- Weight Loss -

Hungry No More

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Hungry Fat

Satisfy your appetite, retrain your fat cells, and lose weight for good.

Weight-loss wisdom has long focused on one thing: Consume fewer calories than you burn.

There’s just one problem. It doesn’t work — at least not over the long term, for most people.

Obesity rates remain at historic highs, despite a 40-year focus on low-calorie, low-fat diets.

While an obsession with counting calories rarely produces lasting weight loss, it regularly causes suffering and shame. If all calories really are created equal, then the onus is on us to exert self-control. This view blames people with excess weight, who are presumed to lack knowledge, discipline, or willpower.

But here’s the thing: An excessive focus on calories isn’t just ineffective — it works against weight loss. Recent studies show that highly processed carbohydrates adversely affect metabolism and weight in ways that can’t be explained by calories alone.

Conversely, nuts, olive oil, and dark chocolate — some of the most calorie-dense foods in existence — appear to prevent type 2 diabetes, heart disease, and obesity.

After two decades of researching obesity and caring for thousands of people struggling with their weight, I’ve come to realize that overeating doesn’t make us fat. The process of becoming fat makes us overeat.

We’ve been following the rules for weight loss and blaming ourselves when they don’t work, but now we’re learning that the rulebook was wrong.

Here’s how you can tame your “hungry fat,” and find your own way to lasting weight loss.

Conquering “Hungry Fat”

Though it may seem counterintuitive, hunger and overeating are the consequence, not the cause, of an underlying problem. Something has triggered fat cells to suck up and store too many calories, leaving too few for the rest of the body.

Perceiving low-energy resources, our brains unleash the starvation response, including hunger (to get extra calories) and a slower metabolism (to save energy). Eating more solves this “energy crisis” temporarily, but it also accelerates weight gain.

Cutting calories can reverse the weight gain — initially — but inevitably increases hunger and slows metabolism even more.

What causes fat cells to hoard calories? The culprit is too much insulin, which we can think of as the ultimate fat-cell fertilizer.

And what’s raising our insulin levels? All the processed carbohydrates that crept into our diets during the low-fat craze of the last few decades — bread, rice, pasta, chips, crackers, cookies, and “low-fat” snacks and desserts.

So the standard American diet — together with stress, sleep deprivation, and sedentary habits — has put our fat cells into calorie-storage overdrive and undermined our efforts to take control of our weight.

The conventional calorie-balance approach fails because it’s focused on the wrong target. The problem isn’t having too many calories in the body; it’s having too few in the right place — circulating in the blood stream and available for our immediate energy needs. It’s a distribution problem.

Processed carbohydrates overstimulate fat cells, which become greedy and consume more than their share of calories. In this way, fat cells feast while the rest of the body starves, and we struggle with constant hunger.

Fortunately, this is all reversible.

How It Works

The best way to deal with “hungry fat” cells is to change what we eat, not how much. The goal is to prevent fat cells from getting the lion’s share of calories.

The most effective strategy is to shift away from fast-burning carbohydrates and toward a more nutrient-dense diet — with plenty of quality protein and healthy fats. These foods burn more slowly and are also more satisfying and filling.

This approach is designed to work from the inside out, creating the optimal internal conditions for weight loss to occur naturally. Follow it, and your body will find the rate of weight loss that’s right for you.

That might be half a pound per week for some people, or 2 pounds or more for others. But without deprivation and hunger, the results will be progressive and sustainable.

In my book Always Hungry?, I present a three-phase program (below) that helps you do all of the following:

Turn off your starvation response by eating nutrient-dense foods whenever you’re hungry — and eating until you’re fully satisfied. (Deprivation slows metabolism.)
Tame your fat cells with a reduced-carb diet that lowers insulin levels (high insulin overstimulates fat cells), calms inflammation, and redirects calories to the rest of your body.
Follow a simple lifestyle prescription focused on enjoyable physical activities, quality sleep, and stress relief. These “life supports” will also improve metabolism and facilitate permanent behavior change. (See “Why Lifestyle Matters for Weight Loss” below.)

Now, I encourage you to forget calories, focus on the quality of your food, and let your body do the rest!

