Periodically, I update metabolism.com with interesting problems from my medical practice. Last week I was reminded of a particular thyroid disease which is little known and deserves more attention. In my patient’s case, she had an inactive thyroid (hypothyroid) due to Hashimoto’s thyroiditis for several years which, on its own switched to become an over-active thyroid (hyperthyroid). I call this event a “Zombie Thyroid”. Don’t bother trying to look this term up since ‘Zombie Thyroid’ is my own terminology. A Zombie Thyroid is, of course, one which returns from the dead. Most times when the thyroid is destroyed by either natural forces or by human intervention, the destruction is complete and irreversible. Rarely however, a thyroid which ceased function for years resumes producing thyroid hormone and may even becoming “hyper” or over-functioning. Such was the case of my patient last week. Confusion may result because the newly risen thyroid begins adding thyroid hormone to the blood of someone already taking thyroid hormone replacement for hypothyroidism (under-functioning thyroid). Recognizing the Zombie Thyroid can take months or years due to the rarity of the condition and the subtlety of the changes that occur on blood testing.

The Zombie Thyroid occurs in the setting of either autoimmune thyroid disease such as Hashimoto’s thyroiditis or a structural thyroid disease, multinodular goiter. Hashimoto’s is the most common cause of naturally occurring hypothyroidism in women under the age of 60 years. Hashimoto’s occurs when the body creates an antibody to the thyroid, resulting in destruction or impairment of the thyroid tissue. It is thought that the thyroid can ‘return from the dead’ if the body begins to produce more of another type of antibody that results in stimulation of the thyroid tissue. The switch from under active to over-active can take months or years. During this time the combination of taking thyroid hormone pills for Hashimoto’s plus the new supply of the body’s own thyroid hormone production can result in disturbing and seemingly unexplainable high thyroid levels. Once it is clear that the thyroid is producing thyroid hormone again it is possible to make appropriate adjustments in medication to return the situation back to normal.

Another situation involving the Zombie Thyroid is seen in elderly people who have had an enlarged and lumpy (nodular) thyroid for years. Some of these “multinodular goiters” produce adequate amounts of thyroid hormone but others can be associated with thyroid hormone deficiency (hypothyroid). When the multinodular goiter causes hypothyroidism, the patient will be treated with thyroid hormone replacement just like the Hashimoto’s patient. Over time the nodules may slowly begin to wake up and begin producing thyroid hormone. If the patient is already taking thyroid hormone due to the previous diagnosis of hypothyroidism, the combination of the two sources of thyroid hormone can result in excess or “hyper” thyroidism. In the elderly the doctor may suspect the elevated thyroid hormone levels are the result of a medication error perhaps due to the patient’s forgetfulness. If no action is taken serious complications of hyperthyroidism can develop such as irregular heart beat, congestive heart failure, excessive fatigue, and mental or mood impairment. Some elderly patients become withdrawn and lose weight mimicking depression, a situation known as “apathetic hyperthyroidism”. Recognition of the Zombie Thyroid is essential to restoring the thyroid levels and the patient’s clinical status back to normal.

Don’t let yourself or loved one become a victim of this ‘back from the dead’ thyroid. Alertness is the key to recognizing and treating the Zombie Thyroid. Ask your own physician for advice if you suspect this condition.

This article is for educational purposes only and is not meant as medical advice. The disclaimer of metabolism.com applies to this and all my blogs.

Gary Pepper, M.D., Editor-in-Chief, metabolism.com

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Thank you for posting this but you havent posted all the information just parts of it.

Most people who have bariatric surgery really DO it as a last resort.

While you are right about that the one sole gastric bypass surgery is NOT a quick solution to the problem, however there are other bariatric procedures that are available to consider. One of them being the latest one called vertical sleeve which just cuts your stomach smaller and does not do all the plumbing that the drastic gastric bypass does. Another form is the popular lapband which is just a band thats inserted over your abdominal to restrict the food.

