Over twenty-five years ago, a health-conscious friend shared an ad with me about the Parcells School of Scientific Nutrition in Albuquerque, New Mexico. The ad promised "five days that would change your life." Nothing could have been truer. After meeting Hazel Parcells, Ph.D., D.C., N.D., my life was changed forever. She inspired me to become a nutritionist with a foot in both clinical and holistic nutrition. Dr. Parcells was eighty-four years old when I met Her - and lived to the incredible age of 106. A true pioneer in natural medicine, she was a woman ahead of her time.

Under Dr. Parcells's masterful tutelage, I first became acquainted with several innovative concepts, many of which later became the foundation of my Fat Flush Plan. The first revelation was the surprising connection between weight loss and the liver. I recognized early on what researches are only now beginning to understand - that not only is the liver the main organ for detoxifying pollutants and chemicals in the body, but this vital organ also is a hidden key to effortless weight loss.

Based on simple biochemistry and the charts from Gray's Anatomy, I learned first hand that one of the best kept secrets to weight loss and lasting weight control is keeping the liver, the key organ for fat metabolism, in tip-top shape. For example, bile, which is synthesized and secreted by the liver and stored in the gallbladder, helps the liver break down fats. Bile cannot do its job, however, if it is lacking certain nutrients that make up the bile salts or if it is congested or thickened with chemicals, toxins, excess sex hormones, drugs and/or heavy metals.

So I researched all the "liver loving" foods and nutrients that would enable the body to produce quality bile and aid in thinning it out. Since one of the primary ingredients of bile is lecithin - a highly effective emulsifier with a detergent-like ability to break up fats - I decided to experiment with adding lecithin-rich eggs to my daily diet. Soon, the addition of fresh lemon juice and water - a well-known bile thinner - followed suit twice a day. Not only did my own cholesterol come down (a good 20 points to be exact), but so did my weight.

Just to make sure I was onto something, I enrolled thirty of my clients in a six-week dietary exploration and instructed them to add at least two eggs daily to their current diet regimens and to add lemon juice and water twice a day - without changing anything else in terms of diet or exercise. Without exception, they all lost weight, especially around the waistline. In fact, one woman lost 21 pounds over the six-week period. I instructed the group to avoid caffeine and medications (including over-the-counter drugs) as much as possible because I suspected even then that these "drugs" were especially toxic to the liver.

Today, light is finally being shed on this vitally important organ. Many laboratories specializing in functional medicine testing offer a liver function test to determine how well the liver's two distinct detoxification pathways, the cytochrome P-450 phase I and phase II detoxification enzymes, are working. An individual ingests caffeine, Tylenol, and aspirin, and then specimens of saliva and urine are taken and analyzed to assess how well the liver is breaking down these substances.

The liver's two detoxification pathways are responsible for breaking down, eliminating, and neutralizing toxins. In this petrochemical world of ours, the sheer number of toxins we ingest from medication, drugs, pollutants, and pesticides can overwhelm the liver's ability to break them down and deactivate them. In addition, the detoxification pathways can become drained of the antioxidants, enzymes, and other nutrients necessary for detoxification because of the overload. The resulting metabolic by-products of incomplete detoxification are often more poisonous to the body than the original toxins.

The April 2001 Consumer Reports on Health provided an extremely helpful list of medications and herbs that can harm the liver with long-term use. The list include common medications (such as ibuporfen); cholesterol-lowering drugs (such as Lipitor); antidiabetic drugs; triglyceride-lowering drugs; anticonvulsants; estrogens used to treat menopausal symptoms (such as Premarin and Ogen) and those used in birth control pills (such as Lo/Ovral and Triphasal); and the herbs chaparral, comfrey, and pennyroyal.

The bottom line is that with so many toxins being dumped into the bile, its storage, concentration, production, and ability to digest fats are seriously impaired.

Another valuable insight I learned from Dr. Parcells was that cellulite - that dimpled accumulation of stored fat on our thighs and buttocks - was more connected to a sluggish lymphatic system than to poor muscle tone or weakened connective tissues. The lymphatic system, a relatively unknown secondary circulatory system underneath the skin, rids the body of toxic wastes, bacteria, heavy metals, dead cells, trapped protein, and fat globules. In essence, the lymphatic system is the garbage disposal of the body.

