Slim and Trim
Measuring the weight of the nation or considering your weight is not necessarily a comment on whether skinny or portly looks better. Rather, it is a fact that your body weight serves as a relatively easy measure of a potential host of problems. Without question, diabetes, high blood pressure, certain cancers, dementia, arthritis, and heart disease afflict more people who are obese. To decrease your risk of chronic illness, to lower your health-care costs, and to enjoy the best odds of avoiding illness and hospitalizations, we have to talk about your weight.
The Centers for Disease Control has been publishing state-by-state graphs of the number of obese citizens as a percentage of the total population since 1985. When I began practice in 1990, only one state classified over 20 percent of its adult population as obese (Mississippi). Now there are only five states with 20–25 percent obesity, with all others being higher than that!1 In fact, four states, all southern, now have more than 35 percent of the adult population obese. Louisiana holds the ominous title of the most obese state with 36 percent. Obesity exceeds 30 percent of the adult population in half of the states in the United States.
The equation for why obesity is skyrocketing is complex. The widespread availability of cheap processed foods in stores, fast-food restaurants, school vending machines, and even hospitals and gyms is surely a major part of the problem. Sedentary lifestyles, where people are glued to smartphones, tablets, and game stations, is another big piece of the problem. Environmental toxins from plastics, pollution, linings of cans and fast-food containers, and other sources is part of it by introducing endocrine-disrupting chemicals into the bodies of young children. Poor sleep contributes to some of the problem. Stress is a factor too.
While the cause of the rise of obesity is complex, a solution that is supported by a large and robust amount of literature is the Plant-Based Solution. This is truly a secret that needs to be shared. The solution is in the produce department at your local grocer. The Plant-Based Solution can return your waistline to a healthier and smaller state. But will it work for you? It worked very well for Allan.
CASE STUDY
The Round Podiatrist Who Learned to Run
I have known Allan for over forty years. We grew up in the same neighborhood a few years apart. I went on to medical school, and Allan pursued training in podiatry. Over the years, we lost touch but reconnected on social media. Since we had been in contact many years earlier, Allan’s weight had increased to 284 pounds on a five-foot, seven-inch frame. His joints ached from the statin drugs he was using to lower his cholesterol, he was winded walking up a flight of stairs, and he was taking blood pressure medicine daily. He wore a mask on his face at night for sleep apnea. He knew he was on a path to disaster and was looking for a way out that would work long term. Allan decided to make a New Year’s resolution and go for a health change after reading my social media posts every day praising the Plant-Based Solution. He bought a vegan cookbook and a few new items like kale, quinoa, steel-cut oats, and farro, and Allan started cooking.
When I last talked with Allan, he said, “It’s coming up on three years now, and I have lost 110 pounds. My waist is thirty-two inches, and my shirts are now M instead of XXL. I am off statins, and my cholesterol is 137. No more blood pressure pills. No more need to wear a CPAP mask for sleep apnea either. I had an overnight sleep study done, and my sleep apnea has disappeared. After losing about 100 pounds, I started running. I got my distance up to 5K and have moved that to 10K distances. I kind of look forward to it now.” Allan’s low cholesterol level is impressive and meaningful because several doctors, including world-famous pathologist William Roberts and Cleveland Clinic legend Caldwell Esselstyn, indicate that a total cholesterol under 150 mg/dl, like Allan’s, can make you essentially heart attack proof. Good job, Allan.
Allan has also begun writing a blog that includes simple recipes he prepares that are plant-based and oil-free. His renewed energy and his commitment to health and weight loss using natural methods have made him a local hero who inspires many to follow his path. I am certain he will never return to an obese body size because he had the willpower to change and found that simple, plant-based cooking allowed him the skill to succeed. Allan is a vegan badass, and I am in awe of the changes he has made. But he will tell you, if he could do it, you can do it too. 
Study In-Depth: The National Cholesterol Education Program Diet Versus a Vegan Diet
Can you really trust the science that the Plant-Based Solution is the answer to your weight issues? You may recall the name Neal Barnard, of the Physicians Committee for Responsible Medicine, for his original research, which was highlighted in the previous chapter. Dr. Barnard contributed to another landmark paper regarding plant-based nutrition, this time on long-term weight loss.2 Sixty-two overweight, postmenopausal women followed a plant-based diet for fourteen weeks. Individuals in the vegan group lost more weight than those who followed a diet endorsed by the National Cholesterol Education Program (NCEP) at one year (eleven pounds versus four pounds) and at two years (seven pounds versus two pounds). The participants who were offered group support lost more weight at one year and two years than those without support. Attendance at meetings was associated with improved weight loss at one year and two years.
The authors concluded that a vegan diet was associated with significantly greater weight loss than the NCEP diet at one and two years. Both group support and meeting attendance were associated with significant weight loss at follow-up. This is science at its best. A tough problem, a well-designed study, and meaningful results. If you will ditch the meat, add the veggies, and get some friends doing the same, you will see your waistline decrease. And wouldn’t that feel nice?
