The secret to surviving the holiday buffet

By Brian Wansink, Ph.D.
msnbc.com

There is probably no greater diet danger zone than the holiday buffet. It's hard to resist grabbing a huge plate and piling it up with buttery breads, cheeses, meats, cakes, cookies and pies.

Although it might seem as if we’re swimming against stream when it comes to the delicious — but calorie-laden — holiday table, there are a lot of people who seem immune to overloading their plates. They have fun at buffets, parties and dinners without gaining weight. What’s their secret?

To better understand how some people survive the pitfalls of all-you-can-eat dining, researchers at my Cornell University Food and Brand Lab observed 213 normal weight and overweight diners at buffets across the country. We found that heavier diners are more likely than slimmer diners to sit closer to the buffet, use larger plates and serve themselves immediately instead of browsing the buffet
In the study, heavy folks grabbed a plate almost as soon as they arrived and immediately started serving themselves. The normal weight diners were more likely to scout things out first. When they did pick up a plate they were seven times more likely than the heavy eaters to take the smallest plate available. Some specifics:

• 71 percent of normal-weight diners browsed the buffet before serving themselves, compared to 33 percent of obese diners.
• 27 percent of normal-weight patrons faced the buffet compared to 42 percent of obese diners.
• 16 percent of obese diners sat at a booth rather than a table compared to 38 percent of normal weight diners.
• Normal-weight people chewed their food an average of 15 times per bite versus overweight people who chewed only 12 times. In fact, speedy eaters are three times more likely to be overweight than people who eat more slowly and who don’t eat until they’re full, recent research found.
• Overweight diners sat an average of 16 feet closer to the buffet than normal-weight diners, presumably to shorten the trip when they go back for seconds … or thirds.
  

Have your cake and eat it
There are three main problems with a buffet, not only at the holidays, but anytime of the year. Those huge tables of food are prime examples of what I call the 3 C's of disastrous dieting:

Convenience: Food is all around and it’s often with arm-reach.

Caloric: Whether sweet or salty, buffet foods are often higher in the indulgence factor than good sense.

Choices: There is a lot of variety, which increases how much you eat because your taste buds don’t burn out on one thing.

The bottom line of the buffet is you really can

have your holiday cake and eat it, too. You just need to browse the food to find what you really want, use a small plate and eat slowly. To avoid the temptation of going back for seconds, sit as far away from the table of food as possible. If you don’t face the goodies, you are less likely to spot something else you want to pile on the plate.

In my book, "Mindless Eating: Why We Eat More Than We Think," I also describe a trick that seems to work well for many holiday buffet-goers. It’s called the Rule of Two. You can choose anything you want at the buffet, but you can never have more than two items on your plate. If you want to load it up with nuts and cake, go ahead. If you want to go back for seconds and load it up again with chips and carrots, go ahead. Although this sounds like a recipe for disaster, it actually works quite well for people for three reasons:

• You tend to take the two types of food you want most. People who love desserts don’t work their way up to desserts. They’ll start with the desserts, and then stop.
• You tend to not overfill you plate. Putting only two things on our plate helps keep our serving sizes somewhat small because we psychologically don’t want to overload on a particular item.
• You tend to not go back more than two times. In one study we did on the Rule of Two, 83 percent of people only made one or two additional returns to the buffet.

Using some of these easy rules can help you take the focus off the food and pay more attention to what really makes the holidays special — your family and friends.

Brian Wansink, Ph.D., author of "Mindless Eating — Why We Eat More Than We Think," is head of the U.S. Department of Agriculture's Center for Nutrition Policy and Promotion. He is also director of the Cornell Food and Brand Lab.

Obese woman has brain surgery for weight loss

LOS ANGELES - Brain surgery for weight loss?

West Virginia mother of two Carol Poe, 60, is only the second person in the United States to undergo deep brain stimulation for weight loss after trying everything from diets to having her stomach stapled.

