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!


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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!

Today’s shopping list is geared toward those of you in Hormone Category 1: women in their 30’s and 40’s. It is also geared toward the morning workout set (your meal plan will change slightly if you are an afternoon or evening exerciser). The food breakdown for the week will look like this:

Monday: Protein Day
Tuesday: Carb Day
Wednesday: Protein Day
Thursday: Carb Day
Friday: Protein Day
Saturday: Carb Day
Sunday: Choice Day

Now that you have filled your kitchen with the non-perishable basics we discussed in the last post, all you need to do is buy your fruits, veggies, fish and meat — I recommend doing this on a weekly basis so that these items are absolutely FRESH. Easy recipe directions are on pp. 94-103 of The Brown Fat Revolution book, but for the purposes of your grocery store visit, here’s a simple list:

fruit = blueberries, strawberries, cantaloupe, granny smith apples (a few will do), peach, 1 or 2 bananas, and (if you want) some seasonal fruits like a papaya, a mango, a pineapple OR a tangerine

vegetable = asparagus, yellow (summer) squash, carrots, broccoli, zucchini, onion, tomato, dark leafy lettuce, green beans, cauliflower, sweet potato, edamame

meat = ground turkey (for turkey burger), lean ground beef (for one hamburger patty), pork chops (1 serving), non-fatty steak (1 serving) and also 1 filet mignon cut, chicken cutlet(s)

fish = salmon

dairy = eggs, skim or low-fat milk, Greek yogurt, low-fat or part skim mozzarella

other = kidney beans, whole grain bagel(s), whole grain hamburger bun, multi-grain sliced bread, semi sweet chocolate chips, red wine

This will take you through an entire week of 6 small meals a day (again, refer to the recipes in the book for more details). If your grocery store doesn’t carry some of these things, or if you hate strawberries and would rather just eat blueberries, that is fine too! Feel free to sub out fruits, veggies and other variables — just make sure to stick to the basic framework of the eating plan. Happy eating!

Shopping List: Basics

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Many of you have been asking for shopping lists. And rightly so! My eating plan is, of course, outlined in the book, including recipes, portion sizes and when to eat throughout the day — but how can you utilize this information when you find yourself pushing an empty cart down the grocery aisle? Good question! In the coming weeks, I’ll be composing Shopping Lists that will help make your visits to the market quick and easy. Let’s start with the basics! For many of my recipes, you will need fresh meat, fish and produce. It is best to purchase those items on a weekly basis. Certain other items, though, you can keep for long periods of time. I recommend stocking your kitchen with these non-perishable basics so that you have them at your fingertips whenever you are whipping up your daily meals.

The first step? Create space. Clear your kitchen of anything that is not on the Brown Fat Revolution eating plan. This includes (but is not limited to):
-white carbs (Wonder bread, white pasta)
-potato chips
-packaged cakes
-salty peanuts (or mixed nuts), candied nuts
-high-sugar cereals and fatty granola
-sugary yogurts (or frozen yogurt)
-ice cream
-sugary alcohols, beer and margarita mix, etc.
-pre-made dinners (like the Lean Cuisine or Healthy Choice in your freezer aisle)
-honey, maple syrup
-heavy cream
-bars (Balance bars, Nutri Grain bars, granola bars, candy bars)
-canned fruit, dried fruit, pre-packaged trail mix

If it is in the cabinet or the fridge, it is a temptation! We can’t expect ourselves to resist that sort of temptation. If you share your home with others (kids, significant others), feel free to separate food items. Let them keep their food in a separate space, and procure your own space — a place where you will keep ONLY HEALTHY FOODS. Your willpower will get an automatic boost — this is half the battle!

NOW that you have space, fill it with all things GOOD. “The Basics” include:
-all-fruit, sugar-free jam
-almond butter or natural, unsweetened peanut butter (smooth or chunky)
-apple cider vinegar, balsamic vinegar, and red wine vinegar
-brown rice
-chunky, unsweetened applesauce
-coffee and/or tea
-Dijon mustard
-extra virgin olive oil, flax seed oil, and sunflower oil
-grated parmesan
-low-fat, sugar-free granola
-nuts: raw almonds (I also love the 50% salted almonds at Trader Joe’s), raw pistachios, raw pecans, raw walnuts, slivered almonds for garnish
-oat bran, unsweetened multigrain cereal, original Cream of Wheat, unsweetened oatmeal
-soy milk or almond milk (unsweetened varieties)
-sugar-free tomato sauce, and sugar-free marinara sauce
-supplements (only if you want): Vitamin A, Vitamin C, Calcium, Iron, Biotin, Chromium, L-glutamine, Fish oil
-stewed tomatoes
-tuna (canned, in water)
-whole wheat crackers
-whole wheat, high fiber tortillas
-whole wheat pasta

You are now ready to stock your new and improved kitchen! Once you have these basics in place, adding the elements to make the recipes will be easy.

The Brown Fat Diet Shopping List

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The most difficult part about getting started on The Brown Fat Diet or any diet for that matter, is getting the food in your house! We have decided to help you and supply a weekly shopping list. This list will reflect not only good choices for healthy fat management, but choices that are interesting and seasonal. Eating is a sensual experience and should be enjoyed and looked forward to. Start with this list and you will find that very shortly, you will intuitively know what to select for the week.

Summer Grilling

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Yesterday was “Grill Cleaning Day” An annual ritual that has for me since it is filled with anticipation of Summer foods and recipes, good times, friends, family and wondrous weather. Most people think of summer as a difficult time to control weight due to popular grill selections: hamburgers, hot dogs and their accoutrement: relish, french fries, potato salad, macaroni salad…the classic American “cook out.” The grill actually opens up your food repertoire and is the best place to cook fresh fish (no smell in the house for days!) and summer vegetables: squash, asparagus, peppers. Delicious and loaded with anti-oxidants. Grill you chicken, throw it over some grilled vegetables or a mixed green salad. Get out all of those Summer condiments and let the flavors run high. You will notice that it is actually easier to maintain and lose weight in the Summer if you focus on natural foods and clean preparation: grilling.

April 2010 and Gym still Full!!

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A new year, 2010. I am convinced that working out has become a lifestyle and not a January resolution. This is the first year that I have noticed that the Jan crowd is till vying for machines and it is almost May 1st! Maybe we are finally realizing that balance and slow steady steps (the long range approach) are better than dramatic commitments (quick fix approach). Dieting is the same and it is my hope that the 2010 gym “hang-ons” are eating as they are exercising: slowly, steadily, intelligently, and effectively. Once you have these two in step, the sky is the limit on how much weight you lose and how youthfully sexy you can make your body.

Latest Biggest Loser’s Mom

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I was very impressed this morning when I saw the mother of the most recent contestant to be voted off of The Biggest Loser. The Mom was more impressive than the contestant! and she had no drama!! She said she “did it all at home.” She realized that she had an excuse for everything connected to working out but once she decided to do it at home, there was no room for excuses. She lost over 89 pounds! Looks sexy and young and should be commended for her ability to take her quest inside herself, come up with a personal and private solution and Just Do It (My favorite statement from Nike). Much more impressive than needing to be on TV with all of the drama and secondary gain. Go Mom! Well done.