Wednesday, July 29, 2009

Bits and Morsels talks 'The Skinny'

"Skinny friendly" egg white and veggie omelette.

Last weekend I took myself to the Whitney Museum
for a look at Claes Oldenburg's Happenings and a quick brunch at Sarabeth’s. Museums are good bets especially come the summer months because they are climate controlled, and in the Whitney's case, the ideal (i.e. manageable) size.

Sarabeth’s is on the lower level and it is a pleasure to dine in. This particular Sarabeth’s is considered the “hidden Sarabeth’s” — you can’t see it from street level unless you peer over the walls of the Whitney. Sarabeth’s is known for its baked goods and homemade preserves. And they always get a large brunch crowd, although this location is considerably (thankfully) quieter. Sound seems to escape up the immensely tall windows and lofty celing. Or maybe it's just that young children and museums don't mix.

For the record ... I only had iced coffee with skim milk and a vegetable egg white omelette.

Sarabeth’s at The Whitney
945 Madison Avenue

The hidden Sarabeth's.
Iced coffee with skim milk. Pumpkin muffin with apricot and orange jam.
Pumpkin waffle with all the fixings.
A good look at my egg white and veggie omelette.
The view from Sarabeth's; Crispy bacon (not mine, promise); the bill as evidence.
The Skinny is unlike many diet books in the oversaturated marketplace because Dr. Louis J. Aronne truly understands how hard it is to lose weight. 'The Skinny' is highly informative in explaining how hormones and the food that we eat impact how much we eat and how hungry we feel. 'The Skinny' is different because its approach is remarkably realistic and Dr. Aronne just plain gets it. This is a serious book compiled by a doctor who has been treating patients (he is David Letterman’s doctor) for over twenty years. The Skinny inspired me greatly to change my diet that I had to talk to Dr. Aronne and share the interview with you.

I really love The Skinny.

Thank you, I really appreciate it. I tried to make it something that would get to people. Obesity is so misunderstood as a problem that there is so much blaming that goes on.

Are you an eat-to-live or live-to-eat kind of guy?

I enjoy eating. I was one of the firsts hosts of the Food Network. I spent several years with Emeril and David Rosengarten. I think food has always been an important part of my life. I grew up here in New York in an Italian Family and food has always been a big part of my life. The approach that we are looking for is something where people can enjoy food and lose weight. Food can be enjoyed and your weight can be in control. It doesn’t have to be one or the other.

What do you eat every day?

I eat very healthfully every day because if I didn't, I would be worried about my own health. I would be worried that I would start to gain weight.

Dr. Louis J. Aronne.
You are in good shape.

Well, I’m trying. I have been trying for a long time. One of the great things about being in this area is that you can try to help yourself. In a lot of other areas in medicine you don’t get to have the problem. This is something that I have and a number of people in my family have and so ... I get to help my family and myself. For breakfast I have an egg white omelet with vegetables. For lunch I have one of a couple of things.

Yesterday I had Chinese food, shrimp and string beans with hot and sour soup. Usually I will have some of the soup first and save the rest of the soup for later because I’m here for hours and hours. The things I don’t have are pizza, burgers, and fries. Things like that.

You don’t have pizza?

For lunch? No. I have it every now and then on a weekend but not on a regular basis during the week. If I have it, it’s at a place that makes really good pizza.

If you are were going to change one thing, what is the smallest change you can make?

The single most important change that people can make is breakfast. The best appetite suppressant is a protein breakfast. I can’t tell you the number of cases I have seen where they are doing well and all of a sudden they start to regain. Many times the thing that starts the weight regain is a change in what they are having for breakfast. People change from eating omelets and cottage cheese to eating oatmeal and raisins.

Isn’t oatmeal healthy?

There is nothing wrong with oatmeal if you are a15-year-old running around all day playing soccer, but if you are someone who is sitting in an office then maybe the amount of carbohydrates is a problem. When you look at how much carbohydrates people need it depends on the amount of activity they are doing.

What does it mean if you aren’t hungry in the morning and can’t eat breakfast?

