Book Review: The End of Overeating, by David A. Kessler

We don’t write much at DrYoho.com about diet and exercise: this is a whole specialty field. But obviously I’m concerned about health; we do a lot of liposuction. I thought our patients from Los Angeles to Fresno would be interested in the following summary.

The most important point of this book is that the eating-out industry, which now takes 50 per cent of the dollars spent on food in the USA, is all about making money and has little interest in your health, perhaps an obvious point—but look below. This has been a progressively worse problem over the past 4 decades. The trend toward (massive) US citizen weight gain was confirmed in the scientific journals about 1970. “Food scientists” working for the restaurant industry are interested in getting you to spend as much as possible, so they try to make the experience as exotic and sensual as possible. While this may seem like it’s all in good fun, it turns out to be the cause of many of our health problems. All successful chain restaurants, with the fast food restaurants leading the pack, have designed the material you are eating to be the most palatable treat they can. And in doing this, they emphasize consumption of what some of the scientists call “the three points of the compass”: fat, sugar, and salt. When they can combine these in ways that are appealing, consumption—and profits—go up. While it’s widely known that the “chicken” in a Macdonald’s chicken product is part beef, part sugar, part other things, and has the nutritional composition more like beef than chicken, it’s not widely known that most of the sit-down chains manufacture their foods also. The emphasis of course is maximum consumption. There are other factors which are used: texture and color considerations and food additives come to mind, but the three unhealthy additives above have come to represent such a major portion of the diet that we all are gaining weight. These designers even make the food softer in some cases in order to make more of it go down faster.

So I don’t trust Appleby’s, for example, any more than MacDonald’s or Jack in the Box now. They are not generally serving real components of what’s grown on the land or taken from the animals, just manufactured mixtures that might look like it’s natural but which are often unhealthy.

One of the sad but I suppose funny insights was thinking about one of our local franchises which sell deep fried chicken and waffles, together! It’s all there: fat, salt and sugar (the syrup of course). And the people going in and out all day are universally obese. The rumor is that the combination is an aphrodisiac… But we don’t have to explain the appeal after reading Dr. Kessler’s book.

The solution to the obesity problem isn’t easy. We have to eat what we cook ourselves, and not give in to the temptation to eat out often. Japanese restaurant cuisine seems healthy to me (what can they do to these ingredients if you stay away from California rolls, mayonnaise, and deep-fried selections?). Portion control seems to be almost more important than ingredients for weight control as shown in some recent studies. This may explain why the French seem to stay thin and healthy despite a high fat composition in their diet and cigarette use. There are various behavior solutions to help your attitude toward food that may help, which Dr. Kessler describes.

I highly recommend this book, available at Costco, where I stumbled across it this last Saturday.

The Shape of Buttocks to Come!

What is an attractive buttock? How do I improve my buttocks? How much is too much? What’s best for Pasadena / Visalia / Bakersfield / Fresno / Los Angeles areas? (Hint: this is a trick question and will be answered at the end of the article.)

Cultural norms vary for how big buttocks should be for a given figure, but generally in America the preferred look is getting bigger, and coming closer to ethnic black buttocks than ever before. At our office, where at least 25 per cent of our patients are pretty dark skinned, we can really appreciate what buttocks should look like and have had a tremendous experience shaping buttocks and the area around the buttocks.

The first idea is that just adding volume does not do it for the vast majority of women. Sculpting the fat around the buttocks, particularly the outer thigh, the lower back, and the waist and lower waist area is critical. While we often add fat to the buttocks themselves, the shaping process is at least as important. Most attractive is what’s under the fat: the natural female form. We should be able to see sacral dimples if possible, and removal of the fat from the lower back and upper buttocks sometimes reveals them. And while some women view their outer thighs as part of their buttocks and don’t want to have them slenderized, usually if these are thinned a bit the whole “rear-end” looks much better. The hip, particularly the lower hip, is too large in many women and detracts from the picture also. When all these areas around the buttocks are treated, you can see improvements that are profound and not related to just putting some fat into the buttocks. There’s an area under the buttocks called the “banana-fold” which is sometimes has extra fat too. This area must be treated with care, because it actually supports the buttock. If it’s suctioned too aggressively, the buttocks can fall and creases will appear under the butt.

The Yoho method technique for adding fat to the buttocks follows. First, we suction the fat into a sterile container using sterile instruments and sterile tubing. We are able to sterilize all of this conveniently because we have a “gas sterilizer” (in addition to steam sterilizers) which is a hospital-standard machine. Next, the fat is allowed to sit (“decant”) so the fluid and other unwanted parts of the fat are partly eliminated. Some doctors use a sterile centrifuge in order to concentrate the fat more, but the value of this has never been clearly proven and we think it leaves room for more bacterial contamination. Then, still sterile, we take the fat and pour it into 60 cc syringes and then streak it through the buttocks with a screw-on “leur-lock” cannula or tube with a hole in the tip that fits the syringe. The better the fat can be evenly spread through both the muscle and the fat of the buttocks, the more likely it’s going to “take,” or stay long-term. The fat has to find new blood supply from the tissue it’s injected into and this is impossible if large quantities of fat are injected into one spot.

What about buttocks implants with hard silicone? Dr. Yoho thinks this makes an unnatural figure, and buttocks are often too big on the top. Recoveries and pain are prolonged and surgical complications are unacceptable. He does not recommend it.

How much is enough and how much is too much? Each patient has to be evaluated very carefully. The amount of fat has to be determined individually, based on needs and body type. There’s a limit on how much fat can be added because if too much is used, infection can occur. Generally, the bigger your buttocks are already, the more fat can be added. There are some surgeons making claims that they can add a liter (about a quart) of fat per side of the buttock BUT we feel the risks of big problems are high when this is done. When fat gets infected, it all gets infected and such a patient can have drainage problems and need to be on antibiotics for over a month. ALSO there’s no need to go absolutely crazy with the volumes of fat added because the buttocks will grow naturally after liposuction when the weight stabilizes. That is: a naturally sexier and more appealing figure emerges after liposuction of the torso and legs, with some growth of the buttocks and breasts.

What about buttocks liposuction? Generally speaking, unless you are referring to sculpting the curve of the upper buttock into the lower back, it shouldn’t be done. There are some exceptions, but if the areas around the buttocks are properly shaped by the surgeon, the (lower) buttocks shouldn’t be suctioned.

And finally, what’s best for Pasadena / Visalia / Bakersfield / Fresno / Los Angeles areas? The trick answer to the trick question is that it’s your ethnicity rather than your location that determines just what is right for you. See an article on this question of ethnic approaches to beauty at DrYoho.com at http://www.dryoho.com/dr-yoho-book/appendix-a-1.cfm. Hispanic and Asian patients are more and more choosing buttocks enhancements.

(Also see DrYoho.com photo section at http://www.dryoho.com/photo-gallery/)

FAQ’s
1) Q Can I use someone else’s fat?
A Only if you have an identical twin.
2) Q Can I have silicone or other synthetic filler injected into my buttocks?
A Silicone can be a disaster. There are some people using this for post HIV wasting, however.
We don’t do this.
3) Q Does the fat go away?
A Sometimes. If you are a smoker fat transplant does not work very well. Generally
expect to retain 1/3 of the injected fat. Weight gain in the areas that are
not liposuctioned (see above) will sometimes help your appearance of
retention.
4) Q If I gain/lose weight what will happen?

A The fat in the areas that are left will gain or lose weight proportionately. Note that weight
loss will usually make you look better and isn’t much of a problem for most people.