Conventional Weight Loss

Conventional Weight Loss

Conventional diets aim to shrink body fat by restricting calorie intake. But this approach is doomed to fail, because it addresses the symptoms, not the problem. After a few weeks of calorie restriction, the body fights back, making us feel hungry, tired, and deprived. This is because when we reduce dietary fat and consume more carbohydrates, fat cells take up and store too many calories, leaving too few for the rest of the body. So we get hungry and metabolism slows down. Though we may be able to ignore the hunger and fatigue for a short while, they inevitably erode our motivation and willpower. Soon we succumb to constant hunger and the weight comes racing back.

Sustainable Weight Loss

Sustainable Weight Loss

The Always Hungry? solution is more effective over the long term, compared with calorie restriction, because it addresses the biological cause of excessive weight gain — fat cells stuck in calorie-storage overdrive. With a lower-carbohydrate, higher-fat diet, this approach lowers insulin levels and reduces inflammation. When that happens, fat cells calm down and release their excess calorie stores. As the body begins to enjoy better access to fuel, metabolism runs better, hunger and cravings subside, and weight loss occurs automatically — without deprivation.

Phase 1: Conquer Cravings

The Always Hungry? program officially kicks off with a two-week boot camp designed to conquer cravings. Phase 1 is essentially the opposite of a low-fat diet. You’ll eat a high proportion of healthy fat (50 percent of your total calories), a lower amount of total carbs (25 percent), and slightly more protein than you might be used to (25 percent). For two weeks, you’ll eliminate all grain products, potatoes, and added sugar.

Don’t worry about being deprived. You’ll fill up on rich sauces and spreads, nuts and nut butters, full-fat dairy, and other high-fat foods that calorie-restrictive diets won’t let you go near. Including more fats and protein, and restricting carbohydrates, helps you stay full and holds insulin in check, breaking your dependence on the quick fix of refined carbs.

This phase is also designed to jump-start weight loss. I don’t recommend it for the long-term (except for those with more extreme metabolic problems, like prediabetes). Most people can tolerate more carbs, and the next phases allow for more flexibility and adaptation.

Portion sizes are recommendations only: You’ll eat until you’re comfortably full, no more or less.

Phase-1-Daily-Nutrient-Breakdown

 

Sample Menu Phase 1

Breakfast: Black bean tofu hash with spinach, cheddar cheese, sour cream, and half an avocado
Snacks (2/day): Cold-cut lettuce boats with lemon-tahini sauce, a small apple with peanut butter, or trail mix
Lunch: Steak salad with blue cheese dressing and a tangerine
Dinner: Broiled white fish with garlic, lemon, and creamy dill dressing, sautéed kale, green salad
Dessert: Poached seasonal fruit, 1 to 2 tbs. homemade chocolate sauce

Download part of the Phase 1 Meal Plan.

Phase 2: Retrain Your Fat Cells

Phase 2 teaches your fat cells to stop hoarding calories. As fat cells calm down and begin to release their calorie stores back into the body, your brain will register that it has enough fuel to run your metabolism in optimum mode (perhaps for the first time in years). This phase will help you lose weight progressively until it stabilizes at a new, lower set point.

Phase 2 can last anywhere from several weeks to six months or more, depending on how much weight you want to lose. You will slightly decrease your intake of healthy fats and increase healthy carbs by adding in some whole-kernel grains and starchy vegetables. The amount of protein remains at 25 percent.

This is the basic plan. If you find you’re sensitive to processed carbs when they are added later in the program, you may do best returning and  sticking to Phase 2 indefinitely. And if you aren’t tolerating the additional carbs here, you can always go back to Phase 1 meals at any time.

Daily-Nutrient-Breakdown-Phase-2

 

Sample Menu Phase 2

Breakfast: Grain-free waffles with berry sauce and fresh whipped cream; turkey bacon
Snacks (2/day): Roasted nuts and seeds, hummus, cold cuts with dressing, cheesy bean dip, or herb-roasted chickpeas
Lunch: Broiled salmon with garlic and lemon; quinoa salad with cranberries and pecans; steamed butternut squash; fresh fruit
Dinner: Chicken (or tofu) and vegetable stir-fry with brown rice
Dessert: Coconut-cashew clusters

Phase 3: Lose Weight Permanently

The ratio of foods in Phase 3 is similar to the way most Americans ate in the 1950s and 1960s, before the low-fat craze hit. Your meals will consist of approximately 40 percent fat, 40 percent carbs, and 20 percent protein. (The classic Mediterranean diet has a similar nutrient ratio.)

