Part I: How to Become Smart for Life

Chapter 1: How I Got Smart—and How You Can Too...21

Chapter 2: Smart (and not so smart) Weight Loss Tools...46

Chapter 3: Smart Foods...................................................64

Part II: Smart Living

Chapter 4: The Smart for Life Exercise Program.......88

Chapter 5: Staying Smart for Life...............................102

Chapter 6: Smart Menu Plans and Recipes...............123

Part III: The Science of Being Smart for Life

Chapter 7: Get Smart.....................................................179

Chapter 8: The Smart Body...........................................198

ThinAdventure Healthy Weight Program for Kids....230

Appendix A: Recommended Reading...........................255

Appendix B: Weight Chart.............................................260

Appendix C: Food Diary.................................................261

Appendix D: Exercise Planner.......................................262

Appendix E: Menu Planner............................................263

Appendix F: Website Code where to buy ingredients...264

Appendix G: Live Chat with Dr. Sass...........................265

Appendix H: Product and Center Information...........268

About the Author..............................................................269

Introduction

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Smart for Life has been in the works for almost a decade. As a busy bariatric (that is, weight loss) physician with dozens of weight management centers around the US and Canada, I was asked repeatedly for a book that would explain in detail the Smart for Life weight loss program. I’m a big reader, and I love well-written books on complex subjects. I’ve wanted to share in book form what I have been sharing with my patients for many years: how to train the body to be healthier and metabolically efficient to get lean, be fit, and slow down the aging process.

I decided I needed to write a book about Smart for Life—but not just any diet book. I wanted to provide readers with  comprehensive yet easy to understand information. I wanted not to only share my program but also to reveal the newest science behind eating for health and longevity. I wanted to tell readers the gripping stories of my patients, everyday people like themselves who had suffered from excess weight and obesity, struggled with weight gain and the associated health issues, only to turn their lives around with Smart for Life. I wanted to provide readers with a book they could use on the most practical level, a book with simple menus and delicious recipes. I wanted to give everyone who wants to lose weight—whether 10 pounds, 100 pounds, or more—a plan anyone can follow safely and successfully.

Smart for Life: Dr. Sass’s Solution is the result. Here is my gift to you! But let me explain something: Smart for Life is not only the underlying basis for my weight management program. Smart for Life is how I live.

I am tall and trim, and I keep myself in good shape. I need to stay thin because of my profession, but I also believe staying fit is the best way to live a long, healthy life. Carrying less weight also keeps us youthful and energetic. I want to live as long as possible and stay healthy and fit for the full length of my very long life. I believe the goal of  a  healthy,  long  life  is  possible.  Modern  medical  science has

demonstrated we can, with some smart choices, be healthy and enjoy a long life.

However, there was a time in my life when I was overweight, unhealthy, and generally miserable.

The weight crept up on me. I was never a fat kid. I was a skinny kid and a skinny college student. I was still skinny in medical school. But during the first year of my residency, I began to gain weight.

Residents in medical school work notorious 36-hour shifts, enjoy sleepless days, and eat on-the-run food of questionable nutritional value. At the hospital where I did my residency, the staff constantly ordered food delivered to the staff room from a variety of area restaurants. We all ate when we could from the foods spread out on the large, white tables. The staff room tables seemed always to be lined with food.

For me, breakfast on the go would consist of two donuts wolfed down with copious cups of coffee. Lunch might be half a pizza or a large Styrofoam container of pasta with greasy sauce. Dinner was often Chinese food rich with fried noodles and eggrolls. I paid no attention to the fat or caloric contents of what I was eating. I was busy, and  what I ate was the one problem I didn’t think about. Besides, I had never worried about my weight. I didn’t think I would ever have a weight problem.

Steadily, I gained pounds and inches. My pants grew tight. My normally narrow face became rounder. I didn’t really take notice. I  kept eating the foods that were killing me.

We all face a similar creep of pounds and fat. Slowly and  steadily, insidiously, the weight accumulates. We tend to ignore the extra weight at first, deny we are getting heavy to ourselves. Until we are forced to face the facts: we’ve become overweight. Fat. Obese.  And the extra pounds are affecting our health. And self-esteem.

The extent of my weight gain finally became obvious to me when I was working as an emergency room doctor. In addition to the ER patients, we covered the entire hospital for cardiac arrests. The

consequences of my problem were clear whenever I made stat calls to tend to patients whose hearts had stopped beating.

When I received word of a cardiac arrest, I would run up the stairs to the floor where I was needed. Immediately: stat. I always used the stairs to avoid getting stuck in an elevator with patients or hospital visitors who might not understand or could be upset by my need to rush to an emergency. I would jog up four flights of stairs at a pretty fast clip, rush down the hall to the room where I was needed, and start up proper procedures while calling out commands to the attending nurses. I had to be sharp and energetic at all times.

Once I had gained too much weight, I began to notice that by the time I ran up the stairs and rushed down the hall, I was so out of breath I couldn’t talk. I would be huffing and puffing. My distress was embarrassing. I was only in my twenties, not an elderly doctor.

Forced to adapt to my lack of fitness, I discovered to my horror I had to walk more slowly up the stairs to the site of a cardiac arrest. After ascending the stairs, I would walk down the hall to the room where the nurses awaited my instructions. When I arrived, I would not be out of breath, and I would be able to yell commands to the staff. But I didn’t feel good about how long they had to wait for me. I didn’t enjoy other staff running past me and arriving ahead of me.

When I had a moment to myself, in between patients or after an exhausting shift, I would think about how easily I had gained weight. I was at least 40 pounds over the proper weight for my height. Yet I had been the right weight only a few years before. I knew I had to do something. But I didn’t feel too worried. I figured losing the unwanted weight would be equally as easy.

You probably know what I didn’t understand when I was a young doctor: losing the weight I needed to lose would not be easy. In fact, I was 100% wrong. And, as it turns out, the very extent of my misunderstanding about weight loss would form the basis of my current career, driving me to seek answers to the obesity problem and stimulating me to create my own weight loss program. Because it took me many years to lose the 40 pounds I had so easily gained.

And it took Smart for Life to help me lose that weight once and for all. And keep the pounds off. Smart for Life allowed me to safely and effectively attain a healthy weight, one I have maintained now for more than a decade.

If your curiosity is piqued, read on. I’ll be sharing the details of my weight loss struggles throughout Smart for Life. You will also read about the weight loss journeys of some of my thousands of patients. I have selected more than a dozen of the most inspirational stories to share with you. I want you to be inspired as you read my story and those of my patients. I want you to be reassured: you can lose weight and keep it off. There is a way, a healthy way, to lose excess weight once and for all.

But my gift to you comes with a request: I want you to be ON THE PROGRAM while you read. Don’t wait until you get to the end of the book to start on the program. Start on Smart for Life right now. I will tell you how.

First you’ll need to understand why you are overweight. You need to know why humans as a species are getting so fat. Believe me, you are not the only one who has gained weight. Look around: your family may be overweight, your neighbors seem to have added girth, certainly the people you see downtown or on the bus or in the local movie theatre look a lot fatter than they did when you were young. Have you traveled lately? Some travelers can hardly fit on a plane.  They have to reserve two seats. And people in other countries like England, Germany, Australia, and elsewhere are looking much heftier, too. Even the well-to-do Chinese are beginning to suffer from weight problems.

Obviously, we humans are making lifestyle mistakes, and the results are showing up as body fat. But we aren’t completely to blame. There are scientific reasons for our increasing problems with weight. The short story I’ll explain now. For a longer, more detailed version and all the science behind these facts, you can read Chapter 8: The Smart Body.

Here’s what’s happening in a nutshell: obesity is a  manifestation

of a dysfunctional relationship between our genes and our environment. I’m not saying we are destined genetically to be overweight, but there is a genetic component to the problem. We are genetically programmed to find and conserve energy.

Energy for the human body is found in food. Our genes are programmed to respond to our food intakes, our food environment,  so our genes are receiving messages from our daily food intake, from our diet and its food components, about energy and conservation of energy. Our genes regulate how we process food, and our body’s automatic regulatory system has allowed the human race to survive and flourish. The messaging system is how we have survived during long periods of famine. Our genes have been able to protect us against starvation so that we could eat during the good times and squeak by during the lean times.

The gene-food relationship has been an effective system from the start of human civilization. Here’s the catch: our diet has changed. Radically. Most of us no longer hunt for wild meat, pick fresh berries, and spear fish for our meals. So the messages our bodies receive from our food environment have also changed. And now, in the modern world, these messages are the wrong ones. We are telling our bodies with the food we are eating that winter is on the way and it is time to store up extra fat to make it through the hard times ahead. Except that there are no hard times ahead—only more food telling our bodies the same wrong message: store and conserve, turn my food into fat. So, because of the food we are eating, our genes are constantly receiving the message it is time to store fat, to convert food energy into fat for later energy needs, for the long winter ahead our ancestors had to survive. Of course, we don’t want to tell our bodies to store fat. Yet, because of the food we eat, we basically force our bodies to convert food to stored fat.

I failed to understand when I was fat and trying to lose weight: The modern human diet is creating metabolic dysfunction. And overweight. And obesity and all the associated health effects. The overweight body is genetically programmed to store more fat. The modern diet is turning us into supersized fat-storage machines.

What I also didn’t know back when I had a weight problem was this: To lose weight, we have to change our environment so that our genes can respond properly. Once we alter the environment by changing the food we are eating, we can start sending the right messages to our genes. We can make our bodies more metabolically efficient.

The system is complex and involves hormones, insulin,  and other complicated body processes. You can read all about it in Chapter

8. All you need to know right now is this: The composition of your daily food intake (environment) is sending signals to your body’s cells (genes) that misinform your body about what to do with the energy (food calories) you are consuming. The result is metabolic inefficiency and a body that is really good at storing energy in the form of fat. Which means too much fat in your cells, around your waist, in your face and thighs, in your heart and everywhere else.

And the solution to this imbalance is simple, effective, and long- term. When I was overweight, I didn’t know what worked, so I spent years doing research until I found out. Then I created a weight loss program based on the research I had done: We need to change how and what we eat to improve our metabolic efficiency.

This is exactly what Smart for Life does for you.

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There are a number of components to the Smart for Life program that make it unique and successful. You will learn about these as you read this book and follow the program. The main points are these:

1.  You will eat six small meals throughout the day and one healthy dinner.

2.  You will eat mostly organic, natural, and healthy foods without preservatives or additives.

3. You will eat low glycemic foods to keep your blood sugar level steady.

4.  You  can  choose  to  include  our  specially  designed  food

products to help keep your hunger at bay and improve your overall health.

5. You will not start on an exercise program until you have your metabolism under control. Early on, you’ll keep your appetite in check by not exercising until your body is ready. (More on this in Chapter 4: The Smart for Life Exercise Program.)

6. You will make a commitment to the program and we will provide you with support and assistance throughout your weight loss journey.

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The Smart for Life diet plan is simple, easy to follow, nutritionally balanced, and delicious. It’s convenient, and does not involve a lot of time in the kitchen, weighing foods and cooking. Smart for Life is an on-the-go diet for busy people.

Smart for Life is not a starvation diet. It is not a calorie  counting diet either, although it is low enough in food calories to allow for fast and steady weight loss, but not so low that your body burns lean muscle tissue for energy. That’s not a healthy or safe way to lose weight.

The Smart for Life diet is well-balanced and appetite satisfying. In fact, we call it a Right Calorie Diet (RCD). Because the RCD is not based on shelf-stable, heavily sweetened, artificially preserved and unhealthy foods. The RCD is natural, organic, and safe.

Most important for weight loss, the Smart for Life RCD does  not send the wrong information to your body’s cells like other diets  do. By eating right on the RCD, you can send positive food messages to your body. That way, you can teach your body to stop storing so much fat. Your metabolic efficiency will return, allowing you to maintain your weight loss permanently. You will also feel and look better, improve your overall health and fitness, and probably change your life.

In fact, by eating less and eating well, you will be sending desirable messages to your body and brain. You will be providing  the

kind of information your genes require for slowed aging and longevity, as well as improved health and weight control. This means you will probably live longer and feel healthier for many years to come.

That’s why Smart for Life: Dr. Sass’s Solution is the last diet book you’ll ever have to read. Once you’ve corrected your  body’s metabolism and altered your lifestyle for permanent weight control, you’ll be Smart for Life.

Also, you’ll cut back on your food expenses. By eating Smart, you won’t waste money on unhealthy convenience and fast foods, and you’ll get more mileage out of the healthy foods you do eat.

So let’s get started.

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As another advice to you, I’m cutting to the chase and providing you with the Smart for Life diet, the RCD, in Chapter 1: How I Got Started—and How You Can Too. My advice to you is to start on the diet program right now. Today. Keep reading the book as you follow the program to learn more about Smart for Life and the science behind the diet. But do get started right away. Obviously, you are motivated right now or you wouldn’t be reading Smart for Life. Take advantage of your current interest: motivation is essential to success!

In Chapter 1, you’ll learn how to select a healthy weight goal and how to begin on the RCD. You’ll learn how to destock your pantry. Once you restock with the kinds of foods you’ll be eating on the Smart for Life program, you should notice immediately your food bills are significantly lower.

Chapter 2 provides information on appetite suppressants. If you find you are not losing weight on the RCD, there could be an issue with hunger. If you try to follow the diet for two weeks and do not  lose weight, perhaps you are too hungry to stick to the program. Battling hunger is not unusual. Don’t blame yourself. Around one-fifth of my patients find they struggle against continued hunger cravings. As a result, I have some natural appetite suppressants I can recommend to help with hunger. There are also a couple of prescription  medications

that work well to suppress appetite. Perhaps medications are blocking your weight loss and/or stimulating your appetite. I will discuss these and related issues in Chapter 2.

On the Smart for Life diet, you won’t have to worry about what to eat. I will delineate the spectrum of Smart Foods and Wrong Foods in Chapter 3. I’ll tell you about my favorite  nutrient-packed Superfoods and the amazing functional foods that help with both weight loss and overall good health. I’ll explain why I’m so adamant about including only natural, organic foods in your diet. I’ll provide you with Smart meal ideas, shopping tips, and dining out advice.

A vigorous exercise program is not the best way for an overweight person to lose weight. Believe me, I didn’t understand exercise wasn’t the key to weight loss, and I wasted years of my life attempting to lose weight through grueling exercise regimens. But I am an advocate for daily activity. We all should adopt a program of regular daily physical activity and follow the regimen for life. We need to remain active but extreme measures are not necessary, and I’ll explain why a time and place exist for eating right and staying active in Chapter 4: The Smart for Life Exercise Program.

Chapter 5: Staying Smart for Life is essential reading. Everyone knows we don’t eat solely to satisfy physical hunger. There are many complex psychological reasons for our food choices, and there are social reasons for over-eating behaviors. Some of us sabotage our  good eating habits or even have food addictions. In Chapter 5, I’m  also going to point the finger at the food industry: they have a major role in your excess weight and the global obesity epidemic now threatening world health. They should be held responsible, and I’ll explain why.

In Chapter 6, you’ll find menu plans and recipes. Here you’ll  find the one week menu plan for the RCD. I’m also including a week  of menus for the Smart Maintenance program.  And I’m  providing what I call the Smart for Life Fixed Meal Plan, a stricter version of the RCD. The Fixed Meal Plan works well for dieters who are unable to remain on the Smart for Life diet program because they struggle to avoid temptation. I know how easy straying from the right path and

cheating your way off a diet can be. I struggled to stay faithful, too.  The Fixed Meal Plan provides a nice kick-start, and most of my patients who try the plan find they are able to switch to the RCD after only two weeks—and stick to the less strict plan. There are more than forty recipes in Chapter 5, including good breakfast foods, healthy lunch and dinner items, delicious