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The Four Cornerstones of Weight Loss


Losing weight seems like a search for the Holy Grail with so many theories and diet plans.  However, there are common elements within the successful programs which reduce weight and successfully keep that weight off.


Let’s look at the common elements for success:


 1. Avoid Refined Carbohydrates.


All carbohydrates are commonly called sugars. We use confusing terminology and talk about “blood sugar” when actually we should be saying “blood glucose”. A carbohydrate is actually a chain of glucose molecules linked together like pearls. How they are linked is called the carbohydrate bond, which determines the name of the carbohydrate. Nature is full of different carbohydrates eaten throughout human history. Some of these carbohydrates, like fructose (fruit sugar) or lactose (milk sugar), are staples of our diet. Our bodies have enzymes to clip off one glucose molecule at a time, slowly releasing the glucose in a steady fashion from the carbohydrate chain into the blood stream. This slow release does not spike your blood glucose level and provides energy over a long period of time. Glucose from refined carbohydrates (which come from processed food), is taken immediately into the bloodstream and spikes the blood glucose level. A refined carbohydrate takes fructose and pre-metabolizes the carbohydrate into free glucose. Sucrose, or table sugar, has 55% of the carbohydrate bonds broken into free glucose. High fructose corn syrup has 45% of the carbohydrate bonds broken into free glucose. This is extremely damaging to your blood vessels, as the body hates a high blood glucose level. Blood is a fluid that flows through tiny tubes called capillaries. The thickness of the blood, or viscosity, greatly increases as the serum glucose rises. High blood glucose is inflammatory to the lining of the blood vessels, and recent research shows that it contributes to atherosclerosis, leading to heart attacks and strokes. A fatty liver does not come from eating fat, but he comes from eating refined carbohydrates. The body does not like high glucose levels and wants no more glucose coming out into the bloodstream. It secretes a hormone called ghrelin. Ghrelin basically blocks the exit ramps from the two “parking lots”. It blocks lipolysis, or the breakdown fat and fatty acids to glucose. When the blood glucose rises, the pancreas secretes more and more insulin to drive the blood glucose into the cells and out of the bloodstream. There are a limited number of cells. What cannot be forced into cells is forced into ”long-term parking”, which is your peripheral fat stores, or ”short-term parking, ” which is fatty acids stored in the liver. When you spike your blood glucose, your body prevents you from breaking down any fat stores for several hours. If you go on a reduced calorie diet, but do not stop refined carbohydrates, then you will produce ghrelin, preventing you from burning your fat reserves. You will then turn to other sources of potential glucose, such as your protein. You will breakdown primarily muscle into glucose, which is called gluconeogenesis. You will lose weight, but it will be muscle mass. You will feel terrible, with increasing weakness, until you have to stop the diet. You will even lose heart muscle. When the diet is stopped, you may have lost 10-20 pounds, but it has not been from your fat stores. Your muscle mass determines your basal metabolic rate (BMR) or the amount of calories you burn at rest. With a lower BMR, you will gain weight back faster, and most people will rapidly regain the lost weight plus additional pounds. No long-term diet is successful if refined carbohydrates are continued, and research suggests there is no safe level without significant health implications from refined carbohydrate intake.


2. One Hundred and Fifty Minutes of Moderate Exercise a Week.


Exercise does burn calories, but that is not the primary reason for one to exercise to lose weight. A hard work out for an hour on an exercise machine will result in 500-700 calories burned in an hour. There are 3500 calories in account of fat. Most people do not have the patience to do that math and continue exercising long enough to lose significant weight. In fact, when you were a child, you were told to go outside and workup in appetite by doing exercise. Exercise actually stimulates your appetite. So why is it so important? The American College of Sports Physicians has a very interesting website called They have gone through all the benefits of exercise studies and have data to prove that 150 minutes of moderate exercise a week, such as walking, cycling or swimming, results in a 50% reduction in hypertension, heart attacks, strokes, diabetes, depression, and cancer. They recommended intensity to be where one can still talk but not sing. It is not necessary to do intense exercise such as running to gain the benefit. The importance to weight loss deals with a hormone called leptin. Leptin is secreted by fat cells and leptin receptors are present in the hypothalamus of the brain. The fat cells secrete leptin when their stores are full, and stop secreting leptin when their stores are depleted. When leptin levels are high, appetite is suppressed by the hypothalamus. When leptin levels are low, the hypothalamus perceives that the fat stores are low and creates a tremendous appetite. This is related to centuries of feast and famine so that in famines, when fat stores are depleted and the food supply suddenly increases, humans were able to gorge themselves to try to replenish their depleted fat stores. Humans with a body mass index (BMI) of 40 (approximately 100 pounds overweight), have a 4 times normal level of leptin. This at first it was confusing to researchers until they realized that, just like a person can have insulin insensitivity and insulin resistance, you can also have leptin insensitivity and resistance. A high level of leptin is telling the obese patient’s hypothalamus they are full, but the message is not being received. The hypothalamus is inappropriately thinking that there is a starvation state, even with an extra 100 pounds of adipose fat tissue on board. The way that you regain leptin sensitivity is through exercise. With exercise, the appetite is controlled and the craving for sweets and sugar is decreased. The calories burned with exercise are important, but the real gain of leptin sensitivity is critical for long-term success.


