My name is Dr. Conrad Smith and I am the Medical Director of the Medical Nutritional Institute. We have been researching the science behind weight loss for seven years, testing various different weight-loss methods and products for their effectiveness, practicality and sustainability. During the process we also treated numerous overweight patients suffering the consequences of the metabolic syndrome at our national network of pharmacy clinics. Our aim was to increase their weight-loss success rate in order to improve their health. Towards the end of our research phase, we managed to achieve a twelve week success rate of 97.3%, thereby establishing, what we believe, to be a new industry record. My involvement has convinced me of two things:

A) Everyone can lose weight.
B) It is certainly not as easy as what many people would have you believe!

Allow me to share my personal observations with you. I will also discuss some of the common pitfalls and give you some basic guidelines that you can use to increase your weight-loss success rate. Once you understand these basics, you will realise how ridiculous many weight-loss myths really are and how it actually increases your chance of failure, rather than success.

Harsh reality no 1: There is no magic wand!
Unless you have the budget for liposuction or are prepared to risk living with the potential side effects of gastric bypass operations, please accept that there are simply no magic wand or quick-fix weight-loss solutions. Numerous advertisements guarantee maximum weight-loss results over a minimum time. If these really worked, why then is the world’s obesity epidemic still growing at an alarming rate?

Harsh reality no 2: You need insight and proper guidance.
There is always a good reason for your weight problem. Do you really know what it is? Are you an over-consumer of energy or are you an over-efficient conserver of energy? Are you perhaps a bit of both?  Has your body changed over time and is it now more difficult for you to lose weight than ever before? If so, what happened and can something be done to improve your situation?

Harsh reality no 3: Your genes are stacked against you and will follow you around for the rest of your life...
In order to survive famine we’ve   been programmed to eat more than we need. This tendency is encoded in the hard-drives of our brains and is impossible to ignore, making it difficult for us to eat less. In addition, numerous other distractions interfere with our eating patterns. Some, like hunger, cravings or low blood sugar, are easy to identify and control. Others, like depression, anxiety, attention deficit disorder, compulsive overeating, etc., are medical conditions which require diagnoses and expert treatment.

To complicate the issue, energy restriction also comes with another problem: not for those who eat too much, but for those who store too much energy! There are many people who have a weight problem due to their hyper-efficient energy-storage mechanisms and slow metabolisms. To give these individuals an instruction to eat even less, makes no scientific sense. Although they will lose weight on a starvation- type diet, it only serves to further drop their metabolic rate and increase their energy-storing ability.

Harsh reality no 4: Hormones control you and your metabolism. Harness the help of the ones that are of practical value! Then, ignore the others...
The hormonal or endocrine system is responsible for regulating most biochemical processes which take place within the body. These processes can all be switched on, turned up or down, or switched off, directly as a result of the relative hormone responsible. Their functions are determined by their design and they are therefore only able to “touch or tweak” certain “levers and switches”. The medical term for the “levers and switches” that hormones interact with is “receptor” and every cell in the body has many of these. Receptors mimic door locks, allowing only certain keys (hormones) to unlock them. Once “unlocked” or activated, numerous biochemical processes begin within the cell.

It is common for patients with a weight problem to blame their hormones. At the Medical Nutritional Institute we totally agree with them. The only problem is that although many people have inherited a combination of hormonal tendencies which lead to the excessive storage of fat or consumption of food, the knowledge thereof offers little or no practical value. Treating the endocrine system is in some ways like trying to fix a computer with a crowbar.

Most people believe that the thyroid hormone is the main driver of the human metabolism. This is a scientific fallacy.  Ask any medical student to show you their physiology textbook – the hormone insulin is by far the most metabolically active substance in the body and dominates your metabolism. Most people with a weight problem have a perfectly normal functioning thyroid gland, producing more than enough sufficient hormones for their bodies. If you have had your thyroid function assessed in the past and it was normal, my advice to you would be to stop worrying about it. Insulin, however, is a hormone which you need to be concerned about. If you’re not, there is a good chance that you will never successfully control your weight.

Each cell in the body needs a continuous supply of glucose to satisfy its energy requirements. Glucose, however, cannot penetrate the outer membrane of a cell without the assistance of insulin. Insulin plays the role of gatekeeper, opening the “door” for glucose to gain access across the cell membrane. Besides this essential role, however, insulin also has some other functions disastrous to those with a tendency to gain weight. Instead of preserving life, (like in the days of the caveman), these functions now reduce the life expectancy of modern man and increase our  chance of developing degenerative diseases like diabetes, heart disease and cancer. But it didn’t start out like that…

In the beginning when food was scarce, insulin protected the caveman from starvation during periods of famine by stockpiling energy during the good times. Insulin did this by stimulating the caveman's body to convert glucose into fat and then helping it to store this fat inside his fat cells. In addition, insulin also prevented the caveman from wasting his valuable store of winter fat by actively blocking the release of fat from his fat cells, using a different biochemical mechanism.

