The principles of the SWLL are the same for everybody but the experience will vary from individual to individual.
Here we look at five people. Their situations are very different. The ease or difficulty with which they lose weight will vary, as will their ability to keep it off.
First, though, a word about Body Mass Index (BMI). BMI is a standardized measure of how lean or overweight a person is. Here are the ranges:
|18.5 – 24.99||Healthy weight|
|25 – 29.99||Overweight|
|30 – 34.99||Stage I obese|
|35 – 39.99||Stage II obese|
|40 or more||Stage III obese|
To learn more about BMI read Appendix 1—Body Mass Index (BMI)
Sandra and Josephine are twins. They are both 38 years old, and 5’5″ tall. They both weigh 162 lb. which translates to a BMI of 27. This puts them near the middle of the overweight category.
Maria is the twins’ mother. She is 60 years old. Her height is 5’4″ and she weighs 204 lb. Her last increase in weight raised her BMI to 35. This puts her in the stage II obese category. She was unhappy being stage I, and she views the transition as a crisis.
Tracy has a BMI of 33, putting her well into the obese range. She has problems other as well as her weight. Her periods are irregular. She has hair growing on her face and she is losing hair from her head.
Ray’s situation is dire. He is a Pima Indian. He is 5’11” and weighs 400 lb., putting him high up in the morbidly obese range.
Sandra’s goal is to get her weight into the healthy range. This will improve her appearance too, but that’s a bonus, not the main goal. She’ll be happy to get down to 144 lb. and a BMI of 24.
Sandra is confident that she can lose the weight. She’s done it before when she has gone on a diet, but the weight has always come back. This time she is determined to keep the weight off. She decides to adopt the SWLL.
Her task is fairly easy. She needs to make some changes to what she eats, adopt a moderate exercise program, and try to build more activity into her life.
Josephine and Sandra were identical at birth. Even now, they’re physically the same too—they both weigh 162 lb. The difference between them is that Josephine’s goal is different from Sandra’s.
When Josephine was younger she wore a size 2 dress. She knows that she will never again fit into that dress, but she yearns to get as close as possible. She figures that she needs to be 126 lb. or less, with a corresponding BMI of 21.
Josephine needs to lose 36 lb. That’s twice as much as Sandra. Losing the weight will take longer, but the main problem will be to keep it off. Josephine will have to adopt a more rigorous exercise program than her sister. She will also have to eat less. To maintain such a low weight she may have to accept that she will always be slightly hungry.
Maria has listened in on the twins’ discussions about losing weight. Some of the things they found during their research really scared her. Maria is not under medical care for anything right now but she learns that her obesity makes it likely that she will be in the next few years. She decides to lose weight and become fit. She decides to adopt the SWLL.
Maria has a long journey ahead of her. Her first step should be to get a physical exam. After the exam she will know how many of the components of metabolic syndrome she has (see the “Health” chapter for details). It is important that the doctor understands the efficacy of lifestyle changes in correcting these conditions. Many doctors just prescribe drugs.
Attaining her goal of being lean and fit will take a long time, possibly up to two years. But there will be rewards along the way. As she starts to get fit she will be able to participate in some of the twins’ activities. There is the joy of shopping for new clothes as she sheds weight. Best of all, she knows that this change in her condition is permanent.
Sandra and Josephine just want to lose weight. Tracy has a more serious problem.
Tracy is obese, but it is enormously difficult for her to lose weight. She is hungry all the time. She’s tried dieting and she managed to lose some weight, but it soon came back.
She also has other problems. Her periods are irregular. She has hair on her face and on other inappropriate parts of her body. The hair on her head is starting to recede in a manner similar to male pattern baldness. She fears that unless she can get her weight under control, she is likely to become diabetic.
Tracy consults her doctor. He finds that her condition is caused by a disease: polycystic ovarian syndrome, or PCOS. The name of the disease comes from the fact that the afflicted woman’s eggs do not ripen and eject from the ovary. This is caused by an interruption in her hormone system.