These concepts were so innovative back then that Dr. Parcells was the only one talking about them. After her ideas on the liver and the value of cleansing began to take root, researchers (for example, Sandra Cabot, M.D. in Australia) and American doctors (for example, Leo Galland, Kenneth Bock, and Elson Haas) started to write about them. Parcells would have been proud to know that in 2001 - nearly five years after her death - a well-respected cardiologist from Philadelphia, Gerald M. Lemole, M.D. came out with a book called The Healing Diet, which links lymphatic system health with overall wellness.

Thanks to Dr. Parcells, I was given a head start in learning about the importance of cleansing both the liver and the lymphatic system for effective weight loss and cellulite control.

Discovery: The Role of Fat-Burning Fats
Another major piece of the weight loss puzzle fell into place during my tenure as director of nutrition at the Pritikin Longevity Center in Santa Monica, California. In the early 1980s, Pritikin diet was widely credited with being the model for the low-fat, high carbohydrate diet prescription. At the center, as well as later in private practice, I found that many women following this type of program were complaining about distressful premenstrual syndrome (PMS) symptoms and other health ailments. I began to study their diet and health histories, hoping to find some underlying patterns.

For the most part, I found that they were loading up on unlimited fat-free complex carbohydrates such as pasta, bread, crackers, potatoes, corn, and beans. I discovered that the more they overate wheat-based carbohydrates (in particular, pasta, bread, cereal, and crackers), the more they craved them - and the more they seemed to become depressed. And these high amounts of grains were somehow contributing to their bloating - along with all that fat-free milk and yogurt they used with cereal. The unlimited use of fat-free but yeast-relation seasonings such as soy sauce, tamari, tomato sauce, and oil-free vinegar dressing s of every persuasion added insult to injury. Of course, the reason they were overusing these kinds of seasonings was that their zero-fat meals lacked any real flavor.

As it turned out, these same women were the ones complaining about retaining fluid, feeling tired and cold, and having allergies and recurring yeast infections, in addition to severe PMS. Therefore, I recommended a highly touted gamma-linolenic acid (GLA) - rich supplement known as evening primrose oil, used widely by European doctors for PMS-related problems. And this is when the unexpected happened. Besides eradicating their symptoms, these also experienced a welcomed side benefit - weight loss.

The GLA fat-fighting connection. Although generations have used the evening primrose plant for its many medicinal and healing properties, the oil in the seeds - containing the powerful GLA - was making a splash in the weight loss arena. In fact, it was through research conducted by David Horrobin, M.D., at the University of Montreal, and M. A. Mir, M.D., a senior researcher and consultant physician at the Welsh National School of Medicine in Cardiff, Great Britain, that helped me realize how the right kind of fat stimulates the body's metabolic ability to burn fat. Their work demonstrated that evening primrose oil was most effective for those who were overweight by at least 10 percent. The key to this calorie-burning mechanism appeared to be the way the GLA-rich evening primrose oil worked via the prostaglandin pathways, a network of hormones that control virtually all body functions at the cellular level.

The GLA found in evening primrose oil mobilizes the metabolically active fat known as brown adipose tissue (BAT). This special form of fat, if available in sufficient amounts, can burn off extra calories and boost energy. BAT is a special insulating kind of fat found deep within the body that surrounds your vital organs such as the kidneys, heart, and adrenal glands. It cushions your spinal column as well as the neck and major thoracic blood vessels.

The series I prostaglandins created from GLA are believed to regulated many aspects of metabolism. GLA-induced prostaglandins regulate BAT by acting as a catalyst to either turn it on to trigger calorie burning or turn it off to trigger calorie conservation. Prostaglandins are also connected to a metabolic process referred to as ATPase. ATPase is also known as the sodium pump, a biochemical process necessary to keep the right amount of potassium inside cell walls and too much sodium out. GLA-rich substances such as evening primrose oil, by means of prostaglandin activity, control the sodium pump, which in turn revs up metabolism.

