Monday, February 21, 2011

Diet Book Review: The Flex Diet (I like it)

It’s called the Flex Diet and it’s written by Dr. James Beckerman – a socially networked cardiologist working out of Portland, Oregon.

The book’s premise is simple and it's not actually a "diet". Rather than provide a set of Draconian rules that everyone has to follow, Jamie offers 200 different "solutions" to help you lose weight. The idea being you get to pick and choose which solutions sound doable to you.

The solutions are straight forward, well-laid out, and in the majority of cases easy to implement, and evidence based, while others (like using microwave meals in a pinch), also reflect reality and common sense.

Now I can’t say that I agree with every last one of Jamie's solutions, and personally I believe in a greater emphasis on caloric awareness and a lesser emphasis on pounds lost per week than Jamie seems to, but I suspect that were you to adopt even 10% of the book’s recommended solutions, you’ll likely lose some weight.

Four large enough quibbles I have to add for my readers.

1. If you choose the eat almonds solution do yourself a favour. Do figure out the calories involved. Indiscriminate handfuls of almonds, while certainly handfuls of a healthy food, are going to rack up the calories pretty darn quickly.

2 Artificial sweeteners. The data on the use of artificial sweeteners as part actual weight management efforts (both loss and maintenance) specifically demonstrate that they are in fact helpful, and while Jamie discourages their use, I don’t. Ultimately if I had to rank sweeteners in order of danger to health, sugar in its many forms would top the list. The studies that do show associations between sweeteners and obesity tend to be studies that look at all comers, small studies or are poorly designed studies. Those designs are problematic in that there’s a very real likelihood that folks drinking large amounts of diet soda have different dietary patterns and habits than folks who don’t and may feel their diet sodas provide them an allowance to choose unhealthy options by means of the health halo effect. This would hold true as well for the recent hullabaloo over the as-yet-unpublished study that linked diet sodas and strokes where the mass media seems to have completely forgotten that correlation doesn’t prove causality.

Of course if you can happily switch to no sweeteners – artificial or otherwise, that’d be ideal.

3. Fasts. I think they’re an awful plan and as someone who has tracked their calorie intake breaking the fast on Yom Kippur I’ll tell you it’s far easier to exceed your total daily burn consuming a single daily meal than by spreading things out well during the day and approaching each and every meal hunger free.

4. Hypnosis and Acupuncture. The data on both acupuncture and hypnosis on weight can be described as preliminary at best, and useless at worst. If weight management were about acupuncture or hypnosis there’d be a lot more acupuncturists and hypnotists and a great many more skinny people. If you want to spend money on something weight management wise how about spending it on my addition to the book - solution 201? Invest in high quality whole foods like a weekly CSA basket of vegetables.

4 quibbles out of 200 sure ain’t bad.

As with any weight management effort, success will only find those who sustain their lifestyle changes. When you're trolling through the solutions, make sure only to take on those that suggest to you that you'll be able to happily employ them forever.

Pick up the book. Chances are there’ll be something in it that speaks to you.

(Oh, and in case you’re wondering when I’m going to write a book – it’s 90% done and by no means is it a typical “diet” book either. Any publishers or agents reading my blog? Feel free to drop me an email. Almost ready to roll.)

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  1. Too bad the book uses the four letter word "DIET". I hope your book presents exactly as you say - slow, manageable changes for a lifetime. The yo-yo effect is so hard on our bodies and self-esteem.

  2. Personally I think the correlations between artificial sweeteners and obesity are just that. I don't know many folks with weight problems who don't switch to diet soda the first time they go on a diet and never go back. In my case, I started drinking soda period when I started dieting.

    Coming from the low carb world, the phantom insulin response is blamed, but, frankly, I see AS's as making it easy to overconsume LC goodies like cheesecake that pack a serious caloric punch.

    So regardlesss of the approach, if one does limit artificial sweeteners they tend to limit intake of yummy foods that can be easily overconsumed.

    Thanks for this review! A book I might even find some new strategies from!!

  3. Just a little personal anecdote regarding hypnotism: I plunked down a large sum of money to participate in a lengthy hypnotism programme that involved weekly counselling sessions and listening to tapes. The results for me were nil.

    Essentially, I was put off by two things. I had "counselling" sessions with a man and anyone with half a brain knows how much easier weight loss can be for men as opposed to women. Every time he emphasized how much the programme had helped him and how easy it was, the message I got was "too bad for you, sister".

    The other thing that drove me around the bend was the poor grammatical quality of the tapes. OK, call me a grammar fascist, but when I am told to "lay" down, I just want to strangle the speaker. Anyone who mangles the English language loses my respect right at the starting gate.

    What a waste of money!!

  4. Anonymous12:45 pm

    I have a general mistrust of artificial sweeteners. Not very scientific perhaps...I also believe that many of us have a sweet tooth, but its power WILL shrink if we can only stop feeding it so much. (This is based on past experience.)
    But if we continue to eat sweet things, how can the sweet tooth shrink?

  5. In my experience sweet teeth often shrink in response to better distribution of calories and protein throughout the day.

    CarbSane, you likely know more about insulin and carbs than I do. Am I wrong in also reporting that sweeteners aside, phantom insulin response occurs even when we simply think about food? I certainly seem to recall reading that somewhere or other.

  6. Anonymous7:35 pm

    Almonds contain omega 6 oils, and we need what? 6 gm/day. Anything more and we need more fish and omega 3 to balance.

    Artificial sweeteners often start the cephalic phase of insulin release, and hyperinsulinemia leads to obesity. See R Lustig paper on hyperinsulinemia to see the world of hurt released by that.

    Fasts- I am hunger at every meal, and no more hunger after 36 hr than 12. By 60 hours the hunger is gone, as long as food is not presented to me.

    Placebo effects are real, but short duration. Hypnosis and acupuncture have at least placebo effects.

    Also note that the book is intended for 20 pound loss, not recovery from obesity.

    But what do I know.

  7. Yes, Yoni, we can secrete insulin at the thought of food, we can secrete it eating a whole bunch of celery from what I've read. Distending the stomach can trigger it. However these small responses are meaningless IMO. They are not sufficient to cause reactive hypos or anything like that, and I don't believe in the whole insulin-centric theories of obesity ;)

    So, rather than eating one bon bon every now and then and acknowledging/accounting for the calories, dieters tend to indulge in sugar free stuff "guilt free" and tend to overconsume.

    So, if one uses AS appropriately - saving the calories from the sugar and having the occasional substitute for a favorite food to keep one on track, they're good. But the problem is those substitute foods tend to pack a caloric punch and are easy to overeat.

    I also think we tend to develop a tolerance for sweets - any sweets - when we eat them regularly. It is amazing to me how I used to put a packet of Equal on a grapefruit and now they taste sooooo sweet to me. So if one avoids sweets I think they'll be satisfied and enjoy a small amount all the more.

  8. Hi Dr. Freedhoff.

    Are you familiar with the work of Martin Berkhan from He uses intermittent fasting with awesome results (I mean AWESOME!), and all of his client will report no hunger issue after a few week of adaptation.

    Thanks for your blog.

  9. Jason Harrison2:33 pm

    The Holiday Diet - no restrictions, but abnormal.

    The vegetarian diet - restrictions but no normal in many cultures.

    The Standard American Diet - whole foods are restricted, very abnormal.

  10. Anonymous12:15 pm

    I've lost 25 pounds - all I needed to lose - through intermittent fasting. I've kept if off for over a year, so far. I continue to fast for the possible health benefits.