Chapter 9: Putting It All Together: The SENSE Lifestyle Program
You've heard it before—the familiar message that health experts (including your dear old grandmother) have been repeating for years: Get enough sleep, eat right, and exercise. Yes, it's a tired old mantra, but these three steps are probably the most effective tools available for combating stress and keeping cortisol levels from getting the best of us. Stress researchers from Yale to the University of California have shown over and over that the best way of managing stress, from both a physical and a psychological perspective, is to adhere to the basic tenets of good health promotion—eat right, sleep, and exercise. (See how smart your grandma was?) Failure to do so, as we know by now, causes an elevation in cortisol levels and sets the stage for chronic diseases.
Unfortunately, when we are exposed to periods of heightened stress, what do we do? We do exactly the opposite of what we're supposed to. Instead of exercising, we stop our workout program, because stress makes us feel as if we simply don't have enough time. Instead of eating sensibly, we allow our cortisol levels to become elevated, which makes us hungryand therefore more likely to grab something at the drive-through window. And instead of getting enough sleep to help our bodies counteract the debilitating effects of stress, we stay up late, wake up early, and suffer from restlessness and insomnia.
As a nutritionist, physiologist, and lifestyle coach for more than a decade, I have used the concepts outlined in The Cortisol Connection to help thousands of clients optimize their own metabolic profiles—and achieve the lasting weight loss they have been looking for. More often than not, these are people who have tried other diets and have lost weight, but who have had that weight come right back (often with a bit more, as an added "bonus"). Like many of my clients, you may already be following what could be viewed as an excellent diet and exercise plan—but no matter how many calories you cut or how many minutes you exercise, you just can't seem to shed those last few pounds. Sound familiar?
Be the Balloon: The "3S" Approach to Managing Metabolic Adaptation
When I teach metabolic concepts to participants in our SENSE Lifestyle Program I often use a balloon to illustrate the concept of metabolic adaptation. I point out that balloons come in a variety of shapes and sizes (just like our bodies), and when we influence one aspect of metabolism (as illustrated by pushing in on the right side of the balloon), we get an opposite reaction in another aspect of metabolism (the balloon swells on its left side). Physicists would refer to this concept as Newton's Third Law of Motion (every action has an equal and opposite reaction), but nutritionists refer to it as metabolic adaptation, and it is one of the overarching reasons why lasting weight loss is so difficult to achieve—unless you know precisely how to use diet and exercise to guide your metabolism in the right direction.
The classic example of how metabolic adaptation applies to weight loss is the one that we've been discussing throughout this book, in which you cut calories to lose weight, but at the same time your resting metabolic rate (RMR, the number of calories your body burns at rest) also drops—so weight loss continues for a few days or weeks, and then it stops (the dreaded weight-loss "plateau"). The weight may even start to creep back on to your hips and belly. This is an example of your body's adapting its metabolism (by burning fewer calories) to its new environment (fewer calories being consumed, higher cortisol, lower testosterone, etc.)—and while the process may have been advantageous for our ancestors' survival when they faced starvation, it doesn't exactly help our weight-loss efforts in the twenty-first century.
The key to lasting weight-loss success is to "outsmart" your body's own process of metabolic adaptation. In other words, you not only need to think about the balloon, you need to be the balloon! You need to use what I call the "3S" approach, which calls for small, simultaneous, and sustained changes in metabolism to help you achieve long-term weight-loss success. The 3S approach is fully incorporated into SENSE, and it means that you control metabolism just enough to achieve a desired effect (weight loss) but not so much that you cross the line into metabolic adaptation.
By small, I mean that we avoid extreme or "big" changes in metabolism, because extreme changes set off an almost immediate adaptation that causes our bodies to conserve energy and slow weight loss. Small changes help us to keep "shrinking our balloon"—and most of us want to be smaller balloons.
By simultaneous, I mean that we need to influence several different aspects of metabolism at the same time, including cortisol, testosterone, and HSD—which in turn help to modulate other hormones and other aspects of the enzyme system such as insulin/blood sugar, growth hormone, thyroid hormones, serotonin, norepinephrine, and others that I collectively refer to at metabolic control points (MCPs). A significant problem with many popular diets is their inappropriate focus on a single aspect of metabolism—such as appetite control or calorie intake. These are both certainly important facets of any successful weight-loss regimen, but when your diet focuses too much on a single aspect of metabolism, it is very easy for your body to adapt to maintain your existing weight. By contrast, it is much more difficult for your body to fully adapt to small changes made simultaneously in several areas of metabolism.
Finally, by sustained, I mean that we need to keep at it. Sometimes this entails changing the plan slightly from time to time in order to stay one step ahead of our own metabolic adaptation. The good news is that the small/simultaneous approach to metabolic control is quite easy to sustain—for life. In fact, most of my clients wouldn't go back to their "old" weight-maintenance approaches if I paid them to do so. Why? Simple. Because by following the principles outlined in SENSE, they look great and they feel great—and who would want to change that?
Researchers at the National Institutes of Health (NIH) have been studying the behavioral effects of heightened stress for more than thirty years. Their work shows quite clearly that stress causes us to undereat during the early stages of our stress response (maybe up to an hour), while our longer-term response to chronic stress, lasting from hours to days, is to overeat. This effect was confirmed in weight-loss centers around the country and the world after the September 11, 2001, terrorist attacks on the Pentagon and the World Trade Center. The resulting stress led many dieters to report stress-induced suppression of appetite, caused by feeling sick to their stomachs, followed some hours later by stress-induced food binges, caused by a cortisol-stimulated appetite. NIH researchers have estimated that at least one-quarter of all Americans—more than sixty million people—will suffer (or already have suffered) an abnormal stress response to the events of September 11, which sets many of us up for increased risk of chronic diseases such as obesity, diabetes, heart disease, and others.
Enough doom and gloom. We know that stress is "bad" and we know that chronically elevated cortisol levels are "bad"—but what can we do about it? That's where the SENSE program comes into play. SENSE, as you know by now, stands for stress management, exercise, nutrition, supplementation, and evaluation. With SENSE, you'll eat all of the foods you love, but you'll learn how to use your food consumption to control the effects of cortisol, testosterone, HSD, and other MCPs in your body—and ultimately to control how many calories you burn off or store as fat. A special feature of this final chapter is its practical approach to helping you make SENSE a part of your everyday life.