CHAPTER 7

The Every-Other-Day Success Program: The Science-Proven Way to Keep the Weight Off

Five out of six dieters regain their weight; you won’t be one of them

You’ve probably heard the famous Mark Twain quote about quitting smoking. “It’s easy,” he said. “I’ve done it hundreds of times.” Many of us could say something very similar about losing weight, and that probably includes you. If you’re reading this book, it’s likely you’ve read other diet books, tried their diets, lost weight, and then gained the weight back—every single pound, every single time. Welcome to the club, which has about 100 million members.

A recent national survey found that 55% of American adults are currently on a weight-loss diet. But research also shows that 5 out of 6 people who diet and lose weight subsequently regain their weight—all of it, after just one year. That’s right: for every 6 people who go on a diet and lose weight, only 1 is trimmer a year later. And scientists now understand why.

THE REASONS YOU REGAIN THE WEIGHT

When you lose a lot of weight, your body’s metabolism—the pace at which it burns calories—resets itself. Moment by moment, day by day, you burn fewer calories than you did before you lost weight.

Scientists call this phenomena adaptive thermogenesis. They don’t know exactly why it happens. But they do have an evolutionary theory, which could be called the Survival of the Fattest. It posits that the body has a mind of its own; when you dieted, it thought its food supply was threatened. Now it thinks it has to preserve fat for you to stay alive. So your body has decided to burn fewer calories—for the rest of your life, which it hopes is as long as possible.

Say, for example, that you weighed 250 pounds, lost 50, and now weigh 200 pounds. If you compare your daily caloric needs to an adult who has always weighed 200 pounds—an adult who has never dieted—you, the ex-dieter, need to eat 15% to 25% fewer calories to maintain the same weight of 200 pounds. That’s because the calories the ex-dieter takes in are burned much more slowly than the calories the “always-200-pounder” ingests.

A moderately active man who has trimmed down to 200 pounds has a daily maintenance level of about 3,250 calories. But postdiet, he needs to eat only about 2,500 calories to maintain his weight, or 750 calories less per day than a similarly active man who has always weighed 200 pounds. That’s nearly an entire meal less, every day!

Forgoing an entire meal every day is no picnic—literally! Five out of six of us can’t do it. And 5 out of 6 of us regain the weight.

There’s a second reason why weight regain is so common. During traditional dieting, you shed metabolically active, calorie-burning muscle along with fat, which further interferes with your ability to burn up rather than store postdiet calories. And if you regain weight, you’re likely to regain most of it as fat, which is why many dieters don’t just return to their old weight; with less muscle to burn calories, they end up heavier than ever.

Another reason you regain weight: Your body doesn’t only reset its metabolism after a significant weight loss to protect you from starvation. It’s a lot smarter than that. It also starts to pump out a different ratio of the hormones that control your appetite. You manufacture more ghrelin, the hormone that increases hunger. You manufacture less leptin, the hormone that decreases hunger. In short, you’re hungrier. And you eat more.

THE EVERY-OTHER-DAY SUCCESS PROGRAM: REVERSING THE REASONS FOR REGAIN

So your metabolism has slowed to a crawl, forcing you to eat about one-third less than a nondieter to maintain the same weight. There’s a hunger hormone sitting on your shoulder like a devil, whispering, Eat, eat, eat. And to make matters worse, a bunch of your muscle has abandoned ship. What’s a dieter to do?

Well, other diet books either ignore this rebound effect or mislead the reader about it, assuring dieters they won’t regain their weight—with no scientific evidence to support the claim.

The Every-Other-Day Diet is different. I don’t avoid or whitewash this issue. Instead, I offer the Every-Other-Day Success Program—a new, every-other-day pattern of eating, similar to the diet itself, but not as low in calories. Once you reach your goal weight, you start the EOD Success Program. And like the Every-Other-Day Diet, the Success Program is supported by scientific research—my newest research, which shows that people who lose weight on the EOD Diet and then go on the Success Program don’t regain that weight. Before we get to those spectacular results, I’m sure you’re wondering just how the Success Program works.

WHAT IS THE EVERY-OTHER-DAY SUCCESS PROGRAM?

