Show #1401, "Losing It"
premiered January 20, 2004.
ALAN ALDA Eating -- it's a problem, isn't it? Everyone's
gaining weight, and everybody wants to lose weight.
On this edition of Scientific American Frontiers, we're
following the fortunes of a dozen volunteers who're
trying to shed those pounds.
ALAN ALDA (NARRATION) Our people are taking a wide variety
of approaches, from just counting calories...
I guess I should start by reading the book.
ALAN ALDA (NARRATION) ... to gastric bypass surgery.
So in the middle of summer I'll be in my Speedo bathing
ALAN ALDA (NARRATION) Along the way we're keeping personal
video diaries of how we do.
WENDY What is wrong with me?
I've got this muscle.
ALAN ALDA I had reached the point where I was just putting
JOHN Had a little relapse. TOM I'm stuck here. KATHY
There they are -- size 10 pants.
ALAN ALDA I'm Alan Alda. Join me now as we try Losing
It. LOSING IT
ALAN ALDA (NARRATION) As 2003 came in, the Frontiers
production staff was busy delivering new year's gifts
to a select few.
JULIE Hi, Amy.
JULIE How are ya?
JULIE Here to set up the camera.
ALAN ALDA (NARRATION) Our plan is to follow the fortunes
of 10 people as they try to lose weight. To help document
their ups and downs, everybody's being asked to keep
a video diary.
Today is the first day of the video diary...
ALAN ALDA (NARRATION) Amy was heading for heart disease,
diabetes and many other problems. And, overweight since
childhood, she's had enough of literally not fitting
Being overweight is a trauma because it's not accepted
in the society. You know, when dealing with people's
reactions to you and feeling like, Oh, I can't go to
that place because, you know, they'll look at me funny
or...unfortunately, people do look at you funny.
JULIE Hi, Eric, how are ya?
Come on in.
ALAN ALDA (NARRATION) Eric will be a new dad in a couple
of months. He's worried his weight's reducing his energy
-- maybe he won't be able to keep up.
...first day of the rest of my life... I haven't even
opened the book yet, so I really don't even know where
to begin. But I know I need to drink a lot more water.
I don't drink nearly enough water. But, I guess I should
start by reading the book.
ALAN ALDA (NARRATION) We've got a whole weight loss
family living here. KATHY Oh, hi...
ALAN ALDA (NARRATION) Kathy wants to lose weight, but
her daughter Kimberly doesn't -- she's thin as a rake
anyway. Kathy's husband Tom also wants to lose, while
Patrick would rather not be involved. This is not going
to be easy. KATHY We're not obese, but we're about twenty
pounds overweight. Um, certainly if, you know all the
statistics tell you even that little bit will make a
difference according to your health in the end.
ALAN ALDA (NARRATION) Tom and Kathy have lost and gained
many times before. They're concerned about Patrick,
and Kathy, who works in healthcare, knows very well
that just 10 or 20 pounds extra increase your risks
of a wide range of health problems -- from hypertension
to cancer. TOM A few of my friends are rather obese
and they've said, You're not obese, what's your problem?
You're not overweight. And I nodded to myself, Yes I
am. I know I am. I can grab a good handful of fat off
my belly anytime I feel like it.
ALAN ALDA (NARRATION) Wanting to look better -- to get
into that bathing suit next summer -- and concerns about
health were the twin motivators for all our weight loss
subjects. Some, like Tom and Kathy, have struggled with
weight for years, while others, like John here, are
just waking up to the challenge.
JOHN I thought 230 was heavy. I thought 240 was very
heavy. Now here I am 250, so... It's time to do something.
ALAN ALDA (NARRATION) Marcy's one of our most experienced
It's my office ...
ALAN ALDA (NARRATION) She's lost and gained weight --
but mainly gained -- many times since she was a skinny
20-something. Now she's determined -- for the first
time -- to try exercise as well as diet, and like most
of our subjects she hopes being on TV will be a motivator.
I think it will be easy in the beginning. I think there
will be hard spots. I think there will be times when
I'm gonna gain weight. There will be times when I plateau
and just stay the same, week after week after week.
And there will be times when I lose.
ALAN ALDA (NARRATION) Unlike Marcy, Robin has always
enjoyed exercise and sports, although she also loves
to eat, as she says. She's dieted on and off since college,
but always stayed active too. She's in a classic bind
-- too heavy to play sports, with her inactivity making
it harder to lose weight.
ROBIN Hey, good morning.
JULIE Good morning.
ROBIN Hi, Julie ...
ALAN ALDA (NARRATION) Now she's determined to lose weight
and get back to softball this summer.
ROBIN There's a part of you that doesn't know how you
let yourself go this far. Then there's another part
of you that goes, Damn, I'm gonna do this, you know,
and you have to wait for that part to kick in.
ALAN ALDA (NARRATION) Rodney is our second gastric bypass
Nice to see you.
ALAN ALDA (NARRATION) When he was working hard on the
deck of a fishing boat, he stayed in shape. Then he
bought his own boat, got to sit in the skipper's chair
all day, and the weight began to accumulate. Now his
doctor's said he's heading for trouble.
In the last few years I've been diagnosed as a diabetic.
I have high blood pressure. I have sleep apnea. And
that's all due to overweight, being overweight. My knees
have been, in the last year, year and a half, my knees
have been killing me. So if I don't do this I'm looking
at knee surgery, replacement. And I just want a better
quality of life in my later years. I worked hard all
my years. I want to enjoy my later years with my grandchildren.
JULIE Hi, Wendy, how are you?
ALAN ALDA (NARRATION) Wendy's very active, but she loves
food and eats a lot after her frequent workouts. She's
going to try switching to Mediterranean-style foods
like fish, olive oil and vegetables, which she hopes
will be satisfying and healthy. And being on TV's important,
WENDY You know this was like exactly what I needed to
get going. And, I can't wait. We'll see what happens
in six months. I'd better be like this, right?
ALAN ALDA (NARRATION) Today, everyone's brought food
that matches their different approaches.
WENDY Fresh basil, fresh tomatoes, roma tomatoes.
ALAN ALDA What kind of cheese is that?
ALAN ALDA Mozzarella.
JOHN Basic hamburger.
ALAN ALDA Now I thought you weren't suppose to have
JOHN Well, I wasn't in the first phase, but I'm sort
of cheating a little bit.
ROBIN This would be probably two carb blocks. So between
that and this, and this is the proper amount of protein,
and the fats from the dressing...
ALAN ALDA And what's this?
ROBIN Just soda water.
ALAN ALDA Oh, just seltzer. KATHY This is what they
give me on the web. They give me the recipes and what
to eat everyday. So I follow that, so... It's peppers
and tomatoes, then there's a dressing made of olive
oil. It's got three ounces of chicken breast for each
one of us in there. And then all the different vegetables
and cous cous.
I'm having Lean Cuisine.
ALAN ALDA Oh, Lean Cuisine.
Yeah, but what I do is I take half of the rice out because
there's way too much rice and carbohydrates. So I just
have the protein and the vegetables.
Turkey on pita with mustard.
ALAN ALDA What are you drinking? A Diet Dr. Pepper.
ALAN ALDA Did you bring something?
I just brought my friend.
ALAN ALDA You just brought your friend.
Chips, and an orange. You can eat anything on this diet.
ALAN ALDA I know...
But I did weight them out. This is an ounce of baked
ALAN ALDA And how many points are an ounce?
ALAN ALDA Two points. One...
ALAN ALDA (NARRATION) And by the way, I'm going to try
losing it, too. Like Marcy, I'm doing Weight Watchers,
but the online version. You still have to count your
ALAN ALDA ... I forget, how many points are five shrimp,
ALAN ALDA (NARRATION) We've asked everyone to stick
with their programs for at least six months. Amy and
Rodney will have their surgeries in March, so we'll
follow them for about four months. Of course this is
a small group, and researchers prefer weight loss studies
to run for a year or more. So we can't claim this is
a scientific study. Most dieters gain their weight back
after a few years, so if anything our time frame may
exaggerate success. But we hope to get some insight
into the personal challenges, the successes and failures.
DIARY For a couple of years now I've been watching this
fat guy come on to the screen and stumble around the
rocks. He looked like if he fell down he would never
get up again. And this was me. And the other thing is
that I noticed that all the scientists I was talking
to who had anything at all to say about longevity and
nutrition, they were all telling me that if I wanted
to be healthy and live a long time, I had to get my
weight under control. I started to eat properly and
exercise, and I lost six pounds like that. And it was
really easy. In fact, it was so easy that I lost the
same six pounds three times in the next two months.
I just kept losing it and gaining it back again.
ALAN ALDA (NARRATION) After my "losing and gaining it"
experience, I wondered what level of confidence we all
ALAN ALDA I feel that it's at least ninety percent.
Eighty percent, sure.
I can't give you a number. I've got to take it one day
at a time.
Eighty to ninety percent.
I think it has to be ninety percent going into something
so big. KATHY I think probably like seventy five percent.
TOM Closer to eighty percent for me.
ROBIN I think for me it's ninety. I like the way it's
working and I like the way I feel on this diet.
WENDY Just scary. I don't have a number. It's just scary.
JOHN I'm at about seventy-five percent. Maybe approaching
ALAN ALDA That's really fine-tuned.
ALAN ALDA (NARRATION) A school cafeteria might not be
your first choice for an imaginative, tasty and healthy
lunch. But Walter Willett -- one of the country's top
nutrition experts -- works upstairs, so this cafeteria's
different. With Dr. Willett's guidance, over the last
two years the menu's been transformed.
GREGORY Today we have grilled turkey cutlets with a
papaya mint salsa.
ALAN ALDA (NARRATION) Brown rice, steamed vegetables,
and olive oil used on the grill.
JOHN MURPHY Glazed salmon. It's marinated in fresh ginger
ALAN ALDA (NARRATION) Same rice and vegetables. And
again, olive oil on the grill.
GREGORY Wild mushroom burger. It has three different
types of wild mushrooms. Pureed tofu binds it. Fresh
thyme, parsley, little salt, little pepper.
WALTER WILLETT We really tried to make sure that everybody
had a healthy option, no matter what kind of meal that
they wanted to choose. There are a wide range of selections
here. For example, some people really do want a pizza.
ALAN ALDA Pizza smells good, too.
WALTER WILLETT It does smell pretty good.
ALAN ALDA (NARRATION) Here you can get a regular pizza,
or Dr. Willett's version. He wants whole grain crust
-- it hasn't lost its nutrients, and it's digested slowly
so it's satisfying.
GREGORY We follow Dr. Willett's guidelines, nutrition
guidelines. Whole wheat grains, brown rice as opposed
to white rice, whole grain pasta, whole wheat rolls.
We don't use margarine. Canola oil, olive oil. It's
a new way of thinking and it's pretty exciting.
ALAN ALDA (NARRATION) Dr. Willett's thinking on fat
is a surprise. He wants us to eat it, so long as it's
the right kind. Fat in food makes it taste good and
ALAN ALDA It is kind of startling after a decade or
two of hearing about the importance of low fat, to hear
from you that's the wrong track to go down.
WALTER WILLETT We've known for a long time that any
type of calories can make you fat. But the public was
really led to believe, and some dieticians just repeated
it so often enough that they believed it themselves,
that it was only fat calories that made you fat. And
of course that led to dramatic over-consumption of high
sugar products and things that were low-fat but high...
ALAN ALDA And foods that were low-fat, the fats were
replaced by sugars to make them more palatable?
WALTER WILLETT Right. People were given the idea that
you could load up on all these fat-free products, and
because they didn't contain fat, you wouldn't get fat,
but of course that was a terrible mistake.
ALAN ALDA (NARRATION) Dr. Willett uses salad dressing
to drive home an important point. Don't eat saturated
fats like butter and hydrogenated "trans" fats like
margarine, but do eat vegetable fats like olive oil.
They're satisfying and have a health bonus.
WALTER WILLETT All too often there's been recommendations
to go for fat-free salad dressings. That's really a
big mistake, because the fat in salad dressings is one
of the healthiest types of fat. It's virtually always
made from non-hydrogenated vegetable oils, which will
help bring down your blood-cholesterol levels. And we
have evidence that people who consume full-fat salad
dressing regularly have a lower risk of dying from a
ALAN ALDA (NARRATION) Widespread refined-carbohydrate,
low-fat, high-sugar foods have helped America become
fatter, says Dr. Willett. We should reintroduce fat
-- the right kind -- and eat whole grains. Our food
would be more satisfying and healthier, and we'd be
WALTER WILLETT These high carbohydrate, low-fat diets
actually make it more difficult to control your total
caloric intake. One of the basic problems is, if you
have this fat-free breakfast, for example, with a bagel
and jam or jelly -- you know, fat-free -- you're going
to be hungry by ten or eleven o'clock.
ALAN ALDA Right
WALTER WILLETT And then if you're running out for a
snack, by the end of the day your total calories could
actually be higher.
ALAN ALDA (NARRATION) The low-fat craze, fast-food and
more sedentary lives have all contributed to a fatter
EDWARD SALTZMAN After you see the behavioral psychologist...
ALAN ALDA (NARRATION) On average, adults have become
10 pounds heavier over the last 20 years, but that's
enough to push obesity rates from 15 to 30 percent.
Increasing numbers of people are seeking help at obesity
clinics like this. It's hard to lose weight and keep
it off, and surgery is becoming more common.
SALTZMAN If we took everyone who tried diets, exercise,
even medications, you know we said the average weight
loss is about ten percent. If we take people who have
surgery, the average weight loss is about thirty-five
percent of their body weight. The other difference between
not-surgery and surgery is that you're more likely to
keep it off when you have an operation.
KIMBERLY SMITH You hit a plateau, so your weight loss
stops. You want to think about your negative thoughts
and beliefs -- you had been losing weight and you stopped
ALAN ALDA (NARRATION) Here the idea is to explore attitudes
to food and weight loss, because they've found educated
patients do better after surgery.
1 I can't stand myself.
2 Same old problem.
KIMBERLY SMITH Same old problem. Here we go. Naomi?
3 I'll never obtain my goal.
KIMBERLY SMITH So, a more positive belief.
3 I guess I need to change my eating pattern.
KIMBERLY SMITH OK. I've overcome so many challenges
in the past. I can handle this. OK?
2 Have to make a better plan. You have to plan your
meals ahead of time and be prepared to change the plan.
KIMBERLY SMITH OK.
ALAN ALDA (NARRATION) There's practical advice, too
-- like how to break habitual "behavior chains" that
lead to over-eating.
KIMBERLY SMITH Buy the cookies. Put them on the kitchen
counter. Stay home on a Saturday afternoon when you
know that's a vulnerable time for yourself. Sit on the
couch. Start to feel lonely, and so forth. And so each
of those events is a link in the chain. And the idea
is that we can learn link breaking techniques for each
link. So for example, buying the cookies, a link-breaking
technique might be, shop from a list, have a partner
shop for you. Let's say that that didn't happen, then
we move on to the next link, which is put them on the
kitchen counter. So to break that link it might be,
freeze the cookies, or portion them out in small bags.
FRIEDMAN I don't think it was fully appreciated the
extent to which this was a biological system...
ALAN ALDA (NARRATION) We'll get back to our weight loss
people in a moment, but first we'll talk to the man
who 10 years ago started a revolution in our understanding
of how the body controls weight.
FRIEDMAN ...actually I've had requests for them...
ALAN ALDA (NARRATION) The revolution began with some
very fat mice.
FRIEDMAN ...for grandchildren. They're actually, as
you'll see, they're very docile animals, and they're
gentle and they make a visual impression. So people
thought they'd be a nice substitute for hamsters. So
those are three obese ones huddled together.
ALAN ALDA (NARRATION) It turned out these obese mice
had by chance acquired a genetic defect.
FRIEDMAN ...brothers and sisters of those animals. I
think the difference among them is pretty obvious. These
animals have been housed in exactly the same fashion
-- all exposed to as much as this food as they care
to eat, all confined to this cage up 'til now, and these
animals weigh three times as much and have five times
as much fat as those animals.
ALAN ALDA So what does this defective gene do to that
animal that makes it obese?
FRIEDMAN In the case of these mutant animals, the brain
never gets the signal that there are adequate fat stores,
and these animals keep eating. And ironically, these
animals are obese because they think they're starving.
ALAN ALDA (NARRATION) The genetic defect stops fat cells
from producing a hormone which signals the brain that
there's enough fat. Jeff Friedman called the hormone
leptin, and there was great excitement when some obese
people were found to be leptin deficient. For them leptin
therapy is effective, but most obese people are not
leptin deficient. The body's weight control system is
more complex than that, as Jeff Friedman explained.
FRIEDMAN The way it appears to work is something like
this. There's a region of your brain called the hypothalamus.
ALAN ALDA (NARRATION) The hypothalamus is constantly
receiving hormone signals. Leptin signals how fat we
are. Ghrelin signals about hunger and fullness in the
stomach. And peptide YY sends signals about the state
of the intestines.
ALAN ALDA So when all these signals gather together
up here in the hypothalamus, is that where they get...
that there's some kind of communication going on and
one is suppressed and the other is given the go-ahead,
FRIEDMAN There's some complex information processing
there, the real details of which we don't understand
yet. And to make it even more complicated, many other
things go into this decision. Not only higher cognitive
thoughts, emotional factors influence the likelihood
you'll eat or not. Sensory factors certainly do. So
somehow all these different factors get integrated and
translated into an on-or-off response -- you either
eat or you don't eat.
ALAN ALDA (NARRATION) The fact that different people
have different tendencies toward obesity is evidence
for the complexity of our eating control system. People
like the Pima Indians who have the so-called "thrifty
gene" are good at laying down fat in an environment
of scarcity. But they get too fat when there's constant
plenty. Now add another layer of complexity. The Pima's
close cousins who live across the border are not fat
at all. But they are much more physically active, and
while they have enough food, it's quite unlike the American
diet that the Arizona Pima eat. The eating control system
we get from our genes is constantly juggling and assessing
how much food we have, what type, how we feel, and our
activity levels. At the end of all that, we gain or
lose weight, or stay the same. That's the complex system
our group is seeking to influence, one way or another.
I asked Jeff Friedman if he thought there are genetically
determined barriers to what we were trying to do.
ALAN ALDA If you have somebody who's 100 or 200 pounds
overweight, then the effect of a genetic defect might
be much more powerful in that individual than willpower
or environment. But if you have somebody who's twenty
pounds overweight, thirty pounds overweight, even though
they might find it hard to take it off and keep it off,
would you think they'd be a candidate more for a genetic
defect than the other two factors?
FRIEDMAN People can function comfortably in a fifteen,
maybe twenty pound range. So that you can see weight
fluctuations in that amount in just about anyone, and
maybe someone has to work a little bit harder to be
at the lower end versus the higher end of their range.
But they won't go too far outside that range by and
large over a very long term. I think once you start
to think about reducing weight in amounts greater than
that, it becomes increasingly difficult because, to
a greater extent, as more weight has to be lost, the
biological drives that resist that get more and more
and more potent. And I think by the time someone has
to lose 100 or 200 pounds, it's exceedingly difficult
and may even be impossible for the vast majority of
ALAN ALDA (NARRATION) We're only beginning to understand
how the body resists weight loss. Robin, one of our
dieters, is having her resting metabolism measured.
That's the energy she burns just keeping her body running,
even if she's asleep. It's normal -- about 1700 calories
a day. This number is fixed -- unless Robin exercises.
Exercise not only consumes calories as you do it, it
also increases muscle. And muscle -- unlike fat -- burns
energy even at rest. Now look at the obese mice. Because
they don't make leptin they think they're starving,
and want to save energy. They can't reduce their resting
metabolism, so their bodies cut back activity. In other
words they're resisting weight loss -- just like the
85 percent of dieters who regain their weight within
ALAN ALDA Everybody is told, eat less and exercise more.
And then you're saying that if you eat less, to some
extent you're not going to feel like exercising more.
JEFFREY FRIEDMAN Yeah. I mean, there could be some subconscious
drive that actually would lead you to be less interested
in exercise. But these differences could be things like
exercise, or could be sort of, unconscious movements,
like how many calories do you burn if you're a little
more rather than less twitchy or shaking your leg or
not. I think there are very powerful forces that control
how many calories we burn, and there's reasons to believe
that these mechanisms are at least as powerful as those
that control food intake.
ALAN ALDA (NARRATION) Our body's powerful forces that
resist weight loss are arrayed against another powerful
force, the diet industry, and neither side can claim
total victory. At a typical Weight Watchers meeting,
for example, some people are losing weight, and some
IN AGENT Did good today. Very good. You did very good
today. You're down 2.8. Good. Good, you stayed the same.
1 I stayed the same?
IN AGENT You stayed the same.
1 I thought maybe I lost.
PROCACINI Why are you disappointed?
1 I can't lose weight.
PROCACINI Yes you can. You really...
1 I've been here since May.
PROCACINI You know what to do? We're going to talk in
class. I'm going to help you. Good morning, good morning,
and welcome. Nice to see everyone here this morning.
You know what, when it's cold like this, it really tells
me how bad people want to lose weight. You've been here
WOMAN 2 A few years ago.
PROCACINI A few years ago? So you're a repeat offender,
huh? WOMAN 2 Yeah.
PROCACINI That's OK. That's all right. Anybody else?
Is this your first time here or have you been here before?
You've come back why? Why? Why did you come back?
3 I need to get healthy. For my kids.
PROCACINI You need to get healthy.
PROCACINI Why don't you do it without coming to the
3 I've been trying that for the last year-and-a-half...
PROCACINI And what happens? WOMAN 3 Keep going up.
PROCACINI If a person has never lost weight before,
won't they tell you, Just stop eating, OK! Just lose
weight, all right! Smarten up! Get some duct tape! Put
it on your mouth. OK? Just do that, all right. But people
that walk in our shoes, you know what they say? It's
hard, but it's possible, it's doable. Isn't it? Brag
about how much weight have you lost.
4 Nine-and-a-half pounds.
4 Nine-and-a-half pounds.
PROCACINI Nine-and-a-half pounds! Tell them how much
you've lost. WOMAN 5 Ah, sixty-one-and-a-half.
It helps to laugh. It helps to share stuff. It helps
to share the failures like she was talking about. Because
I mean I'm only on week two, and it's pretty much a
given that I'm going to lose weight at this point because
I'm really motivated. Three months from now, you know,
there's nothing that says that I'm not going to be up.
We measure everything in Weight Watchers.
ALAN ALDA (NARRATION) Marcy can eat anything, so long
as she stays within her daily points allowance. Take
a frozen dessert, for example.
OK, say for instance these. This has one gram of fiber,
fifty calories and half a gram of fat. So you take your
handy dandy point finder. Fifty calories, one gram of
fiber. Then you go over here to this column and you
find your fat grams. So it's got half a gram of fat.
It equals one point.
ALAN ALDA (NARRATION) The point system is designed to
limit calories -- to about 1000 a day in Marcy's case
-- while encouraging balanced nutrition. So vegetables,
salad or fruit have low point value, while steak is
high. Marcy's husband, Tim, is also on Weight Watchers.
Marcy's allowance is 22 to 27 points a day -- the same
DIARY I just got back from joining a gym, and this is
no small thing, because I hate exercise, I hate it,
I really hate it. I went to the gym three times and
still come back with a gain. Just, you know, it's like,
you just want to just quit. Fortunately I have a television
camera in my office, so I have a little more motivation
than normally I would at this point. Basically, what
I did was drown my sorrows in cream cheese, which is
actually a change of behavior for me. You know, normally
it would be chocolate, although come to think of it,
there was a little bit of that involved. Anyway, I decided
to just give myself the day off, and then regroup tomorrow.
I still have these little arm bat-wing things that I
hate, but I have, for the first time in my life, I've
got... See that mound, can you see that? I've got this
muscle. I actually have quite a collection. Yes, I've
made a number of attempts at this throughout my life.
This represents my attempts at losing weight since 1987.
I want to show you this bag of potatoes. This is a fifteen
pound bag of potatoes. This is a ten pound bag of potatoes.
Well, actually it's a little less than ten pounds because
we ate three of them for dinner, but together with this
fifteen pounds, and this ten pounds, this is twenty-five
pounds of potatoes and I've lost twenty-six pounds as
of today. I mean, it's like I had no idea I had this
many potatoes on my body.
DIARY I'm paying attention to what I'm eating, and I
had reached the point where I was just putting it away.
And I really wasn't enjoying it. I'd eat a big plate
of pasta and drink more wine than I'm drinking now and
not really noticing. I really am noticing what I take
in now and I really like it. The interesting part of
course is going to be when I reach that final goal,
and then see if I can maintain it for the next four
months or six months or, what I hope, forever. Counting
anything out about the food, whether it's calories or
points, or portions, whatever it is, you would think
that would make you enjoy your food less. It continues
to make me enjoy my food more. I mean, I'm thrilled
at every meal. I'm really paying attention to what I'm
eating. Much more so than when I stuffed myself.
ALAN ALDA (NARRATION) Now let's see how John's doing
with the Atkins diet. Many doctors are concerned that
this high protein, low carbohydrate diet could increase
heart disease, cancer and other problems. But there
are no long-term studies, so we don't know for sure.
We do know people who stick to it can lose weight fast,
probably because they just eat less -- protein and fat
are very satisfying.
JOHN'S DIARY Hi, how are you doing? End of the second
week in the Atkins diet, which is supposed to be the
end of phase one. But I had a little relapse on Saturday.
Bread was the first thing that I had almost craved as
I went down the bread aisle feverishly looking for low-carb
or no-carb bread. And I just couldn't find it. Next
day, after work, I just went in and bought the bread
and proceeded to make a few sandwiches and be happy.
I was just gonna eat dinner with my mother who had just
come back from Italy. And Italy is the land of pasta.
So we went to the North End of Boston, which is the
Italian section. And I had linguini with clam sauce.
And I loved it. I actually was at home and I had the
craving for pizza, my other favorite carb. And I held
off for about an hour. And then I ordered one. I ordered
one out. I consumed about half of it. Then I said, OK
that's enough. But then about two hours later, I was
eating the other half. So, that was the end of phase
ALAN ALDA (NARRATION) After a few weeks John abandoned
his diet, having lost about 10 pounds. He then entered
a diet study, was placed in the control group, and gained
the weight back. Here's Wendy, making one of the Mediterranean-style
dishes that she hopes will help her lose weight.
WENDY I put a little bit of tofu cheese in. Or I'll
put a little bit of regular cheese in, which kind of,
you know makes the fat content go up, but still very
good. So basically, I just put this... I have jalapenos
and regular red peppers and onions, lightly sautéed.
A little bit of cilantro in there.
ALAN ALDA (NARRATION) If Wendy sticks to the diet and
controls her portions she'll lose weight -- especially
since she works out a lot. But there was something Wendy
was not admitting -- even to herself at first.
WENDY'S DIARY I just quit smoking on Sunday, by hypnotism.
And so far, so good. I'm a little edgy and actually
want to eat more. You know what, I think in every entry
I will give some kind of excuse as to why I have not
lost weight. You know this is me, this is the truth,
I apparently am not so great at this weight losing thing.
What is wrong with me? Ahh! I get so frustrated. Why
do I get so, you know. You get so frustrated with yourself.
You want to do things, you don't want to do things.
You want to do... You know, it's up and down, up and
down. It... ahh! Drives me nuts!
ALAN ALDA (NARRATION) Here's Kathy logging on to her
online diet service, where she can plan an entire week
of meals for herself, Tom and the kids. For practicality,
everyone's going to eat the same meals, although the
two kids aren't dieting. Meal plans are aimed at balanced
nutrition with limited calories. She modifies the system's
Peanut butter and jelly sandwich is not going to go
over big for dinner in this house, that I know, so we'll
change that one. Look for something that everybody will
eat. Lemon caper chicken breast -- we've had that before.
They like that so we'll have that.
ALAN ALDA (NARRATION) She prints out the recipes and
a shopping list to match. So a lot of tedious thinking
and calculation are done for her.
DIARY There's no food in the house. There's nothing
DIARY Why I did this is because my mom forced me to
do it.. I just eat what they give me.
DIARY So I'm like, really hungry, and I'm, like, trying
to get my friends to bring me food.
DIARY Tom's been sick with bronchitis, so, it's kind
of put the whole family into a standstill for the week.
DIARY Today I weighed one hundred and ninety three and
a half pounds. That means no change over the past week.
I'm not really surprised at that. Once again I've been
sick for the week. Now, it's going to stop. Starting
today, it's going to stop.
DIARY We haven't been doing the diet as much as we did
in the beginning. I think that our enthusiasm is starting
to wear off. We just went out to eat. My mom had a salad
and my dad had a bowl of clam chowder and some fries
and a deep fried fish, I think. Bad, very bad.
DIARY I haven't been exercising over the last few weeks.
Two weeks, probably. And that's why my weight's pretty
well stayed the same. I'm going to try and do the old,
ah, put a picture of, on the refrigerator, of maybe
a pig, I guess. I don't know. Something that I am going
to put on the refrigerator to keep me out of it.
DIARY I'm satisfied with the weight loss I have. Actually,
that's not true. I'm stuck here. I'm down to about 191
pounds, which is making me feel a little bit better
about myself. Unfortunately the fat content's gone up
to about 23 percent, so again, I don't understand what's
going on. Losing weight, fat content, going up. I don't
DIARY I am back in size 10 pants. I don't know. They're
fitting pretty good today. Here. I don't know if you
can see me or not, but here. There they are -- size
ten pants. They're better.
ALAN ALDA (NARRATION) In the fourth month, there was
a big change for Tom. He left his office job to become
a full-time archery coach. So his days became much more
active. We'll see how the family did -- along with all
our weight loss subjects -- at the end of the program.
Here's Eric, with his new son Henry. Having a lively
and exhausting son in his future was the main reason
Eric wanted to lose weight.
What's he doing? What's he doing?
DIARY I guess I've been fairly grumpy. That's what my
wife and my friends tell me. I'm not drinking my favorite
soft drinks. I'm not getting the caffeine and sugar
that I usually get out of them. I'm starting to crave
pizza, so I think I might have to break down and get
a slice or two to put it out of my mind. Diets are pretty
boring. Nothing happens really quickly. It's a little
bit over a long amount of time. But... it seems to be
ALAN ALDA (NARRATION) Henry was born at the end of March
-- week 13 of Eric's diet, which was still going well.
We'll check in with Eric and Henry later. A few months
after the start, we looked in on Robin -- who's using
the Zone, a low carbohydrate diet
ROBIN These are my old ones. I can just like take them
off without, without even trying.
ROBIN'S DIARY My mom broke her leg on Sunday night,
this past week., and it's just been a nuts week, going
back and forth. My eating has been off. I've probably
had too much carbs at one point or another. So, it wasn't
a great week. The big news for this week is that I passed
30 pounds. Which is cool. I mean I guess I'm going to
be giving a lot of clothes away, which is fine with
ALAN ALDA (NARRATION) By summer Robin had met her goal
of joining a softball team. Her diet requires fixed
ratios of carbohydrate, proteins and fat at every meal
-- an idea that's scientifically controversial. Nonetheless,
something worked for Robin.
ROBIN I think I did surprise myself. You know, anytime
you start a diet, you're really gung ho, and you're
doing everything to the finite degree. And it just seemed
like it wasn't that hard and yet the weight was dropping
ALAN ALDA (NARRATION) Amy's one of our two subjects
who are heading for gastric bypass surgery.
DIARY This week's been kind of rough. I got on the scale
and I did gain a couple of pounds, which I was really
discouraged about. And I think that's where that, "Oh,
even though I have a surgery date" mentality comes in,
that I allowed myself to eat the things that I shouldn't
have. So now, you know, tighten up the belt again, and
back to the grindstone. Now that it's only a few hours
away, I'm feeling a little ... I'm not really anxious,
I'm just... It's the unknown, I think.. It's just a
lot of emotions come out. Because you just think about
everything. And, I don't know. It's time to go to bed,
though. SCOTT SHIKORA You all set?
I'm set. SCOTT SHIKORA Alright.
Are you ready? SCOTT SHIKORA We are. You're seeing the
A-Team today. MICHAEL TARNOFF See you when you wake
ALAN ALDA See you later, Amy. If seventy-five to eighty
percent of the patients are successful at reducing their
weight, what happens to the other twenty, twenty-five
percent who have had a kind of severe operation. Can
it be reversed?
SHIKORA It can be reversed, but it's very difficult
to reverse it. And if somebody fails, and gains their
weight back, or never loses the weight they should lose,
there's no reason to reverse it, because essentially
they've behaviorally reversed it. Now what we're going
to do is go through every layer of the abdominal wall.
Everything you see yellow is usually fat.
ALAN ALDA How are you getting through those layers?
SHIKORA This instrument has a little blade at the tip,
and when you hit the trigger the blade juts out and
it makes a little cut.
ALAN ALDA I see.
ALAN ALDA (NARRATION) The laparascopic instruments are
monitored with a fiber-optic TV camera.
SCOTT SHIKORA So that's called a linear stapler.
ALAN ALDA (NARRATION) The surgeons make a new, smaller
stomach out of the top few inches of the natural one,
using an instrument that staples and cuts at the same
SHIKORA We're going to sculpture this little stomach
chamber or pouch.
ALAN ALDA (NARRATION) Amy's new stomach will hold only
about one ounce, whereas her natural one held half a
gallon. The natural stomach will remain in place, to
keep generating digestive fluids.
TARNOFF So this part here is going to be her new stomach.
SHIKORA That's the first major portion of the operation
is just getting that pouch created.
ALAN ALDA So now you have the esophagus naturally going
into that new pouch.
ALAN ALDA And then you have a new connection from that
pouch to the intestine.
ALAN ALDA (NARRATION) To connect the pouch to the intestine,
the surgeons first cut the intestine below the stomach
and make a new connection for the natural stomach lower
SHIKORA So that's the completed closed connection. So
we're down to the last major step which is connecting
the intestine up to that one ounce stomach chamber.
ALAN ALDA (NARRATION) Finally, the intestine that had
been cut below the natural stomach is brought up and
connected to the new, small stomach. MICHAEL TARNOFF
There we go. Look under here. OK.
MICHAEL TARNOFF Yeah.
ALAN ALDA (NARRATION) The procedure takes about 90 minutes
SHIKORA So the bulk of the operation is done. We'll
throw an extra stitch or two in a few places and then
DIARY I got home and laid on the couch and just relaxed
for a while, and my husband made dinner for my, you
know my family. I smelled baked potato, and I said,
"Oh, I would love to have a baked potato." But it's
not that I'm hungry, it's I remember how it tastes in
my mind. You can see my collarbone when you couldn't
see it before. And I notice it a lot in my legs and
my ankles. My ankles look so thin to me.
ALAN ALDA (NARRATION) In a few months, Amy was going
up the stairs without pausing for breath.
That's 3 ounces. It's not a lot. You know, three ounces
before would be like, Oh, that's all you're going to
have on your sandwich? And now, it's like, I have to
eat that much? Sometimes my brain will say, It's been
a while since you've eaten, you probably should eat
something. But I don't have that pit in my stomach like,
Oh my Gosh, I'm so hungry, I need to eat. Nothing like
what it used to be. Nothing at all. I never thought
anybody could feel this, but I definitely do.
ALAN ALDA (NARRATION) Four months after surgery, Amy
achieved her goal of shopping in a regular -- not a
plus-size -- store.
I would never wear a cocktail dress, because I wouldn't
want that much of my body showing. I mean I still have
a long way to go, but I'm at a point now that I can
wear a cocktail dress and get away with it and not be
like, everybody looking at you like, What in the world
do you think you're doing? I don't like it. It's too
big. It's like way too big in here. I like this dress.
It's longer. It covers more. I like it.
It's March today, right? So in the middle of summer
I'll be in my Speedo bathing suit.
ALAN ALDA (NARRATION) Rodney was up and about soon after
Hi ya. How ya doing?
ALAN ALDA Oh you look great -- walking around. When
did you have your operation?
ALAN ALDA Yesterday and you're already around walking?
I was walking at three o'clock this morning.
ALAN ALDA Really?
Yeah. It felt good to walk.
ALAN ALDA Are you in any discomfort?
No, just a little. You know, you know that somebody's
done something. Before I came here, I was like a very
closed person, I didn't talk to anybody. Now they can't
shut me up . When I come here I talk to everybody, you
ALAN ALDA So what's the relationship between being more
open and getting your diet more...
I don't know I feel comfortable with the people and
I know they're going through the same thing I'm going
through. So it's not like we're trying to, you know
hide anything from anyone.
ALAN ALDA So does that mean that you're more honest
with yourself about what you're eating?
Yes, yes, yes.
ALAN ALDA That's interesting. Being closed off from
other people in a way is a way of being closed off from
DIARY I've already lost 10 pounds since I left the hospital.
It feels good to have everything loose. I mean, everything
is already a size too big for me. It's better than hitting
the lottery, you know? Because if I'd have hit the lottery,
I'd just probably gone out and bought a dozen cheesecakes
and eat them. I haven't even craved a sweet. Before
I used to walk into a room, you know, all my friends,
nobody would say anything, but I'd always be wondering
what they thought, you know. Now they all come up, "Boy
you look good." "How do you feel?" "You look great."
"You look twenty years younger." You hear all of this
stuff. And it makes you feel good. It makes you want
to go on and keep this thing up.
This is my attire before I had my operation. Now I can
fit another person in here. I wasn't able to button
this shirt. Now I got a little room. Actually, I've
gone down a size. This is the shirt. Towards the end
there these buttons would be like this, before my operation.
ALAN ALDA (NARRATION) Rodney discovered a new, positive
outlook on life. He's now full of energy, walking several
miles a day. He could barely walk before.
Two weeks before I went into the surgery, I was questioning
myself a lot. I was thinking, I really love food. Am
I gonna be able to live like this without the food,
you know? I mean, I used to like the breads, the cakes,
the pastries, the ice cream, the puddings, all that
stuff. Am I really gonna be able to do this? And then
I said, Well, let me try it. I'm four months out from
my surgery. I don't miss it at all.
