How to Succeed Long Term Without Weight-Loss Drugs | Video 4

Welcome back to our video series on how to get weight-loss drug results without the drugs. If you've been following all along and you've been putting comments down below, thank you, thank you, thank you. We've been responding, I've been reading them. It's so exciting. Yeah, just thank you for your engagement. I just love hearing what you're learning and what you're getting out of it. If you're here for the first time, just notice on this page there's thumbnails of other videos you could catch up on, but this video will stand alone, so don't go click on those other videos yet. Just stay right here with me and I'll even give you a little recap. Just briefly.

I'm Dr. Susan Peirce Thompson. I'm a professor of brain and cognitive Sciences, and I myself am maintaining a 60-pound weight loss now for over 20 years, and I've helped tens of thousands of people from over a hundred countries on planet Earth to lose their excess weight. Published results in peer-reviewed articles show that this method of eating that I'm talking about in this series produces exactly the same results as weight-loss drugs, but naturally. Take a look at this graph here. You can see that these new drugs that are called semaglutide, that's Ozempic and Wegovy, are producing amazing weight-loss results compared to all the other commercial weight-loss programs. Bright Line Eating®, which is what we're talking about here, is right with it neck and neck and so different from all these other approaches. In fact, if you look longer term, those are the green bars here, and these are new data just published super recently, hot off the presses, people start to regain some weight on weight-loss drugs. Look at those green bars, their four-year data for the weight-loss drugs. By four years people have already regained a third of the weight they had lost, and that's while they're still taking the drug. But at six years, people doing Bright Line Eating are still going strong. It's remarkable.

In the first video we talked about the weight-loss drugs, all about what they are, how they work, the cost, the side effects, the pros and upsides of them, which are significant. They do work really well, right? We talked about exactly how they work. There's three main pathways by which they have their amazing effects. The first one has to do with appetite suppression and hunger control. We dove in deep into that. In the second video, we talked about how they produce that effect and how you can actually get it naturally by adjusting what you eat and what you don't eat to mimic the type of hormonal release that happens with these weight-loss drugs. Then in the next video we talked about the second pathway, which is all about cravings, about drugs, and about dopamine and about the mesolimbic reward pathway and how these drugs suppress cravings by modulating dopamine activity, and how you can do that too by changing the nature of what you eat and not eating those addictive foods that flood the brain with dopamine.

Now we're into the final video here where we need to talk about the last pathway by which these drugs work. These weight-loss drugs, what they do is they essentially take the whole issue of making sure that you execute your plan of eating faithfully over the long term. They take that out of the equation by making you feel so not wanting to eat, so nauseous, and kind of stuffed in the esophagus that you really never want to eat, which takes the issue of willpower just out of the game. But if you're not going to take a pharmacological solution, then how do you handle the Willpower Gap™? The issue of making sure that you eat the right things and not the wrong things day after day, hour after hour, month after month, year after year, over the long term. It's essentially an issue of willpower control. How do you get that naturally?

Willpower, how does it work in the brain? Another way to say willpower is resisting temptation. In 2012, some researchers published a study where they took 400 people, and they gave them beepers to wear all the time. They would beep them at random intervals and say, Hey, what are you doing? Are you resisting some kind of temptation right now? Were you recently resisting a temptation? What was it for? Were you successful at resisting? What they found was that people are resisting temptations an average of four hours every day. The number one temptation is for food. Then on the list is other things like leaving work and going to catch a movie, wanting to have sex with a person in the cubicle next to them at work, wanting to scroll Facebook and check social media when they're at work or they shouldn't be, or what have you. But food was number one for sure, and people were about 50 50 at resisting temptations.

The part of the brain that's responsible for reining in our impulses, for helping us resist temptations for willpower control, if you will, is the anterior cingulate cortex. It sits about two inches back from the third eye on your forehead, right behind the prefrontal cortex. It's a hub, I'm afraid for a lot of things, not just resisting temptations, but also making decisions, which is ever more important in our modern environment as we have so many choices. You can't even rock up to the grocery store and just get mustard, right? It's like old world mustard, stone ground mustard, organic mustard. There's 35 choices of mustard. And checking email is a nonstop task of making decisions. Am I going to reply? Am I going to reply to this person or to all, is someone BCC'd on this that I have to be careful about? Am I going to save it in a folder? Am I going to label it? Am I going to file it away for later? Am I going to leave it in the inbox making decisions? We're doing it all the time now. Decision fatigue is a real thing.

The anterior cingulate cortex is also responsible for regulating our emotional responses. So, if we're in traffic, not lashing out with road rage, if our kids are being frustrating and we can't say to them what we would really like to say to them, we have to be appropriate and rein in those responses. And then finally, task performance. If you're a teacher and you're entering grades or attendance into a spreadsheet, if you work with spreadsheets. If you're having to be careful about setting a table and making sure everyone gets a napkin and everyone gets a fork, there's so many occasions in our life where we have to monitor our task performance and the minutia of it very precisely.