Last month, she took part in a clinical trial at West Virginia University hospital in which neurosurgeons drilled into her brain and used electricity to control her feelings of hunger and satisfaction.

Poe's story will be told on ABC Television's "Nightline" program on Monday, March 9.

Poe, who is 5 feet 2 inches tall and who weighed 230 pounds before the surgery, said that at her heaviest she weighed about 490 pounds.

Dr Julian Bailes, chairman of West Virginia University's department of neurosurgery, said Poe was a good candidate for the radical treatment.

"This is not for overweight patients. It's for obese patients," Bailes told "Nightline."

"This is a frontier of medicine...to be able to generate tiny pulses of electricity in these deep nuclei of the brain, and to see what effect they may have on behavior, including in this case the behavior of eating and the issue of uncontrolled appetite," he said.

Bailes told Reuters that the West Virginia University hospital was the only one in the United States, and the only center he knew of worldwide, using the deep brain stimulation technique specifically on obese patients.

He said the first patient underwent surgery in November 2008. The second, Poe, took place in February. Both are part of a clinical trial, approved by the U.S. Food and Drug Administration, conducted by fellow neurosurgeons Michael Oh and Donald Whiting.

Poe was awake during the three-hour surgery, in which wires carrying an electrical impulse were inserted into her brain in the region where the stomach is controlled, and linked to two pacemaker devices implanted in her chest.

The voltage going into her brain is turned up slowly over future months to give Poe the sensation of feeling full.

"We hope her sensation is a sensation of satiety, a sensation of fullness, a lack of compulsion to consume excess calories," Bailes told "Nightline". "And a sensation again of satisfaction, of not having the feeling we need to eat some more when we know we don't."

Doctors said it would be several months before any weight loss is noticeable while the voltage to the brain is gradually increased. But a week after the voltage was turned on, Poe told "Nightline" she had already lost three pounds.

"When I eat, I get full faster. I just don't have the cravings like I used to have," she said.

Copyright 2009 Reuters. Click for restrictions.

Heavy? You may live three to 10 years less

LONDON - Being obese can take years off your life and in some cases may be as dangerous as smoking, a new study says.

British researchers at the University of Oxford analyzed 57 studies mostly in Europe and North America, following nearly one million people for an average of 10 to 15 years. During that time, about 100,000 of those people died.

The studies used Body Mass Index (BMI), a measurement that divides a person's weight in kilograms by their height squared in meters to determine obesity. Researchers found that death rates were lowest in people who had a BMI of 23 to 24, on the high side of the normal range.

Health officials generally define overweight people as those with a BMI from 25 to 29, and obese people as those with a BMI above 30.

The study was published online Wednesday in the medical journal, Lancet. It was paid for by Britain's Medical Research Council, the British Heart Foundation, Cancer Research UK and others.

"If you are heading towards obesity, it may be a good idea to lose weight," said Sir Richard Peto, the study's main statistician and a professor at Oxford University.

Moderately heavy people lost 3 years of life
Peto and colleagues found that people who were moderately fat, with a BMI from 30 to 35, lost about three years of life. People who were morbidly fat — those with a BMI above 40 — lost about 10 years off their expected lifespan, similar to the effect of lifelong smoking.

Moderately obese people were 50 percent more likely to die prematurely than normal-weight people, said Gary Whitlock, the Oxford University epidemiologist who led the study.

He said that obese people were also two thirds more likely to die of a heart attack or stroke, and up to four times more likely to die of diabetes, kidney or liver problems. They were one sixth more likely to die of cancer.

"This really emphasizes the importance of weight gain," said Dr. Arne Astrup, a professor of nutrition at the University of Copenhagen who was not linked to the Lancet study. "Even a small increase in your BMI is enough to increase your risks for cardiovascular disease and cancer."

Previous studies have found that death rates increase both above and below a normal BMI score, and that people who are moderately overweight live longer than underweight or normal-weight people.

Other experts said that because the papers used in the study mostly started between 1975 and 1985, their conclusions were not as relevant today.