You transition to the EOD Success Program as soon as you reach your goal weight. And the essence of the program couldn’t be simpler:

My study participants were asked to limit their calories every other day, and they did—but only during the week! Most of them decided to take the weekend off. And that turned out just fine. They still maintained their weight loss and all the other healthful changes they had achieved while on the EOD Diet. (And that was okay with me. As a scientist, I’m most interested in what really works, not an approach I think might work.)

During the EOD Diet, Diet Day typically consisted of one 400-calorie meal and one 100-calorie snack. During the EOD Success Program, Success Day consists of two 400-calorie meals and two 100-calorie snacks. You can consume those meals and snacks in any pattern of daily eating that you prefer—one large meal, three smaller meals—as long as you don’t exceed 1,000 calories.

Feast Days are the same as they were on the EOD Diet: eat all the food you want, and eat any food you want. However, because this is a lifelong program, my study participants were counseled about healthy food choices and lifestyle habits to support a lifetime of weight maintenance and good health. You’ll find similar information later in this chapter. But before getting to that practical info, let’s take a closer look at the results of my study on the Success Program—results that will give you the confidence you need to embark on this lifelong journey to weight maintenance.

SPECTACULAR RESULTS IN WEIGHT LOSS AND IN WEIGHT MAINTENANCE

In chapter 1, I describe the results of many of the studies I’ve conducted on the Every-Other-Day Diet, including the results from the first year of an ongoing three-year study sponsored by the National Institutes of Health (NIH). But the NIH study is unique. It doesn’t just look at the Every-Other-Day Diet. It also looks at the Every-Other-Day Success Program.

This three-year study consists of three one-year experiments. For the first six months of the year, the participants are on the EOD Diet, losing weight. For the next six months they are on the Every-Other-Day Success Program, maintaining weight.

I’m delighted to report (as I did in November 2013, at the annual “ObesityWeek” conference, the world’s most prestigious conference on obesity and weight loss1) that both every-other-day programs work: on the Every-Other-Day Diet people shed pounds; and on the Every-Other-Day Success Program people maintain that weight loss. Let’s take a closer look at those results—and what they mean for you.

You’ll eat fewer calories automatically. The Every-Other-Day Success Program was originally designed to provide 50% of normal calories on one day (Success Day) and 150% of normal calories on the next (Feast Day). My first surprise: hardly anybody could eat 150% of their Feast Day calories in a single day! The study participants topped out at an average of 125%.

In other words, whatever metabolic and hormonal forces were in play, the unique effect of EOD eating stopped those former dieters from overeating. They automatically ate the more limited amount of calories necessary for weight maintenance!

You’ll keep losing weight—and keep it off. If you’re sitting down, stand up and cheer! Because the study results are worth celebrating.

While on the EOD Diet, the participants in the study lost from 15 to 50 pounds, with an average loss of 25 pounds. While on the EOD Success Program, those same dieters gained back an average of 1 pound. (That’s right—1 pound.)

Bottom line: Participants hardly regained any weight. They maintained their weight loss. Where 5 out of 6 dieters on other diets failed, they succeeded. And they did that by continuing the EOD pattern: eating 1,000 calories one day and all they wanted the next.

You’ll lose fat, not muscle. As I pointed out previously, people lose 75% fat and 25% muscle on a typical diet, and shedding all that muscle sabotages the ability to maintain weight loss. In this study, as in all of my previous studies on the Every-Other-Day Diet, the participants shed most of their weight as fat, and very little as muscle.

The average weight loss was 25 pounds:

  • 23 pounds of that was fat;
  • 2 pounds was muscle

That’s a big reason why the Every-Other-Day Success Program is a success.

You’ll bust belly fat, big-time. The EOD Diet whittled away the waistlines of the study participants, with an average decrease of more than 5 inches. (The men lost more belly fat than the women, because they had more to begin with.) And that extra abdominal fat wasn’t regained on the Success Program:

  • Belly fat lost on the EOD Diet: 2 to 6 pounds
  • Belly fat regained on the EOD Success Program: 0 pounds
  • Average waistline reduced on the EOD Diet: 5½ inches
  • Average waistline regained on the EOD Success Program: 0 inches

Trimming tummy fat does more than boost your self-esteem and help you get back into your skinny jeans. A bulging belly is the outward sign of excess visceral fat, the “deep” fat that wraps around your inner organs and ruins your health. Every extra pound of visceral fat translates into higher risk for heart disease, stroke, and type 2 diabetes. Likewise, every pound you lose lowers your risk.

