The 4 Day Diet

Ian K. Smith, M.D.

St. Martin's Press

CHAPTER 1

Sense of Where You Are

START WITH HONESTY

One afternoon I was rummaging through my uncle’s vast attic filled with dusty memorabilia, the equivalent of gold to an adventurous teen. I came upon a box that had been pushed into a corner underneath a tangle of dust and cobwebs. Hoping for collectible baseball cards or rare coins, I was disappointed to find a pile of books most of whose titles were so worn I couldn’t read them. Those I could read I couldn’t understand. But midway through the stack I was drawn to a skinny paperback that featured on its jacket a photograph of a young man dribbling a basketball. The title is what caught my attention: A Sense of Where You Are.

A serious athlete myself, I plucked the book from the box, brushed off the dust, and lost myself in its sepia-colored pages. The book was about former presidential candidate, three-term U.S. senator, and one of Princeton University’s greatest basketball players, Bill Bradley. From his childhood as a banker’s son to his storied career at Princeton, the book told the story of a hardworking, disciplined, intelligent ball player whose tremendous success on the court was largely attributed to his awareness at all times of his position in relationship to the basket, thus the title A Sense of Where You Are.

It is this understanding of one’s relationship to the ultimate target that became the blueprint for this chapter. Regardless of how fatigued he was, how outmatched athletically, or how fast the pace of the action, Bill Bradley always had that sure sense of where he stood relative to his ultimate goal: scoring a basket. This understanding is also critical for anyone trying to lose weight. Regardless of what’s going on in your life, whether it is stress at the job, a busy day of running around with the kids, or traveling for pleasure or business, you must always know where you are relative to your goals. It’s not about obsessing over your goals but, rather, having them readily present at least in your subconscious so that when you come to one of those proverbial forks in the road, you don’t even have to think about the right choice. The right choice becomes a simple reflex of your body.

You will often hear people say that they don’t go to the doctor for annual checkups or don’t undergo recommended screening tests even though doing so could possibly catch illnesses in their earlier stages when they’re most curable. Why don’t they want to know what’s going on with their bodies? One of the most common and equally mystifying answers is "If there’s something going on with me, I don’t want to know."

What will best guide your success during THE 4 DAY DIET journey is complete honesty and knowing fully what’s going on. You will have to face the truths that you discover along the way. Rather than run from these truths or try to bury them, you will learn how to embrace them—starting right now. There are some tough questions that you must answer. Write your answers down in order.

Why are you currently overweight?

Why have previous weight-loss efforts failed?

How does your weight influence your self-esteem/self-image?

What are your strengths related to sticking to a weight-loss program?

What are your weaknesses related to sticking to a weight-loss program?

Without weighing yourself or looking at a Body Mass Index (BMI) chart, how many pounds away do you think you are from your target weight?

Once you’ve answered these questions, take some time to consider the answers. These answers are critical not only to give context to your current situation but to serve as a springboard moving forward.

Now there is a second set of questions whose answers will give you a better sense of where you are. Weigh yourself on a reliable scale, one that is convenient and that you’ll be able to use throughout your journey. Once you have the number, use the BMI chart in this chapter to help you answer some of these questions:

What is your current BMI?

What does the chart say is a healthy weight for your height?

What are your bad habits when it comes to exercising/eating right?

What are your good habits when it comes to exercising/eating right?

When was the last time you were at a weight you were happy with?

Keep these answers stored in a place where you won’t lose them. You will need to refer to them throughout your weight-loss journey.

WHERE YOU ARE RIGHT NOW: YOUR BMI

Let’s get down to work. Every journey needs a starting point, so let’s establish yours right now. Your current weight and BMI are a good place to start. According to the Centers for Disease Control, Body Mass Index (BMI) is calculated from a person’s weight and height and is a reliable indicator of a person’s body fatness. The BMI is used to determine which of four major categories you fit into: underweight, normal, overweight, and obese. Determining which category you fall into is critical because it can help indicate your risk for certain diseases and health conditions.

Your BMI can be calculated or simply found on a BMI chart readily accessible on the Internet. Let’s do the calculation here:

So let’s take a man who is 5' 10" (70 inches) and weighs 200 pounds.

You can also get this number by simply using the BMI chart in the Appendix, page 216. Once you’ve figured out your BMI, you can look to see which category you fit into.

The man in our sample would be considered overweight according to his BMI. Why does this matter, since he’s clearly not obese? His being overweight increases his risk for certain medical conditions and even death.

Diseases and Health Conditions Related to Obesity

Hypertension (high blood pressure)

Dyslipidemia (for example, high LDL cholesterol, low HDL cholesterol, or high levels of triglycerides)

Type 2 diabetes

Coronary heart disease

Stroke

Gallbladder disease

Osteoarthritis

Sleep apnea and respiratory problems

Some cancers (endometrial, breast, and colon)

Source: Centers for Disease Control.

EVERYTHING IS NOT AS IT APPEARS

It’s important to distinguish between the medical definition of your weight and the visual interpretation. These can be very different and thus very confusing. You’ve almost certainly heard the expression "She wears her weight well." This typically refers to people who are overweight but don’t look overweight, because they are either very tall or their weight is distributed throughout their body in such a way that no one area looks particularly alarming.