What that means you ate too much and too late last night. Sometimes we tell people to force themselves to have the protein breakfast and cut back at night. It can be hard to do because some people find that they can’t sleep. It isn’t always easy because people get used to a certain pattern. It becomes a vicious cycle and there are two typical patterns. One is where people skip breakfast because they are not hungry or if they have breakfast they have a starch, which makes them hungrier. Then they start eating at lunchtime and their lunch is actually their breakfast, the dinner is their lunch and then they wind up night-eating. That is the worst thing for you because you are sleeping through the night and absorbing the calories of what you just ate before you went to bed.

What is the general rule of when you should stop eating at night?

I don’t like to give people a hard and fast rule because it’s very hard in New York to say stop eating at 7:30. Nobody would eat in New York. The idea is not to eat that much or make it a gigantic meal before you go to bed. Having a snack before you go to bed is ok. Having a pint of Haagen Dazs before you go to sleep is never going to work.

I like you and you get it.

For this to really work it has to be practical and fit with people’s lifestyles. Our program here has to be customized around what you are doing. It can be done. There are some things that may have to change but you would be surprised. If you eat a big enough breakfast and a big lunch you will not be very hungry later in the day.

Click to order The Skinny.
Why did you decide now to write The Skinny?

I felt that the knowledge base that we have had reached a point where a book was worth writing. I wrote a book about 10 years ago and between then and now I didn’t think I had anything to write about that was really different. Within the past couple of years with everything going on with weight regulation and how to manage it better, it has become really clear. Certain things have become so clear to me that there will be a number of books coming out of this. We have developed a whole new way of taking care of patients with weight problems. It’s going to turn into a field called obesity medicine.

What got you interested in this field?

It started a long time ago when I was a fellow in Medicine. It’s interesting given what is going on now in healthcare economics. I was a Kaiser Foundation Fellow in healthcare economic research in cost effectiveness of care and one of the studies that we did showed that obesity was a major driver of healthcare costs in patients who are in the hospital. It got me thinking about obesity and trying to treat it. This was 1984 and I vividly remember a patient in her late thirties who had heart disease, arthritis and walked with a cane and I could not get her to lose weight no matter what I did. I couldn’t understand what was going on. Then I joined the faculty shortly after that and the chairman asked us to start a unique program. The Women’s Health Center started that year and the AIDS Center, and I started the obesity program.

A few years after that I was involved in a teaching program here and a guy running the pediatric teaching program approached me and said 'you have to see these animals we are breeding in our lab at Rockefeller University.' He showed me ten mice in a cage with one of them being hugely obese. He did an experiment where the obese mouse would go down to normal weight in just 3 days if he gave it a transfusion from the skinny mice. That mouse was lacking something in its blood which the other mice had. It was lacking the hormone, lepton. The hormone turns out to be the signal from the fat cells to the brain telling the brain how much fat is stored. Now we recognize that a big problem in obesity is that the brains of people with weight problems are resistant to this hormone. So when you start eating fattening foods your brain becomes resistant to lepton. Your brain can’t tell how much fat is stored and as a result you are able to eat more food. It becomes a feed forward system where you are just eating more and more. Something that starts out as maybe behavioral or environmental becomes something physical very quickly. That’s the whole topic of The Skinny. It’s trying to help people understand how this happens.

Dr. Louis Aronne, founder and director of the Comprehensive Weight Control Program at New York/Presbyterian Hospital/Weill Cornell Medical Center, recently founded the Cardiometabolic Support Network, a site that people can use to help with weight loss, giving more people access to Dr. Aronne’s program and other useful technology.

It just so happens that this week the CDC is hosting a conference about obesity.
Obesity causes us to spend tens of billions of dollars every year on health care as it is a serious risk factor for ailments like heart disease and diabetes. If we want to reverse the obesity epidemic, we must change our eating habits and activity levels.

One more reason to pick up a copy of The Skinny today.

Until we eat again,
Jordana Z.

Comments? Contact Jordana here