When I have an obese patient in his 300 pound state, many times he comes to me for advice and clearance for gastric bypass surgery. Some insurers require these patients to undergo 6 months of diet and psychological counseling before undergoing surgery, some only require that they have a primary care physician like myself to care for them during the perioperative period (the time surrounding the surgery) because to all of the complications that a risky surgery entails. I’m usually the person who says if it’s safe to go through with the surgery.

However, with my obese patients I hate giving this clearance because I have seen so many of my patients end up with complications…including death. I had a patient who died of sepsis after surgery. One patient ended up going in the opposite direction of obesity and became bulemic. One patient is constantly transfused due to iron deficiency anemia and another is b12 deficient because the part of the stomach that absorbs vitamin b12 cannot absorb it now. And I have countless patients who lost weight… only to gain it back. For every successful patient after gastric bypass, I have another 8-9 patients who have had major complications that will continue for the rest of their lives due to the permanent change made to their stomach.

But I have fewer and fewer patients who experience these problems, but STILL have similar weight loss to gastric bypass. The reason is due to my new understanding of the “Hungerstat”, the hunger thermostat in our bodies. I give my patients an alternative weight loss method that is free and does not require surgery and most of them have avoided bypass surgery with this weight loss system. Let me explain the hunger gauge before we get to this diet.

The hunger indicator is in all of us and it is controllable. Our satiety levels can be vigorously changed through surgery and gastric bypass. That is a given or else we would not be giving our sickest patients such a dangerous treatment option. However, Alwin Lewis, MD, MPH and I have been using our bodies’ natural hunger control system to divert our gastric bypass patients and allow them to lose weight at the same rate WITHOUT SURGERY.

How do we do this? We use our body’s natural system to lose weight and maintain health. When we were hunter-gatherers before the ice ages, when famines or winters came and food was scarce to hunt or gather, our bodies would starve…for 3 days. After 3 days, the hunger disappears because the body goes into catabolic mode: a mode that allows it to burn fat. When you eat 10 or fewer bites of food per day, this mode automatically kicks in after 3 days.

So, to be specific, if you eat five bites twice a day, after 3 days of being hungry and tired, your body turns off the feeling of hunger and satisfies itself with minimal food! The body satisfies itself because it starts burning fat to keep you alive. This is how we were designed. Your hunger thermostat, or hungerstat, tells your body to stop feeling hungry.

Let’s look at the children in those poorer countries, in those commercials that ask you to sponsor them for a few dollars a day. When you see them, they are sleeping. Even though they are malnourished, believe it or not, they don’t feel hungry. They look terrible, don’t get me wrong, to be in that situation. But nature was kind enough to design us so that we don’t feel hungry after 3 days so we don’t have to suffer. Those kids are using their fat stores to survive and their hunger stats are completely off.

So the amazing thing is that if you eat five bites twice a day, in 3 days you will feel absolutely no hunger. It will feel like you have a gastric bypass.

However, here is the second amazing thing. After 14 days of easily taking just 5 bites twice a day, the stomach shrinks naturally. In other words, after 14 days of eating just 5 bites twice a day, the stomach shrinks to the point where eating more than 5 bites makes you feel drastically full. Your hunger thermostat drops to a point where you are satisfied with smaller amounts of food. Your portion sizes, from then on, are naturally controlled as if your stomach had undergone a gastric bypass. My patients who are on this diet end up having portion control for the rest of their lives because they have naturally controlled their hunger and no longer feel the need to go to the buffet with a full plate for 3 visits, no longer overeat, and no longer they don’t have the capacity in their stomachs to overeat (unless they mess everything up and eat huge amounts of food and stretch their newly shrunken stomach capacity too far).

If you’ve ever seen a friend after surgery, many times your appetite won’t allow you to eat more than a few bites from your plate. Hospitals constantly have people with full plates on the table even though the surgeon has given the person the go-ahead to eat as much as they want. But many people simply cannot regain their appetite after a few days of not eating due to abdominal surgery or abdominal conditions. These people are having the exact same effects on their hunger gauge. So the question is… does gastric bypass really help people lose weight or does the post-surgery period create a lower state of hunger?

So with drastic portion reduction and only eating 5 bites twice a day, within 3 days you are not feeling hungry and within 14 days you are full after only 5 bites. Sounds like a person who’s had a gastric bypass, doesn’t it? But instead, you’re using your body’s natural hunger indicator to make the exact same changes.

After a gastric bypass, you end up eating 3 bites 3 times a day. When my patients come to me for pre-op counseling, I put them on Dr. Alwin Lewis’ “five-bite diet” and they lose the same amount of weight, have the same effects on their hunger, and avoid surgery altogether. While on this diet, they lose 1 pound per day. And best of all, the diet costs NOTHING. You save surgical costs and costs to your body by avoiding life-threatening surgery.

A lot of surgeons are starting to get mad at me because when they send these patients to me for pre-op counseling, they rarely come back, because this diet has allowed them to lose 1 pound a day as if they had the bypass. They finally see weight loss success when they thought their only option was surgery. And they smile for having avoided such a great risk. And all thanks to this new knowledge about the hunger indicator.