”

Jan’s problem was common. How do you stick to a sensible but strict diet? It has to be sensible; otherwise you’ll jeopardize your health. But if it’s too strict, there’s too much temptation to break the rules. That’s where Chitosan comes in handy. It allows you the occasional splurge that helps you stay on the Fat Blocker Program, but minimizes the consequences by preventing your body from absorbing much of the excess fat. The psychological desire for a treat is reconciled with the physiologic need to keep your fat intake low. You can’t quite have your cake and eat it too, but you can quench the desire for “forbidden foods” that pushes so many of us off our diets and undoes all of our hard work.

I told Jan about the Fat Blocker Program. When she tried it, she began losing weight almost immediately and for the first time ever she was able to stick with a diet. “My successes were like a snowball rolling down a hill, getting bigger and bigger. Only I was getting smaller, not bigger. Each month I lost more than the month before. And I could stick to the diet because once a week I could have something like a hot fudge sundae. The Chitosan made it possible for me to eat the foods I love without ballooning up again. Since I wasn’t breaking my diet, I didn’t feel guilty and I didn’t start stuffing myself like I used to. It’s been great.”