Any of the bariatric doctors do WARN the patient that with the gastric bypass that you run the risk of malabsorption and that can be detrimental in the long run.

As far as bariatric procedures are concerned I know TEN people who had various bariatric surgeries. I know 8 of them that are doing great! I know my cousin had the gastric bypass and she didnt do well. She has to go back in and get it removed because it was dangerous for her. But this was when gastric bypass first started out as a new procedure. The other person i dont know what procedure she had done but her situation is that she stopped taking the vitamins that she was supposed to take so she became ill. Shes doing better now that she is taking her supplements.

I”ve been to many bariatric seminars and i strongly recommend the vertical sleeve. Out of the ten i mentioned I know two of them had that done and are doing fantastic. They do not get malabsorption and just mainly control what they eat. If people are concerned then i suggest they opt for the lapband and if its not for them they can have it removed.

I personally cannot have ANY of these procedures even if i had the money for it. In 1996 I had acute pancreatitis(which left me diabetic) and they did abdominal surgery on me therefore the bariatric doctors will not touch anyone who had any kind of abdominal surgery due to that it might cause complications. How i dont know though. I’m hoping to find out.

Do know this that you can have any surgery and STILL gain the weight back. You can still eat tons of milk shakes with the lapband or constantly eat small portions with the vertical sleeve and re-stretch out your stomach. So they aren’t a cure all.

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A few years ago the book, Eat Right for Your (Blood) Type, was published by Dr. Peter D’Adamo with the premise that our present day nutritional needs are dependent on the types of food available to our genetic ancestors. For example, if your ancient ancestors evolved in a region of the world where protein was plentiful, then your body now requires a protein rich diet to stay healthy. According to the author your blood “type” is the clue to determining your nutritional heritage and your ideal diet type. I was never convinced of the usefulness of this blood type theory but agree that genetics strongly influences the way an individual stores fat and what constitutes their optimal nutritional requirements.

Along these lines recent research points to a connection between success with various weight loss diets and genetic differences between individuals. This was the conclusion of a study known as the A to Z Weight Loss Study. This study compared the results of 300 women who followed one of four possible diets ranging from those low in carbs (Adkins diet) to those low in fats (Ornish diet) to those high in protein (Zone diet). The women were then screened for genetic differences in specific genes that control fat metabolism.

Found was that some participants needed low carbs to lose weight while others required a diet low in fat to achieve weight loss. Analysis of the fat metabolizing genes showed that a specific favorable genetic profile was associated with up to a 6 fold increase in the amount of weight loss achieved with a particular diet. A participant was much more likely to lose weight if they were on the diet that harmonized with their particular genetic type.

How can you tell in advance if you are a carb sensitive or a fat sensitive dieter? For those with access to these experimental genetic tests (conducted by Interleukin Genetics) you could conceivable get the information you need. For the rest of us, starting with one type of diet and switching to the other type if weight loss isn’t achieved seems like a common sense approach.

Gary Pepper, M.D.
Editor-in-Chief, Metabolism.com

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We thank those of you who submitted your thoughts to this contest and hope that by keeping up with Sally’s comments, problems and progress that you can gain useful information to help you achieve your own goals. We also plan to rerun the contest in the near future so keep your eyes open for more information.

Sally’s winning comment is as follows:

The biggest obstacle to acheiving my weight loss is many-fold and complex as I believe it is for most. I believe my sleep apnea is the worst “culprit”. I also have Hashimoto’s thyroid disease and in 2006 I crash dieted and lost 82 lbs in 11 months only to suffer a rapid rebound weight gain of 40 pounds. For over two years, I have not been able to get this weight off. I was previously insulin resistant and had surgery on PCOS. The fibromyalgia affects working out. I feel that all of these issues feed off one another. It is crystal clear to me that feeling poorly every day from debilitating fatigue is the biggest obstacle to acheiving the weight loss I so desperately need. I really do need help. I want to live before I die.

