Most diets are guaranteed to fail. Popular diets focus on limiting calories, fat and/or carbohydrates. They don't address addiction, which is the underlying cause of both weight gain and repeated failures to lose weight.

Like other addictions, an addiction to food causes intense cravings, particularly during time of stress. People also experience withdrawal when they go without food for even a short time. The discomfort of cravings and withdrawal is so intense that people find themselves unable to reduce portion sizes, eat less often or avoid fattening foods. It hurts too much when they try.

Toxic Hunger

The American diet is loaded with fried foods, sugar-laden baked goods, soft drinks and other foods that stimulate the production of free radicals and other toxins. After eating, the body goes through a detoxification phase in order to break down and remove these toxins.

• Detox is painful. People who eat a lot of unhealthy foods invariably experience both physical and emotional discomfort, including feelings of anxiety, irritability and fatigue, in the hours between meals. In an effort to stop the discomfort, they eat again... and again. As long as the digestive tract is working, detoxification is delayed. Without knowing why, people find themselves eating all the time just to forestall these uncomfortable feelings.

I call these feelings "toxic hunger" because they're produced by a toxin-producing (and fattening) diet-and because people often confuse the sensations of withdrawal with the sensation of hunger.

• Detox takes a few weeks. You may feel strange the first week, but during week two, the sensations will start to change and soon you will not be driven to overeat.

To break the cycle.

Eat high-antioxidant foods

These include beans, fresh vegetables, nuts, seeds and berries. The body experiences high levels of oxidative stress when it's detoxifying between meals. This is largely what fuels the symptoms of toxic hunger. People can reduce this discomfort by consuming foods high in disease-fighting antioxidants. These foods also make it easier for the liver to eliminate metabolites (chemical by-products that are produced during digestion and that intensify discomfort between meals).

Recognize true hunger

Most people who struggle to lose weight complain that they're always hungry. What they're really experiencing is the discomfort of detoxification, which includes symptoms such as a growling stomach and irritability. They eat to feel better, not because they need to.

People should eat only when they feel true hunger, the body's call for nutrients. True hunger feels different from toxic hunger. What to notice...

A hard-to-describe sensation in your throat that only occurs when you're genuinely hungry. It's like an itch that's relieved by eating.

A slight increase in salivation.

A dramatically heightened taste sensation, in which anything you eat tastes wonderful. If you notice that you're craving a specific food, you're not experiencing true hunger, because everything should taste wonderful at this point.

I often advise patients to delay or skip meals so that they learn to distinguish true hunger from toxic hunger. The first step is to eat a high-antioxidant diet for two weeks. Then try eating a light breakfast and postponing lunch for perhaps six hours until you are sure that you feel hungry. This simple experiment can be revelatory for those who rarely go more than a few hours without eating. They discover that even ordinary foods taste great (and extraordinary foods taste amazing).

Eat more, not less

Food volume is critical for controlling hunger. Feelings of satiety are largely controlled by stomach stretch receptors. Eating large amounts of healthy, low-calorie foods activates these receptors and "turns off' hunger sensations to a degree that's not possible with snacks or high-fat or fried foods-unless you eat way too many calories.

Example: Imagine two different stomachs, each containing 400 calories of a single kind of food. The stomach with 400 calories of protein (such as beef) would be mainly empty space-all of the calories come from a small volume of food. A stomach filled with 400 calories of vegetables and legumes, on the other hand, would be filled to capacity, prompting the stomach to send "I'm full" signals to the brain.

This is why people who eat two to three servings of vegetables, fruits, legumes, whole grains or other wholesome foods at every meal are more likely to lose weight-and experience less discomfort-than those who diet.

Choose nuts and seeds

Even though these foods are high in fat, people who eat nuts and seeds regularly are more likely to lose weight than people who don't eat them. Nuts and seeds are high in plant sterols, which promote feelings of fullness and contain substances that suppress appetite.

Bonus: Clinical trials have shown that diets that include nuts can lower cholesterol and reduce the risk for diabetes. On average, people who eat one or more servings of nuts a day have a 59% lower risk of developing fatal heart disease than those who don't eat nuts.

Recommended: One ounce daily of unsalted nuts (all nuts are good) and/or seeds, such as pumpkin seeds and sunflower seeds.

Socialize more

Many people who are overweight use food for emotional comfort just as other addicts use drugs or alcohol. Eating temporarily increases dopamine, a brain chemical that elicits feelings of well-being, temporarily suppressing feelings of unworthiness or depression. This naturally encourages people to eat more.

Better: An active social life. People who engage in pleasurable activities with other people experience the same dopamine surge that they would otherwise get from eating. They also tend to have higher self-esteem and are more motivated to take care of themselves and improve their health.

Don't overload on caffeine

People who are trying to lose weight often use caffeinated beverages, such as coffee, tea and diet colas, in place of food to forestall between-meal discomfort. It doesn't work. People feel even worse when caffeine levels drop. At that point, they're even more tempted to "self-medicate" with food.

I usually advise patients to give up caffeine initially because it will help them get through the detox phase more quickly. Once they've reached a satisfactory weight, they can start drinking caffeine again.

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