Astrup worried that rising obesity rates may reverse the steep drops in heart disease seen in the West.

"Obesity is the new dark horse for public health officials," he said. "People need to be aware of the risks they're taking when they gain weight."

© 2009 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

Weight loss surgery revs sexual function in men

New York - Sexual dysfunction that commonly occurs in morbidly obese men improves after weight loss surgery, according to a new study.

"Sexual dysfunction should be considered one of the numerous potentially reversible complications of obesity," the study team concludes.

Dr. Ramsey M. Dallal, from Albert Einstein Healthcare Network, Philadelphia, and colleagues measured the degree to which 97 morbidly obese men suffered from sexual dysfunction and then analyzed the change in sexual function after substantial weight loss following gastric bypass surgery.

Before surgery, the morbidly obese men had significantly lower sexual function relative to that of a previously published reference control group of men before surgery, the investigators report.

After losing an average of two-thirds of their excess weight, men experienced significant improvements in sexual function, with the amount of weight loss predicting the degree of improvement.

"We estimate that a man who is morbidly obese has the same degree of sexual dysfunction as a nonobese man about 20 years older," the investigators report. "Sexual function improves substantially after gastric bypass surgery to a level that reaches or approaches age-based norms."

"Sexual function is an important aspect to quality of life and is now well documented to be a reversible condition," Dallal explained.

"We are interested in examining sexual function in females, as well as understanding the mechanism of obesity-related sexual dysfunction," Dallal added.

Brain-zapping device OK’d for OCD therapy

NEW YORK - Patients suffering from obsessive, distressing thoughts have a new treatment option: a pacemaker-like device that relieves anxiety with electrical jolts to the brain.

The Food and Drug Administration on Thursday approved Medtronic's Reclaim Deep Brain Stimulator device as the first implant to treat obsessive-compulsive disorder, which causes uncontrollable worries, such as fear of germs or dirt.

Patients suffering from the disorder try to relieve their anxiety with obsessive behavior, such as washing their hands or checking locks repeatedly.

"These are obtrusive thoughts that take control of people's lives to the point that they lose their jobs, can't have relationships and in many cases, can't even leave their homes," said Dr. Hooman Azmi of Hackensack University Medical Center.

While about 2.2 million Americans have the disorder, the new device would only be available to a small group of patients who don't respond to other treatments, such as antidepressant drugs and therapy.

The FDA approved the device under a program reserved for conditions that effect fewer than 4,000 people each year.

The FDA's director for devices stressed that Reclaim provides some relief, but patients likely will have to continue taking medications as well.

"Reclaim is not a cure," Dr. Daniel Schultz said in a statement. "Individual results will vary and patients implanted with the device are likely to continue to have some mild to moderate impairment."

Shaped like a pacemaker, the Reclaim device is implanted under the skin of the chest and then connected to four electrodes in the brain. The electrodes deliver steady pulses of electricity that block abnormal brain signals.

Similar devices have been used since the 1990s to treat movement disorders like Parkinson's disease and tremors. But where prior devices target areas of the brain that deal with movement, Medtronic said its product delivers electrical signals to areas that control mood and anxiety.

"What deep brain stimulation does is modulate those circuits that we believe are hyperactive in patients with obsessive compulsive disorder," said Paul Stypulkowski, the company's senior director of research.

Medtronic Inc., the world's largest medical device maker, also is studying the use of the technology in patients with severe depression.

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In 2005, rival Cyberonics became the first company to win FDA approval for a device to treat depression. However, the company's Vagus Nerve Stimulator has been plagued by questions of effectiveness.

Members of Congress and consumer watchdog groups campaigned against the Cyberonics device, citing research that some patients who have received it had worsening depression. A number of insurers, including the government's Medicare program, have refused to pay for the device in depression patients.

Medtronic representatives point out that their technology differs from that used by Houston-based Cyberonics, which delivers an electrical signal to nerves in the neck. Medtronic's devices stimulate the brain directly.

Copyright 2009 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.