Cape Town. 020312. Author Dr Luc Evenepoel. Picture Leon Lestrade

You have been waiting for it all your life: permission not to diet. Now it’s here, and it comes coupled with a promise that once you lose weight you will keep it off – a promise many women only dream about.

Google “diets” and you’ll get more than 75 million results, including “diets that work”, “diets that work fast”, “diets that work fast for women”, and “diets that actually work”. But, according to a book by Cape Town anaesthetist Dr Luc Evenepoel, there is only one sure way to lose weight, and that is not to diet.

The title, Lose Weight and Keep It Off (Penguin), may not catch your attention, but the subtitle, Dr Luc’s Promise will pique your interest.

Belgian-born Evenepoel became interested in the repercussions of diet because as a child he had chronic hay fever and, after two years of cutting sugar and refined foods out of his diet, his hay fever had largely disappeared.

“I realised food is more important than eating. Then at university our professor of endocrinology gave us lectures on weight control. He was a very inspiring character and I remember him saying: ‘Massage is very good for weight loss. The masseur loses a lot of weight.’

“A bit silly,” he laughs, “but it stuck in my mind. I kept looking at all the adverts in magazines and on TV about weight control and weight loss. I asked myself how people could believe the unbelievable. I thought that one day someone would have to write a book about what is true and untrue about weight control, but no one seemed to do it, so I took it upon myself.”

“Then a couple of years ago we started with bariatric (weight loss) surgery in South Africa and I got involved in a national programme as an anaesthetist. You have to evaluate the people pre-operatively to see if they are healthy enough to undergo surgery. The stories you hear from these people often very saddening, especially because they never follow decent advice. They follow advice from popular magazines, friends, the internet and they get worse off as they go along.

“People try things and they get disappointed. I want to tell them the truth. I don’t want to point fingers at anyone, but there is a mind-boggling amount of misinformation out there. Even for medical doctors it’s difficult to figure out what’s true and what’s not true. If you want to lose 20kg in a month, don’t come to me. I’m telling you not to do that because it’s not sustainable. Do it gradually.”

In his book, Evenepoel says: “Of all the people who go on a diet, 85 percent put all the kilos back on within two years, and 95 percent within four years.”

“Unfortunately there isn’t one single message where I can say ‘do this and you’ll be slim’. There are plenty of small little tips, ones that mankind has been applying for centuries, millennia.”

Evenepoel emphasises the importance of finding your “ideal weight” rather than being lean, slim or thin. He advocates eating just 12.5 percent less and moving just 12.5 percent more. That gives you the same result as a 25 percent calorie deficit of going on a low calorie diet, which he insists is not sustainable.

“Eating 12.5 percent less (the equivalent of four to five slices of bread) and moving 12.5 percent more (the equivalent of a half-hour walk) is sustainable and will give you an energy deficit of 25 percent. Great for gradual weight loss, and to keep that weight off.”

Learning to identify calorie-dense foods that contain a shocking number of calories will help you identify your personal trouble areas. It’s also helpful to know the basics, for instance that one gram of carbohydrate or protein provides four calories, while one gram of fat provides nine calories.

“When you start explaining how the body works, people lose interest,” Evenepoel says. “They want an injection, or a tablet. So I started telling them to write down everything they eat and come back to me the following week. I’ve told hundreds and hundreds of people that. Very few of them come back.”

In his book Evenepoel asks 20 questions aimed at getting you to think about your relationship with food and he provides 174 tips to get you going.

He suggests adopting just three new tips every month that, one hopes, will become lifelong habits. These include things such as asking yourself, before you start eating, whether you are actually hungry, ending your meal while you are still a bit hungry, and remembering that it’s not necessary to empty your plate.

Often we don’t eat only when we’re hungry. Our lifestyles, culture, environment and social factors play a huge part in when and why we eat and being overweight is not something that happens overnight. Our bodies constantly give us signals we ignore.

“Our bodies are incredibly complex organisms,” Evenepoel explains. “They do their best day after day to keep you at your ideal weight, but every single day we obstruct them in their efforts. Just let your body do what it does. You don’t need to kickstart your metabolism. Your body does everything itself.”

So why is obesity on the increase?

