Chapter 1

YOU TOO CAN BE SUCCESSFUL

Anybody who can read this book can succeed in losing weight if they really want to and they can maintain that weight loss for the rest of their lives. That's the way I began the original Charleston Program way back in 1988 and That's what I still believe today about this new and improved edition.

This book and the program in it are for people who want Permanent Weight Loss. If you are tired of going from fad diet to fad diet, always trying for the quick fix, and if you want a medically approved, safe diet that will work forever this is the book for you.

The New Charleston Program has been designed for people who are anywhere from five to 200 pounds overweight. It will work not only for the slightly overweight person who needs to lose a few pounds to look good in a bathing suit, but also for the very obese person who has tried to lose weight for years.

YOU HAVE A RIGHT TO BE THIN

We are going to teach you what you need to know to be in control, to make the right food choices, and to stay in a positive, motivated mind-set that allows you to do what you need to do to be thin, including coping with diet saboteurs.

Realize that your brain is the most important weight-control organ of your body. There are reasons why you overeat. Once you understand these reasons - once you identify what patterns of life are causing you to be overweight - then you can eliminate those patterns and replace them with healthier, conscious behaviors.

In this book, we will give you the tools to change these patterns. Once you do that, losing weight is a cinch.

WHY THIS BOOK IS DIFFERENT

Despite a plethora of fad diets, overweight/obesity is one the most difficult and discouraging health problems faced by many people. Many people can lose weight but few can keep off the lost pounds. If you have tried diet after diet, but have never managed to keep off the weight you lost, you are not alone. Most persons return to their pretreatment weight within five years. 

Why? it's because diets are not the answer. Take the letter "t" away from the word diet. See what you are left with? That's what many people feel like doing when on diets - they feel so deprived that they believe they are going to die. As a result, when they fall off of a diet they overeat and rapidly regain the lost weight.

In recent years the goals and methods of obesity treatment have changed because of the realization that rapid weight loss sets one up to regain it. Doctors also now realize that losing as little as 5% of body weight can offer protection against the complications of obesity, complications such as diabetes. The new goal, according to The Merck Manual, a medical reference text so used by doctors that it is called "The Physician's Bible," is weight management, achieving the best weight possible in the context of one's overall health.

In reality, except on the Internet, diets are rarely prescribed by medical doctors now. Most authorities now recommend safe, sensible, and gradual changes in eating patterns. The changes include increased intake of complex carbohydrates including fruits, vegetables, breads, cereals, and pasta, and decreased intake of fat and sugar. Those are the food that The New Charleston Program: The Permanent Weight Control Solution is all about. BUT THIS BOOK IS ABOUT MORE THAN FOOD. It is about reshaping your behaviour and your body!.

YOU CAN RESHAPE YOUR EATING - AND YOUR BODY!

The behavior changes begin at the grocery store. It is essential to buy the right foods, those with complex carbohydrates and ignore those with high levels of fat and sugar. 

That's not hard to do when you know what to buy. Chapters Four, "The Charleston Program Food Plan, and Chapter Five, "Tips to Make the Program Work, will guide you.

Behaviorists emphasize that overweight people can change themselves, but that doing so involves changing habits, indeed, one's manner of living. That may sound scary to you, but it's really easier than you think. The secret of success is a simple of setting achievable, measurable goals (Chapter Three) and learning to identify what triggers own overeating, and then learning to deal with those environment triggers, and with people in your life who might be encouraging you to overeat (Chapters Six).

There are many situations that trigger the urge to eat. Once you identify them, you can change your environment to eliminate the trigger. Do you want a sneak peak about what I am talking about? Of course, you do. Among the many overeating triggers are:

1. Eating place. Certain locations become associated with eating. For instance, some people always eat in the kitchen. One of my patients would come home after work, park her car, enter her home through the back door to the kitchen, and go directly to the refrigerator for a snack. She broke that pattern by altering her route. On arriving home, she entered through her front door and went directly to her bedroom to wash up and change clothes. By avoiding the kitchen until meal time, she avoided triggering her hunger.

