Speaking With...: Ian Smith

Most of you know him simply as "Doctor Ian," nutrition expert on Vh1's Celebrity Fit Club, creator of the 50 Million Pound Challenge, host of the nationally syndicated radio show HealthWatch on American Urban Radio Networks, and author of #1 New York Times Bestsellers like The Fat Smash Diet.

Yesterday, Dr. Smith -- a graduate of the University of Chicago Pritzker School of Medicine -- launched his latest work, The 4 Day Diet, which is composed of a variety of 4-day modules.

My e-mail interview with him, transcribed below, covers the new book (I received an advance copy last month in preparation for our correspondence) as well as other current issues of interest in the fields of nutrition and public health.

The concept of motivation plays a significant role in this book. What motivated you to pen The 4 Day Diet?

So many people who I've worked with over the years have always talked about a lack of motivation or the inability to stay motivated. They wanted to know how to figure out a solution to this deficit.

I looked at all of the best diet books and none of them really gave the topic of motivation any real coverage. I know as a fact that the mental part of dieting is the most critical, because if your mind isn't in the right place, then regardless of how good the plan might be, you're not going to succeed.

The 4 Day Diet is my rendition of a COMPLETE program. There's the mental plan, diet plan, and exercise plan. The people who I worked with while creating this program not only lost a lot of weight, they lost it consistently and they constantly told me how "doable" the program was compared to others they had followed.

I also wrote the 4 Day Diet so that if parents want to put the entire family on a program, this could be that program. Most diet plans are not kid-friendly, but the 4 Day Diet is one that everyone can enjoy and see results.

The psychological and emotional factors behind weight loss are thoroughly explored in The 4 Day Diet. Do you recommend that, if financially possible, people simultaneously seek psychological counseling before/while trying to achieve significant weight loss?

In the best of worlds, people who need to lose a serious amount of weight or who have some psychological component to their cause(s) for being overweight would seek some type of psychological consultation. It's not because they're crazy or not smart. It's because sometimes we have anxiety or stress-related problems and don't even know it, and a professional might help tease these problems out.

I know that everyone can't afford to go to a psychiatrist/psychologist or doesn't want to go, so that's why I've included this material in the 4 Day Diet.

A lot of people will learn more about the cause of their problems and the strategies they can employ to solve them as they go on and lose the weight while regaining their health.

On a similar note, do you think periods of high stress are not a good time to begin implementing dietary changes?

One of the worst times to start a diet program is during a period of high stress. I tell people all the time, if you have some type of major life disruption such as relationship problems, job problems, financial crisis, loss of a loved one, medical crisis--these are not the times to undertake a diet program.

Unfortunately, too many people start a program simply because they believe it's the right time on the calendar to do so and they don't make sure it's the right time in their life. Success is more attainable if one begins this journey at the most appropriate time.

That being said, one must also guard against coming up with every excuse in the book as to why they shouldn't lose weight. Major stress-inducing situations are the only things that should stand in the way, not the small stuff.

Are you at all concerned the "Be Thinner by Friday!" label on the cover of the book can set up unrealistic expectations in readers or make this look like a gimmick?

There is that risk and to be honest I wrestled with the idea of putting it on the cover. I had those exact concerns, but the publishing team felt as though given my history of creating medically sound programs and being honest with people, that they would not interpret it as a gimmick.

The truth of the matter is that with the 4 day detox that's at the beginning of the program, people will lose weight right away. Will they lose all of their weight? NO WAY! That's not what I'm saying. They will lose weight and they will think differently.

One of the chapters talks about "thinking thin." That is as important as the physical part of looking thin. So, people will be thinner by Friday not just physically but mentally, and they will be on the road to significant changes if they stick to the plan.

Is there a particular reason why the modules [in the diet plan] only allow one teaspoon of milk (even skim or low fat) in coffee?

Great question. The honest answer is that people tend to go overboard. If the limit is 1 teaspoon, then most people are going to have 2. If I said 2 teaspoons were allowed, then they would rationalize having 3. Sometimes you can't win.

The major point with this is that you must try to cut calories wherever possible, even a small amount. If you get into the behavior of cutting calories with drinking coffee, then you're also likely to do the same when there are bigger calories at stake such as eating an entree or dessert.

It's all about learning how to make lifestyle changes that will lead to permanent good health.

What is your approach to people who "excuse themselves" from ever attempting to lose weight by saying "it's just how they are built" because they come from "large families"?

This is one of the most frustrating excuses I hear when people talk about reasons they don't try or can't lose weight. The truth of the matter is that unless one has a genetic medical condition that has been inherited from their family, there really is no such thing as "coming from a large family, therefore it's inevitable that they are large."

Can you come from a tall family? Yes. But that's genetic. Weight is rarely genetic. Families tend to be large because the choices they make from a dietary and exercise perspective make them large. There are no genetic plans that say everyone in a family is going to be 50 pounds overweight.

But if there's a medical condition that's inherited, then that's a different story. The truth is that you have a better chance of winning the lottery than truly being large "because your family is large."

Only 40 percent of medical schools in the United States offer a nutrition course. Of that 40 percent, very few actually require it as part of their curriculum. What are your thoughts on the apparent dismissal of nutrition that appears to be prevalent in the medical field (i.e.: "to lower blood pressure, take this pill, rather than be mindful of sodium and potassium intake.")

I think the lack of nutritional education is medical schools is a tremendous oversight and we are now seeing the manifestation of it with the obesity crisis we're now facing. More doctors and nurses need to know a lot more about nutrition and supplements and non-medicinal ways to control weight.

Obesity is a medical epidemic just like the plague was an epidemic. The front line fighters against this epidemic should be the doctors and nurses and other healthcare professionals. But there's not enough nutritional and related training, thus they are not effective at fighting on the front lines.

Are doctors entirely to blame for the obesity crisis? Absolutely not. Do doctors share some of the blame? Absolutely. I hope in the coming years that medical schools will see the need to take nutrition as serious as they take pharmacology and physiology and help train a new generation of obesity fighters.

Mandatory calorie labeling has proven to be a successful policy in New York City. What are some other public health nutrition policies you would like to see implemented in the coming years to help people achieve their health goals?

I think NYC has gotten off to a good start and I hope it proves successful and others will follow this lead. There are lots of health nutrition policies that should be implemented over the coming years to help cut into our obesity problem.

I think that schools across the country are getting an F grade when it comes to providing healthy food for our children. This is an embarrassment for the US, a country so rich and so full of resources and intellectual capital. Our children need to be served healthier food and mandated to participate in regular physical activity. At a time when we need children to be more active, we're dramatically cutting funding to programs and classes that would help our children get moving and lose some of this weight that will only harm them in their adult years.

I also believe that the government needs to be more instrumental in helping lower-income areas attract healthier grocery stores. Too many neighborhoods have nowhere to shop but stores that sell unhealthy, calorie-rich, sweet, processed foods and not enough natural, fresh food.

Yes, the communities must first want and then work to get these stores in their communities, but the government at some level should step in and play some role in incentivizing businesses to set up shop in these very needy communities. Remember, the healthier our fellow citizens, the healthier we all are!

Many thanks to Dr. Smith for taking time to participate in Small Bites' "Speaking With" section!