A crucial mechanism of PCOS is insulin resistance. If this can be alleviated the symptoms are greatly lessened.
Happily for Tracy, medical science now has a solution. The drug metformin, also known as Glucophage, regulates the release of sugar into the blood stream and also makes her body more sensitive to insulin.
Lifestyle has a role to play in managing PCOS. The diet is stricter than the SWLL diet in that it restricts foods that would cause a sharp spike in blood sugar. This includes refined grains and food and drinks containing sugar. Fruits can be eaten in moderation, as part of a meal. Exercise is important both in burning existing glycogen (the form in which the body stores glucose) and in building muscle to absorb future glycogen.
PCOS is not a treat-it-yourself disease. Someone diagnosed with PCOS should be under a doctor’s care and, ideally, be receiving advice from a nutritionist.
Ray is even worse off than Tracy. At 5’11” and 400 lb. his BMI is an incredible 56. He is at imminent risk of diabetes with its attendant risks of amputations, kidney failure, blindness and heart attack.
Many other Pima Indians are in Ray’s situation. In fact, Pima Indians are among the heaviest groups of people in the world. Scientists hypothesize that this is because of the way they evolved.
Pima Indians are indigenous to the southwestern United States and Northern Mexico. This is an area of desert, and living conditions are harsh. Over generations the Pimas were subjected to recurrent famines. It is thought that they evolved a “thrifty gene,” which tells the body to, whenever food is available, pack it away as fat to help survive the next famine. Another factor is that their metabolisms are fantastically efficient. A Pima Indian can subsist on 700 calories a day, whereas someone of European descent would starve on less than 1,200 calories.
Pima Indians today can be divided into two groups: those who maintain the traditional lifestyle, and those who have adopted modern ways.
The traditional lifestyle group is in Mexico. They eat a diet that emphasizes corn and beans and has little meat. The ratio of nutrients is: 10% fat, 15% protein and 75% complex carbohydrates, coincidentally the same as the SWLL. To maintain themselves, they average 23 hours of physical labor each week. The result is that they are lean and healthy.
Pima Indians in Arizona have adopted a modern lifestyle, with its ready access to high fat foods and little need for exertion. The result is widespread obesity and type 2 diabetes, both occurring at early ages.
Because of their genetic makeup, it is more difficult for the Pimas to lose weight than any other population. Yet lifestyle changes work whenever they are tried. Pima Indians who go on a low fat, high complex carbohydrate, diet and who exercise regularly all lose weight and their diabetic symptoms are reduced or eliminated.
In a sense, Ray is more fortunate than Tracy. If he chooses to, Ray can solve his problem on his own. If he adopts the SWLL he will gradually attain a healthy weight. He will have to be more rigorous than other people. He will have to strictly control his food intake. He will have to exercise longer and harder. He will have to learn and apply every scrap of information in this book. But, in the end, he will succeed.
Of course, doing it by himself, while possible, is not optimum. Ray is at least pre-diabetic and probably has diabetes. A doctor should supervise Ray’s condition and possibly add medical interventions, such as drugs. A nutritionist should tailor a diet to his specific condition. Finally, a professional trainer should show him how to start exercising.
This chapter poses a question: What can you expect with the SWLL? As can be seen from the examples above, the answer is not simple. What you can expect depends on three main factors:
1) Your goals. The more ambitious your goal, the more rigorous your adherence to the SWLL will have to be and the longer it will take you to achieve that goal.
2) Medical problems. If your being overweight is caused by a medical condition, then your primary source of advice should be your doctor. You should not implement the ideas in this or any other book unless your doctor instructs you to do so.
3) Genes. Some people have more difficulty maintaining a lean weight than others due to their genetic makeup. The Pima Indians are an extreme example of this. Another example is people of African descent. Their resting metabolic rate is lower than that of people of European descent. So people of African descent have to work harder to achieve and maintain a lean weight.