So, as you can imagine in modern life, the anterior cingulate cortex gets overloaded. Here's the problem. It's actually a part of the brain that doesn't function well when it's overloaded. Research shows and studies have been very clear on this, that after about 15 minutes it gets profoundly fatigued and works at less than 10 or 15% capacity. Then it's Friday night and we're grabbing our plate and going down a buffet line. And yes, we know that we should get the grilled chicken breast and the steamed broccoli and approach the salad bar, but suddenly there's a bunch of pasta on our plate and we've got a slice of pizza and we're checking out the dessert bar instead. This is what I mean when I say that people fall into the Willpower Gap. The Willpower Gap. It's a problem. You don't have to fall into the willpower gap often, just maybe two or three times a week for it to be enough to completely thwart and stymie your weight-loss efforts, like ruin them so that you're not losing weight or you're even gaining weight over time, even though you know what you should be eating and you're following a really good program.

What is the solution? How do you bridge the Willpower Gap? I'm afraid that there actually is no direct solution. There is no way to effectively make good decisions around food day in and day out. So, we're going to need to imagine a world in which we have no effective willpower anymore ever and work from there. But the good news is that there are things we do using zero willpower, and we do them just fine. We do things like brushing our teeth regularly without taxing the anterior cingulate cortex at all. We're not resisting the temptation to do otherwise than brush our teeth. As a matter of fact, what we do is we recruit the basal ganglia a much deeper, more primitive structure in the brain that executes automatic behavior sequences. At a certain time of day or night, based on certain cues, it's time to get to bed. We find ourselves putting toothpaste on a toothbrush and brushing our teeth, whether we're tired, whether we're sick, whether we're traveling, whether it's late, whether we feel like it, whether we have a sticky note on our mirror reminding us to do it or not. The teeth get brushed. Automaticity, that's the crux of the issue. Once we realize that automaticity is the name of the game, we can look around and notice that most ways of eating are not automatizable at all. And yes, I think I coined the term. It's a very important function when it comes to sustainable weight loss in a natural behavioral way.

Automaticity. Let's talk about two things related to it. One is finding a plan, crafting a plan, using a plan that is maximally automatizable. Then the second is setting aside a period of time at the beginning when you first start that plan to make sure that you can groove in the habits and set up the automaticity. You don't just get automaticity for free. You've got to work for it. It's like building a habit. So, let's cover these one at a time.

What makes a plan? Well, first of all, it's got to not be relying on you to make calculations and decisions all day long at every choice point. I mean, research shows that we're making something like 200 food-related decisions every day. It's crazy making. If our anterior cingulate cortex is depleted, our prefrontal cortex is feeling fuzzy and we're not in a place to make a good decision, we find ourselves saying, “Oh, what the heck?” And ordering takeout. An automatizable plan is not going to be relying on us to be counting calories all day long and making a decision about whether something has too many calories or not enough. It's not going to be relying on us to be counting points all day long and making decisions about what things have the right amount of points. It's not going to be counting on us to track macros and calculate which foods have the right ratios of macros and adding it all up and making decisions about it. Can you see how that's too many decisions all day long, every day? It would be great if our brains were in a fully replenished, well rested, fresh state of mind every day. It would work great, but in real life it's going to break down very fast. Or these plans of eating, I shouldn't say, or I should say, and these plans of eating expect us to eat far too frequently for it to work. Now, yes, for example, brushing your teeth is automatic twice a day, morning and night. What makes it so automatizable is the time of day and the circumstance in which you do it so that it's wired into your waking up routine or maybe your showering routine. It's wired into your going to bed routine. Those endpoints are particularly automatizable timeframes. If you had to brush and floss six times a day, the next time you visited your dentist and they said, “How'd you do there with your six times a day brushing and flossing? Are you on board? Did you do a great job?” You'd be like, “No, I tried for a little while and then I went on a trip, and I didn't have my stuff with me.” You wouldn't succeed at it. I wouldn't succeed at it. Nobody would succeed at it. So, these meal plans that expect us to eat meals and snacks five and six times a day, they're setting us up for failure. It's too many decision points. It's not automatizable at all.

