Q&A with Reza Yavari, M.D.

by Charles Stuart Platkin www.thedietdetective.com.

REZA YAVARI, M.D. is the founder of the Connecticut-based Beyond Care, LLC,(www.beyondcare.net), a lifestyle-management center that focuses on endocrine and metabolic disorders, and is also a faculty member of the Yale University School of Medicine. He is the author of a book on metabolic syndrome titled It Must Be My Metabolism! (McGraw-Hill, 2005). This first "advice book" on therapeutic lifestyle change to reverse metabolic syndrome by losing excess body fat.

Platkin: Tell us how you got to where you are now.

Dr. Yavari: As an endocrinologist, I have always been interested in hormonal and metabolic disorders such as diabetes, obesity, thyroid disease, menopause, among others. However, instead of just diagnosing and medicating my patients, I wanted to offer them lifestyle change solutions to enhance their health and prevent disease. So, six years ago I created a lifestyle management center called Beyond Care (www.beyondcare.net), which offers medically supervised programs including fitness, stress reduction, nutrition intervention as well as hormonal and metabolic evaluations. There was clearly a need for this new "lifestyle medicine" approach and I was asked to write a book about it (published by Mc-Craw Hill and titled It Must Be My Metabolism) and recently asked to launch a national program called MDiet (www.mdiet.net).

Platkin: Define and discuss failure.

Dr. Yavari: There is no failure or success! But there are degrees of failure and degrees of success. "Black and white" thinking is a common cognitive obstacle in lifestyle change for weight loss. If one loses weight but is still unhappy and stressed out is that a failure? Well, that person has succeeded in overcoming one challenge but there is more work to do. Satisfaction comes from overcoming challenges we face. Everyday we fail a little and succeed a little. If we try to enhance our lives in incremental steps we are more likely to achieve wellbeing. For every small successful step we take, we should reward ourselves to keep the spirit of change going. After every failed attempt or a setback we should pick up where we left and again reward ourselves for resuming our efforts.

Platkin: Is there anything about yourself that you've changed your mind about in the last 20 years?

Dr. Yavari: Yes! I always thought that money and power made the world go around. But I have reached the conclusion that emotion is the main motivator for most of our actions. Guilt, regrets, envy, loneliness, sadness are examples of negative emotions that often make us behave in unhealthy ways such as indulging in stress-related eating. Love, kindness, fulfillment, gratification are among positive emotions that keep us going. Much of obesity is related to emotions. How many people do we know who gain weight when they are going through a divorce, or are planning a wedding, or when they suffer setbacks? We are emotional beings first and rational second.

Platkin: What's the next major item on your "to-do" list?

Dr. Yavari: Every item on my list of "to-do" tasks is a major one - or at least it appears like that. I have always had my plate full and I let life pick the next one. Currently, my list includes next book(s), publishing research articles, expanding my national and local businesses. But it also includes planning a meditation retreat for me, training my puppy, reaching out to friends and family. A big one is to prepare my kids for a rich and happy life.

Platkin: Define individual responsibility and how you react to adverse situations.

Dr. Yavari: I believe that in real life - not in philosophy books - there is a balance between individual responsibility and luck (good or bad.) We often say "when life gives you lemons, make lemonade," meaning that life hands us cards to play, and they can be good or bad cards. But if we do not know how to play we lose anyway. I react to adverse situations by contemplation, relaxation and self-assessment. When the going gets tough and stress level is high, I spend more time exercising, doing yoga and breath work, listening to music and getting massages. I have learned from personal experience that by doing so I handle difficult times more effectively.

Platkin: When do you have time to think about your mistakes, mishaps, achievements, and minor victories; in other words, do you have any reflective time for yourself of your career?

Dr. Yavari: I often think about my life, my past mistakes, my future strategies when I am either exercising or when I am traveling (mostly on the plane.) I find yoga and simple aerobic workouts particularly useful for introspection. As a rule, during these sessions I do not pursue stressful thoughts - I let them go - but I follow deeper thoughts that I find revealing or inspiring.

Platkin: What is your most influential story, fiction or nonfiction, from a film, book, magazine, newspaper or parable? Explain its impact on your life? What's you're favorite saying?

Dr. Yavari: Sorry, I do not have a single most influential story but many. Every day that I counsel my patients, they share their stories with me. Each one is different and every single story has an impact on my life. I don't have a favorite saying either but I do tend to repeat "no" in ten different languages - as a joke!!

Platkin: Was there a defining moment in your life when you made a decision that changed the course of the rest of your life forever?

Dr. Yavari: I decided to quit my last job and go on my own after I started weight training eight years ago. There was something very empowering about that training that helped me reach the decision that I could start my own medical practice. That experience still allows me take on new challenges: whether to learn to sea kayak or to agree to write a book.

Platkin: What's the most bodacious chance you've ever taken?

Dr. Yavari: As a young man I dropped out of graduate school at UC Berkeley to follow my future wife to Paris. As it turned out it was the best thing that happened to me. However, in everyone else's eyes I took a huge risk leaving a great career for an unpredictable future with another equally "flighty" person. My wife and I have been together 26 years and often go back to Paris to re-live those moments!

Platkin: What's the biggest lesson you've learned about yourself? What's the biggest lesson you haven't learned?

Dr. Yavari: I have learned that I am very good at thinking of new ideas and creating new things but not so good at following them through. I get bored with the daily routine. One way to combat that is to always combine the daily routine with new "pet projects" or new initiatives. For me, combining the mundane with the extraordinary is just what the doctor ordered. As for the lessons to learn, I will get there in due time.