2. Social Situations. Some people always eat while visiting certain friends who encourage them to try "special recipes." Such situations can be avoided by learning assertiveness skills in order to refuse the tempting creations. Being assertive doesn't mean being aggressive. Assertive people are those who act in their own best interest, are able to express their feelings clearly and honestly, and accept responsibility for their own actions. They can chose to refuse food when it is offered without feeling guilty and without offending. An honest, quiet statement such as, "thanks, but I really don't want any" asserts your wishes without hostility. 

3. The sight, smell and thought of food can also be an overeating trigger. The sound of the ice cream truck's music or commercials on TV can inspire cravings. But cravings can be calmed. First, tell yourself, "I don't need what I want." Then engage in some activity that will take your mind away from the craving.

Emotional states drive many people to overeat. Anger, stress, hostility, frustration, even boredom can induce feelings many of us interpret as the beginnings of hunger. 

Later on I will help you develop a plan about what to do when those emotional states reoccur. You can learn other, healthier behaviors. Chapters Eight, "Learning the Skill of Willpower, and Chapter Ten, "How to Cope with Saboteurs and Food-Pushers will help you by providing detailed, easy-to-implement information

When attempting to make major habit changes, rewards are essential. Learn to give yourself a well-deserved pat on the back or other reward when you recognize that you have avoided a trigger that used to cause you to eat inappropriately. Don't forget to give yourself tangible rewards. Buy yourself a ticket to a concert or a play, buy a CD or an exciting book. Do whatever it takes to give yourself a good feeling. You will learn more about strategies for success and how to handle hunger, cravings, and binges in Chapters Eight and Nine. 

Chapter Ten will help you deal with diet "saboteurs and other "food pushers while Chapter Eleven aids you to "Keep Your Weight Down While Living It up on Holidays and in Restaurants.

You Don,t Have to Sweat to Lose Weight Another self-care method of combating overweight and obesity is increasing your physical activity. A sedentary lifestyle is a risk factor not only for overweight and obesity, but also for cardiovascular disease. You're never too old to increase your level of physical activity. Even people with physical limitations and chronic conditions can benefit from increased activity. Some people believe that the only way to increase physical activity is through rigorous exercise. They think they have to work out in a sweatsuit and perspire profusely to the point of exhaustion. Not true. It is possible to combat overweight and obesity without torturous exercises. 

Simple walking is one of the best activities to stimulate your circulation, improve the pumping of your heart, and generally make you feel better. Flexibility activities will help you to move more easily and allow you to do the daily tasks necessary for long-term independent living and self-reliance. Most people just think of simple stretching when they think of flexibility exercises, but gardening, washing and waxing the car, mopping the floor, vacuuming, and yard work are also flexibility exercises. Golf, yoga, bowling, T'ai Chi, and dancing also enhance flexibility. In Chapter Seven, I also recommend strength and balance activities. These are activities that challenge all your muscles. They involve pulling, pushing, lifting and carrying. Lifting weights as light as soup cans can be helpful. Carrying groceries or carrying the laundry count as does climbing stairs or doing wall push-ups. To learn more, read Chapter Seven, The Charleston Program Exercise Plan. You will be surprised how easy it is to put more physical activity into your life. 

So, even if you have tried diet after diet, but have never managed to keep off the weight you lost, even if you've been to fat farms, diet clinics, diet doctors, diet groups, and have had shots, medications, wraps, massages, or even surgical procedures, and you're still fat, you can still be helped on this program. That's MY PROMISE. The patients on the Charleston Program have done it and you can too. 

You can get off the roller coaster of fasting and feasting and learn how to eat and look like a thin person for the rest of your life. will no longer have to just dream about waking up thin some day; you can start doing something about it. And you can do it without feeling deprived.

And - this is important - the weight loss will be safe. It won't leave flabby, ugly skin folds on your body. And it's consistent - you keep losing pounds week after week after week until you reach the goal you want.

Overweight people can change themselves. With the right program, they can lose unsightly, unhealthy extra pounds and remodel themselves to be slim and trim. it's a joy and satisfaction to me I see it happen and I do see it happen with so many of my patients. They pound after pound and transform themselves into new persons - slimmer, trimmer, happier and healthier persons.

