Wheat Belly: Lose the Wheat, Lose the Weight and Find Your Path Back to Health (10 page)

BOOK: Wheat Belly: Lose the Wheat, Lose the Weight and Find Your Path Back to Health
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Enlarged breasts on a male are therefore not just the embarrassing body feature that your annoying nephew snickers at, but B-cup evidence that estrogen and prolactin levels are increased due to the inflammatory and hormonal factory hanging around your waist.

An entire industry is growing to help men embarrassed by their enlarged breasts. Male breast reduction surgery is booming, growing nationwide at double-digit rates. Other “solutions” include special clothing, compression vests, and exercise programs. (Maybe
Seinfeld’s
Kramer wasn’t so crazy when he invented the mansierre.)

Increased estrogen, breast cancer, man boobs … all from the bag of bagels shared at the office.

CELIAC DISEASE: A WEIGHT LOSS LABORATORY

As noted earlier, the one ailment to which wheat has been conclusively linked is celiac disease. Celiac sufferers are counseled to remove wheat products from their diet, lest all manner of nasty complications of their disease develop. What can their experience teach us about the effects of wheat elimination? In fact, there are unclaimed gems of important weight loss lessons to be gleaned from clinical studies of people with celiac disease who remove wheat gluten-containing foods.

The lack of appreciation of celiac disease among physicians, coupled with its many unusual presentations (for example, fatigue or migraine headaches without intestinal symptoms), means an average delay of
eleven years
from symptom onset to diagnosis.
15,
16
Celiac sufferers may therefore develop a severely malnourished
state due to impaired nutrient absorption at the time of their diagnosis. This is especially true for children with celiac disease, who are often both underweight and underdeveloped for their age.
17

Some celiac sufferers become positively emaciated before the cause of their illness is determined. A 2010 Columbia University study of 369 people with celiac disease enrolled 64 participants (17.3 percent) with an incredible body mass index of 18.5 or less.
18
(A BMI of 18.5 in a 5-foot-4 female would equate to a weight of 105 pounds, or 132 pounds for a 5-foot-10 male.) Years of poor nutrient and calorie absorption, worsened by frequent diarrhea, leave many celiac sufferers underweight, malnourished, and struggling just to maintain weight.

Elimination of wheat gluten removes the offensive agent that destroys the intestinal lining. Once the intestinal lining regenerates, better absorption of vitamins, minerals, and calories becomes possible, and weight begins to increase due to improved nutrition. Such studies document the weight
gain
with wheat removal experienced by underweight, malnourished celiac sufferers.

For this reason, celiac disease has traditionally been regarded as a plague of children and emaciated adults. However, celiac experts have observed that, over the past thirty to forty years, newly diagnosed patients with celiac disease are more and more often overweight or obese. One such recent ten-year tabulation of newly diagnosed celiac patients showed that 39 percent started overweight (BMI 25 to 29.9) and 13 percent started obese (BMI ≥ 30).
19
By this estimate, more than half the people now diagnosed with celiac disease are therefore overweight or obese.

If we focus only on overweight people who are not severely malnourished at time of diagnosis, celiac sufferers actually
lose
a substantial quantity of weight when they eliminate wheat gluten. A Mayo Clinic/University of Iowa study tracked 215 celiac patients after wheat gluten elimination and tabulated 27.5 pounds of weight loss in the first six months in those who started obese.
20
In the Columbia University study cited above, wheat elimination cut the
frequency of obesity
in half
within a year, with more than 50 percent of the participants with a starting BMI in the overweight range of 25 to 29.9 losing an average of 26 pounds.
21
Dr. Peter Green, lead gastroenterologist in the study and professor of clinical medicine at Columbia, speculates that “it is unclear whether it is reduced calories or another factor in diet” responsible for the weight loss of the gluten-free diet. With all you’ve learned, isn’t it clear that it’s the elimination of wheat that accounts for the extravagant weight loss?