Unlike the caveman of the past, modern man does not have to survive long periods of famine and uses significantly less energy to find food and keep warm. Modern man also eats food with a much higher energy content.  For genetic survival purposes, however, insulin still faithfully does the same job, converting all your excess energy into fat and squirreling it away into your fat cells. Once safely tucked away, insulin guards your fat by blocking its release from the fat cells.

How fat cells aggravate your weight problem.
Originally, fat cells were thought to have two functions, namely storing energy and keeping the body warm by insulating it. Recently, scientists have discovered that when they are filled with fat, fat cells also assume an hormonal function by releasing various chemical substances. For reasons not quite understood, these substances interfere with insulin's gate-keeping role relating to glucose and somehow renders insulin less effective. The medical term for this condition is insulin resistance. To get the same task done, the body compensates by producing more insulin and insulin levels rise above the norm.

Why can’t doctors solve the problem by just shutting your insulin production off?
This sounds like an excellent idea in theory, especially if you hear that in the absence of insulin all aspects of fat break down and its use in providing energy are significantly increased. This occurs normally between meals when insulin secretion is minimal and   becomes extreme when the pancreas fails and stops producing insulin, as in type 1, diabetes, (type 2 diabetes is very different). When this happens, fat stores are broken down so efficiently that rapid weight loss takes place.

Besides causing you to lose large amounts of weight, however, type I diabetes also makes your blood sugar and cholesterol levels soar, causing many other life threatening medical problems, which will significantly decrease your life expectancy if not treated correctly with regular insulin injections.

Is there any medical evidence that proves that insulin makes you gain weight?
Yes. Doctors deal with this evidence on a daily basis. Some type 2 diabetics cannot be successfully managed with oral medication alone and will eventually require regular insulin injections. A large study (UKPDS) showed that insulin therapy causes an average weight gain of 6.5 kilograms. Many oral ‘type 2’ diabetic medication also makes you gain weight because of a similar biochemical principle.

A visual example of insulin’s tendency to store fat can be seen at the site of the injection. If insulin is repeatedly injected into the same area, a localised lump forms under the skin.  These bulges are actually engorged fat cells refusing to release their content because of insulin blocking the release of fatty acids.

Can I perhaps be suffering from insulin resistance?
Are you finding that you are battling now, more than ever before, to lose weight? Then you may just in fact be suffering from the effects of insulin resistance. The good news is you don’t need a blood test - just check your waist circumference! Males more than 102 cm and females more than 88 cm will have a 90% chance of having insulin resistance, according to American guidelines. European guidelines are even more stringent, with 93 cm for males and 79 cm for females being the cut off.

Here is what others have to say about insulin resistance:

“For years I battled with my weight, trying various diets and products but never losing an ounce. One day my doctor checked my fasting insulin level and found it elevated - no wonder I was fighting a losing battle. By treating the condition properly, the weight has begun to drop off me at a constant rate and I am feeling years younger.”
H vd M - Alberton

“By focusing on my insulin resistance, I managed to lose 39 kilo's and could reduce my diabetic medication.”
GN - Sandton

“I wasted so much time in the past. Insulin resistance helped make me fat and then kept me fat. For the first time I am having satisfactory weight-loss results.”
FB - Douglasdale

Harsh reality no 5: The Forrest Gump exercise method may just be a bit too extreme for your liking.
I have no doubt you have been told that in order to lose weight, you should be exercising more. Whilst physical activity is crucial to good health, the truth is it doesn’t always help you lose weight – in fact, it may actually make you gain more.

More Americans are now exercising on a regular basis than ever before. Yet obesity figures in the States have risen dramatically in the same period. (Minnesota Heart Survey). Although exercise is good in that it lowers your risk of all sorts of diseases, ranging from heart disease and diabetes to cancer, many recent studies have found that exercise is not as useful as was thought in helping you lose weight. Let’s do the maths.... Doing a half hour’s worth of cardio-vascular exercise in the gym and then rewarding yourself with an energy drink, will make you gain weight. Why? You’ve just put more energy back into your system than you’ve burnt! Frankly, you would have been far better off having stayed at home lounging on the couch twiddling your thumbs.

Even worse, research has shown that rigorous cardio-vascular exercise often increases your appetite and makes you eat more. Evidence of the weight-gaining effects of exercise is reported in a study by Dr. Timothy Church - Public Library of Science. The basic problem, in other words, is that while it’s true that exercise burns energy necessary to lose weight, it may also stimulate your hunger. This increases your energy intake, making more difficult to shed those extra kilos.