You’ll continue to protect your heart. In my NIH study, participants lowered their LDL cholesterol by an average of 11% during the diet, and that decrease continued during the Success Program. They lowered their blood pressure by an average of 9 points, and that drop continued during the Success Program. They decreased their fasting glucose by 8% (high glucose is a risk factor for both heart disease and type 2 diabetes), and that decrease continued during the Success Program.

As you can see, both the Every-Other-Day Diet and the Every-Other-Day Success Program work.

  • You lose weight and don’t regain it.
  • You lose fat (but not muscle), and the fat stays away.
  • You trim inches off your waistline, and they don’t inch back.
  • LDL cholesterol drops and stays down
  • Blood pressure lowers and stays lower.
  • Glucose levels fall and don’t go back up.

KEEP UP THE GOOD WORK!

There are a lot of habits I recommended that you start while on the EOD Diet, to help you maximize weight loss and good health, and I hope you keep on doing them! We’ll review them below.

Get regular exercise. In chapter 6, I discussed the power of combining the Every-Other-Day Diet with regular exercise and introduced you to a pedometer-based walking program. If you started walking (or doing any other type of regular exercise) while on the EOD Diet, congratulations—don’t stop now! Here’s why. A national registry of thousands of people who have lost weight and kept it off for at least one year shows that 94% of them increased their physical activity level. Most of them did so by walking.

And when researchers at Harvard Medical School studied more than 4,500 women age 26 to 45 who had lost weight, they found that those who added just 30 minutes of physical activity to their daily routine (brisk walking was a favorite) were 52% less likely to regain a lot of weight in the two years after they shed the pounds.2

If you haven’t read chapter 6—“Every-Other-Day Dieting and Exercise”—I strongly encourage you to do so. And I also strongly encourage you to do what that chapter says to do: exercise regularly, using either the pedometer-based walking program described in the chapter or some other form of exercise.

Weigh yourself every day. Studies show this habit not only helps with weight loss, but also with weight maintenance, as we discussed earlier. If, for whatever reason, you see the pounds creeping back on, go back on the EOD Diet until you’ve returned to your goal weight—and then restart the Success Program.

Drink plenty of water. Drinking an 8-ounce glass of water 15 or 30 minutes before each meal is a great way to control hunger and calorie intake on Success Day, as we discussed earlier. Drinking water throughout the day also helps.

Chew gum. This is another simple habit that can improve your chances of long-term weight maintenance. It cuts hunger and appetite and increases alertness. It even burns a few extra calories.

 

MINDFUL EATING AND PORTION CONTROL: TWO OTHER KEYS TO WEIGHT MAINTENANCE

In addition to the tips we’ve already given you in this book, I want to discuss two others that will go a long way toward helping you maintain your weight loss.

Maintaining your weight loss isn’t just about what you eat. It’s also about why you eat. And what you do when you eat. Maybe there are times when you eat not because you feel hungry, but because you feel lousy. You use food to tranquilize negative emotions, ease stress, or relieve boredom. Maybe there are food “cues” that you always respond to—see a cookie, eat a cookie—whether you’re hungry or not.

And maybe there are times (maybe even most of the time) when you don’t pay attention to the smell and taste and sensual enjoyment of eating. Instead, you eat in a rush—in the car or in front of the TV—barely noticing the food.

Research links these three habits—what scientists call emotional eating, external eating, and distracted eating—to overweight and obesity. But there’s a habit that’s pretty much the exact opposite of emotional, distracted, and external eating. And many studies, as I’ll describe in a moment, link this habit to successful weight maintenance. It’s called mindful eating.

Mindful eating is being aware of your emotions and moods in the moment—not judging them, not trying to get rid of them, just observing and accepting them—and therefore not letting anxiety, depression, boredom, or stress compel you to eat when you’re not hungry.