With insulin finally in check, most people can tolerate the moderate increase in carbohydrates without weight regain. You may need more food to stay full in this phase, as you’re no longer burning off stored calories from body fat.

Phase 3 is for life. The focus here is experimentation: to create a personalized dietary blueprint that will serve you over time. I recommend limiting processed carbohydrates to no more than two servings a day, and to continue to emphasize healthy fats, protein, and vegetables.

Still, including more carbs here is optional, if you find your body can handle them without side effects (like cravings, mood swings, and weight gain). If you notice yourself getting voraciously hungry between meals, that’s a sign you’re not tolerating them well. (Remember, you can always return to the Phase 2 or even Phase 1 eating plan.) But if you’re feeling good, enjoy the extra flexibility.

Daily-Nutrient-Breakdown-Phase-3

Sample Menu Phase 3

Breakfast: Spinach and cheese omelet; whole-grain toast and nut butter
Snacks (2/day): Same as earlier phases: roasted nuts and seeds, hummus, cold cuts with dressing, cheesy bean dip, or herb-roasted chickpeas
Lunch: Chipotle chicken tacos
Dinner: Coconut-curry shrimp served over brown or white rice
Dessert: Berries and heavy cream topped with homemade granola

Why Lifestyle Matters for Weight Loss

The choice of what we eat does not exist in a vacuum. Everything we consume enters into a complex feedback system that’s continually influenced by the way we live. Our culture of sedentary living, excessive stress, and insufficient sleep creates changes in the body that, independent of the quality of our diet, can raise insulin, cause chronic inflammation, and drive fat cells to hoard too many calories.

But if we make modest changes to how we move, relax, and sleep, we encourage fat cells to release trapped calories, leading to increased energy and a greater sense of well-being.

Here are a few simple strategies:

Stroll for Your Health

Italians have a name for their daily walk — the passeggiata. It doesn’t involve pedometers or spandex; these walks are purely for pleasure. A passeggiata before nightfall can help recalibrate your body clock — and lower insulin levels.

A 2013 study in Diabetes Care found that for older people at risk for impaired glucose tolerance, three 15-minute walks daily increased their ability to regulate blood sugar for the following 24 hours. This effect was most pronounced during the three hours after dinner.

Take Time to Breathe

Sporadic moments of positive stress can be energizing and motivating, but if you endure too much stress for too long, your hormones become unbalanced, and that can program fat cells for weight gain.

Taking moments throughout the day to consciously relax can be a powerful antidote to excessive stress and inflammation. The specific practice you choose is not as important as finding one that works for you.

Daily practice is the most beneficial; five minutes of relaxation every day is better than 35 minutes once a week.

Lose Weight While You Sleep

More than 30 percent of adults in the United States get less than six hours of sleep per night. Among the biggest victims of sleep deprivation are our fat cells.

A 2012 University of Chicago study found that after healthy participants slept 4.5 hours a night for just four nights, the insulin sensitivity of their fat cells decreased by 30 percent.

Practice good habits of “sleep hygiene,” like avoiding screens for the hour before bed and keeping your bedroom free of electronics.

David Ludwig, MD, PhD, is a professor at Harvard Medical School, professor of nutrition at Harvard T. H. Chan School of Public Health, and the author of Always Hungry?: Conquer Cravings, Retrain Your Fat Cells & Lose Weight Permanently.

Dr. Ludwig is the founding director of the Optimal Weight for Life (OWL) program at Boston Children’s Hospital. He also directs the New Balance Foundation Obesity Prevention Center, where his research focuses on the effects of diet on hormones, metabolism, and body weight.

Adapted from Always Hungry? by David Ludwig, MD, PhD. Copyright © 2016 by David Ludwig, MD, PhD.  Used by arrangement with Grand Central Publishing. All rights reserved.

WEB EXTRA!

Adapted from Always Hungry? by David Ludwig, MD, PhD. Copyright © 2016 by David Ludwig, MD, PhD.  Used by arrangement with Grand Central Publishing. All rights reserved.

Black Bean Tofu Hash

Tofu is a blank canvas: It takes on the flavor of your favorite seasoning. If you’ve never been a tofu enthusiast, give it another try. With the right blend of seasonings, you’ll be surprised at how versatile and delicious this high-protein plant food can be.

