The Dukan Diet (16 page)

Not taking elevators or escalators is an integral part of my stabilization program. As I have said, if you live in a city of skyscrapers, this instruction is not practical and I recognize that 5 flights of stairs is a reasonable limit, but you should still make the effort to take the stairs as often as you possibly can. Anyone, especially someone who has lost weight and knows how much effort this has cost and how much satisfaction it has given them, has to accept this extremely simple condition.

At a time when expensive step machines are sold and gym subscriptions make a hole in many people’s pockets, why not think of the stairs as a little exercise you can include for free in your normal daily activities? Here again, you see this advice bandied around in magazines; I make a habit of writing it out at the top on my prescriptions and I have noticed that this is far more effective.

Going up or down the stairs makes the body’s largest muscles contract and in a short time uses up a considerable number of calories. Moreover, it gets sedentary city folk to change their heartbeat regularly, which is an excellent way of preventing coronaries.

However, as well as getting you into the habit of burning up calories in the long term, this instruction also has a deeper purpose. It allows you, several times a day, to test your determination to never put weight on again.

At the bottom of the stairs, individuals trying to stabilize their weight are symbolically confronted with a choice that helps them measure their determination. Grabbing hold of the banister and walking up enthusiastically is a simple, practical, and logical choice, a kind of wink from my readers to tell me that they believe in my program, that they are following it, and that it works for them.

Choosing the elevator or escalator with the excuse that you are late or your shopping is too heavy is a sign that you are letting go, and that this is just the beginning. A stabilization program to which you are unwilling to make a modest contribution is doomed to failure. So always firmly opt for the stairs.

I have noticed that the patients, readers, and Internet users from my coaching website (
www.dukandiet.com
) who have achieved the best results and the best stabilization in the long term are those who most regularly eat oat bran, and in particular the
oat bran galettes
, which they make a habit of eating twice a day, 1 in the morning and 1 in the middle of the afternoon.

I think that in addition to making you feel full, just like taking the stairs and pure protein Thursdays, oat bran stands guard over you, making sure that you are still on course, aware of any dangers and equipped to deal with them.

In practice, you now must include 3 tablespoons of oat bran in your daily routine. There is nothing to stop you having a fourth one, though, if one day you feel the need or inclination.

Insofar as oat bran slows down the assimilation of nutrients and moves waste through the intestines more quickly, I am often asked if it does the same with vitamins and certain medications. The answer is yes. But there is nothing to fear with a dose of up to 3 tablespoons a day. However, I have noted that some patients can easily exceed this dose, in which case it is best to take a multivitamin supplement and, if you are taking prescription medication, to wait for 1 hour after eating the oat bran to take your pills. I repeat this is only if you are taking more than the 3 tablespoons.

Those who are very overweight often have a more difficult time losing excess pounds and in maintaining that weight loss, whether because of emotional, psychological, metabolic, or genetic reasons. If you are very overweight, the suggestions in this section are supplementary weapons that will enhance your chances of success.

However,
these measures are not reserved for the very overweight
. They can serve all who are motivated enough to want to control their weight.

People with weight problems can be divided into three categories, according to the amount of weight they wish to lose.

• People who put on extra pounds occasionally
  
• People with a predisposition to obesity
  
• People with major obesity
  

This category includes anyone who does not have a predisposition to being overweight, whose weight has always been normal and stable, but who has started to put on extra pounds because of a specific, identifiable reason such as a sudden decrease in physical activity.

Putting on extra pounds often happens after a woman gives birth, usually with her first child. Weight gain is even more common if the birth has been difficult, requiring prolonged bed rest, or if the mother has had in vitro fertilization or other fertility treatments.

This kind of weight gain can also happen to anyone who is temporarily immobilized by an accident and eats out of sheer boredom, or to people receiving steroid treatment for a medical condition.

Some men and women are predisposed to put on weight. Whether this predisposition is “inherited” or due to overfeeding in early childhood leading to bad eating habits, the results are the same. Such people have a tendency to put on pounds easily and to extract an excessive amount of calories from what they eat.

In roughly 90 percent of cases, however, this predisposition is moderate, and the excessive calorie extraction is manageable.

Some individuals with strong willpower and motivation watch what they eat, lead an active lifestyle, and can stop the pounds piling on, or at least keep them under control. My program offers such men and women real security, freeing them forever from their legitimate anxiety about their weight. But where the Dukan Diet can really help them is to get through those unavoidable critical periods in life when simple willpower is just not enough.