The good news is good old-fashioned breakfast, lunch, and dinner. Now you can wire breakfast into your morning routine. Sounds familiar, right? At lunch at noontime, there's this beautiful pause where people stop and think about food. At that point, you can grab what you packed the night before for your lunch, you'll be fine, and dinner can be wired into your evening routine. And that's about it. Breakfast, lunch, and dinner. The interesting thing is more recent research is showing that we don't want to be eating as often as we've been eating anyway. Like breakfast, lunch, and dinner is about as often as we should be eating for maximal health. When we stop eating after dinner and we don't have any bites of food for 12, 13, 14 hours until our first bite of breakfast the next day, now all of a sudden autophagy can kick in. This is the healing and repair and recycling of damaged and dead cells and cell parts so we can stay young and healthy and live our longest, vibrant lives. Also, research shows that digestion doesn't work very well when we're eating multiple small things all day. It's kind of like putting in a big load of laundry and then 40 minutes later opening the lid and throwing in more clothes. The stomach is like, “What are you doing to me? I'm working on a job here. Give me some peace.” We want to be eating three discreet meals a day and nothing in between. It's actually the healthy way. So, the plan itself has to be fully automatizable. The Bright Line Eating plan was designed to be maximally automatizable. This is the kind of stuff that I used to teach in my college courses on behavioral psychology. It's interesting stuff. You don't have to know all about it, but you can trust that there are plans out there. Bright Line Eating is one such plan that is fully automatizable.

The next part is more on you, which is to really focus when you first begin on creating a sacred bubble, like a space of time to three, four months where you're not starting and launching other new big projects. You're sort of aware that you're going to need to use pretty much all of your excess resources, your willpower, to setting up the plan and getting it established. Because automaticity doesn't come for free. It doesn't just, poof, exist. You've got to build it up. It does take willpower, focus, dedication, effort, practice to do that. One good example here that everybody, not everybody, but almost everybody gets wrong, that I see people getting wrong all the time, is they decide to overhaul their eating, and they start a massive exercise program at the same time. They think of exercise and weight loss as completely linked, even though research shows that exercise does not make you thin, the science on that is very, very clear. Actually, a huge study took hundreds of people and put them into four different groups, a no exercise group, and then a little bit of exercise a little more. And then a lot of exercise group and the exercisers were working with personal trainers. We know they were doing their exercise. Nobody changed their eating at all. At the end of the study, everybody weighed the same and their body composition was the same. There was no effect on weight loss of all this exercise that people did. But exercise is great for mood, for heart health, for lung health, for bone health, for sex drive, for self-confidence, for self-esteem, for self-efficacy. I'm probably missing 10 other things. I'm a big proponent of exercise. I recommend that people exercise. I exercise, everybody should exercise. Who should not be exercising is someone who's committing to change how they eat for life right now. They should be carving out just a couple few months to get their food dialed in first. People make that mistake all the time. Then what happens is they're burning up their excess willpower, getting to the gym, getting that exercise routine off the ground, and then they fall into the compensation effect, which is they're leaving the gym and they're thinking, “You know what? I deserve a little something. I just worked out hard again. I've worked out all week now.” They go through a drive-through and they don't even know why it happened. I'm like, yep. That's what happens when you try to pair launching an exercise regime with getting your food straight at the same time.

That's about it. We covered how weight-loss drugs work, and they work by three main pathways by suppressing appetite and hunger, modulating dopamine to suppress food cravings. Just taking away the pleasure in eating, taking away the desire to eat, making you not want to eat, which really takes willpower out of the equation because it doesn't take any willpower to do something. You have zero motivation to do if you're not going to go that path or if you're going to go that path, and then maybe look to get off the drugs. Because actually research shows that these GLP-1 medications, these weight-loss drug medications, the average time that people spend on them is 13 months. Something about the combination of the cost, the side effects, not enjoying eating or sort of things anymore. The way it impacts the reward centers of the brain to just dampen pleasure in general. People don't like it and they get off the drugs on average after 13 months. If you're someone who's looking to phase off of these drugs, then you're going to need an alternate approach.

We've been talking about the Bright Line Eating approach where you get appetite suppression naturally, you get the elimination of cravings because cravings go away when you stop eating the foods that are making your brain crazy. You learn how to set up a system of automaticity that takes willpower out of the equation, so you feel utterly free, and your eating is happening automatically, like brushing teeth, and you just end up eating the right thing at the right time without having to make a decision to do it or really activating willpower at all. Earlier on, we talked about the side effects of these drugs, which for some people there's profound gastrointestinal side effects of vomiting, nausea, diarrhea, and bowel obstruction, which is up 450% thanks to these drugs. We talked about pancreatitis, which is up 900% thanks to these drugs. We talked about thyroid disease, which they can cause and muscle loss. Now, the evidence doesn't show that these drugs cause muscle loss directly, but indirectly because people just don't want to eat much, so they don't eat nearly enough protein, and they lose muscle mass. We talked about anhedonia, which is the reduction of pleasure and everyday activities. People really don't like the elimination of pleasure with food and drink on these drugs, but some people are experiencing a more joyless life overall as well. That's not great. We talked about depression and suicidal ideation, which is only seen in a subset of people, but it's a risk for sure. We talked about NAION, which is non-anterior ischemic optic neuropathy, which can cause sudden blindness usually in one eye. It's not reversible. The study in question showed that if you have type two diabetes, you're five times more likely to get this retinal condition if you're on one of these GLP one medications. If you have obesity, you're eight times more likely to get this form of vision loss if you're on one of these weight-loss drugs. All that was just published in JAMA Ophthalmology. That's the “Journal of the American Medical Association,” a top top journal. We talked about all those side effects.