“For 99 percent of its existence, the genus Homo had little food, did daily physical work, drank only water, and ate something sweet as an occasional treat. Through evolution we became perfectly adapted to that. Our modern lifestyle is exactly the opposite: we have a lot of food, we hardly move, we drink plenty of calories, and we think chocolate is an essential food group. Evolution has had zero time to prepare our bodies for such a lifestyle, and the result is there for all to see – obesity.”

Portion sizes have also increased dramatically. Recipes recommended for six to eight people 50 years ago are now recommended for four people.

“More than 60 percent of the US population is overweight and half of that group are obese,” writes Evenepoel, “and yet many of them are also malnourished. “Healthy food is the best preventive medicine there is. You can have it every day. If you are overweight, every kilo you lose will benefit your health.

“The food that is best for us is not always the food that hits the billboards. The cheaper food is the fattening type and low in nutrients: poor-quality carbs, sugar, bad fats. Good, high-quality, nutritious and balanced food is more expensive.”

One example he mentions that hits home is our – often unintentional – overconsumption of sugar, which has increased from 2kg by each person a year in 1700, to 9kg in 1800, 18kg in 1850 and 50kg nowadays. It is hidden in a variety of foods one would probably never think contained sugar – processed meats, salad dressings, fish pâtés and low-fat products – apparently to improve the taste.

While the body is complex and it may well help you to know about the chemicals released or how the hypothalamus region of your brain works, it’s the basics that count.

Evenepoel refers to a study published in the New England Journal of Medicine in June that looked at 120 000 people over 20 years.

“The most important finding is that people don’t overeat massive amounts. It’s a little bit too much every single day. That’s what makes you gain all that weight. You can combat it with a low carbohydrate intake like we’ve heard recently.

“The Atkins diet of low carbo-hydrate intake has been shown not to work in the ‘real world’. We’re taking this whole complex topic of weight control and focusing on just one topic and expecting salvation from that. You cannot live on 100g of carbohydrates as your maximum intake every day. First of all you’re going to smell bad. Nobody speaks about it, but your breath stinks from the release of ketones and your sweat stinks. That will disappear after a while, but what won’t disappear is constipation because you’re not eating enough fibre.

“There is enough information in the scientific literature to say that low carb diets are not suitable for modern society. First, it’s not sustainable and second, physiologically, for our environment, it’s not going to work.

“My mainstay is carbohydrates,” says Evenepoel who, at 70kg, weighs the same as he did in high school.

“I don’t do anything special. I eat what I should eat and I don’t eat what I shouldn’t eat.”

In his introduction he says: “I admit that nothing in this book is revolutionary. People keep trying the revolutionary stuff, but all they lose is money, not weight. There is no need for revolution; there is only a need to do what we should do. After all, that’s what human beings have been doing for the past 200 000 years, and they’ve mostly been slim until just two generations ago.”

Health authorities and dietitians can be guilty of making it too complicated. Says Evenepoel: “Just live your life. Don’t live by calories or carbohydrates.”

Evenepoel says his book is the first step to aiming for policy changes in SA.

“I’m trying to change the world. The first thing to tackle is the mind-boggling overconsumption of sugar and refined carbohydrates. It’s killing our blood vessels and exploding our waists. Let’s be the first country in the world which says ‘This contains an excessive amount of sugar’ on a can of cold drink or on a packet of chips – ‘Did you know that six chips contain the same amount of calories as a slice of bread?’ I’m just trying to create an awareness. It’s small things that you do every day.” - Cape Times

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10 things to do to reach ideal weight:

1 Do not diet! Have healthy food you enjoy in appropriate portions. Keep it simple.

2Be careful with calorie-dense food.

3Listen to your body’s signals. It will tell you if you’re hungry.

4Portion caution! Portions served these days are between 1.5 and five times larger than recommended. Your heaped meal should fit in your cupped hands and contain vegetables, carbohydrates and protein.

5Stay close to nature. Choose foods that are identifiable with their original form.

6Have at least five servings of fruit and vegetables daily. They keep your fat-burning fire going. This is non-negotiable.

7 Keep an honest food diary to get yourself going.

8 Be realistic about exercise. Weight loss is 80 percent proper eating, 20 percent exercise.

9You are what you drink. One serving of a caloric drink (cola, lemonade, juice, beer, wine, spirits etc) is equal to two to three slices of bread. If you have one, make a conscious effort to eat less. Water is the only thing you should drink for thirst.

10Apply relaxed restraint to your eating habits. Remember that life is about happiness, not about how flat your tummy is.