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"The Biggest Loser" Diet Doctor Offers Advice

Michael Dansinger, MD, is the weight loss and nutrition doctor for NBC’s “The Biggest Loser." A native of Newton, MA, Dr. Dansinger is also the diabetes doctor for WebMD and an assistant professor at Tufts University School of Medicine in Boston.  He recently sat down for an interview with The Boston Globe and discussed a number of topics, including the value of a food journal, the need to decrease starches and increase protein and vegetables, and the need to focus weight loss efforts on diet changes, not exercise alone.

Here are some highlights from the interview:

Q. What are the biggest mistakes dieters make?

A. The first is failure to keep a food record. It’s hard to lose weight efficiently if you don’t know how many calories you are eating. It’s like having a financial budget. Most people want to use their money wisely, and it’s similar with calories. Another mistake is failing to recognize that changes in eating are the main determinant of weight loss.

Q. You mean to say that you can’t exercise your way thin?

A. Exercise is important, but even if someone exercises for one hour every day — and that’s an ambitious goal — the average calories [lost] might be 300 calories a day. It’s much easier to shave 300 calories off your food intake. Even on “The Biggest Loser,’’ only half their weight loss is coming from exercise.

Q. You’re a slim guy, how do you do it?

A. I love the taste of unhealthy food, and I find it a daily battle like most people to find the right balance between treats and healthy foods. In the past, I weighed up to 20 pounds more. That was before I learned how to reduce my hunger by eating less starch.

Q. What do you eat and do you exercise?

A. A lot of protein and a lot of fruits and vegetables. I draw a strict line between healthy foods versus treats, and I try to be about 90 percent healthy. As for exercise, I do about 30 minutes of push-ups every morning — about 150 to 200. That keeps my heart rate up for 30-40 minutes. I also walk 30 minutes a day as part of my commute.

Q. You’ve got three young children. Are they healthy eaters, too?

A. With my kids, I’m 50 percent strict about food. I think 50 percent of the plate should have healthy food, and the other half can be treats.

Q. Fifty percent treats — can it be that you’re looser than most of the parents I know?

A. Well, I use the same definition of treats for both children and adults. Mac and cheese fall into the treat category because of the starch. Sandwiches fall into the treat category because of the bread. The kids can earn treats by eating fruits and veggies or other healthy foods.

Q. You direct a Diabetes Reversal Program at Tufts where you use lifestyle coaching to achieve remission in about one-third of your patients. What do you tell them?

A. When you inform patients with type 2 diabetes that they have a good chance of remission if they lose around 35-40 pounds, it starts to become much more realistic to them. The most surprising thing I’ve learned is that most patients have enough pancreas function remaining to achieve remission. When the patient believes the doctor believes, it can make all the difference in the likelihood of dramatic improvement in their health. My experience with “The Biggest Loser’’ allows me to think in terms of big results.

Q. Speaking of “The Biggest Loser,’’ how did you land the gig?

A. I was in the right place at the right time. I’m 44 now, and I was early enough in my career [in 2005] that it made sense for me to take a risk on an unproven show. It was unknown if we could get rapid and dramatic weight losses large enough to make people watch a show about dieting. The producers found me because I’d been in the newspapers a few months previous because I published research comparing popular diets.

Q. Remind me which one came out on top from a weight loss and heart-health perspective — Atkins, the Zone Diet, Ornish, or Weight Watchers.

A. It was a four-way tie. It turned out that adherence levels, rather than diet type, were the main predictors of weight loss and health improvements. The one you should choose is the one you can stick to. That’s the main lesson from that study. Saying there is one best diet for everyone is like saying there is one best color.

Q. How has being involved with "The Biggest Loser" changed your life?

A. I’m entirely behind the scenes, but it’s changed my life because it’s been such a vivid reminder of the power of lifestyle change.

Source: Beth Teitel, The Boston Globe