“If you are more physically active, you’re going to get hungry and eat more,” said Steven Gortmaker, who heads Harvard’s Prevention Research Centre on Nutrition and Physical Activity. (Time Magazine, August 2009.) Gortmaker, in an eighteen month study involving 538 students, found that when his research participants started exercising, they also ate more, consuming, on average, 100 calories more than they had burnt. (International Journal of Obesity). His findings were supported by another study of the exercise and eating patterns of schoolchildren by the Peninsula Medical School (European Congress on Obesity). Another problem is that exercise may lead to a condition called compensatory eating. Muravan and Baumeister published a paper on dietary control in the Psychology Bulletin, 2000, showing how your self-regulatory capacity for dietary control becomes impaired with increasing levels of exercise.

Both the American College of Sports Medicine, as well as the American Heart Association advise that, in order to lose weight, you need to do between sixty and ninety minutes of physical activity on most days of the week.

Harsh reality no 6: Take care of your stumbling blocks before they take care of you.
One of the new strategies we developed at the Medical Nutritional Institute which enabled us to almost triple our weight-loss success rate, was to focus on what we call “stumbling blocks”. These are all the conditions that make dietary control a real struggle for you.

Some individuals, for example, gain weight because they eat too much. This could just be due to bad habits yet often stem from any one of the emotional stumbling blocks. Physical stumbling blocks like hunger, fatigue and especially low blood sugar, affect most of us. During the research and development phase of our LightHouse weight loss system, clients with slow metabolic rates posed a far greater challenge for us than those who consumed too much energy, with Insulin resistance proving a major medical stumbling block for most.

Only once a stumbling block is identified, can one implement a remedial solution. This minimises the stumbling block’s disruptive influence, making it easier for one to maintain the discipline needed to achieve weight-loss success.

Harsh reality no7: Desperation clouds your judgement.
There are many weight loss solutions on the market. Which one should you pick? Who should you ask for advice? Are they safe? If they include injections and “fat-burning” products, what do these actually contain? All these questions are extremely valid, especially if you consider that it just so happens to be your health and money that’s on the line. I tell my own patients to always ask the following 3 questions before making a final decision.

1) What would your own doctor say about your weight loss programme? Be assured, your doctor will be able to spot pseudo-scientific mumbo jumbo and snake-oil at a mile. If there is no promotional information available to show him/her, for example, a brochure or website, – BE CAUTIOUS.

2) If injections are involved, are you able to attain the names of the active ingredients to show your doctor? If they refuse – BE CAUTIOUS. Please do not accept the “because-its-so-effective-someone-may-steal-my-idea” nonsense. If vitamins are being injected, – BE CAUTIOUS.  All vitamins (including B12) can be taken in their oral form. There are numerous multivitamin tablets of excellent quality available.  Chances are, you will be injected for a “marketing gimmick” rather than for scientific benefit.

3) If tablets and mixtures are involved, ask for the same information. Has it been registered by the Medical Control Council of your country? If not – BE CAUTIOUS. Most homemade weight loss mixtures are a combination of the following: ephedrine, laxatives, diuretics, appetite suppressants and often, as we have found, copious amounts of thyroid hormone. Of course you will rapidly lose weight if you empty your colon and dehydrate yourself – but that’s not fat going down the drain!

Harsh reality no 8: Fat burning pills will burn your money, not your fat...
Ever wondered why your doctor has not prescribed you a metabolic booster or fat-burning tablet to burn away your excess fat whilst you sleep at night?

In spite of many marketing claims, the answer is quite simple. They don’t work. Agents like Apple Cider Vinegar, Capsicum, Coleus forskohlii, Caffeine, CLA, Garcinia (Hidroxi Citric Acid), Ginseng, Gotu kola, Synephrine, White willow bark and Yohimbe all make numerous weight-loss claims, but our investigation at the Institute revealed significant evidence that they do not work. Green tea extract, only in substantial quantities, however, is effective, and because of its additional health benefits is a worthwhile agent to consider.  

The most popular and certainly the most notorious agent to raise the metabolic rate is ephedrine, naturally occurring as ephedra in about 40 species of plants. Ma Huang, Mormon Tea and Sida Cordifolia are the better known sources of herbal ephedrine. Pseudoephedrine and norpseudoephedrine are common synthetic derivatives.  Ephedra functions bio-chemically as a sympatho-mimetic, mimicking some of the effects of the body’s own sympathetic (stimulant) hormones, such as adrenaline and noradrenaline. But ephedrine is also a non-selective sympathomimetic, which means that it acts on all the sympathetic receptors without discrimination affecting many parts of the body simultaneously (lungs, heart, blood vessels, adrenal glands, etc.). This explains the common side effects on the nervous and cardio-vascular systems such as elevated blood pressure, heart palpitations, insomnia, irritability, headaches, etc. For these reasons, most ephedra-like products are either under scrutiny or have been given a high scheduling registration by the Medicine Control Councils in most countries.