Preparation time: 3 minutes
Total time: 10 minutes
Makes 4 servings (about 6 cups)

  • 1 tablespoon extra-virigin olive oil
  • 1 clove garlic, minced
  • 14 to 16 ounces extra-firm tofu, drained, gently pressed with an absorbent towel
  • 1 tablespoon chili powder
  • 1/2 teaspoon ground black pepper
  • Dash of cayenne pepper, or more to taste
  • 1 teaspoon salt
  • 1/4 teaspoon ground black pepper
  • 2 tablespoons water
  • 1 3/4 cups cooked black beans, drained (one 15-ounce can)
  • 1/2 cup chopped fresh cilantro

Heat the oil in a large skillet over medium heat. Add the garlic. Crumble in the tofu and sprinkle with the chili powder, cumin, cayenne, salt, and pepper. Sauté for 2 to 3 minutes. Add the water, stirring to allow the tofu to absorb the seasonings and water. Stir in the black beans and sauté for 2 to 3 minutes more. Add the cilantro and adjust the seasoning to taste.

Serve with sliced avocado, sour cream, salsa, or your favorite sauce.

Calories: 243, Protein: 22 g, Carbohydrate: 21 g, Total Fat: 10 g, Dietary Fiber: 10 g

Cold-Cut Lettuce Boats

This versatile snack lets you do away with the bread, but not the convenience.

Preparation time: 3 minutes
Total time: 3 minutes Makes 2 servings

  • 3 tablespoons dressing or sauce of your choice
  • 8 romaine heart leaves or endive leaves
  • 4 ounces sliced deli meat of your choice

Spread your favorite dressing evenly over the lettuce leaves. Roll half a slice of deli meat in the middle of each leaf, and enjoy!

Steak Salad with Blue Cheese Dressing

This beloved recast of a classic is one of those dishes that caused many pilot participants to ask, “This is diet food?” The recipe gives you a range for the amount of blue cheese dressing to use: Start with 6 tablespoons, but feel free to add up to 2 additional tablespoons if you like more dressing on your salad.

Preparation time: 5 minutes
Total time: 10 minutes
Makes 2 servings

  • 8 ounces beef tenderloin steak
  • 1 teaspoon extra-virgin olive oil
  • 1/4 teaspoon salt
  • 1/4 teaspoon ground black pepper, plus more for garnish
  • 2 to 3 cups chopped romaine lettuce
  • 1/2 cup cooked cannelloni or other white beans, drained and rinsed
  • 1 cup shredded carrots (about 1 large carrot)
  • 2 small tomatoes, diced, or other raw vegetables of your choice
  • 6 to 8 tablespoons Blue Cheese Dressing

Heat a heavy-bottomed skillet over medium-high heat. Rub the steak with the oil and season with the salt and pepper. Place the steak in the hot pan and cook until browned on one side, about 90 seconds or longer for steak thicker than 1 inch. Flip the steak and cook for 90 seconds more, or until the meat is cooked to your desired doneness. Remove the meat from the pan and let rest on a cutting board.

With a sharp knife, thinly slice the steak. In a large bowl, combine the lettuce, white beans, carrots, tomatoes, and steak. Toss with the Blue Cheese Dressing. Garnish with freshly ground black pepper.

Calories: 525, Protein: 38 g, Carbohydrate: 27 g, Total Fat: 30 g, Dietary Fiber: 7 g

Blue Cheese Dressing

This dressing turns simple salad greens into a satisfying side dish. You’ll also use it in a Different varieties of blue cheese vary greatly in taste, from strong to mild. Experiment with different varieties until you find your favorite.

Preparation time: 5 minutes
Total time: 5 minutes
Makes about ½ cup

  • 2 ounces crumbled blue cheese
  • 1 teaspoon finely chopped fresh chives or scallions
  • 2 tablespoons sour cream
  • 2 tablespoons of mayonnaise with no added sugar
  • 1 1/2 teaspoon fresh lemon juice
  • 1 tablespoon water
  • Dash of salt, if needed
  • Dash of ground black pepper

Place 1 ounce of the blue cheese, the chives, sour cream, mayonnaise, lemon juice, water, salt, and pepper in a wide-mouthed mason jar or cup that will fit an immersion blender without splashing. Blend with the immersion blender until combined. Stir in the remaining 1 ounce blue cheese, as this dressing is best if it remains a bit chunky. Place a lid on the jar. Allow the flavors to develop for 1 hour or more in the refrigerator. The dressing will keep for 1 to 2 weeks in the refrigerator.