But you know what we haven't talked about yet is the side effects of doing Bright Line Eating because there are side effects of doing Bright Line Eating. I published a study on this in 2021 in “The Annals of Behavioral Medicine.” We looked at a cohort of people who did the Bright Line Eating Boot Camp, which is the foundational course that sets up people's experience doing Bright Line Eating, teaches them the system and helps them create the automaticity that's needed. What we found was that not only did they lose a bunch of weight, not only did they learn how to eat, and they got their food straight and they had all this weight-loss success, and their hunger went down, and their cravings went down. We've covered all of that. Not only that, but their depression went down. Their days of poor mental health went down, their happiness and flourishing went way up. Their feelings of being loved, supported and connected in the world went way up. Their loneliness went down and also their energy went way up. Those are the side effects of doing Bright Line Eating. We call these psychosocial side effects. Pretty good stuff.

Now, we did something interesting. We analyzed the data a different way. We pulled out the people who started the Bright Line Eating Boot Camp in April, May, and June of 2020. Can you think back now for just a second about what life was like in April, May and June of 2020? How the world was shutting down, how scary it was, how nobody knew what was going on, how it was hard to find what you needed at the grocery store. It was just a horrifying time of uncertainty, and contention, and fear. We analyzed the data for those people wondering, did they still get the benefits? What's interesting, they got all of those benefits to a significantly greater degree, every one of them, like massively more. What that shows is that Bright Line Eating also has the side effect of building in resilience, that when life gets the hardest, it helps you have the fortitude to know that you've got what it takes, that you're okay in the world, no matter what is coming down around you, that you've got this, that you've got a group of people supporting you and surrounding you that you're loved, protected, and you know how to show up for your own best good.

Okay, there's one more side effect I need to tell you about. It's not really a side effect, but it's just a really interesting thing we found in our data. In 2021, in “Current Developments in Nutrition,” we published a study on 4,509 people who did the Bright Line Eating Boot Camp. That's a lot of people, 4,509 people, right? The reason it was such a big sample size for this study is because they had to come from every age group. All the way from their 20s, 30s, 40s, 50s, 60, 70s, and beyond. When we looked at the data at the rate of weight loss in the first two months, what we found was that there was no difference based on people's age. Meaning people who were post-menopausal, post-manopausal, people in their 50s, 60s, 70s, and beyond, were losing weight as if they were in their 20s and 30s. Again, you might say, “Dr. Thompson, how is that possible? I've lived a while on this Earth, and I know it's harder to lose weight when you're in your 60s than it is when you're 20s. So, what gives?” Well, there's actually a really simple explanation here. The reason it's harder to lose weight when you're older is that after a certain age for both men and women, estrogen tanks. Now, women have more estrogen, but men have estrogen too. Estrogens. It's a class of hormones, not just one hormone. It goes down to very low levels after age 50 or so. Right now, estrogen has the effect among many other things of facilitating the effectiveness of insulin, which is a fat storage and fat release hormone. If you're eating sugar and flour, if you're eating ultra-processed foods, even at all, your insulin better be right on point, adjusting and accommodating and mopping up the damage from the results of that eating. But when you stop eating those foods and you eat only whole real foods, now what happens is it doesn't matter that you don't have estrogen on board helping out your insulin and it levels the playing field. And even at 60 years old, you can release weight as if you're 20.

Those are the side effects, if you will, that you can expect if you change your eating in the ways that we've been talking about. That really concludes our video series on how exactly to get weight-loss drug results without the drugs. I have though created a fifth and final video for you, and it's a video that goes more into detail about Bright Line Eating and about the Boot Camp that teaches people exactly how to do the system that we've been talking about, how to set it up, how to build the foundation, how to gain the automaticity, exactly how it works. If you'd like to join me in that fifth video, I really would love that, and I would love to see you there. If not, I just want you to know, I am so glad that you watched. Thank you for your time. Thank you for spending your moments with me. I know your time is so valuable.

As just one last favor, I would love for you to scroll down and just leave a comment because the video series is over now. I'm curious what you're taking away from it, what you learned, what you loved, what you didn't like, and I'll just be reading those comments. Thank you so much for your comments and thank you for tuning in to Weight-loss Drugs and Beyond: What Really Works for Lifelong Success. If I see you in video 5, I'll be introducing you to some people who've had their full Bright Transformation with this way of eating, because nothing can convey it like their stories convey it. I hope to see you there. Bye now.