Platkin: What keeps you going (your motivation)?

Dr. Yavari: From a purely emotional angle, I see my life as a series of creative and worthy projects lined up for the foreseeable future. I like to accomplish every one of them. From a realistic and rational perspective, I like to create a rich and meaningful life for my children and all my loved ones.

Platkin: How do you stick to your diet on days when you really don't want to? What are techniques you use to stay on track?

Dr. Yavari: I do not follow a diet now. I make sure I am never hungry or forced to eat the wrong choice because I did not plan. I try to have healthy snacks and protein bars with me all the time - to hold me over till I can eat healthy foods. My current eating pattern and food choices are my way of eating so there are no days that I "do not" want to follow it. However, there are days that I cannot because I travel a lot and sometimes things do not go as planned. On those days I try to make the best of it and put things in perspective: there is always tomorrow!

Platkin: If you could eat one forbidden food whenever you wanted without gaining weight, what would it be?

Dr. Yavari: Probably really tasty farmer cheeses. I love great cheeses. But they often pack a lot of calories and cholesterol.

Platkin: What dessert do you dream about?

Dr. Yavari: I am not a "dessert person." I prefer to save my calories for a real good piece of French cheese. However a little chocolate raspberry cake would be nice!

Platkin: If there were one healthy food item (something you love) that you had to eat every day, what would it be?

Dr. Yavari: I love fruits in particular berries. I could eat berries all day! I also really enjoy cooking with mushrooms. I try to use exotic mushrooms every time I cook.

Platkin: What do you think is the most important thing that makes or breaks a diet for someone?

Dr. Yavari: Weight loss has to be a "pull" not a "push." Meaning: that the dieter has to be pulled or has to be drawn to her or his weight loss goal not forced to or talked into doing it. People stop dieting because they lose sight of why the started or get demotivated. One factor that demotivates people is too much restriction. Restrictive diets or complex diets often increase the dieters' stress level and they ultimately stop. Diets have to personalized, easy to do and not too restrictive. Weight loss can not be rushed or forced.

Platkin: How did you come to your conclusions about weight loss and dieting?

Dr. Yavari: Clinical experience: I have counseled thousands of patients and learned from them. As an endocrinologist and expert in the field, I understand the underlying neuro-hormonal regulation of eating and satiety, weight gain and dieting. We aim healthy lifestyle change as our goal and consider weight loss as a consequence of that and not as the main goal. Dieting without healthy lifestyle change including exercise, stress reduction and cognitive shifting will not work.

Platkin: Do you think that failed attempts have influenced your approach to dieting? How have past struggles help you find a system that works for you?

Dr. Yavari: I have learned a lot from my patients' failed attempts. They all have one thing in common. Their attempts did not encompass lifestyle change but were just another diet. Just because some author wrote a book about dieting, or just because a diet is currently fashionable, it does not mean that it will work for me. Lifestyle change and dieting need coaching. That is why we always recommend seeing dietitians on a regular basis to customize the diet to that individual's preferences and life conditions. Customization and coaching are key.

Platkin: Have you dealt with weight issues personally?

Dr. Yavari: Yes. I gained weight when I was unhappy in my previous job. I hired a personal trainer, lost the weight and quit my job. I would like to lose a little more weight but I am relatively lean and healthy so I plan to get to my goal slowly.

Platkin: What's the best book about health that you've read?

Dr. Yavari: My own book: It Must Be My Metabolism!

Platkin: What are your two favorite health magazines?

Dr. Yavari: I like Prevention and Self. But I also enjoy a variety of other magazines (as a consumer not an expert): Outside, O, Men's Health.

Platkin: What do you consider the world's most perfect food? Please be specific and try not to answer with a category but rather with a specific food item: for example, not "whole grain" but "raisin bran cereal"?

Dr. Yavari: Wild mushrooms. They are loaded with minerals, vitamin D, fiber and flavor and they have medicinal properties. They add great aroma and flavor to all kinds of dishes.

Platkin: What physical activity do you do to keep yourself in shape?

Dr. Yavari: I do a number of different exercises depending on my mood, how my body feels and how much time I have. I enjoy Kundalini and Vinyasa yoga a lot. I do all my weight training on the physioball. I like the cross trainer and rowing machine for aerobic work outs. But currently, I am in Pilates kick: I get the best work outs ever on the "reformer" and the "Cadillac."

Platkin: Do you have a favorite healthy recipe or cooking tip? If so would you share it?

Dr. Yavari: My book has recipes by the celebrity TV chef Jacques Pépin. These recipes are chosen because they fit with our diet but also because they could be used as leftovers, used in omelets or as side dishes. I also recommend one of Jacques' old books called Healthy and Simple Cooking as a source of great recipes. I have cooked a lot of those recipes and most of them can be used in a weight loss diet. Currently, I am into Moroccan cooking. My favorite is a tamarind chicken dish cooked slowly with vegetables, nuts and berries.

Platkin: Do you have a Calorie Bargain? What food did it replace? Was that an important food in your diet, since you ate it so often?

Dr. Yavari: I recommend eating lean high-protein snacks or meals every three hours. That keeps the satiety hormone level high and the appetite hormone in check. This way we are never hungry and keep our cravings under control. Once we are able to control our appetite we can settle for calorie bargains. A good calorie bargain for night time use is low fat popcorn instead of other calorie-dense snacks. We also recommend broth for night time use. Finally low-calorie protein bars, puddings, and shakes are always handy.