REMEMBER, THE AVERAGE DIET SIMPLY DOESN'T WORK

Even Obesity and Bariatric Medicine, the professional journal for diet doctors, points out that there has been little change in the dismal "success" rate of weight-reduction therapy in the past 25 years. The reason: much of the advice given in the past has been wrong. The article suggests taking a closer look at slim people " and finding out what they do right to be successful at weight control.  And that's what this program does. It will teach you how to eat and live like a thin person. Once you learn the new principles of how to do this, you should have no trouble losing weight and keeping it off. You can and will lose weight and maintain your weight loss if you follow the guidelines.

Most old-fashioned diets tell you what to eat, when to eat, and how much to eat, but they don't tell you other essential things about how to lose weight and especially about how to keep it off. Unlike a "diet" the Charleston Program tells you all the things you need to do to keep the pounds off for life. The program gives you the total support system that you vitally need for the changes you want to make.

New information has been learned to change approaches to weight loss. Nutritionists and medical scientists have learned more about the factors that really control weight, and new research has exploded many old ideas about weight gain and loss. The new research also sheds light on why most diets in the past have eventually failed.

For example, we now know that there is more to losing weight than just cutting back on calorie intake. To lose weight permanently you have to identify the environmental and social cues that stimulate you to overeat. We now know that you don't have to live with hunger to lose weight. The Charleston Program incorporates nutrient-dense foods that will fill you up and allow you to lose weight without feeling hungry all the time.

We now know that even on the best diet, unless you modify your habits and behavior, you'll regain lost weight. Only through a reshaping of attitudes, eating, and activity habits will you have a chance for long-term weight-loss success. This book will give you a powerful but easy-to-learn toolkit of techniques to accomplish this.

Many people have known intuitively that they have a slow metabolism, but have been unable to do anything about it or to get their doctors to do anything about it. We now know that metabolism can be increased by either one or a combination of several factors; by using these factors to increase your metabolism, you'll find that you lose weight and maintain that loss much more easily.

Specific food groups can actually alter your metabolic rate. For instance, the ingestion of carbohydrate or protein triggers a "processing mechanism" that involves the expenditure of approximately 25 percent of the calories involved. On the other hand, fat requires only about two percent of the calories involved to complete the processing. So, in effect, when using carbohydrate or protein instead of fat, you've increased your effective metabolism considerably " and your body does much of the "work" for you.

Another method of increasing your metabolism is through the use of exercise. During exercise, the metabolism increases markedly (depending on the type of exercise being done), but then you get a bonus. The metabolism stays elevated for a full eight-hour period. This recent discovery means that exercise pays off not just once, but twice. It makes your body burn calories while you are exercising, and also speeds up your metabolism so that even after you have stopped exercising " even while you are asleep " your body continues to burn calories up to 20 percent more rapidly than normal. Also the metabolism is affected by WHEN you exercise. Morning is better than evening for metabolic increase. And to maximize benefit, twice daily is better than once daily.

So by using a combination of these methods, you'll be able to increase your metabolism to a significant degree and, in so doing, improve your rate of weight loss and ability to sustain that loss.

The total plan should enable you to permanently lose weight even when you have never been able to lose weight before.

NOT A `DIET' BUT A TOTAL WEIGHT-LOSS PROGRAM

The program will start by showing you how to lay the groundwork for your weight loss. It will help you determine how overweight you are and what your ideal weight should be, and it will help you learn how to pinpoint your particular problem areas that keep you from losing weight " and keeping it off.

It will tell you about pattern restructuring " a method better than behavior modification to change fat-producing habits to fat-burning habits. It will teach you how to change your "crooked" thoughts " the negative thinking that sabotages successful dieting. It will teach you how to use "self-talk" that will help you accomplish this. It will teach you how to rely on yourself to cope with the stresses and triggers that make you overeat so that you take control of situations that previously would have caused you to overeat, even dealing with the manipulators and saboteurs who want to sabotage your weight-loss efforts.

You will discover how to fat-proof your house, how to decalorize almost any recipe, how to use water to help you reduce, and how to cook in the least fattening ways.

You will find out about painless and practical techniques to increase physical activity, conquer sluggishness and fatigue, and increase stamina and endurance without killing yourself. You will learn an easy, safe exercise program that will burn up fat, inhibit the hunger urge, and help you feel better and sleep better as well as put more pep and zest in your life.

