A Role for Consciousness

Dr. Philip Grossi
Thursday, 05 April 2012

illustration to role for consciousness blogTwo recent patients come to mind that each can contribute to the question of the role of consciousness.  One is a young man who sold his company, is quite wealthy as a result, drinks champagne daily, and has lots of female friends.  He has good physical health, trim, and enjoys a large number of pleasures. Another young man spends most of his time playing video games and enjoys those experiences, including the competition with other gamers. He too has many pleasurable conscious experiences yet feels unfulfilled.  Isn't the ultimate value of consciousness to us as humans that it allows us to enjoy pleasure? Does actual contact with the real world matter? These two patients offer limited help in answering this question because one in engaged in the real world and the other in locked in his own phenomenologically bounded world.


John Stuart Mill, the British philosopher who wrote extensively about the relation of the individual to the state as well as the principles of falsification used in the scientific method, underwent what would appear to be a major depression when he was 22 years of age. As he recovered, he discovered that those that are happy are those that have their minds on some other object than their own happiness. What he meant was that experiencing pleasure was essential for good life but not sufficient.  He also meant that subjective sense was insufficient to judge the senses but their origin had to be considered. Therefore, a good feeling in order to be valuable had to arise from an experience that was considered worthwhile. So aiming at something that is considered valuable or worthwhile in the real world is what we as human beings care about and the good feelings that result are a by-product of those activities. Therefore the good feelings of consciousness are valuable in themselves but even more because  they help to produce objects in the real world that are considered valuable by the individual.

The two patients cited above were not producing anything that they considered valuable in the real world. The first person had when he created his company, but he was no longer.  The second had a more difficult problem in that he was not engaged with the real world but only in a conscious sensory one.

 

The Rational Diet that Works

Dr. Philip Grossi
Monday, 02 April 2012

I am going to present a weight loss program that will work.  It is not a quick-weight loss diet that experience tell us does not work (remember Oprah and some of your friends) nor a fad program built on questionable scientific basis; but, weight loss that is likely to be permanent and healthful.  You will need to learn to eat in this manner for the rest of your life and learn that you don't need to look like the latest popular supermodel.

We need to start with some basic calculations because people are highly individualized and of two sexes.  We need to calculate the calories a person burns at rest which is called the basal metabolic rate (BMR). This is done at room temperature and 12 hours after eating.

  • If you are female, calculate your BMI using the following equation: B=(6.25 x H) + (9.99 x W) - (4.92 x A) - 161.  B=BMR in calories per day, H is your height in centimeters (1 inch = 2.54 cm.), W is your weight in kilograms (1 Kg = 2.2 lbs.), and A is your age in years.
  • If you are a male, calculate your BMI by the equation: B = (6.25 x H) + (9.99 x W) - (4.92 x A) + 5.

Convert pounds to kilograms by dividing weight in pounds by 2.205 and height in inches multiplied by 2.54 to convert to centimeters.  A good rule of thumb is about 10 calories per pound of body weight - a 150 pound woman would need about 1500 calories per day at rest and a 200 pound man would be about 2000 calories per day at rest. .

illustration to rational diet blog

Almost everyone thinks that is you exercise it automatically raises your basic metabolism.This is untrue as I will show.  Let's take a hypothetical female who burns 1500 calories at rest daily and 1900 calories with moderate activity: if she eats 1900 calories she will maintain her weight; if she eats 1700 calories, she will gradually lose; if she eats less than 1500 calories daily, her metabolism will slow down and her gastrointestinal time will likely slow down too in order to allow more time for the intestine to  absorb more nutrients from the food. If the woman has been eating substantially less that 1500 calories then she will likely gain water weight which is temporary but is disturbing if unanticipated. It is also beginning to be known that certain neurotransmitters regulate fat, carbohydrate and protein.


What then is the advice to those that wish to loose weight?  Adjust your eating to fit into the above described window and then begin to exercise moderately after two weeks. From my clinical practice I have learned that it is best not to travel during the beginning of this transition and for the first two months. It is much easier to get thrown off stride when away from your home environment. Remember food should be enjoyed and is necessary for life. Good luck and happy eating!

The Failure of Low-Calorie Diets

Dr. Philip Grossi
Tuesday, 03 April 2012

If you have not read the previous blogs on starvation (Dieting & Starvation) and it's effects as well as the effects of re-feeding, I suggest that you go back and read those quickly as they provide context for this blog.

The community experience with low-calorie diets is extensive, having been suggested by many doctors and professionals for over forty years.  Their success rate as measured by keeping weight off for a few years is almost zero. Why is this the case?

First, some of the most popular diets recommend 800 to 1000 calories per day. Often people will be delighted when they look at the scale in the first two or three weeks. Unfortunately 70 per cent of the weight loss is water, not fat. Most people don't realize that when they loose water they are also loosing essential electrolytes and nutrients such as potassium, sodium, magnesium, phosphorus, and calcium. The body tries to compensate by retaining sodium which leads to water retention, which Keys labeled re-feeding edema. Also, increased insulin production needed for metabolism of food fosters retention of sodium and thus fluid.

Another change produced by extremely low-calorie diets or starvation (your body can't distinguish) is the reduction in the rate at which your body converts caloric intake into energy and slows to conserve the few available calories. This produces fatigue, dry skin, hair loss, cold intolerance, depressive symptoms and others as described by Ancel Keys and cited in a prior blogs. Indeed, your body becomes more efficient with each episode of starvation and this accounts for the increasing difficulty in loosing weight. Eating actually increases metabolic rate and so skipping meals works against the goal of weight loss. I have had a number of patients who have eaten six to eight small meals per day and have lost weight. Another aspect of eating frequently is that one is eating when one is not hungry and preoccupation with food disappears.illustration to low-calorie diets looping blog

Skipping meals or starving also produces binging once food is available as was demonstrated in the Minnesota study. Often this is experienced by the dieter as a lack of self-control or will. This produces reinforced efforts to eat less with subsequent failure. The person is fighting his/her own biology which is responding as if it is in a famine. Again, this was described 62 years age by Keys.

What is the secret to loosing weight then?  Calculate you daily caloric need at rest and eat about 12 to 15 per cent fewer calories distributed in frequent meals and exercise moderately, i.e., walk about 30 minutes three or four times each week. You can calculate your daily resting caloric need or use the rule of thumb which is about 10 calories per pound of weight.