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To kick off this new service, Metabolism.com is running a contest to win a free consultation with Beth Ellen. To enter the contest simply post to the Comments Section on Metabolism.com’s homepage with the theme: ….What is the biggest obstacle to achieving weight loss?… We want to hear what you have to say about this common and perplexing problem.

Within 4 weeks the staff of metabolism.com will choose the best response to the question. The winner will then be entitled to a free consultation with Beth Ellen worth $80 but actually worth much more when the results you are striving for are finally achieved with her help.

So enter today and post your opinion to metabolism.com; What is the biggest obstacle to achieving weight loss?

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Marion writes:

Just wanted to give you an update, quit smoking 8 months ago and have gained exactly 20 pounds, seems like the weight gain has finally slacked off. Last Monday a week ago I started Atkins, lost 9 lbs in 7 days, must be alot of fluid. Just the effects of being on Atkins, I feel so much better, but the best part is it forcing your body to burn fat and increases your metabolism. Try it its not as hard as you think. The NEW Atkins is alot more flexible and easy to learn than the old version. Basically the same with a few easier ways of understanding it. Good Luch I hope it works. Thanks, my goal is to wear a bikini this summer, not in public of course just at home in my pool, lol.

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Long term success with a weight program sometimes follows a bumpy, uneven path. Many obstacles can keep you from achieving a more healthy weight.

Learning to identify potential roadblocks and confront personal temptations is an important part of being successful in losing weight. To make it past the rough spots, it’s important to have strategies ready to guide your response as problems arise.

This easy-to-use action guide identifies common weight-loss barriers and practical strategies for overcoming them. If you find a strategy that helps you, include it with your weight-loss program.

The barriers are grouped into three categories: nutrition, physical activity and behaviors. To lose weight — and to maintain that weight loss — it’s important that you address all of these components.

Behaviors obstacle
I’ve tried to lose weight before, but it didn’t work. Now, I don’t have confidence that it’ll work this time.

For many people, losing weight will be one of life’s most difficult challenges. Don’t be discouraged if you’ve tried losing weight in the past and you weren’t able to — or you lost weight but gained it all back. Many people experiment with several different weight-loss plans before they find an approach that works.

Strategies
Following these tips may help you succeed this time around.

* Think of losing weight as a positive experience, not a negative one. Approaching weight loss with a positive attitude will help you succeed.

* Set realistic expectations for yourself. Focus on behavioral changes and don’t focus too much on weight changes.

* Use problem-solving techniques. Write down the obstacles that you experienced in previous attempts to lose weight, and come up with strategies for dealing with those obstacles.

* Make small, not drastic, changes to your lifestyle. Adjustments that are too intense or vigorous can make you uncomfortable and cause you to give up.

* Accept the fact that you’ll have setbacks. Believe in yourself. Instead of giving up entirely, simply start fresh the next day.

Behaviors obstacle
I eat when I’m stressed, depressed or bored.

Sometimes your most intense longings for food happen right when you’re at your weakest emotional points. Many people turn to food for comfort — be it consciously or unconsciously — when they’re dealing with difficult problems or looking for something to distract their minds.

Strategies
To help keep food out of your mood, try these suggestions.

* Try to distract yourself from eating by calling a friend, running an errand or going for a walk. When you can focus your mind on something else, the food cravings quickly go away.

* Don’t keep comfort foods in the house. If you turn to high-fat, high-calorie foods whenever you’re upset or depressed, make an effort to get rid of them.

* Identify your mood. Often the urge to eat can be attributed to a specific mood and not to physical hunger.

* When you feel down, make an attempt to replace negative thoughts with positive ones. For example, write down all of the positive qualities about yourself and what you plan to achieve by losing weight.

Behaviors obstacle
I have a hard time not eating when I’m watching television, a movie or a live sporting event.