The Charleston Program shatters the false idea that a dieter is not responsible for his or her eating choices. It shows you how to assume responsibility for your own eating behavior, the key element to successful weight control.

People who have been on this program have told us that they " for the first time " felt in control of their lives, and their weight.

A special note from Dr. Johnson: Overweight people " especially those who need to lose 30, 40, 50 pounds or more " often feel they are doomed to be fat. But they don't have to be.

I know; I've been there. When I was in medical school " I ate when I studied or was under stress " I went from my previous slim 145 pounds to a flabby 220. When I graduated I looked for someone to tell me how to lose weight, but no physicians seemed to be interested in obesity. I finally located a doctor in Gary, Indiana who was doing some work in obesity. He was willing not only to help me lose weight, but also to teach me what he knew about the process.

From the beginning I became interested in the specialty of bariatrics (weight loss). I now have been in medical practice for more than 30 years, am founder and director of the Bariatric Medicine Center in Charleston, South Carolina, have been president and chairman of the board of directors of the American Society of Bariatric Physicians (the national professional association for physicians specializing in problems of obesity), have taught thousands of other physicians how to help their patients, and have designed motivational programs used all over the world by physicians and patients and such programs as Medifast.

I have brought all the knowledge that I have gained over the years " knowledge that has helped over 13,000 of my own patients and tens of thousands of other physicians' patients " to this book to help you win your battle of weight once and for all.

One lady who lived some 90 miles away used to drive in to the office every week. In a little over a year she lost 165 pounds. Another lady who lived in Charleston was able to lose 125 pounds in just over seven months. They both have kept their weight off.

Another typical patient was Mrs. J.B. who lost 113 pounds in five and one-half months on the program, and kept it off.

"Before going on Dr. Johnson's program, my weight was 396 pounds," she said. "I've tried just about every diet in the world from Weight-Watchers to university diets, and even pills and shots for weight loss. I lost weight on these programs, but the weight just came back again. I had given up hope. I didn't think I could ever lose weight and keep it off. I was self-conscious. I felt everyone was looking at me. I had to keep buying bigger and bigger sizes. I was tired all the time. I was angry at myself for not being able to keep the weight off. Then I discovered Dr. Johnson's program in Charleston. I didn't feel hungry or deprived on the program, I lost my weight, and thank goodness it has not come back."

Another woman " a 39-year-old schoolteacher named C.D. " told me: "I weighed 237 pounds and was afraid for my own health. Now I feel fantastic! Over a seven-month period, I lost 96-1/2 pounds. I had more energy during this period of time than I had had since I was in college." All the staff at the medical center who were in contact with C.D. said she had a complete personality change. When she first came into the center she was withdrawn, irritable, and grouchy, and cried at the drop of a hat. But after losing her weight, she became assertive enough to stand up for her own opinions while still being likable, in fact was very outgoing and pleasant, and had no more crying spells. She has maintained her weight loss for two years now, is very enthusiastic and feels very definitely that having made significant lifestyle changes she will not regain her weight.

R.H., a 37-year-old executive with a marketing firm, felt that his weight was interfering with his success in the executive suite. He had tried most of the other programs and, like other patients, had lost weight, but had never been able to maintain his weight loss. As he said, "I simply was not able to make any lifestyle changes." Within six months on our program he had lost 88 pounds. He noticed an improvement in his working effectiveness, became much happier with himself, and in fact felt so much better he was able to repair a shaky marriage.

I'VE HELPED MORE THAN 13,000 PATIENTS LOSE AN AVERAGE OF 50 POUNDS EACH. That's 650,000 pounds " an amazing 325 tons of fat! I believe the reason the patients have been so successful in losing weight is that they felt in control of their own eating.

We will tell you more about the details of the program in the next chapters.

Meanwhile, just remember: If you are concerned enough about being overweight to do something about your problem, this program can help you. It contains methods that can work for you just as they have worked for thousands of my patients.

If you sincerely want to lose weight and are willing to follow the instructions, the Charleston Program can help you lose weight AND develop new eating patterns that can last a lifetime.

My patients learned how to lose weight and keep it off. YOU CAN TOO.

You are cordially invited to join the Charleston Program so that now you can finally consider yourself on the launch pad to successfully losing weight forever.  

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