Others who suffer from the same predisposition to put on weight, but who are sedentary or have no self-control when eating, experience a slow but inevitable increase in weight. For them the Dukan Diet is ideal. They extract a high level of calories from their food, but the combination of protein Thursdays and regular consumption of oat bran neutralizes this
problem. Their lack of willpower or difficulty in maintaining organized eating patterns is balanced by this small sacrifice one day a week

Major obesity is a predisposition that often runs in the family, leading to such huge weight gain that the body is deformed.

The energy that such people absorb from what they eat is so great that everyone, doctors included, are confounded. All nutritionists have some such patients who seem to live off thin air, defying the most elementary laws of physics.

I have known patients who have weighed themselves before going to bed and who immediately on waking up and even before urinating had found a way of putting on a little weight; fortunately they are the rare exceptions.

Most often, individuals with a strong predisposition to gain weight are clearly obese. It is here that we encounter people who have already tried most diets, almost always losing weight that they then put back on again. For them, the fourth phase of the program is a good basis for stabilization, but it is unlikely to be sufficient in the most difficult cases. For such people I developed a series of extra measures to shore up their stabilization—measures that are useful for all three categories of people with weight problems.

In line with my philosophy, however, these measures are not based on restricting what you eat. Everything that I have recommended from the beginning in this book remains valid, even for those with a special talent for extracting calories from their food. After a successful diet, eating during stabilization must be spontaneous 6 days out of 7.

The three measures that follow are intended for anyone with a extreme tendency to obesity, but what is good for them may also help those people who, although not obese, already have a “weight history” and are looking for effective control.

First, however, I want to give you some vital information about the physiology of your fat cells—information that will help you better manage your weight on a lifetime basis.

Nowadays we know that we are born with a genetically determined supply of adipocytes, yellow cells that make and store fat. Normally the number of these cells is fixed and does not vary. It is interesting to know that although this number is fixed, it does vary for individuals. and those with a greater number of adipocytes have a greater capacity to put on weight.

Genetically, women have more adipocytes than men, as fat plays a more important role in expressing a woman’s femininity as well as in reproduction and motherhood. A woman with less than 10 percent of fat reserves stops ovulating to prevent her from starting a pregnancy she will not have the energy to sustain to term.

Once the number of these adipocytes has been determined at birth, it then remains relatively constant, except for certain key moments.

When a woman—or a man—who eats badly or puts on too much weight, the person’s adipocytes put on weight too. As the person continues to put on weight, the adipocytes continue to gorge themselves on fat, gradually becoming distended. If the weight gain continues, the adipocytes enlarge until they reach the limit of their elasticity. At this critical moment, any additional weight gain triggers a new and exceptional event, completely changing the future prognosis for weight problems. No longer able to contain any more fat, the adipocyte cell divides into two daughter cells.
This suddenly doubles the body’s capacity to make and store fat
.

From this moment on, the tendency to put on weight increases. Quite simply, it becomes easier to put it on and more difficult to take it off. This is because you can always reduce the size of adipocytes, but two daughter cells will never again become a single mother cell.

When the adipocytes divide, what was excess weight gain through behavior becomes metabolic excess weight, and nothing will ever be as simple as it was before.

I am not saying this to make anyone who is seriously overweight feel worried or guilty. I can reassure you that my method
does
give you the means to deal with your resistance.

However, because of the consequences of adipocyte cell division, it is important to pinpoint simply and concretely the moment in your weight history when there is this risk of cell division so that you do not reach it.

Having worked with tens of thousands of patients throughout my career as a physician and nutritionist, I was able to work out statistics that enabled me to pinpoint this moment as being after a body mass index (BMI) of 28 has been reached and is going toward a BMI of 29.

To determine if you are at risk for adipocyte cell division, you must calculate your BMI, or body mass index.

To make this calculation yourself, you need to divide your weight by your height squared. So, for example, if you weigh 150 pounds (70 kilograms) and are 5 feet 3 inches tall (1.6 meters), the calculation is—using metric, which is easier—1.6 × 1.6 = 2.56; 70 ÷ 2.56 = 27.34. (Alternatively, there are also many websites that will calculate your BMI for you.)

This BMI has not yet reached 28 but it is not far off. The main thing is to do all you can to avoid ever reaching this danger point.

When you get near to a BMI of 27, be careful and do not allow yourself to go any further, as your adipocytes are very full. And if you do reach a BMI 28, you must take action: your adipocytes are at saturation point and are likely to divide at any moment, making managing and controlling your weight more complicated.

Here is an unusual way of burning calories: making the body use up calories by keeping itself warm.

Imagine a 182-pound man, 5 feet 9 inches tall, with a semiactive profession. During his normal routine he eats and uses up on average about 2,400 calories a day.

Let’s pinpoint exactly how and where he uses these calories: