McDonald’s, Government, or Parents?

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I have spent 30 years studying the habits that allow people to over eat, become fat, stay fat, and falter at repeated diets.  The present issue of the government controlling the McDonald’s happy meals is ridiculous at several levels.  First,  why should the government get involved in this?  We have a free enterprise system and last I noticed Americans were still allowed to make their own decisions as to what they want to eat.   So, politically, I see legal control of human behavior  as a very dangerous step…. a slippery slope that  feels “socialistic.”   The responsibility of teaching children about nutrition is NOT that of McDonald”s nor the government but of the parent(s).  Children cannot drive to McDonald’s.  They do not have the money to pay for a meal.  The parents do!   The subliminal messages they absorb from watching their parents’ behavior is much stronger than that of an occasional commercial on TV.

I agree that these meals and most fast food is unhealthy (from a “fat” perspective) and may be a major contributor to the obesity problem in America.  However, if parents took the time to have healthy choices available,  to teach good nutrition habits by their own behavior, this would be a non-issue.  The operative word here is time.   Time to plan, shop and prepare food.  Since the key to a healthy body is good nutrition, it is definitely worth it to invest this time. BTW an occasional treat of a Happy Meal in a child who knows good nutrition with a toy is perfectly OK!    In my books, THE BROWN FAT REVOLUTION and LOSE THE FAT LOSE THE YEARS, I recommend an occasional “cheat” meal so that a sense of deprivation is avoided.

The government cannot dictate what our choices are.  It is the parental responsibility to teach “body respect”  and the importance of nutrition.   Ironically, like alcohol and drugs, creating a forbidden McDonald’s Happy Meal might make it more inviting…. what a paradox!  Michelle Obama has declared “Childhood Obesity”as the centerpiece of her First Lady platform.  I wonder how /if this dictum to control McD’s little meal is connected.   It appears to me that the PR buzz of laws to control the little box is more enticing to a publicist than a McDonald’s Happy Meal is to a child!

Plastic Surgery Then and Now

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I have been in practice for 28 years and have seen a 180 degree change in the specialty of Plastic Surgery.    In 2010,  the term “Plastic Surgery” clearly misrepresents the specialty.   A better umbrella to cover all of the techniques now available to rejuvenate the face and body would be “cosmetic medicine.”    Not “cosmetic surgery”  but  “cosmetic medicine”  I  prefer the use of the term medicine. It underscores the multilayered approach that a good plastic surgeon takes to a patients chief complaint.  My first consideration after good general health is the nutritional investment each patient has in themselves.  Proactive involvement in the process of looking better/younger is mandatory! Are they overweight?  Have they made a commitment to their body by  eating what is natural and healthy.   Do they exercise regularly?  Are they psychologically stable?  Are the expectations appropriate for the selected procedure?  Can they  really afford the procedure without undue financial stress?   Only after considering all of these issues, should the “cosmetic medical” plan be “prescribed.”  It might be Botox in one patient, laser lipo in another  and a facelift in another, but at the end of the day, each case is customized.

The Brain and Body Image

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You might find this hard to believe but after 28 years of morphing my patients bodies with plastic surgical procedures and 20 years of an avid interest in body building, I continue to be perplexed on how people perceive their physical appearance, their body image.  I continue to study neurobiology since it is clear to me that the answer to most issues that seem so illogical is found in the uncontrollable and unpredictable chemical reactions in the brain.    The study of Neurobiology has  clearly improved my understanding of body image more than all of my experience in dealing with patients and friends who are devoted to “controlling” their images/bodies.  Basically, our brains are  hard-wired to see  shapes and contours.  These are stored in our brains.   Once registered , it is difficult to change  neural “impressions” or brain memory  despite a change in appearance that is clearly seen with the eyes.  Basically, the objective reality of the body is only processed by the eyes, and delivered to the brain for perception.  This is a pivotal mechanism in understanding the lack of positive feedback in some people who have lost significant weight,  or had extensive plastic surgery, or  dramatically changed their bodies with exercise/diet regimens.  I  now understand the genesis of the problem.  Modifying the brain is another issue!

BROWN FAT AND LOOKING YOUNGER

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It may seem evident to most that losing weight and looking younger are complimentary.  This is not usually the case in folks who lose weight with non-nutritional restrictive diets.  In The Brown Fat Revolution and Lose the Fat/Lose the Years, I make the case for eating well AND losing weight so that all tissues are rejuvenated.   Once  nutritional discipline sets in, why not seize the opportunity to not only achieve optimal weight but to restore your skin, muscles, bones and fat to look, feel and act younger?  All it takes is  attention to the  “natural” quality of what you eat.  So simple, yet so rewarding!  Your body needs fat  “on it” to look young.  It is the fat that creates the “volumes” of youth that we see in a young woman’s body and face.  But it must be high quality, well nourished fat that hugs the underlying bones and supports the overlying skin creating the three dimensional contours of youth.  Just as you can change your skin to look younger with stress control, diet, exercise and topical care….you can modify the quality of your fat with nutrition and exercise and look younger!

Wrinkle Obsession

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I am continually fascinated by the obsession with wrinkle eradication as the only way to make the face look younger.   I  strongly propose that most faces look old due to  a distinct change in shape with time.

The brain of the viewer sees shape and contour before it appreciates wrinkles.    Think about a 20 year old face without wrinkles and a 60 year old face without wrinkles.   Your brain intuitively knows the “older” face by its shape.  Artists know this very well as do sculptures and plastic surgeons.

This point lays the groundwork for a pivotal change in the way that we should look at facial rejuvenation.   Most faces need volume not wrinkle effacement to look younger.  Volume is naturally supplied by fat.    Though there are now a number of excellent “fillers” that can make a face look young in a matter of minutes with little to no down time, including  Restylane, Juvederm, Sculptra, Radiesse.  These are but a few of the more commonly used fillers to restore faces to the wonderful, flowing, three dimensional contours that are so taken for granted in youth.

My advice after 28 years of rejuvenating faces both nonsurgically and surgically:  start with  contour improvements if you want to look younger.  Then, assess the skin, and treat the wrinkles secondarily.  Once volume is added to create the contours of youth, the  wrinkles  may be gone or certainly look a lot better and require less or no treatment.

Remember, as you diet and exercise, you need some fat for volume.  Your face will look wrinkled, dry and haggard without fat.  Do not sacrifice the face for the body!  In the Brown Fat Revolution Diet you learn how to eat to lose fat, maintain optimal weight and look younger in your face and body by making fat your friend.  Good, healthy fat hugs muscles, supports the overlying skin and defines the shapes that make a woman look young and beautiful.

Images Speak Louder than Works

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Images Speak Louder than Words

As the author of The Brown Fat Revolution, a Diet and Exercise program to lose weight and  the sloppy yellow fat, I must say that I take great pride in what I have personally accomplished by living according to my own principles for the last 20years.  The results of  consistent training and healthy eating can be so gradual that the individual who lost the weight and gained lean muscle does not see a dramatic difference in the mirror.   As a plastic surgeon , I am well aware of the disconnect between what is real and what people see in their mirrors!

I have found that the way that I look makes people react to me in a very interesting way.   There is a clear subliminal message that one projects when they look fit.   I know that obese individuals  tell unfortunate stories on how their physical appearance defines the way the world treats them.

In my case,  strangers come up to me and ask me what I eat or how I train.   Commonly, both women and men (none of whom know that I wrote and diet and exercise book) approach me in the gym to ask training questions.   More subtle and interesting  is the way I am treated in restaurants.  When I  order a meal that comes with fries, the waiter will always say, “you do not want the fries, right”  I recently had occasion to order a bagel at a coffee shop and the server said, “you want the “whole wheat” right?”….or…. “Of course, you do not want to see the dessert menu.”

We live an intensely visual world and  appearance definitely affects the way people react to us.   This is a fact!  Beyond the self-gratification and healthiness of being in control of the way you look,  the opportunity to say that you are in control without words is extremely empowering….one of the many benefits of respecting yourself by paying attention to the condition of your body.   It’s all good!

Images Speak Louder than Words

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Images Speak Louder than Words

As the author of The Brown Fat Revolution, a Diet and Exercise program to lose weight and  the sloppy yellow fat, I must say that I take great pride in what I have personally accomplished by living according to my own principles for the last 20years.  The results of  consistent training and healthy eating can be so gradual that the individual who lost the weight and gained lean muscle does not see a dramatic difference in the mirror.   As a plastic surgeon , I am well aware of the disconnect between what is real and what people see in their mirrors!

I have found that the way that I look makes people react to me in a very interesting way.   There is a clear subliminal message that one projects when they look fit.   I know that obese individuals  tell unfortunate stories on how their physical appearance defines the way the world treats them.

In my case,  strangers come up to me and ask me what I eat or how I train.   Commonly, both women and men (none of whom know that I wrote and diet and exercise book) approach me in the gym to ask training questions.   More subtle and interesting  is the way I am treated in restaurants.  When I  order a meal that comes with fries, the waiter will always say, “you do not want the fries, right”  I recently had occasion to order a bagel at a coffee shop and the server said, “you want the “whole wheat” right?”….or…. “Of course, you do not want to see the dessert menu.”

We live an intensely visual world and  appearance definitely affects the way people react to us.   This is a fact!  Beyond the self-gratification and healthiness of being in control of the way you look,  the opportunity to say that you are in control without words is extremely empowering….one of the many benefits of respecting yourself by paying attention to the condition of your body.   It’s all good!