Per tablespoon: Calories: 52, Protein: 2 g, Carbohydrate: 0 g, Total Fat: 5 g, Dietary Fiber: 0 g

Broiled White Fish with Garlic and Lemon

This quick, easy recipe works with almost every kind of white-fleshed fish, as well as salmon. A perfect weeknight meal—you can have it on the table in twenty minutes with all the sides.

Preparation time: 5 minutes
Total time: 15 minutes Makes 4 servings

  • 1 1/4 to 1 1/2 punds white-fleshed fish fillet (cod, scrod, hake, or other white fish)
  • 1/2 teaspoon salt, or more to taste (fillets thicker than 1 inch may need more salt)
  • 2 tablespoons extra-virgin olive oil
  • 1 to 2 cloves garlic, minced
  • 1/2 lemon, cut in thin slices
  • Chopped fresh parsley, cilantro, or scallions, for garnish

Set the oven to broil.

Rinse the fish, pat dry, and sprinkle lightly with the salt. Heat the oil in a cast-iron skillet or ovenproof skillet over medium-high heat. Add the garlic and sauté for a few seconds. Place the fish in the pan and sear for a few seconds on each side. Remove the fish from the skillet and turn off heat.

In a single layer, arrange the lemon slices in the pan. Place the fish on top GROUP of the lemon. It is best if the fish is covering most of the lemon slices so that the lemon doesn’t burn in the broiler, but still makes a nice sauce.

Place the skillet in the oven and broil until the fish is opaque and begins to brown on top, 8 to 10 minutes per inch of fillet thickness. Transfer the fish to a serving plate. If liquid still remains, heat the skillet on the stovetop for 3 to 5 minutes to thicken the sauce. Pour the sauce over  the fish and arrange the lemon slices on top. Garnish with chopped parsley. Serve immediately.

Calories: 205, Protein: 31 g, Carbohydrates: 2 g, Total Fat: 8 g, Dietary Fiber: 0 g

Poached Seasonal Fruit with Homemade Chocolate Sauce

Get creative with any fruits that are piling up in the produce section. Late summer or early fall fruits are best, from peaches and nectarines to apples and pears. This year-round treat suits every phase of the plan.

Preparation time: 3 minutes
Total time: 15 minutes Makes 4 servings

  • 2 medium pears, apples, peaches, or apricots, halved and cored or pitted
  • 1/2 cup water
  • 1/4 teaspoon ground cinnamon
  • 1/4 teaspoon ground cardamom
  • 1/8 teaspoon ground or freshly grated nutmeg
  • Pinch of salt

Arrange the fruit cut-side up in a single layer in a shallow skillet. Add
the water. Sprinkle the spices and salt over the fruit. Bring to a boil over medium heat. Reduce the heat to medium-low, cover, and simmer for 10 to 15 minutes, or until the fruit is soft. Remove from the heat. Serve warm.

Calories: 68, Protein: 0 g, Carbohydrate: 18 g, Total Fat: 0 g, Dietary Fiber: 4 g

Chocolate Sauce

Chocolate sauce that’s allowed from day one of your plan—need we say more? This versatile sauce makes any fruit a special treat.

Preparation time: 3 minutes
Total time: 15 minutes
Makes 2 to 4 servings (about 6 tablespoons)

  • 1/4 cup unsweetened soy milk, almond milk, or whole milk
  • 2 ounces dark chocolate bar or pieces (at least 70% cocoa content)

Pour the milk into a pan. Heat over medium-low heat until warm, then reduce the heat to low and add the chocolate. Heat, stirring regularly, until the chocolate is melted and smooth, 3 to 5 minutes. Be careful not to overcook. Chocolate should be smooth and creamy. If it starts to look grainy, it may be overcooked.

Spoon or drizzle the chocolate sauce over fruit on a tray or on individual plates. Serve warm.

Tip: The chocolate sauce can be refrigerated and reheated over low heat until soft. At room temperature, it will have the consistency of a thick frosting.

Per tablespoon: Calories: 60, Protein: 1 g, Carbohydrate: 5 g, Total Fat: 4 g, Dietary Fiber: 1 g

, MD, PhD, is a professor at Harvard Medical School, ­professor of nutrition at Harvard T. H. Chan School of Public Health, and the author of Always Hungry?: Conquer Cravings, Retrain Your Fat Cells & Lose Weight Permanently.

Photography by Terry Brennan and Cindy Syme