Mindful eating is not letting old habits rule your life, but instead taking a step back—paying attention to your hunger and desires in the present moment—and deciding whether or not you really want those cookies. And even if you decide to eat cookies, maybe you decide to eat just one or two, and not the whole bag.

Mindful eating is paying attention to eating when you’re eating. You notice the smell, taste, and texture of the food, and you eat slowly enough to enjoy it. You don’t do anything else while you eat. Mindful eating is having an intention—maintaining your weight loss—and then having the attention to accomplish it.

I think mindful eating is one of the most powerful and important aids to success on the Every-Other-Day Success Program. The participants in my NIH-sponsored study were taught the skill. Plus, there’s a lot of scientific research supporting the role of mindful eating in controlling weight. Some recent studies found the following:

If you’re distracted, you eat more—a lot more. When a team of UK researchers analyzed studies on “eating attentively,” they found that people who were distracted during eating ate a lot more food—up to 76% more than people who were attentive while eating. “Attentive eating is likely to influence food intake,” wrote the researchers in the American Journal of Clinical Nutrition.3

If you eat mindfully, you eat smaller portions of high-calorie foods. In a study of 171 people published in the scientific journal Appetite, those who were more “mindful eaters” ate smaller portions of high-calorie foods.4

If you’re mindful, you have fewer cravings and do less emotional eating. In a study by Dutch researchers, 26 women took a training course in mindful eating and as a result had fewer food cravings, and did less emotional and external eating. “Mindfulness practice can be an effective way to reduce… problematic eating behavior,” wrote the researchers in Appetite.5

When you’re mindful, your brain is less preoccupied with food! Researchers at Wake Forest University School of Medicine conducted brain scans (functional magnetic resonance imaging, or fMRI) on 19 obese people after they ate breakfast and weren’t allowed to eat again for nearly three hours. Those with more mindfulness had “greater… efficiency” in their “brain networks,” indicating they were less preoccupied with eating again.6

Mindfulness = weight maintenance. Researchers at the Osher Center for Integrative Medicine at the University of California, San Francisco, studied 47 overweight and obese women, dividing them into two groups. One group received mindfulness training aimed at reducing “stress eating” and one group didn’t. After four months, the mindful group was less anxious, had less external-based eating, pumped out less of the stress hormone cortisol, and maintained their weight. Meanwhile, the nonmindful group gained weight.7

How to be a mindful eater

One of the top experts on mindful eating is Michelle May, MD, founder and CEO of the Am I Hungry? Mindful Eating Workshops, and author of Eat What You Love, Love What You Eat and several other books on mindful eating. Here are some of the key principles of mindful eating that Dr. May has shared with Bill. We’d like to note that Dr. May does not endorse the Every-Other-Day Diet, the Every-Other-Day Success Program, or any other weight-loss program or diet. But because her recommendations about mindful eating are uniquely insightful and effective, we wanted to share them with you.

Before you eat, ask yourself: “Why am I eating?” “People eat for reasons other than hunger,” Dr. May said. “Often the cues are emotional, such as loneliness, depression, anxiety, stress, or boredom. These cues override our internal cues of hunger and fullness, and send you in the direction of comforting, convenient, and calorie-dense foods. And because you’re not hungry when you start to eat, you don’t know when to stop. You eat until the food is gone.

“Instead,” she says, “ask yourself this simple question before you eat: ‘Why am I eating?’

“Put a speed bump—a pause—between wanting to eat and starting to eat. Take a moment to realize what’s really going on, whether you’re physically hungry or responding to an emotional cue. If you discover you’re not hungry, make a choice whether to use food to deal with something that isn’t a physical need for food or to redirect your attention to something else until you’re actually hungry.”

Learn to recognize the physical signs of hunger. How can you tell whether or not you’re hungry? Scan your body—particularly your stomach—for physical signs, Dr. May advises. “Get quiet for a moment,” she said. “Scan your body from head to toe. Look for clues that your desire to eat isn’t hunger, such as tension in your body, or pain, or worried thoughts. Also look for clues that your desire to eat is hunger, like a hollow or empty feeling in your stomach, or rumbling and growling. Do this scan whenever you feel like eating, and also about every three hours throughout the day, to see if you’re truly hungry and need to eat.”