There’s nothing inherently wrong with eating while watching a show, film or live event, but when you’re distracted, you tend to eat mindlessly — which typically translates into eating more than you intended to eat. If you’re unable to break this habit, at least make sure you’re munching on something low in calories.

Strategies
Here are suggestions you might consider.

* If you’re at a theater or stadium, order a small bag of popcorn with no butter and work on it slowly.

* Eat something healthy before you leave home so that you’re not extremely hungry when you arrive.

* Drink water or a calorie-free beverage instead of having a snack.

* Try to reduce the amount of time that you spend watching television each day. Studies show that TV watching contributes to increased weight.

Behavior obstacle
When I go to parties, I can’t resist all of the snacks and hors d’oeuvres.

In most social situations where food is involved, the key is to treat yourself to a few of your favorite hors d’oeuvres, in moderation. If you try to resist the food, your craving will only get stronger and harder to control. By following a few simple strategies, you can enjoy yourself without overeating.

Strategies
Next time you step up to the hors d’oeuvre table, try these strategies.

* Make only one trip and be selective. Decide ahead of time how much you’ll eat and choose foods you really want.

* Treat yourself to one or two samples of high-calorie or fatty foods. Fill up on vegetables and fruits, if you can.

* Take only small portions. A taste may be all that you need to satisfy your craving.

* Nibble. If you eat slowly, you’ll likely eat less — but don’t nibble all night long.

* Don’t stand next to or sit near the hors d’oeuvre table. As the old saying goes, “Out of sight, out of mind.”

* Eat something healthy before you arrive. If you arrive hungry, you’ll be more inclined to overeat.

Behavior obstacle
I’m a late-night snacker.

Avoid eating late at night because loading up on calories right before bed only intensifies the challenge of not overeating. There’s less chance for you to be active and burn off those calories until next morning. It’s better to eat during the day so that your body has plenty of time to digest the food before you go to bed.

Strategies
Here are suggestions if you often find yourself battling the late-night munchies.

* Make sure you eat three good meals during the day, including a good breakfast. This will help reduce the urge to snack late at night, simply because you won’t be so hungry.

* Don’t keep snack foods around the house that may tempt you. If you get late-night munchies, eat fruits, vegetables or other healthy snacks.

* Find something else to keep you busy in the hours before bedtime, such as listening to music or exercising. Your snacking may be more of a mindless habit than actual hunger.

Behavior obstacle
When I lapse from my eating plan, it’s hard for me to get back on track.

Lapses happen. Many times a minor slip — a busy day when you couldn’t find the time to eat right or get exercise — leads to more slips. That doesn’t mean, though, that you’ve failed and all is lost. Instead of beating yourself up over a lapse, accept that you’re going to experience bumps along the way and put the incident behind you. Everyone has lapses. Think back to the initial steps you took when you first began your weight program and put them to use again to help you get back on track.

Strategies
Here are suggestions to prevent a lapse from turning into a full-blown collapse.

* Convince yourself that lapses happen and that every day is a fresh opportunity to start over again.

* Guilt from the initial lapse often leads to more lapses. Being prepared for them and having a plan to deal with them is important to your success.

* Keep your response simple. Focus on the things that you know you can do and stick with them. Gradually add more healthy changes until you’re back on track.

* Open up an old food record and follow it. Use those meals like a menu to help get you back to a healthy eating routine.

The above is an excerpt from the book The Mayo Clinic Diet: Eat well. Enjoy life. Lose weight., by the weight-loss experts at Mayo Clinic and Donald Hensrud, M.D., M.P.H. The above excerpt is a digitally scanned reproduction of text from print. Although this excerpt has been proofread, occasional errors may appear due to the scanning process. Please refer to the finished book for accuracy.

