Did you know that around one in three adults are overweight in the United States? While many strive to lose weight and keep it off, the weight loss process can be incredibly difficult to maintain. With that in mind, we interviewed Dr. Oster, whose new book The Three Rules to Lose Weight and Keep It Off Forever provides life-long sustainable practices to help you look and feel your best.
What inspired you to write The Three Rules to Lose Weight and Keep It Off Forever?
I was inspired to write The Three Rules to Lose Weight and Keep It Off Forever and update it with this edition because of my personal difficulties with weight control and the difficulties my patients experienced. I have lost hundreds of pounds over the years and have weighed fifty pounds more than I do now at least three times. Many of my patients have had the same experience. For most people, losing weight by cutting calories does not work. If it does, we regain weight when we return to our old ways. The same applies to very low-carb diets such as Atkins and the ketogenic diet.
Everyone knows we should adopt a new lifestyle rather than go on a diet, but it is not easy. Hunger and our love for carbohydrates get in the way. We act like we are addicted to fattening foods, and maybe we are. My plan treats it like an addiction. For most addicts, the best solution is to stop doing the addictive activity completely. This is true with hard drugs, alcohol, and what I call “bad carbs.” I find it much more difficult to eat one Oreo cookie than to have none, just like people with an alcohol problem find it difficult to have only one drink. Many appealing foods are allowed on the Three Rules Plan. I cook, go out for meals, eat at parties, and go on vacations. I do not have to think much at all about the diet plan—just avoid foods in three categories. I do not count calories, count carbs, or wake up hungry. If I ever am hungry, I eat something within the Rules.
- What do you think is the main reason behind the growing rates of obesity worldwide?
The underlying reason is the marked increase in the availability of sugar and high-glycemic and ultra-processed foods. Instead of most meals being prepared at home with unprocessed ingredients, we now eat away from home or bring food prepared by others back to our homes. Over a third of adults in the United States consume fast food daily. (https://www.cdc.gov/nchs/products/databriefs/db322.htm) It may be even worse for children. That does not count ultra-processed high-carb snacks or prepared foods taken from grocery stores. In a study published a few months ago, thousands of nurses were divided into quartiles based on the number of servings of ultra-processed food consumed on an average day. The study showed the harm of ultra-processed food, but I was most impressed by the number of servings eaten. In the lowest quartile, those who consumed the lowest amount of ultra-processed food, the nurses averaged three servings per day. (http://press.psprings.co.uk/bmj/may/food.pdf) I am fifty-five years old and grew up in an upper-middle-class home. We ate out about once a month and had processed snacks less than once a week.
If you look at the Pacific Islands, as soon as the islands were colonized and started to get fast food, the body mass index of the Islanders increased dramatically. Ultra-processed food, besides being easily accessible, is affordable. That is why, in many cases, our poor populations have the biggest weight problem. A smaller issue than our eating habits is the ease of our daily life. We do not have to work as hard manually to live our lives. We have devices to clean, do laundry, and maintain the home. Most people have cars or access to public transportation, so we do not have to walk much to get around. This and the massive increase in calorie and carbohydrate consumption explains most or all the rise in obesity.
- What sets The Three Rules apart from other diets/eating patterns?
The Three Rules is different from other plans because it is simple and lifelong. You must learn the Three Rules, but they are straightforward. There are no charts or lists of food to memorize. You do not have to moderate how much you eat. For example, the South Beach Diet, which I have tried many times, allows you to eat more carbs in the later stages. In stage 3, you can eat almost anything, but portion size is limited. If I could limit my portion size, I would never have had a weight problem. My analogy of alcohol holds. You would never want a friend with a history of an alcohol problem to allow them one glass of wine a day. I cannot have one-half of a bagel (a staple in my house growing up) without risking eating four wonderful sesame bagels and cream cheese. Eliminate foods from the three categories of bad carbs and eat virtually all you want from the tasty foods that are not prohibited. No counting anything and no moderation required, assuming you are not purposefully trying to gain weight by eating four pounds of peanut butter a day.
- Do you have any advice for people starting their weight loss journey?
The advice I gave virtually every patient I recommended my plan to is this. Do not start the diet unless you are fully committed to it. Our bodies are so good at gaining weight that doing my plan or any diet plan halfway will fail. When patients told me that my plan failed, I would ask what they had eaten the night before. Frequently, they would describe a meal that contained items that were against the rules. They might say that they had a burger. When I asked about the bun (bread is against Rule 2), they would say they had one, but they usually don’t eat bread. You cannot follow the Three Rules, or any diet plan that way. You are on the Three Rules, or you are not. If you want to succeed, you must be all In. An update I made for the Second Edition is for people who have more willpower than I do. My son will go on my diet for a few months, but on vacation, he eats whatever he wants. As soon as he gets home, he goes back to the Three Rules. We were just in Savannah for my niece’s wedding, and he ate whatever he wanted, even desserts at almost every meal. I cannot do that because I would have trouble stopping when I got home and would probably gain twenty pounds before getting back in control. I know it sounds unlikely, but my wife can attest to how many times I have done that. Most people are like me and are better off taking the all-or-none approach that I take.
The Three Rules to Lose Weight plan works if you follow it. Like all diets, it fails when you don’t. Another point I like to make is that there are no foods that cause weight loss. My plan works because you remove the bad carbs from the diet. You must eat something to replace it, and on my plan, you eat protein, fat, and good carbs. It is not the protein, fat, or good carbs that cause the weight loss—it is the removal of the bad carbs. Many people make this mistake. If you eat yogurt and berries for breakfast, tuna salad and an apple for lunch, steak and roasted peppers for dinner, and snacks of peanuts and almonds in the afternoon (all allowed in the Three Rules), you will not lose weight if you have a bowl of ice cream at bedtime. Good carbs and protein do not protect you from bad carbs.
Harold Oster, MD graduated from medical school in Miami, Florida in 1992 and moved to Minnesota in 2004. After more than 25 years of practicing Internal Medicine, he recently retired. Dr. Oster is especially interested in nutrition, weight management, and disease prevention. Visit his website at haroldoster.com.