Based on mounting evidence the essential fatty acids are important to overall health - from studies that started to appear in such prestigious medical journals as the New England Journal of Medicine in the mid-1980s - I published my first book, Beyond Pritikin. Released in 1988, the book became a best-seller. It featured a chapter entitled "The Two-Week Fat Flush" that, as I look back, was really the origin of today's Fat Flush Plan. I inserted this program in my book as an antidote to the high-carbohydrate, high-grain-based, yeast-rich, fat-free diets of the era. It contained a one-day sample menu and touched on liver cleansing for more efficient fat metabolism. The diet featured the GLA supplements I had worked with in my private practice.

In 1996 I updated Beyond Pritikin and altered the Two-Week Fat Flush by replacing the safflower oil component with omega-3-rich flaxseed oil. Flaxseed oil works much like GLA but helps the body burn fat even more efficiently by increasing the production of a certain groups of prostaglandins or eicosanoids, as they were called in the 1990s.

When Beyond Pritikin came out, my private practice in California grew, and soon people everywhere were resonating to my message that essential fats where absolutely necessary for rapid weight loss, longevity, and good health.

Discovery: Excess Insulin and Fat Storage
By the mid-1990s it was becoming increasingly clear to me that the public finally was ready to accept my finding that a low-fat diet isn't good for you because of the emergence of yet another piece of the weight loss puzzle: Fat-deprived, carbohydrate-stuffed individuals were realizing, due to the popularity of such books as The Zone (Regan, 1995) and Dr. Atkin's New Diet Revolution (Evans, 1992), that they were seriously jeopardizing their weight loss attempts because of the insulin factor. A fat-free diet, low in protein but high in carbohydrates (even the highly touted complex carbs) keeps insulin levels elevated, which promotes fat accumulation since insulin is a fat storage hormone.

Thankfully, insulin awareness has ushered in a brand new era of balanced nutrition and has legitimized the return of insulin-lowering fats and proteins to America's dining tables. The Fat Flush formula of healthy fats, lean proteins, and slow-acting (low-glycemic) carbohydrates is right on the low-insulin track.

Discovery: When Fat Is Not Fat and the Stress-Fat Hidden Factors
I learned about the remaining weight loss stumbling blocks through my most dependable sources - you (my readers) and clients. Time and time again I was finding that even when some of my clients were doing everything else right, they still couldn't lose weight. Thanks to the nutritional assessment questionnaire and food diary record sheets I had every client fill out, a pattern began to emerge. I discovered that many of those who were resistant to weight loss had a history of long-tern use of birth control pills, hormone replacement therapy (HRT), antidepressants, and other medications as well as hidden food allergies. In Chapter 2 you will learn that this kind of weight gain is really not fat per se but rather severely waterlogged tissues masquerading as fat.

In addition, I noted from my client's assessment forms that those who had the hardest time losing weight were also those who were the most stressed out. They were living on caffeine (from 2 to 4 cups daily), juggling home and career, definitely not getting enough rest (four to six hours daily), feeling "on edge" most of the time, and reporting an increase in food cravings and fat storage, particularly in the abdominal area. I suspected that the adrenal glands - our "fight or flight" glands that produce hormones in response to stress - were intimately connected to the stress-fat cycle. And I had a very strong hunch that I could disrupt this cycle with some simple changes in lifestyle habits.

So I honed the Fat Flush Plan to include stress-relieving protocols (such as exercise and journal keeping) that would zap the stress trigger and accelerate weight loss. Probably the most vigorous stress-busting dietary suggestion was to increase protein - at least 8 ounces or more of poultry, fish or lean meat - because the body has higher protein needs when it is under stress. Just by adding another couple of ounces of protein to lunch and dinner, I had elated reports form clients who were dropping two dress sixes in two weeks - at last.

You may be asking, "What about other hidden weight gain factors like low thyroid or chronic dieting that throw the body into a metabolic slowdown?" I believe that these are also valid but secondary to the five hidden factors I have defined and outlined above.

DESTINATION: A NEW BODY AND A NEW YOU
In Chapter 2, I explain how hidden weight gain factors can sabotage your weight loss goals. It has been only in the last few years that my understanding of the scientific basis for the Fat Flush Plan has come together. For over a decade I have been collecting the latest studies, research, and books (which are referenced in the back of this book) that have helped to substantiated my Fat Flush discoveries.
Finally, there is an answer for someone like you, like me, like all of us.