At our network of healthcare clinics, however, we have found that certain pharmaceutical products have greatly assisted many of our patients and made weight loss far easier for them. All medication works because of its biochemical effects on the body. Whilst these are mostly beneficial, there are always potential side effects that need to be considered.

Weight-loss products can be divided into the following categories:

Appetite suppressants
These do exactly what they say: they help to suppress your appetite. Fighting against hunger all day makes weight loss a real struggle. You may last in the beginning when your motivational levels are high, but your resolve will soon be whittled away and you may give up. This is where appetite suppressants can play an important role. Owing to their biochemical effects on the appetite centre in the brain, however, these suppressants may have unpleasant side effects, and you will need to ask your own doctor for guidance as well as a prescription.

Hoodia is the latest product to claim appetite suppression, but the scientific evidence to support this claim is rather sparse. A new anti-cellulite product containing Hoodia warns against extreme weight loss when you apply it to your skin. Unless you believe in magic, to suggest that Hoodia, (a supposed appetite suppressant taken orally), will also burn your cellulite away if you rub it on your skin, is simply outrageous! Ask any pharmacist for a second opinion – there are some logical and basic limitations to chemistry.

Fat blockers
There are many false claims made about these products. Chitosan is the biggest culprit in this regard. After   reviewing many scientific studies, we concluded that Chitosan is not effective and we do not recommend that you waste money on it. Orlistat, however, is effective.  We often prescribe Orlistat at our clinics as part of a damage control strategy on a “when-needed-basis” for those celebratory meals where you are likely to consume too much fat, (especially the saturated kind). Depending on your country of residence, you may require a prescription from your doctor for Orlistat.

Agents that lower insulin levels
There are products that either improve the effectiveness of insulin or mimic its effects regarding the transfer of glucose molecules across the cell membrane. By reducing insulin requirements, blood insulin levels naturally diminish. Many oral diabetic agents belong to this category, but some of these have the unfortunate side-effect of actually increasing your weight, rather than reducing it.

A Japanese study conducted on the anti-diabetic effects of an Eastern medicinal plant sparked off our own research programme in this category at the Institute. We found that not only could the agent help control diabetes, but also initiated weight loss by lowering blood insulin levels. Further studies over seven years led to the development of AntaGolin™, our own patented insulin resistance formulation.  AntaGolin™ has such a low side-effect profile that it has been granted a “natural product” classification by the South African Medical Control Council. By lowering your insulin levels, you are able to maximise your weight loss results without exposing yourself to any unpleasant or detrimental side effects.

Emotional and mood controllers
These are indicated only if you suffer from specific emotional stumbling blocks that interfere with your weight-loss ambition. As part of our LightHouse weight-loss system we do a comprehensive emotional screening on our patients, testing them for impulsive and compulsive eating patterns, as well as for stress levels and mood. Depending on our findings, we often advise these individuals to use prescription medication for their particular emotional stumbling block. We do so in conjunction with their own doctor, and the results achieved once their distractions are gone are simply phenomenal. I tell all my colleagues not to give their patients with Attention Deficit Disorder or an Obsessive Compulsive Disorder a sheet of paper containing a meal plan, sending them forth with instructions to go and lose weight. Without a proper treatment strategy in place, they simply stand no chance.

Harsh reality no 9: There’s a fine line between success and failure.
Wanting to look and feel good certainly doesn’t mean having to torture or deprive yourself. Unless you are somewhat of a fanatic, no one can sustain a depravation-type diet or gruelling exercise programme before something snaps in your head. You will crash and burn, and even worse, your experience will make you hate the process so much that you will give up and lose all interest,-a highly counter-productive strategy!

I have told you that some will say it is easy to lose weight. I have also mentioned that I do not share this opinion. During the research and development phase of the LightHouse weight-loss system, as well as for the purposes of our study, we deliberately chose overweight subjects who had failed to lose weight on other programmes. We soon found out how complex and difficult weight-loss really can be. Whilst running the programme, however, and witnessing the many successes achieved by candidates with numerous medical and psychological stumbling blocks standing in their way, I now firmly believe that anyone can lose weight!

There are only two things you need:
A) The basic desire to do so.
B) A superior, well-researched and holistic strategy.

If you have reached that cross-road in your life when you know you need to lose weight but have been postponing your obligation for whatever reason, please use this opportunity to reconsider.  Do not allow your emotional mind to portray you as the victim of circumstance with statements like: “Nothing works for me!” or “I just can’t do it!”

If other people can do it, so can you! It is procrastination and apathy that keep us trapped. Use courage and initiative to set you free.