Redirect your attention. If you’re not hungry, one strategy is to distract yourself rather than eat, Dr. May said. Go for a walk. Pet your dog. Take a shower. Brush your teeth. Do your nails. Or, if you’ve identified the underlying emotional need that you’re looking for food to satisfy, meet the need instead, in a small way. “Maybe you’re overworked and stressed out and need a vacation,” Dr. May said. “Take a few minutes to surf online and look at a travel site, or visualize being on vacation and resting in a hammock, or take a few deep breaths.”

Learn to recognize when you feel full. Being able to decide not to eat when you’re not hungry is one feature of mindful eating. Deciding to stop eating when you’re comfortably full is another.

“Mindful eating is not about being good but about feeling good,” said Dr. May. “Identify signs of fullness and stop when you feel comfortable. A smart idea for figuring out when you’re full: set an intention before you eat. Ask yourself, ‘How do I want to feel when I’m done?’ You probably want to feel good, energetic, and satisfied, not bad, tired, and stuffed,” Dr. May said.

PORTION SIZES: DON’T SUPERSIZE YOURSELF

There’s another habit that’s probably every bit as important as mindful eating: controlling portion size. In fact, many nutritional scientists think the trend toward ever-bigger portions—in supermarkets, restaurants, convenience stores, at home, and even in cookbooks—is the main reason why so many us have become overweight or obese. There’s a lot of evidence supporting that perspective. For example, researchers in the Department of Nutrition at the University of North Carolina at Chapel Hill analyzed 30 years of scientific data to find out why Americans were eating 600 more calories per day in 2006 than they were in 1977. They discovered two main reasons: the increase in portion sizes; and the increase in the number of times per day we eat and drink.8 During those 30 years, the average amount of food/drink consumed per “eating occasion” increased by 2.3 ounces per occasion. And those extra ounces add up pounds more quickly than ever, because we also had an average of 4.9 eating occasions per day in 2006, compared to 3.8 in 1977.

A few other alarming facts, courtesy of Brian Wansink, PhD, a professor at Cornell University and author of Mindless Eating: Why We Eat More Than We Think:9

There are two main reasons why all of this supersizing causes us to overeat, according to Dr. Wansink:

The Every-Other-Day Success Program helps you control portions by alternating the 1,000-calorie modified fast of Success Day with Feast Day—you don’t overeat automatically. But to limit those portions can’t hurt.

Science-based tips for portion control

Bill and I reviewed the last decade of studies on portion control to find the best, science-proven ways to help you manage portions on Success Day and Feast Day:

Use your plate to control your portions. Researchers at the Mayo Clinic studied 65 obese people, dividing them into two groups. For six months, one group used a “portion control plate” for their meals; they lost nearly five times more weight than those who did not use the plates.10 In a similar six-month study, published in the Archives of Internal Medicine, obese people with type 2 diabetes using portion control plates lost 18 times more weight than a similar group not using the plates.11

In the Mayo study, the plate was clear glass with black print that divided it into three parts: one-half was labeled “vegetables”; one-quarter was labeled “fish, lean meat, chicken & nuts”; and one-quarter was labeled “potatoes, pasta, rice, beans and whole grains.” The study participants were instructed to use the plate for their main meal and encouraged to use it for every meal.

I think dividing your meals into half vegetables and fruits, one-quarter protein, and one-quarter starch is a great (and easy) way to control your portions. Those portion sizes also match the latest recommendations from the USDA, where “MyPlate” (www.choosemyplate.gov) has replaced the food pyramid as the government’s main nutritional advice. The USDA also recommends several daily servings of low-fat dairy; I think that’s also a helpful strategy for weight maintenance.

You don’t even have to imagine the portions: you can buy portion control plates like the kind used in the Mayo study, at every level of elegance and price, in retail stores and online. Examples include Lifestyle Dinner Plates from Precise Portions, the Portion Plate from beBetter Health, and Portion Conscious Dinner Plates from Slimware.

