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March/April 2004 Featured Stories
Weight Health for Life
An interview with Andrew Packard, M.D.

by Miriam Knight

Andrew Packard, M.D.

When a graduate of Yale Medical School, who is today a leading gastroenterologist, says with a grin that the medical fraternity "can stand to be insulted over how we have taken care of weight", you know it is going to be a fun interview. Dr. Andrew Packard has seen so much misery in his practice due to excess weight that he spent the last 10 years studying the work of the world’s leading weight-loss experts. He collected the best, most reliable medical research on the subject. He then integrated it with sensitive understanding of the hungers of the human spirit, and came up with a refreshing and practical plan for weight health for life – one that is NOT a diet plan.

"I am interested in the concept of Weight Health, not thinness," said Packard, whose bouncy vitality and trim figure show he practices what he preaches. The science and principles he proceeded to lay out (and which can be read in detail in his newly released book, The Packard Weight Health Plan) made a lot of good sense.

Tackling the Obesity Epidemic

Dr. Packard has a real sense of urgency behind his crusade. He cites the statistics behind the obesity epidemic sweeping this country, but more than that, he sees the flood of chronic pain and illness directly related to excess weight in his medical practice.

How acute is this problem? "Poor weight health is not a benign condition," says Packard. "If I told you that 30% of the children in your community and 70% of the adults had a medical condition that was leading to cancer, arthritis, heart attacks, strokes, diabetes, Alzheimer’s disease, early aging, heartburn and reflux, sleep apnea, would you demand a solution and an explanation? One out of three children born after the year 2000 in the United States is expected to develop obesity related diabetes!

"Today we know that the important unifying theme behind the diseases that we associate with abnormal weight health is an excess in free radicals produced by too many fat cells in the body, particularly in the belly area, and diets don’t work in the long run." The reason, according to Packard, is that they don’t take into account the new science about fat cells, the brain and their relation to exercise. Both your brain and your fat cells are programmed to survive, so without reprogramming your brain and your body’s chemical factory, your body will do everything in its power to hold on to or regain the weight you’ve lost – plus a bit more for insurance.

Hormones & Hard-wiring

Some of the programming is due to your genetic make-up; some is due to environment and habit; but much of it is in the "hard wiring", i.e. the triggers for releasing the neurohormones, dopamine, serotonin, GABA and endorphins and other hormones like leptin, insulin and ghrelin.

"If you have a very abnormal serotonin wire, or dopamine wire or GABA wire, you can’t just think it through to make it better; you can’t just get a grip. We have to stop the blame and the guilt and stop producing all these diet books that in my opinion are part of the problem, not the solution."

Interestingly, the solution lies in understanding the relationship between abnormal hormone levels and the emotions they stimulate that may trigger cravings. Packard goes even further out on a limb and suggests things to satisfy these cravings like aromas, and touch and intimacy, and meditation and creative thought! This is "because it all helps endorphins, and endorphins are so crucial to how well that biologic brain feels."

We’ve all heard the studies about endorphins being the body’s natural opiates, and exercise junkies being addicted to endorphin highs, but this is the first time an allopathic physician has come out and said that a better way to make yourself feel good is by supplying spiritual nourishment! "There are people who are so sick in weight health that it is going to require more than natural methods. However, the majority of people, if they understand how this works, can actually do very well with natural methods."

Cravings & the Limbic Brian

Packard was convinced that we needed to look at weight differently if we were going to solve the problem. Our weight is as strongly genetically determined as is our height, but in different environments they will vary. So he came up with the term "Weight Health", to describe the range of weights that might be normal. We’re not all greyhounds; some of us are labs, some are St. Bernards, some are Chihuahuas. The number of pounds is not what makes you sick; it’s your abnormal weight jacket. (Think of a puffy jacket made up of fat cells.) What makes you sick is a high % body fat, not your Body Mass Index.

In his book Packard defines weight health, and has a number of quizzes that you take and add up the score to determine your own craving type.

He asks these four questions –

• do you crave
• Are you happy or sad
• Are you safe
• Do you have intimacy in your life

The answers are designed to let you and your practitioner determine the health of your limbic brain, and clinically to evaluate dopamine, serotonin, GABA and endorphins, so you can then make sense out of the other parts of the body.

On his website, he created an online consult, where he can do a virtual consult for patients to print out and take to their doctor. It details where you are not in the right categories, so your doctor actually has something to go with. For the near future, if people buy the book, he will actually give that consult for free.

Five Steps to Weight Health

The second part of the book outlines five steps that teach you how to achieve permanent weight health. They are 1) learning how turn off your cravings, 2) knowing how to identify the triggers for your habits, 3) learning how to eat so that you burn calories, and 4) a very simple meal plan. "This is where I try to make it different, so that it is not a diet. I’m a guy and I produced this for what guys could do, because I knew if guys did it, women would do it," he said with a grin.

"What I did is looked at all the different studies and applied principles for weight health, not weight loss. So I encourage protein for breakfast for weight loss, complex carbohydrates for lunch for weight health (fruits, vegetables, whole grains), and a mixture for dinner, "for fun." If you add some nutraceuticals and fiber, you get everything you need nutritionally, but with less calories, so you have a weight loss program. I don’t like Atkins, because it encourages saturated fats, and saturated fats encourage free radicals.

"We need people to be able to sustain the program for life, so by having a normal dinner we have better adherence. By separating proteins and carbohydrates, you digest them better and by having the protein breakfast, which is easy to do, it will give them weight loss. The fiber from psyllium and complex carbohydrates reduces cholesterol and protects the GI tract from cancer and diverticulosis."

The fifth step is exercise. He is appalled at any diet programs that make exercise an option. "With this world obesity crisis I don’t see physical activity as a negotiable item. I see physical activity as important as brushing your teeth or wearing a warm jacket in the winter. It can be very simple – a walk, occasional light weights, some stretching. If you want to go to a gym, great! Any activity is good. But to have your fat jacket fit properly, you need an endurance exercise of 35 minutes non-stop, and the best way to do that is with a walk."

Dr. Packard had a number of thoughts about the Low-Carb and Atkins phenomena. "We’re saying, let’s cut the carbs out, like the carbs are the big culprit. Fat has nine calories per gram as opposed to four calories per gram for carbs. Your fat cells will produce free radicals that lead to tissue damage and aging, but high saturated fat intake will do the same. I also don’t think the diet provides enough fiber.

"It’s simple really. Just think that 3500 calories is a pound. Therefore if you eat only 100 extra calories a day for a month you gain a pound. But if you decrease your intake by 100 calories a day you’ll lose a pound. And remember that one of the main ways to decrease the risk of free-radicals and achieve weight health is exercise. It’s non-negotiable. I don’t want to hear about the weather, or any other excuse. We have a crisis, and the only way we are going to solve it is if we increase everybody’s level of energy expenditure. It’s non-negotiable."

Dr. Packard’s website is www.packardweighthealth.com. The Packard Weight Health Plan is published by Ballantine Books, hardcover, 279 pages, $23.95.