The visual interpretation of weight can be a tricky thing. Just because someone doesn’t look overweight doesn’t mean that he isn’t. Sometimes a person won’t appear to be heavy, but then she steps on the scale or calculates her BMI and realizes she is not only overweight, but in some cases obese. I had this happen with a famous plus-size model who insisted that she was "curvy and voluptuous" and not overweight. She was one of the contestants on my show, Celebrity Fit Club. Her argument was that she didn’t look overweight, that she was full-figured and attractive, and men found her curves irresistible. But her BMI actually pegged her as obese. She not only refused to accept her BMI but even went so far as to suggest the BMI chart was wrong and it didn’t apply to her or others like her. In her estimation, the BMI chart had a bias against ethnic women.

The BMI chart is certainly not perfect, but it is the best tool we have to approximate a person’s degree of overweight and obesity without a more thorough body fat test in a specialist’s office. It was not designed to judge who is beautiful and who isn’t. BMI is simply an objective measure. It doesn’t know or care about the length of your eyelashes, the color of your skin, or what you do for a living. It simply takes objective measures—your height and your weight—and gives you a number that helps you and your doctor determine your risk for certain diseases.

I have heard many people say, "The chart says that I’m overweight, but I still don’t have diabetes or high blood pressure. I’m fine." That might be true—for now. The negative consequences of poor eating habits and lack of physical activity are often not immediate. They slowly add up over time, but be assured that once they reach the critical threshold, adverse health conditions are an inevitability. This is why the medical definition of obesity is better suited than any highly subjective visual interpretation to determine whether weight loss will make you healthier.

UNLOCKING THE MYSTERY OF WHY YOU’RE HERE

No one suddenly wakes up one morning and discovers that she is 30 pounds overweight. There’s a reason that the scale is registering the number staring back at you, and it’s not because you swallowed a bowling ball before you went to bed last night. Whether it has been years of poor eating, a chronic illness, medications you’ve taken, a life of too little physical activity, or a slowing of your metabolism, there is a reason or a combination of reasons that you’re in this predicament. The first step in making a change is an acknowledgment of where you are and how you got there.

We’ve already figured out your BMI and what your weight status is. This is the "where you are" part. Now it’s time to see how you arrived at this point in life. This requires more honesty and reflection. Think back to the time when you were at the weight and degree of health that you most enjoyed. Find a quiet place where you won’t be distracted, close your eyes, and see an image of yourself at that point in your life—the length of your hair, the shape of your legs, the cut of your jaw. Feel once again what it was like to run up stairs and not be winded. See the size of the clothes that was stamped in the labels. Smell the freshly cut grass of the park you walked in or played softball. Take not only your mind but your entire body back to that point in your life. Once you’ve been there for five minutes, open your eyes and answer the following questions. You will be completing your own Then/Now chart.

Your Then/Now chart is extremely valuable for your weight-loss success. It provides a road map of not only where you were but also how you got to your current location. Once you’ve completed this chart, look carefully at the differences between then and now. They can help you pinpoint where and why things changed and your detour began. It can also give you clear directions to get back on course to a healthier weight and better lifestyle. Best of all, the Then/Now chart will prove to you that you had good, strong eating and exercise habits at one point in your life. And if you had them once, you can have them again.

ASSESSING YOUR BODY IMAGE

What you think about yourself really matters. Those thoughts influence your behavior, and that directly impacts what happens to your body. Your body image is the mental picture you have about the way you think you look. It involves how you feel about your body’s shape, look, overall size, and weight. You might be a normal weight, but if you think you’re overweight and unattractive, this could influence the way you eat and exercise. Just the same, if you really are overweight and much larger than what is considered healthy for your height but see yourself as a normal size and weight, then you might be less inclined to make the necessary changes to improve your health risks.

Having a healthy body image also means having a true understanding of whether or not you are at a healthy weight and, if you aren’t, an acceptance of the idea that you need to make some behavioral changes.

There are many self-assessment tools available to help you better understand your body image. Here is a quiz that I find simple, direct, and extremely useful. It is the Villanova University Body Image Self Quiz. It helps measure how comfortable you are with your body and how accepting you are of yourself.

JOURNALING

You might have heard of a dieting journal, and maybe you’ve even kept one in the past. Whatever your past experience with journaling, I need you to wipe the slate clean and commit yourself to starting a new one.

Journaling is one of the most effective weight-loss tools you can take on your journey. The cost is minimal—just a notebook and a writing instrument. Keeping an honest journal is another means of helping you maintain a sense of where you are. It’s important that you log information that will give you a clear picture of not only what you eat and what type of physical activity you’re doing, but also your mood throughout the day. Journaling allows you to identify areas of weakness that can be improved and areas of strength that you should build upon as you go through THE 4 DAY DIET program.

Before starting the diet, you should journal for ten days, keeping track of everything and recording as many details about the activity as possible: After these ten days, study your entries and identify your strengths and weaknesses. Some people like to keep journaling and there’s nothing wrong with continuing if you’d like to. But for the purposes of beginning an assessment of where you are and gathering information, ten days is enough. Make sure you’re as specific as possible in your entries. For example, instead of simply writing that you ate carrots for a snack, write that you ate half a cup of carrots. Instead of writing that you exercised in the morning, write that you performed 30 minutes of cardiovascular exercise of moderate intensity.

Excerpted from The 4 Day Diet. by Ian K. Smith, M.D.
Copyright © 2008 by Ian K. Smith, M.D.
Published in January 2009 by St. Martin’s Press.
All rights reserved. This work is protected under copyright laws and reproduction is strictly prohibited. Permission to reproduce the material in any manner or medium must be secured from the Publisher.