(AT SUPPORT GROUP) Before I entered the program I was
375 pounds. This morning, I weighed 224 and I had the
operation six months ago. No matter what I did I was
uncomfortable. When I first come and I sat in those
chairs I was uncomfortable. They didn't make them wide
enough. Get on an airplane -- I used to travel to Washington,
D.C. a lot -- I'd always get the extensions. And it
was getting so the extension wasn't long enough. I always
had to get the big cars. My pickup truck had to be extra
king size, you know, like you get the piggy size at
McDonald's? I would get the biggest size pickup truck.
Now I own a little Mazda. I haven't come to one of these
support groups that I haven't walked out of here with
a tool. And I'll never forget my very first one I came
to. There was a lady talking about how she controlled
what she ate. And she always would say, she would get
a napkin and put it over half of her plate, and only
eat what was exposed. I told my wife about it, and just
the other day, we were eating, and she noticed that
I was eating a little bit more. She grabbed a napkin
and put it over half the plate.
DIARY It's not a line you cross. There's no finish line.
I can see that pretty clearly now. You're always running
the race. But it's fun to run.
ALAN ALDA (NARRATION) Eight months after we'd started,
the "Losing It" weight loss group got together for a
farewell dinner -- calorie controlled and nutritionally
balanced of course. We'd had one drop out from the group,
but Eric's new son Henry made a good substitute. Unfortunately,
Eric's diet collapsed when Henry was born. Life got
too hectic to think about dieting, and he's now gaining
ALAN ALDA As I remember a big thing in your, the change
in the way you ate, was that you stopped drinking so
ALAN ALDA Soft drinks.
Yeah. I've kept that...
ALAN ALDA You still...
Yeah, I've still kept to the diet soda and water and
that kind of thing. So I've kept on that. But, as far
as the rest of the diet goes, it's gone. I've gained
about 13 pounds of the 27 that I lost, back. But, I've
got bigger fish to fry now. I've got a new look on life.
ALAN ALDA (NARRATION) Marcy, to her surprise, found
she liked exercising -- she thinks the TV show helped.
She lost half what she'd hoped to lose, but she's still
ALAN ALDA Have you noticed any change in your health?
ALAN ALDA Like what?
Well, my cholesterol's way down. It like went down 20
points. I noticed a big difference -- just, we have
13 steps in our house and I'm going up and down them
all the time.
ALAN ALDA And you don't feel winded.
ALAN ALDA You know I have a change in my health and
I didn't tell the video camera about it. I'll tell you
now. I... my blood pressure went down, and I had been
on a blood pressure pill and I'm off it now.
ALAN ALDA (NARRATION) I discovered just how much effort
it takes to lose weight. You have to think about it
all day, every day. After all that I really don't want
to get the weight back. I'm sticking with it. Amy's
and Rodney's surgeries were both successful, and they
both lost weight rapidly. They're both full of new energy
and getting healthier.
ALAN ALDA Do you just eat now in a utilitarian way?
Or do you enjoy your food?
I eat because now I have to nourish my body, you know
what I mean? And I concentrate on the protein, because
that's what they want you to get -- 65 to 80 grams of
protein a day.
ALAN ALDA And is it hard to get that down?
Oh, it's wicked hard.
ALAN ALDA Really?
Yes. Because you're not hungry so you have to remind
yourself to eat.
ALAN ALDA Is it harder to remind yourself to eat than
it used to be to remind yourself to eat less?
ALAN ALDA It is?
ALAN ALDA So, is this really good?
It is good.
It is. It really is.
Like Amy says, we're never hungry.
ALAN ALDA Is this something you would recommend?
If I'd have kept going the way I was going, there was
a danger that I wasn't gonna live another year...
ALAN ALDA Yeah.
You know because I was headed for a stroke.
ALAN ALDA (NARRATION) Wendy failed in her diet, but
she discovered how to confront her life-long binge eating.
She thinks the TV show helped her do that.
WENDY Pretty much everything that I said that I was
going to do within these next few months, I didn't do.
But I'm okay with it, because, it took a lot to actually
come back here tonight and film this last part because
I was embarrassed, you know. But then I realized I really
don't have anything to be embarrassed about.
ALAN ALDA What do you think you'll do now?
WENDY Therapy, is the main thing. You know because that
is unwinding a lot of things. And I take the steps as
it goes, and I'm fine with that, you know. I'm happy.
ALAN ALDA (NARRATION) Kathy and Tom each lost about
20 pounds -- less than planned. They hope the kids learned
new, healthier eating habits -- although I wasn't sure
Dad had learned the lesson himself. KIMBERLEY He goes
through a bag of chips in one day.
ALAN ALDA You go through a bag of chips in one day?
TOM When I binge I do.
ALAN ALDA When you binge. Now have you binged much during
these eight months? TOM No. No.
Did too. When we were at...
ALAN ALDA Is she the binge police? KATHY Yeah, she is.
TOM She's the police, period. KIMBERLEY If they don't
feed me chips, how come he gets some? KATHY Total denial
is what it is, I guess. KIMBERLEY He tries to hide it
in the trash. Then we come home, and you can hear it
crinkling in the trash.
ALAN ALDA You here it crinkling and the bag starts to
like open up...
ALAN ALDA (NARRATION) Robin was the most successful
of our 8 dieters, losing 45 pounds. She plans to keep
going and lose another 50.
ALAN ALDA Do you have any health issues that have gone
away since you...
ROBIN Just fat.
ALAN ALDA (NARRATION) If they are like most people,
the five of our dieters who succeeded in losing weight
will have quite a struggle keeping their weight off.
It won't be impossible, but it will be tough. Our two
gastric surgery patients are still losing weight, and
given their program's success rate, neither would expect
to regain weight within five years. Of course, our program
has not been a controlled experiment. On the Frontiers
web site -- at pbs.org -- you can see how dieters do
in scientific studies, and find out the latest on all
our weight loss people.