Increase the portion of fruits and vegetables. If you want to lower your calories, increase the portion of vegetables and fruits and decrease the portions of protein and starch. A study from researchers at Pennsylvania State University published in the American Journal of Clinical Nutrition showed that slightly increasing vegetables and slightly decreasing protein/starch decreased the overall calories of a meal by 14%.12

Serve food from smaller bowls. When people used a large bowl to serve pasta, they served 77% more than when using a medium-sized bowl, reported Dutch researchers in the Journal of Nutrition Education and Behavior.13

In a similar study, people given large bowls (34 ounces) and large ice-cream scoops (3 ounces) served themselves 53% more ice cream than people given medium-sized bowls (17 ounces) and medium scoops (2 ounces).

When people at a Super Bowl party were served from either a half-gallon or 1 gallon bowl, those eating from the larger bowl served themselves 53% more snacks—and ate 92% of what they’d served.

And when moviegoers were given free medium-sized or large buckets of popcorn to eat during the movie, those with the large buckets ate 51% more popcorn.

Buy smaller packages. “A shopper can buy smaller sizes, or create their own single-portion servings by subdividing the bargain-size bag into smaller ones,” writes Dr. Wansink. During mealtime, keep the large packages or containers off the table and out of sight, he adds. That goes for beverages, too, of course. Research shows we get 21% of our daily calories from beverages, nearly double the amount in 1965.

Buy smaller snacks. People given 100-calorie snacks for a week ate 841 fewer calories from snacks compared to people given standard-size snacks, reported researchers from the University of Colorado.14

Order less at restaurants, or take some home. In one study, increasing a restaurant’s portion size of pasta by one-third increased calorie intake by 43%, adding 172 more calories. “These results support the suggestion that large restaurant portions may be contributing to the obesity epidemic,” wrote the researchers in Obesity Research.15

Don’t count on well-meaning chefs to protect you. A study by researchers at Clemson University, published in Obesity, found that the majority of 300 executive chefs believed “large portions are a problem for weight control.” Seventy-six percent of those chefs also claimed portions in their restaurants were “normal.” But the researchers found that the portions of steak and pasta the chefs were actually serving were two to four times larger than the healthy portion sizes recommended by the government.16

What to do? “Consider splitting an entrée, or ordering an appetizer as your entrée, or having half the dinner packaged to go,” advises Dr. Wansink.

Eat bigger portions of high-volume, low-calorie foods. Decreasing portion size by 25% led to a decreased mealtime intake of 231 calories in a meal, reported researchers from Pennsylvania State University. But so did increasing the portions of low-calorie, high-volume foods, like fruits, vegetables, soups, and low-fat milk—all of which allow you to eat and drink big portions of food without getting a lot of extra calories. “Reductions in both portion size and energy [calorie] density can help to moderate energy intake,” wrote the researchers in the American Journal of Clinical Nutrition.17

Go to bed—you’ll eat smaller portions tomorrow! Yes, getting enough Zzz’s may mean eating smaller portions. In a study from Sweden, people who got less sleep chose breakfast portions that were 14% larger and midmorning snacks that were 16% larger, compared to people who had a good night’s sleep.18

These changes and the diet and lifestyle tips in this chapter are for a lifetime of good health. No need to rush! If you make these changes slowly, you’ll make them successfully. And you’ll be rewarded by the intense satisfaction of being one of the few dieters who have lost weight and kept it off!

 

THE KEY WORD IN THE EOD SUCCESS PROGRAM IS SUCCESS!

Whether you bought this book to lose those last 5 or 10 pounds or an extra 20, 30, 40, or more; whether you’ve never dieted before or failed at every diet you’ve tried, I know you’re going to find success with both the Every-Other-Day Diet and the Every-Other-Day Success Program. And I know it the way a scientist knows: because my careful, repeated studies show that the weight-loss and the weight-maintenance programs described in The Every-Other-Day Diet actually work.

The Every-Other-Day Diet works to help you lose weight—whatever your weight-loss goal, I know you’ll reach it!

The Every-Other-Day Success Program works to help you keep the weight off—if you follow the program, I know you won’t regain the pounds you shed.

It’s been my pleasure to bring the EOD Diet and Success Program from the pages of scientific journals to the pages of this book, and into your life. Bill and I wish you the best, for a trim and healthy life!