Reprinted from The Mayo Clinic Diet, © 2010 Mayo Foundation for Medical Education and Research. Published by Good Books (www.GoodBooks.com). Used by permission. All rights reserved.
About Donald Hensrud, M.D.
Donald Hensrud, M.D., M.P.H., is chair of the Division of Preventive, Occupational, and Aerospace Medicine and a consultant in the Division of Endocrinology, Metabolism and Nutrition at Mayo Clinic, Rochester, Minn. He is also an associate professor of preventive medicine and nutrition at the College of Medicine, Mayo Clinic. A specialist in nutrition and weight management, Dr. Hensrud advises individuals on how to achieve and maintain a healthy weight. He conducts research in weight management, and he writes and lectures widely on nutrition-related topics. He helped publish two award-winning Mayo Clinic cookbooks.

About Mayo Clinic
Mayo Clinic is the first and largest integrated, not-for-profit group practice in the world. Doctors from every medical specialty work together to care for patients, joined by common systems and a philosophy that the needs of the patient come first. Over 3,600 physicians and scientists and 50,000 allied staff work at Mayo, which has sites in Rochester, Minn.; Jacksonville, Fla.; and Scottsdale/Phoenix, Ariz. Collectively, Mayo Clinic treats more than 500,000 patients a year.

For more than 100 years, millions of people from all walks of life have found answers at Mayo Clinic. Mayo Clinic works with many insurance companies, does not require a physician referral in most cases and is an in-network provider for millions of people.

For more information, please visit www.goodbooks.com/mayoclinicdiet.

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Here is what Maya writes about her own life:

I replied some time ago to this thread and would like to add something. Everybody here posted a personal story of dealing with weight gain after quitting smoking. I went through that too. I smoked since I was 15, quit to have a child, picked up just that one cigarette a year after…, and than quit again 7 years ago for good. I did start gaining weight and was diagnosed with hypothyroid condition right prior to quitting. However what was effective for me is to modify almost all my life habits, not only eating and exercising. I did go to gym every day (and worked out hard) , ate small portions, meditated, made peace with few people in my life, looked at the bright side of things, etc. I even got certified as a fitness trainer! By no means it was easy but it was worthwhile doing. I wrote down all my life patterns and changed them all – even good ones modified slightly. I did it to reset my system completely. All the women in my family are very overweight and I’m not – only due to the discipline and frame of mind I choose to keep.
I started helping people to quit smoking with customized individual hypnosis sessions, because it is the best thing you can do – quit smoking forever. All it takes is a firm decision and sometimes some help.
I know that you can do anything when you make a decision to do it. Real firm once-and-for-all decision. I came to Dr. Pepper four years ago as a mess on Synthroid, and now with Armour, Selenium, meditation, and holistic medicine even my antibodies levels are going down. I decided to get healthier and did everything it took that is healthy for me. We all are not getting younger so I choose to take care of my body and eliminate unhealthy habits on daily basis, and help my patients do the same.
Good luck to you all, congratulations on quitting, and I wish you health.

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I am intrigued by this new concept because until now I have always considered carbs an appetite stimulant because of their action to raise insulin levels which can then cause blood sugar levels to drop a few hours later, resulting in relative hypoglycemia (low blood sugar) which is a powerful trigger to more eating.

Thanks to the authors and their publisher we are able to provide an excerpt from the book The Serotonin Power Diet, and you can decide for yourself if this is an idea you would like to pursue.

Serotonin: What It is and Why It’s Important for Weight Loss
By Judith J. Wurtman, PhD and Nina T. Frusztajer, MD,
Authors of The Serotonin Power Diet: Eat Carbs — Nature’s Own Appetite Suppressant — to Stop Emotional Overeating and Halt Antidepressant-Associated Weight Gain

Serotonin is nature’s own appetite suppressant. This powerful brain chemical curbs cravings and shuts off appetite. It makes you feel satisfied even if your stomach is not full. The result is eating less and losing weight.

A natural mood regulator, serotonin makes you feel emotionally stable, less anxious, more tranquil and even more focused and energetic.

Serotonin can be made only after sweet or starchy carbohydrates are eaten.

More than 30 years ago, extensive studies at MIT carried out by Richard Wurtman, M.D., showed that tryptophan, the building block of serotonin, could get into the brain only after sweet or starchy carbohydrates were eaten. Although tryptophan is an amino acid and found in all protein, eating protein prevents tryptophan from passing through a barrier from the blood into the brain. The reason is simply numbers: Tryptophan competes for an entry point into the brain with some other amino acids. There are more of those other amino acids in the blood than tryptophan after protein is eaten. So in the competition to get into the brain, tryptophan is at a total disadvantage and very little gets in after a protein meal like turkey or snack like yogurt.

But carbohydrates tip the odds in tryptophan’s favor. All carbohydrates (except fruit) are digested to glucose in the intestinal tract. When glucose enters the bloodstream, insulin is released and pushes nutrients such as amino acids into the cells of the heart, liver and other organs. As it does this, tryptophan stays behind in the bloodstream. Now there is more tryptophan in the blood than the competing amino acids. As the blood passes by the barrier into the brain, tryptophan can get in. The tryptophan is immediately converted to serotonin, and the soothing and appetite controlling effects of this brain chemical are soon felt.

Our studies with volunteers found that when people consumed a pre-meal carbohydrate drink that made more serotonin, they became less hungry and were able to control their calorie intake. Volunteers whose drinks contained protein — so that serotonin was not made — did not experience any decrease in their appetite.

Most of us have experienced the carbohydrate-serotonin effect on our appetite even though we were not aware of the connection. Have you ever munched on rolls or bread while waiting for the main course to be served in a restaurant? By the time dinner is served, twenty minutes or so after you ate the roll, your appetite has been downsized. “I don’t even feel that hungry” is a common response when the plate is put down on the table.

This blunting of appetite is not because you may have eaten 120 calories of roll. It is caused by new serotonin putting a brake on your appetite.

Successful weight loss depends on the power of serotonin to control food intake.

The carbohydrate-serotonin connection has a direct impact on our emotional state, too. Drugs that increase serotonin activity have been used for several decades as a therapy for mood disorders. However, our studies showed that natural changes in serotonin could have a profound impact on daily fluctuations in mood, energy levels and attention. In one of our early studies, we found that our volunteers became slightly depressed, anxious, tired, and irritable around 3 to 5 pm every day. At the same time, they experienced, in the words of one volunteer “a jaw-aching need to eat something sweet or starchy.” Several studies later, we were able to state that late afternoon seems to be a universal carbohydrate-craving time, and people who experience this craving use carbohydrates to “self-medicate” themselves. Carbohydrate cravers who consume a sweet or starchy snack are increasing serotonin naturally.

We carried out careful clinical studies to measure the effect of carbohydrates on mood and to make sure that the effect was not just due to taste or the effect of taking a break from work. Volunteers, all carbohydrate cravers, were given a carbohydrate or protein- containing food or drink that had identical tastes. Their moods, concentration and energy were measured before and after they consumed the test beverages. The carbohydrate serotonin-producing beverage improved their moods but the protein-containing beverage had no effect on either their mood or their appetite.

Eating carbohydrates allows serotonin to restore your good mood and increase your emotional energy.

Eating low or fat-free, protein-free carbohydrates in the correct amounts and at specific times potentiates serotonin’s ability to increase satiety. You will eat less, feel more satisfied and lose weight.

Here are five tips to get serotonin working for you:

Eat the carbohydrate on an empty stomach to avoid interference from protein from a previous meal or snack. Wait about 3 hours after a meal containing protein.

The carbohydrate food such as graham crackers or pretzels should contain between 25-35 grams of carbohydrate. The carbohydrate can be sweet or starchy. High-fiber carbohydrates take a long time to digest and are not recommended for a rapid improvement in mood or decrease in pre-meal appetite. Eat them as part of the daily food plan instead for their nutritional value.

The protein content of the snack should not exceed 4 grams.

To avoid eating too many calories and slowing down digestion, avoid snacks containing more than 3 grams of fat.

Do not continue to eat after you have consumed the correct amount of food. It will take about 20-40 minutes for you to feel the effect. Eating more carbohydrates during the interval is unnecessary and may cause weight gain.

Stress may increase your need for serotonin and make it harder to control food intake. Prevent this by shifting protein intake to the early part of the day; i.e. protein for breakfast and lunch and switching to carbohydrates by late afternoon. Eating a carbohydrate dinner with very little protein increases serotonin sufficiently to prevent after dinner nibbling. And the soothing effect of the serotonin prevents stress from interfering with sleep.

Boost Serotonin to switch off your appetite and turn on a good mood.

©2009 Judith J. Wurtman, PhD and Nina T. Frusztajer, MD, authors of The Serotonin Power Diet: Eat Carbs — Nature’s Own Appetite Suppressant — to Stop Emotional Overeating and Halt Antidepressant-Associated Weight Gain

Author Bios
Judith J. Wurtman, PhD, co-author of The Serotonin Power Diet: Eat Carbs — Nature’s Own Appetite Suppressant — to Stop Emotional Overeating and Halt Antidepressant-Associated Weight Gain, has discovered the connection between carbohydrate craving, serotonin, and emotional well-being in her MIT clinical studies. She received her PhD from George Washington University, is the founder of a Harvard University hospital weight-loss facility and counsels private weight management clients. She has written five books, including The Serotonin Solution, and more than 40 peer-reviewed articles for professional publications. She lives in Miami Beach, Florida.

Nina T. Frusztajer, MD, co-author of The Serotonin Power Diet: Eat Carbs — Nature’s Own Appetite Suppressant — to Stop Emotional Overeating and Halt Antidepressant-Associated Weight Gain, counsels private weight management clients and is a practicing physician and certified professional life coach. She received her master’s degree in Nutrition from Columbia University and her medical degree from George Washington University. She lives in Boston, MA.

For more information, please visit www.SerotoninPowerDiet.com and Amazon.com.

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In her recent book, Eat Your Way to Happiness, expert and author Elizabeth Somer offers readers excellent advice for dealing with cravings and carbs in general.

We thank Elizabeth and her publisher for permission to post this excerpt again:

10 Steps for a Carb Makeover
by Elizabeth Somer, M.A., R.D.,
Author of Eat Your Way to Happiness

If you are a carb craver, you need to treat yourself with a little kindness. It’s not your fault you can’t keep your fingers out of the cookie jar or the bag of chips. You can’t “will away” those cravings. They are hardwired in your head.

So work with your carb cravings. Make sure each meal contains at least one whole grain. Plan a quality-carb snack at your most craving-prone time of the day (typically midafternoon or late evening). To maximize your mood and minimize your weight, you need to take this quality-carb message seriously. That means tackling the issue with a 10-step plan.

Step #1. Purge the kitchen of all white flour. Open the cupboards and toss the junk. Throw out the obvious: the white rice, the instant mashed potatoes, any cracker or cookie made with anything but 100% whole grain (you are pretty much down to Triscuits and 100% Whole Wheat Fig Newtons), all potato chips, Pop-Tarts, boxes of bread crumbs, Pasta Roni, Hamburger Helper, cans of Chef Boyardi Ravioli, Costco muffins and such. Search the freezer for French fries, hash browns, breakfast foods made from processed grains or other high-calorie/low-quality items like Marie Callender’s frozen pasta entrees or pot pies.

Definitely toss your carb triggers, junk foods that you are powerless to resist. Remember, if you have to drive to the store to get ice cream, you will be much less likely to binge.

Then read labels on the rest. If wheat flour or enriched flour is in the top three ingredients on a label, you are holding a poor-quality carb. Toss it.