Cozy Foods

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Barbara, the monster snow storm is hitting Connecticut today and my wife and I are pretty much in a welcome lock down at home.   As the author of The Brown Fat Diet , I intuitively know what to eat to stay in shape;  however, this morning,  I found my mind acting differently.  I was thinking about baking a cake/brownies or having pancakes for breakfast!   The power of the brain and memory!   Hmmm how to handle this conflict of food choice that I am sure so many of us feel on days like today?

The brain (specifically, the amygdala) has this incredible ability to connect to past experiences and create cravings for things associated with good times.  In this case, probably,  those  unexpected and welcome days off from school, when my mom would cook all the comfort foods.

Those of you who follow me or have read my book, The Brown Fat Revolution, know that I strongly believe that occasional side steps when you are on a diet are OK and actually work to keep you comfortable with food and not feel deprived.  So, I will have a brownie today and whole wheat pancakes with low sugar syrup/no butter and not feel at all guilty.

Life is about the experience and not to embrace the connections that we have garnered from the past in a positive way and enjoy is nonsense.  After 20 years of eating according to the principles of The Brown Fat Diet, I can firmly testify that this one day of  relaxation combined with visual beauty (the snow) and gustatory coziness will not affect the shape of my body!

Little Girl with an Old Face

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On Monday, February 1, 2010, the TODAY Show had a riveting segment on a 13-year-old English girl with the face of a 50-year-old woman.  She is the victim of a genetically-determined disease called Lipodystrophy Syndrome.   In this disease, there is little or no subcutaneous fat, so the skin is not supported or filled with fat, and the normal facial shapes that we associate with youth are absent.   This girl indeed looks 50.   Her mother, who is 40 but looks 70, has the same syndrome, as do three of her seven siblings.

This heart-wrenching story highlights the obvious psychological trauma that awaits this young girl as she enters her teens, when peer criticism typically ranges from acute to mean.  

As a plastic surgeon, I can think of a number of treatment options to fill her face so she looks like a teenager.   Sculptra, an injectable poly L lactic acid first used in men with AIDS and now approved by the FDA for aesthetic facial filling, would be an excellent option.  It is long lasting, extremely effective for global filling, and has not shown any allergic reactions.  It is basically the same material used for decades to dissolve sutures.  Therefore, I do not see any contraindication in a young girl.   Since she does not have fat to spare, we cannot transfer fat as a graft, which would be another good option.  

I am trying to reach out to this family.  The course of this young girl’s psychological life can be dramatically changed with two office visits and Sculptra!   Her mom needs to know that this is available. 

As the author of The Brown Fat Revolution, I make the point that fat is the most important determinant of facial aging.  The effects of Lipodystrophy Syndrome illustrate that point.  This 13-year-old face doesn’t look old due to gravity, the descent of tissue, or wrinkles, the common characteristics that we think cause aging.  The only missing structure is fat!  Women need fat to look young and healthy.  They need toned, well-structured brown fat!   Brown fat is the answer to an ageless face.

Skinny Women

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American women are obsessed with being thin.  Ironically, as a woman ages, if she becomes too thin, she also looks older.  The face needs fat to look young and the body needs fat to create the curves that define femininity.  Deprivation diets and extreme exercise can produce thinness, but should thinness be the goal? 

A recent Japanese study found that extremely thin people shorten their life span by 5 years.  The study included people between the ages of 40 and 79.  Other possible parameters to account for thinness, such as smoking or illness, were taken into account and the findings were still found to be significant.

I am not at all surprised by this study.  Most extremely thin women have over-dieted and made unhealthy food choices.  As someone who assesses tissue quality every day in the Operating Room, I’ve seen first-hand how their tissues pay a price, appearing physically older than their chronological age.  Ironically, I observe poor quality yellow fat more frequently on very thin women than the preferred resilient brown fat.  So skinny is not good!   Most super-thin patients that I see are not healthy, which supports the findings in this Japanese study.

However, you can be attractively thin and healthy!   To accomplish this goal, you must eat well to supply all tissues with the nutrients necessary for continuous repair and restoration.  This need to consider tissue quality when making food choices is at the heart of The Brown Fat Diet:  Lose weight, but maintain a healthy layer of fat to look good and feel energized all of the time.  

This study does not take into account the fact that extreme thinness is a symptom of poor quality tissue,   It is not the thinness per se that defines lifespan but the tissue quality.  You can be thin, increase your lifespan and be very healthy if your tissues are lean in the sense of “healthy lean”, not “deprived lean.”  The Brown Fat Diet can achieve this goal:  shred yellow fat (become thin) but replace it with a healthy layer of brown fat and a global improvement in the quality of all tissues.