FIVE HIDDEN WEIGHT GAIN FACTORS
We learn wisdom from failure, much more than from success; we often discover what will do by finding what will not do and probably he who never made a mistake, never made a discovery.

- SAMUEL SMILES

QUICK QUIZ

Your struggles with weight are not the result of simply too much food and too little exercise. A myriad of unsuspected elements come into play. Before wee look more closely at these, take this Quick Quiz to put your own lifestyle in focus.
YES/NO

Do you drink caffeinated beverages daily? _______ _______
Are you taking antidepressants or prescription or over-
the-counter drugs? _______ _______
Do you eat margarine or foods made with hydrogenated
(solid or semisolid) fats? _______ _______
Do you take birth control pills? _______ _______
Are you on estrogen-or hormone-replacement therapy? _______ _______
Did you take antibiotics two or more times during the
past twelve months? _______ _______
Do you avoid fat at all cost (e.g. by eating fat-free
yogurt and fat-free cookies)? _______ _______
Do you often crave sweets, bread, or other high-
carbohydrate foods? _______ _______
Do you eat pasta, potatoes, bread, or other carbohydrates
two or more times daily? _______ _______
Does at least one meal a day contain processed and/or
packaged foods (e.g., frozen entrees or
luncheon meats)? _______ _______
Do you eat fewer than two servings of protein (e.g.,
meat, eggs or fish) daily? _______ _______
Do you drink fewer than eight 8-ounce glasses of
water daily? _______ _______
Do you regularly sleep fewer than 8 hours a night? _______ _______
Do you lead a high-stress life? _______ _______
Do you frequently skip a meal because you are "too
busy to eat"? _______ _______
Would you describe your lifestyle as sedentary? _______ _______

If you answered "Yes" to even one of the these questions, read on to learn how you may be unknowingly sabotaging your efforts at weight control and what you can do to make a difference.

If you are like most people, the Fat Flush Plan is not your first attempt at weight loss. You've exercised, counted calories, and cut out fat, then protein, and now even carbohydrates. Perhaps you lost weight; perhaps not. Chances are you've regained most, if not all, of the pounds.

For thousands of individuals, the Fat Flush Plan has been different. They've lost pounds and inches and kept them off. I believe this is so because the plan, unlike any other weight loss program, targets the five hidden factors mentioned in Chapter I that bring on unwanted pounds:

• Liver toxicity
• Waterlogged tissues
  
• Fear of eating fat
  
• Excess insulin
  
• Stress fat

How do these factors really affect your weight? Over the past several years, I have followed the research and, in some cases, the work of the nutritional pioneers who spearheaded these breakthroughs to answer this question. If you are like most of the Fat Flushers who have followed my work, when you understand some of the no-nonsense reasoning and the science behind the plan, you'll march confidently toward your ultimate success.

HIDDEN FACTOR #1: YOUR TIRED, TOXIC LIVER
Poets and songwriters may wax poetic about the heart, but your liver is by far the most versatile organ in your body and one of the most important. Weighting between 2.5 and 4 pounds in adults, the liver is the largest internal organ as well. Between 3 and 4 pints of blood flow through it every minute.

The Vital Liver
Researchers now estimate that the liver performs nearly 400 different jobs. It is the body's most important organ, functioning as a living filter to cleanse the system of toxins, metabolize proteins, control hormonal balance, and produce immune-boosting factors. Many of these functions are essential to your overall health, for example, the liver's synthesis of fibrinogen and other blood-clotting factors to protect you when you are injured. However, other liver functions have a direct bearing on your weight loss efforts, and these are the focus of the Fat Flush Plan.

A Fat-Burning Machine. Each day your liver produces about a quart of a yellowish green liquid called bile that emulsifies and absorbs fats in the small intestine. Bile contains water, bile acids and pigments, cholesterol, bilirubin, lipids, lecithin, potassium, sodium, and chloride. The liquid is stored near the liver in the gallbladder, from where it is transported to the intestine as needed during digestion.