Okay, okay, if this cold-turkey approach is a bit over the top, then keep two or three junk carbs and toss the rest. But beware: these items may be “trigger” foods that tempt you to indulge. Also, keep in mind that this is not so much about “giving up” as it is giving to” your health, your mood, and your belly and thighs.

Step #2. Restock the kitchen with the 100% whole grains you like, such as 100% whole-wheat bread, old-fashioned oatmeal, Kashi Autumn Wheat Cereal or GoLean Cereal, Zoom hot cereal or instant brown rice. Experiment with new grains, like barley, millet, amaranth, whole-wheat couscous or bulgur.

If you can’t imagine your spouse or kids loving whole-wheat pasta or whole-wheat tortillas, then choose the next best thing. For example, try Aunt Jemima frozen Pancakes with Whole Grains, or tortillas or pastas made from blends of whole wheat and refined wheat, such as Ronzoni or Barilla whole-wheat blend pastas.

Step #3. Switch to quality carbs in recipes. For example, if a recipe calls for

white rice: use instant brown or wild rice, bulgur, millet or other whole grains

flour: use at least half whole-wheat flour

bread (such as French toast): use whole-grain bread

potatoes: use sweet potatoes, yams, squash and/or corn

Step #4. Plan snacks and bring grains with you. When packing your lunch and snacks for the day, make sandwiches with 100% whole-grain bread, use low-fat cheeses such as Cabot Vermont 50% Reduced Fat Cheese, and include other grains like 100% whole-grain crackers or air-popped popcorn.

Step #5. Create nonfood rewards. Praise yourself with a manicure, flowers, a game of golf on Saturday or a Netflix movie. Follow the “if . . . then” rule: if you steer clear of the junk, then you get the back rub, hour of alone time or bubble bath.

Step #6. Take time. Often we grab food before we even know whether we really want it. That knee-jerk reaction gets us into trouble. Take a 10-minute pause before diving into any snack, from popcorn to leftover doughnuts.

Step #7. Identify the craving. Is it for something crunchy or chewy? Cold, sweet or creamy? Once you have pinpointed exactly what you want, then find a low-calorie food that satisfies that craving. Luckily, the better you eat, the more your cravings for fatty or overly sweet carbs will dwindle.

Step #8. Eat breakfast. As discussed in Chapter 2, eat a nutritious breakfast and you are much more likely to resist junk-food temptations throughout the day.

Step #9. Keep hunger at bay. Eat small meals and snacks evenly distributed throughout the day. This helps keep serotonin levels (and other nerve chemicals like NPY) in the normal range.

Step #10. Out of sight, out of mind. Put another way, seeing is craving. Watch out for temptations at the mall, restaurants and friends’ houses. It is easy to overdo carbs when most of the ones offered to you are the low-quality ones. For example, studies at the University of Illinois found that people ate 45% more calories when there was a bread basket placed on the table in restaurants than when the waiter came by and offered them a slice from a basket. Ask that the tortilla chips be removed when dining at a Mexican restaurant and you will save yourself 300 unnecessary calories. Avoid the coffee shop with the display of muffins, scones and croissants.

The above is an excerpt from the book Eat Your Way to Happiness by Elizabeth Somer, M.A., R.D.. The above excerpt is a digitally scanned reproduction of text from print. Although this excerpt has been proofread, occasional errors may appear due to the scanning process. Please refer to the finished book for accuracy.

Copyright © 2009 Elizabeth Somer, M.A., R.D., author of Eat Your Way to Happiness

Author Bio
Elizabeth Somer, M.A., R.D., author of Eat Your Way to Happiness, is a registered dietitian and author of several books, including 10 Habits That Mess Up a Woman’s Diet, Food & Mood and Age-Proof Your Body. She is a member of the editorial advisory board of Shape magazine and editor in chief of Nutrition Alert, a newsletter that summarizes the current research from more than 6,000 journals. She appears frequently on NBC’s Today and other national television shows.

For more information please visit www.EatYourWayToHappiness.com.

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