Similar observations have been made in children. Kids with celiac disease who eliminate wheat gluten gain muscle and resume normal growth, but also have less fat mass compared to kids without celiac disease.
22
(Tracking weight changes in kids is complicated by the fact that they are growing.) Another study showed that 50 percent of obese children with celiac disease approached normal BMI with wheat gluten elimination.
23

What makes this incredible is that, beyond gluten removal, the diet in celiac patients is not further restricted. These were not purposeful weight loss programs, just wheat and gluten elimination. No calorie counting was involved, nor portion control, exercise, or any other means of losing weight … just losing the wheat. There are no prescriptions for carbohydrate or fat content, just removal of wheat gluten. It means that some people incorporate “gluten-free” foods, such as breads, cupcakes, and cookies, that cause weight
gain,
sometimes dramatic. (As we will discuss later, if you have a goal of weight loss, it will be important not to substitute one weight-increasing food, wheat, with yet another collection of weight-increasing foods, gluten-free items.) In many gluten-free programs, gluten-free foods are actually
encouraged.
Despite this flawed diet prescription, the fact remains: Overweight celiac sufferers experience marked weight loss with elimination of wheat gluten.

Investigators performing these studies, though suspecting “other factors,” never offer the possibility that weight loss is from elimination of a food that causes extravagant weight gain—i.e., wheat.

Interestingly, these patients have substantially lower caloric intake once on a gluten-free diet, compared to people not on a gluten-free diet, even though other foods are not restricted. Calorie intake measured 14 percent less per day on gluten-free diets.
24
Another study found that celiac patients who strictly adhered to gluten elimination consumed 418 calories less per day than celiac patients who were noncompliant and permitted wheat gluten to remain in their diets.
25
For someone whose daily calorie intake is 2,500 calories, this would represent a 16.7 percent reduction in calorie intake. Guess what that does to weight?

Symptomatic of the bias of conventional nutritional dogma, the investigators in the first study labeled the diet followed by participants recovered from celiac disease “unbalanced,” since the gluten-free diet contained no pasta, bread, or pizza but included more “wrong natural foods” (yes, they actually said this) such as meat, eggs, and cheese. In other words, the investigators proved the value of a wheat-free diet that reduces appetite and requires calorie replacement with real food without intending to or, indeed, even realizing they had done so. A recent thorough review of celiac disease, for instance, written by two highly regarded celiac disease experts, makes no mention of weight loss with gluten elimination.
26
But it’s right there in the data, clear as day: Lose the wheat, lose the weight. Investigators in these studies also tend to dismiss the weight loss that results from wheat-free, gluten-free diets as due to the lack of food variety with wheat elimination, rather than wheat elimination itself. (As you will see later, there is no lack of variety with elimination of wheat; there is plenty of great food remaining in a wheat-free lifestyle.)

It might be the lack of exorphins, reduction of the insulin-glucose cycle that triggers hunger, or some other factor, but elimination of wheat reduces total daily calorie intake by 350 to 400 calories—with no further restrictions on calories, fats, carbohydrates, or portion sizes. No smaller plates, prolonged chewing, or frequent small meals. Just banishing wheat from your table.

There’s no reason to believe that weight loss with wheat elimination is peculiar to celiac disease sufferers. It’s true for people
with
gluten sensitivity and for people
without
gluten sensitivity.

So when we extrapolate wheat elimination to people who don’t have celiac disease, as I have done in thousands of patients, we see the same phenomenon: dramatic and immediate weight loss, similar to that seen in the obese celiac population.

LOSE THE WHEAT BELLY

Ten pounds in fourteen days. I know: It sounds like another TV infomercial boasting the latest “lose weight fast” gimmick.

But I’ve seen it time and time again: Eliminate wheat in all its myriad forms and pounds melt away, often as much as a pound a day. No gimmicks, no subscription meals, no special formulas, no “meal replacement” drinks or “cleansing” regimens required.

Obviously, weight loss at this rate can be maintained for only so long, or you’d end up a pile of dust. But the initial pace of weight loss can be shocking, equaling what you might achieve with an outright fast. I find this phenomenon fascinating: Why would elimination of wheat yield weight loss as rapid as
starvation?
I suspect it is a combination of halting the glucose-insulin-fat-deposition cycle and the natural reduction in calorie intake that results. But I have seen it happen time and time again in my practice.

Wheat elimination is often part of low-carbohydrate diets. Clinical studies are accumulating that demonstrate the weight loss advantages of low-carb diets.
27,
28
In fact, the success of low-carb diets, in my experience, originates largely from the elimination of wheat. Cut carbs and, by necessity, you cut wheat. Because wheat dominates the diets of most modern adults, removing wheat removes the biggest problem source. (I’ve also witnessed low-carb
diets
fail
because the only remaining carbohydrate source in the diet was wheat-containing products.)

Sugar and other carbohydrates do indeed count, too. In other words, if you eliminate wheat but drink sugary sodas and eat candy bars and corn chips every day, you will negate most of the weight loss benefit of eliminating wheat. But most rational adults already know that avoiding Big Gulps and Ben and Jerry’s is a necessary part of weight loss. It’s the wheat that seems counterintuitive.

Wheat elimination is a vastly underappreciated strategy for rapid and profound weight loss, particularly from visceral fat. I’ve witnessed the wheat belly weight loss effect thousands of times: Eliminate wheat and weight drops rapidly, effortlessly, often as much as fifty, sixty, a hundred or more pounds over a year, depending on the degree of excess weight to start. Just among the last thirty patients who eliminated wheat in my clinic, the average weight loss was 26.7 pounds over 5.6 months.

The amazing thing about wheat elimination is that removing this food that triggers appetite and addictive behavior forges a brand-new relationship with food: You eat food because you need it to supply your physiologic energy needs, not because you have some odd food ingredient pushing your appetite “buttons,” increasing appetite and the impulse to eat more and more. You will find yourself barely interested in lunch at noon, easily bypassing the bakery counter at the grocery store, turning down the donuts in the office breakroom without a blink. You will divorce yourself from the helpless, wheat-driven desire for more and more and more.

It makes perfect sense: If you eliminate foods that trigger exaggerated blood sugar and insulin responses, you eliminate the cycle of hunger and momentary satiety, you eliminate the dietary source of addictive exorphins, you are more satisfied with
less.
Excess weight dissolves and you revert back to physiologically appropriate weight. You lose the peculiar and unsightly ring around your abdomen: Kiss your wheat belly good-bye.

Down 104 Pounds … 20 More to Go

When I first met Geno, he had that familiar look: gray pallor, tired, almost inattentive. At 5 feet 10, his 322 pounds included a considerable wheat belly flowing over his belt. Geno came to me for an opinion regarding a coronary prevention program, triggered by concern over an abnormal heart scan “score,” an indicator of coronary atherosclerotic plaque and potential risk for heart attack.

Not unexpectedly, Geno’s girth was accompanied by multiple abnormal metabolic measures, including high blood sugars well into the range defined as diabetes, high triglycerides, low HDL cholesterol, and several others, all contributors to his coronary plaque and heart disease risk.

I somehow got through to him, despite his seemingly indifferent demeanor. I believe it helped that I enlisted the assistance of his chief cook and grocery shopper, Geno’s wife. He was at first puzzled by the idea of eliminating all “healthy whole grains,” including his beloved pasta, and replacing them with all the foods that he had regarded as no-no’s such as nuts, oils, eggs, cheese, and meats.

Six months later, Geno came back to my office. I don’t think it would be an exaggeration to say that he was transformed. Alert, attentive, and smiling, Geno told me that his life had changed. He had not only lost an incredible sixty-four pounds and fourteen inches off his waist in those six months, he had regained the energy of his youth, again wanting to socialize with friends and travel with his wife, walking and biking outdoors, sleeping more deeply, along with a newly rediscovered optimism. And he had laboratory values that matched: blood sugars were in the normal range, HDL cholesterol had
doubled,
triglycerides dropped from several hundred milligrams to a perfect range.

Another six months later, Geno had lost forty more pounds, now tipping the scale at 218—a total of 104 pounds lost in one year.

“My goal is 198 pounds, the weight I had when I got married,” Geno told me. “Only twenty more pounds to go.” And he said it with a smile.

BE GLUTEN-FREE BUT DON’T EAT “GLUTEN-FREE”

Say what?

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