Local dietitians weigh in on Dr. Phil's new role as diet guru

By Judith Blake
Seattle Times staff reporter

	AP TV psychologist Phil McGraw's weight-loss advice emphasizes the power of positive thinking and behavior-changing techniques.
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Somewhere in between, it seems. Some nutrition professionals praise Phil McGraw's advice as essentially sound, if not exactly new. But at least one expert contends it's not only a rehash of old ideas, but in certain instances, incorrect. And some are leery of a weight-loss guru who lends his name to dietary supplements, as McGraw has done with the Shape Up brand.

TV psychologist McGraw — "Dr. Phil" to his fans — offers his take on fighting flab in his new book, "The Ultimate Weight Solution: The 7 Keys to Weight Loss Freedom" (Free Press, $26).

His method emphasizes positive thinking, behavior-changing techniques and a supportive environment, though he also gives attention to diet and exercise.

"His number one key is to change your basic thinking" to a can-do outlook, "and I would totally agree with that," said Seattle registered dietitian Kathleen Mahan, noting that the self-esteem of obese people is often "in the pits."

Mahan, who works with overweight and other patients in private practice, lectures on nutrition at the University of Washington and is co-author of the nation's most widely used college nutrition textbook, found McGraw's dietary advice generally sound, though she disagreed with certain details.

As blunt in his book as he is on his show, McGraw delivers this opening message on shedding pounds permanently: To succeed, "get real."

"I know you are looking for something that melts fat off like the sun melts ice," he writes. However, "experience has taught me that effective weight control will never be quick and easy, but it is doable."

McGraw says he has counseled patients on weight loss for more than 30 years, eight of those focusing on individuals who were 100, 200, 300 or more pounds overweight.

He claims that more than 80 percent of these severely obese patients lost their excess weight and kept it off using his strategies — an exceptionally high success rate, if true.

McGraw devotes a chapter to each of his seven keys to weight control:

Key one: "Right thinking." It's essential to "get rid of self-defeating thought patterns and believe you will succeed," writes McGraw, offering techniques to that end.

Key two: "Healing feelings," or learning to prevent overeating linked to emotions such as anger, guilt, loneliness, stress or boredom.

"Glossing over this key, or denying that you have emotional issues with food, is a deal breaker," says McGraw.

Key three: "A no-fail environment." Some of his tips: Keep troublesome foods — cookies, potato chips or any food you habitually binge on — out of your house; stock the fridge and pantry with veggies and other healthy foods; shop with a list and stick to it; and give away your "fat wardrobe" as you lose weight.

Key four: "Mastery over food and impulse eating." Among his ideas: Eat only at the dining table, not in front of the TV; completely chew and swallow each bite before taking another; chew sugar-free gum while cooking, to avoid sampling; take a brief break between dinner courses; and brush your teeth immediately after dinner to discourage later snacking.

Key five: "High-response cost, high-yield nutrition." McGraw's cumbersome term means you should choose foods that take time and effort to prepare and eat and that offer high nutrition and low calories.

"By the time you chew and swallow (such foods), you're starting to feel full, so there is little chance that you will overeat," McGraw contends. Example: raw broccoli, which is highly nutritious but takes time to chew.

Among his favored foods: fresh vegetables and fruits, legumes, whole grains and products made from them, fish, tofu, lean meats, eggs and nonfat dairy products.

Fast foods, he says, are not only often calorie-laden, but are too quick and easy to purchase and consume, leading to overeating.

Key six: "Intentional exercise." Permanent weight control is impossible without it, says McGraw, offering tips to make exercise effective, enjoyable and a daily habit.

Key seven: "Your circle of support." Build support for your efforts among family and friends.

Mahan, the Seattle nutrition expert, said that while most of McGraw's behavioral advice isn't new, it's sensible and fits with what she's observed in her own practice.

"He's just putting it in different words," but that's fine if those words motivate his readers, she said.

Though she likes most of his diet advice, she disapproves of certain details, such as including orange juice in a breakfast menu. Better, she said, would be a whole orange, requiring more time to peel and eat.

Less approving is Lisa Dorfman, a Florida dietitian who reviewed McGraw's book as a spokeswoman for the American Dietetic Association.

Dorfman likes McGraw's exercise chapter and says "there's no question" that behavior modification and changes in thinking, combined with appropriate diet and exercise, can lead to long-term weight control.

But she says McGraw's diet "basically boils down to a low-calorie, high-protein diet deficient in several vitamins and minerals," as she contends a computerized dietary analysis of his menus has revealed.

Dorfman asserts there's no scientific evidence to support McGraw's claim that certain vitamin/mineral/herbal supplements can help control weight in people with apple- or pear-shaped bodies. Some stores now carry a McGraw-endorsed Shape Up supplement billed as "weight management and complete multivitamin for apple body types" and another for pear-shaped people.

Dorfman also takes aim at the Shape Up nutritional bar, saying it contains more than two teaspoons of refined sugar, as well as palm kernel oil, a source of saturated fat. Though McGraw doesn't specify a brand in his book, his food plan includes occasional use of such meal-replacement bars. His Web site recommends Shape Up by name.

Still, for many who hope to trim down, it may not be Dr. Phil's specific dietary advice or products — good or bad — but his get-real and get-going attitude that might spur them to action for the long haul.

Judith Blake: jblake@seattletimes.com

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