Bile, as briefly discussed in Chapter 1, is the real key to the liver's ability to digest and assimilate fats. It can be hampered from doing its job because of a lack of bile nutrients, congestion, or even clogged bile ducts, which hamper bile flow and result in less bile production. If there is not enough bile produced, fat cannot be emulsified.

If you have a roll of fat at your waistline, you may have what is commonly called a "fatty liver". Your liver has stopped processing fat and begun storing it, for reasons I'll explain in a moment. Only when you bring your liver back to full function will you lose this fat.

An Efficient Metabolizer. The liver metabolizes not only fats but also carbohydrates and proteins for use in your body. The organ has a triple role in carbohydrate metabolism. First, it converts glucose, fructose, and galactose in glycogen, which it stores. Second, when your blood sugar level drops and no new carbohydrates are available, the liver converts stored glycogen into glucose and releases it into your bloodstream. Third, if your diet is regularly low in carbohydrates, the liver will convert fat or protein into glucose to maintain your blood sugar levels.

The liver converts amino acids from food into various proteins that may have a direct or indirect impact on your weight. Many proteins, for example, transport hormones through the bloodstream; as you've read, hormone balances are crucial to avoid water retention, bloating , and cravings, as well as other health problems. Proteins also help transport wastes, such as damaged cholesterol and used estrogen and insulin, to the liver for detoxification and elimination through the kidneys.

A Potent Detoxifier. Perhaps the liver's most important function, and the one that puts it at greatest risk for damage, is to detoxify the myriad toxins that assault our bodies daily. A toxin is any substance that irritates or creates harmful effects in the body. Some toxins, called endotoxins, are the natural by-products of body processes. For example, during protein metabolism, ammonia is formed, which the liver breaks down to urea to be excreted through the kidneys. Other toxins you consume by choice, such as alcohol, caffeine, and prescription drugs (more about these later). Still others are the thousands of toxic chemicals we breathe, consume, or touch in our environment: pesticides, car exhaust, secondhand smoke, chemical food additives, and indoor pollutants from paint, carpets and cleaners, among others. Under ordinary circumstances, your body handles toxins by (1) neutralizing them, as antioxidants neutralize free radicals, (2) transforming them, as fat-soluble chemicals are transformed to water-soluble ones, and (3) eliminating them through urine, feces, sweat, mucus, and breath. Working with your lungs, skin, kidneys, and intestines, a healthy liver detoxifies many harmful substances and eliminates them without contaminating the bloodstream.

The detoxification process has two phases that should work in close synchronization.

Phase 1 uses a group of enzymes to break apart the chemical bonds holding the toxins together. Known as hydroxylation, phase 1 makes some toxins more water soluble and temporarily more chemically active.

Phase 2, known as conjugation, attaches other enzymes to the chemically altered toxins, or intermediates. These enzymes complete the conversion of the intermediates, producing substances that are nontoxic, water-soluble, and easily excreted.

When the Liver is Overloaded?

Your liver is a workhorse that can even regenerate its own damaged cells. However, it is not invincible. When it lacks essential nutrients or when it is overwhelmed by toxins, it no longer performs as it should. Hormone imbalances may develop. Fat may accumulate in the liver and then just under the skin or in other organs. Toxins build up and get into your bloodstream. Among the signs of "toxic liver" are:

• Weight gain, especially around the abdomen
  
• Cellulite
  
• Abdominal bloating
  
• Indigestion
  
• High Blood pressure
  
• Elevated cholesterol
  
• Fatigue
  
• Mood swings
  
• Depression
  
• Skin rashes

When your liver is sluggish, every organ in your body is affected, and your weight loss efforts are blocked. Blood vessels enlarge, and blood flow becomes restricted. A toxic liver is unable to break down the adrenal hormone aldosterone, which accumulates to retain sodium (and water) and suppress potassium. This can raise your blood pressure. The liver fails to detoxify the components of estrogen (estrone and estradiol) for excretion, so symptoms of estrogen dominance arise. Unable to carry out its activities to control glucose, a toxic liver can lead to hypoglycemia, which can produce sugar cravings, weight gain, and Candida overgrowth. Fluid accumulates, and you may develop one or more autoimmune diseases such as lupus or arthritis. A liver overloaded with pollutants and toxins cannot efficiently burn body fat, and thus will sabotage your weight loss efforts.