Science Corner: Plants and Weight
If you need more data that eliminating animal products and eating exclusively plant foods can control your waistline, let me tell you about another study conducted by Neal Barnard and other researchers. Dr. Barnard and his team performed a randomized study of diet and weight loss, this time in a work setting.3 Employees from ten sites of the GEICO insurance company who were either overweight or had a diagnosis of diabetes followed a low-fat vegan diet with weekly group support and work cafeteria options available for eighteen weeks. Mean body weight fell six pounds in the low-fat vegan group and not at all in the control group. Along with the weight loss, the low-fat vegan diet resulted in lower cholesterol and blood sugar. The people who completed the study to the very end lost even more weight overall.
You can actually use your work site as a place to kick off your plant-based health plan. All you have to do is develop the habit of packing low-fat, plant-based meals in your lunchbox and you may be on your way to a slimmer waistline. Get a group to do it with you and your success increases.
More Proof That a Plant-Based Diet Leads to Weight Loss
A meta-analysis is a research technique that combines several similar studies and analyzes the overall results, which are larger and may be more powerful. A meta-analysis was performed on twelve randomized studies of weight loss involving 1,151 subjects who were studied on average for eighteen weeks.4 Subjects assigned to vegetarian diets lost more weight than those assigned to non-vegetarian diets, with the most weight loss in those eating a vegan diet (five to six pounds). Of course, studies that limited calories showed more weight loss overall.
In another study designed to examine the role of plant-based diets on weight loss, five different diets were compared for six months.5 Overweight adults between the ages of eighteen and sixty-five were put on a low-fat, low–glycemic index diet that was either vegan, vegetarian, pesco-vegetarian (fish and plants), semi-vegetarian, or omnivorous. At six months, the weight loss in the vegan group (sixteen pounds) was significantly greater than the other groups. Vegan participants also decreased their fat and saturated fat more than the pesco-vegetarian, semi-vegetarian, and omnivorous groups. The study indicated that vegan diets may result in greater weight loss than more modest recommendations.
Let’s turn again now to that very special church in Loma Linda, the SDA, and healthy diets. Researchers assessed the body-mass index (BMI), which is used as a measure of body weight, of 22,434 members of the SDA Adventist Health Study. Normal BMI is between about 18 and 25. BMI was lowest in vegans (a score of 24), higher in lacto-ovo vegetarians (26), higher yet in pesco-vegetarians (26.3), climbing more in semi-vegetarians (27), and peaked out (29) in non-vegetarians.6 These data strongly suggest that a nutrient-dense, plant-based diet is the best path to sustained weight loss and management.
CASE STUDY
The Comedian Who Laughed Last
Comedian and magician Penn Jillette, of Penn and Teller, knew he was in trouble. Despite his six-foot, seven-inch frame, the Vegas headliner weighed 330 pounds, and his blood pressure was spiking, which sent him repeatedly to the emergency room. He was facing bariatric surgery as he approached his sixtieth birthday. He realized that extreme results would require extreme measures, so he adopted a plant-based diet of about 1,000 calories a day and lost just under one pound a day. He ate no animal products, no processed grains, and no added sugar or salt. He patterned his weight loss after the program of Dr. Joel Fuhrman, stressing nutrient-dense foods but took it further than most. He ate only potatoes for two weeks but then added in large amounts of spinach, oranges, blueberries, cayenne pepper, and cacao powder.
Jillette got what he wanted from his weight loss: He’s healthier and lost over 100 pounds without surgery. He has kept it off for over a year and allows himself to splurge a bit once every two weeks. He has managed to make the plant-based diet work on the road and has restaurants prepare him simple plant-based meals without oil. Although most of us do not need to lose over 100 pounds, the results obtained by Jillette are a reminder that if you take away the foods that inflame and irritate the body and replace them with WFPB foods, the body will tend to heal itself.7
Plant Rant
Diets patterned after the Atkins plan, using low-carbohydrate, high-fat eating patterns, can lead to short-term weight loss in studies. Trading short-term weight loss for the long-term adverse consequences of LCHF diets, including reports of increased death rates, is simply not reasonable or advisable. The Adventist Health Study makes the point that vegan diets win the race for the best dietary pattern for long-term weight management. It is the dietary pattern you should adopt.
THE PLANT-BASED PLAN Build Your Snack Arsenal
Having a variety of healthy snacks available can set you up for success on your plant-based diet, especially when you are transitioning. Plan ahead to have healthy options available, so you aren’t tempted by something simply because it’s easy:
• Apple or banana with nut or seed butter
• Hummus with gluten-free crackers or veggies
• Celery with nut butter and raisins
• Smoothie
• Granola and plant milk
• A handful of nuts and a piece of fruit
• Crispy chickpeas: drained and rinsed chickpeas, tossed with olive oil and salt, baked until crunchy (about 1 hour)
• Kale chips: destemmed, torn curly kale leaves, tossed with olive oil and salt, baked until crisp (about 20 minutes)
• Energy balls: In a food processor mix 1 cup pitted dates; ⅔ cup oats; 3 tablespoons nut or seed butter; 1 tablespoon chia, hemp, or ground flax seeds. Stir in ¼ cup chocolate chips or cacao nibs. Roll into golf-ball-sized rounds. Refrigerate.
• Tortilla chips and guacamole or salsa
• Store-bought options: seaweed snacks; individually packaged nut butters; baked plantain chips; granola bars; banana, apple, or kale chips