3. 35 Grams of Fiber per Day.


A study by the University of Southern California has determined that the reason for the epidemic of obesity in the modern world is directly caused by the increasing amount of refined carbohydrates (sucrose or table sugar, and high fructose corn syrup) and the removal of dietary fiber by the food processing corporations. Fiber is cellulose, a naturally occurring carbohydrate. It comes only from plants. The carbohydrate bonds in cellulose cannot be broken by human digestion. Fiber that one takes in orally will stay in the GI tract. The importance of fiber in your diet is critical for successful weight loss. Fiber in the large and small bowel causes the secretion of the same hormones that cause satiety, or fullness, that are secreted by a distended stomach. Fiber is also hydrophilic, or likes water. Fiber, or cellulose, sucks up water like a sponge, preventing the colon from recycling all of the water from the bowel movements. A low fiber diet results in hard, high pressure bowel movements that result in diverticulosis, hemorrhoids, and gastroesophageal reflux disease with hiatal hernia. A low fiber diet results in chronic high intra-abdominal pressures. A diet that is high in fiber results in large, bulky, moister bowel movements. Mass has energy, so a larger, bulkier bowel movement basically puts more energy into the toilet.  This is called the fiber flush phenomenon. The formula for calories lost per gram of dietary fiber is: for every gram of dietary fiber you consume, you will put 7 calories in the toilet. If 2 people eating the same number of calories, one on a typical American diet of 5 g of fiber a day compared to someone on a 35 g of fiber a day are compared, in one month, the high fiber diet with the same number of calories results in a 2.1 pound weight loss. At one year, a 25 weight loss. Theoretically, you can lose 25 pounds in one year without cutting your calories by increasing your fiber to 35 g a day.


4. Sixty-Four Ounces of Cold Water a Day.


We recommend 64 ounces or more of cold water a day for several reasons. First is that your body can confuse hunger for thirst, and consuming water will relieve your hunger. The second reason is that when fat is broken down, toxins are released in your system and water helps to flush toxins from your body. When you drink water, you actually help remove salt from your body. Water does not call swelling but actually treats swelling with normal kidney function. Eating food or even drinking water increases your basal metabolic rate by 15%. You will burn 15% more calories just resting after drinking water. The energy required to heat up 64 ounces of cold water a day in one year is equivalent to 10 pounds of fat energy. You can lose 10 pounds in one year but just drinking cold water.

Food for Thought


The 4 cornerstones of weight loss are:


    - Avoidance of refined carbohydrates

    - 150 minutes of moderate exercise a week

    - 35 g of fiber every day

    - 64 ounces of cold water a day


The successful diet plans that have been publicized all have some common features. The Sugar Buster’s Diet, the Atkins Diet, the Fiber 35 Diet, the South Beach Diet, the Paleo Diet and the Mediterranean Diet all have you abstain from refined carbohydrates. Studies show that a diet high in vegetables and fruit is the healthiest diet.


Arguably, the first clinical diet study ever done is in the book of Daniel of the Bible. Daniel was captured from Israel and taken to Persia. He was given the fancy food and wine of Nebuchadnezzar and was going to be trained as a court advisor. He refused the food and wine of the king and requested only fruits, vegetables and water. After 10 days, he and his 3 fellow captives were visibly more attractive than the other captives and were allowed to stay on their diet.


A healthy diet should consist of fruits and vegetables, with meat being more used as a flavoring than a primary source of protein. It should avoid refined wheat and grains that have no fiber, avoid refined sugars, and avoid artificial oils. Natural oils such as olive and peanut oil, which have anti-inflammatory properties, should be used instead.  Artificial sweeteners should be avoided. Natural sweeteners such as stevia, honey, or agave syrup have a low glycemic index and are recommended.


Good habits are as hard to break as bad habits. If you don’t enjoy something you aren’t going to continue with it. Find a healthy diet that you enjoy and stay with it! Set reasonable diet goals and be patient. Two pounds a week of weight loss is obtainable and can be done without unhealthy weight loss. Start your day off with a breakfast that is high in protein and fiber. Avoid refined carbohydrates, especially sugared beverages, like they were poisoned. Find healthy foods and recipes that you and your family enjoy. Avoid processed food. Food should be from a farm, not from a factory. Enjoy the return of energy and good health that will come from a good diet.




Chris C. Smith MD, FACS