Book Review

The Cheater's Diet: Lose Weight by Taking Weekends Off

Paul Rivas, MD Reviewed by Cynthia Sass, MPH, MA, RD, LDN February 2006

Claims:

Dr. Rivas is the author of Turn Off the Hunger Switch, a board certified internist and bariatrician. Dr. Rivas states the two main reasons people are unsuccessful at weight loss involve boredom and excessive restriction. The Cheater's Diet is designed to allow the reader to enjoy food without guilt, prevent feelings of restriction and monotony and avoid the metabolic slow down caused by strict diets. The main premise of the book is you will achieve weight loss by eating healthfully throughout the week and "cheating" from 9 a.m. on Saturday to 9 p.m. on Sunday. In fact, in order to follow this plan, you must cheat as prescribed. The book also includes fitness information and brief strategies for dealing with special occasions, overcoming weight plateaus and selecting dietary supplements.

Diet Plan:

During the week, readers are advised to eat three meals and two small snacks daily. The composition and quantity of each meal is based on the plate method: one half of the plate as vegetables or fruits (or one quarter as produce and the rest empty); one quarter as lean protein; one quarter as whole grains. Visuals of appropriate portion sizes are provided, e.g., a fist for veggies, ice cream scoop for grains, deck of cards for protein. Week day snacks consist of: small portions of fruit; nuts; sugar free or low-fat hot cocoa, fudge Popsicles, yogurt or pudding; protein bars or protein shakes. Two weeks of week day menus with recipes are provided.

Day 1 sample menu:

Breakfast

Two eggs, any style (cook with Pam spray)

One medium orange or one half grapefruit

Coffee or tea with artificial sweetener and non-fat milk

Lunch

Four ounces tuna packed in water on a whole-grain pita or tortilla. Mix with olive oil or fat-free mayo or

mustard or lemon with salt and pepper

Tomato and lettuce

A serving of any vegetable

Diet iced tea or water with lemon and artificial sweetener

Snack

One handful of peanuts (fresh, dry-roasted, no salt or oil added)

Dinner

Grilled sliced chicken breast strips

Steamed broccoli and peppers

Wild rice

Snack

One cup hot cocoa, sweetened with artificial sweetener

During the week, you must avoid:

• Sugar
• Bread
• Saturated fats
• Alcohol

You must strive to include:

• Protein
• Peanuts
• Yogurt
• Fruits and vegetables
• Unsaturated fats
• Approved snacks

The Cheater's Diet (continued)

Dr. Rivas claims you must cheat on weekends in order to "stoke your metabolism" and boost fat loss. From 9 a.m. on Saturday to 9 p.m. on Sunday, you are allowed to eat whatever you want. If you prefer to count calories, you are advised to eat an additional 10 calories per pound of your body weight per day (e.g., if you weigh 150 pounds, eat an excess 1,500 calories on Saturday and on Sunday). The only foods that are off limits on cheat days are those you feel you may binge out of control on. Dr. Rivas endorses cheating on 11 particular foods because of their nutritional value. They include:

• Pizza
• Wine
• Chocolate
• Peanut butter
• Cinnamon buns
• Ice cream
• Strawberry shortcake
• Cheese
• Bread
• Meat
• Nuts

He provides an explanation for why each of these foods is linked to health benefits. Some are a real stretch: e.g., the cinnamon in cinnamon buns will help improve blood sugar control and lower LDL - this is stated even though the cinnamon is surrounded by globs of saturated fat and refined sugar.

Genetics, hormones and emotional eating are each briefly discussed. However, the basic formula for weight loss in this book is the week day per weekend diet combo and physical activity. Readers are encouraged to exercise as much as possible.

Weekly exercise plan includes:

• One N.E.A.T. (non-exercise activity thermogenesis) five days per week, such as recreational activities, yard work, etc.
• A walk at least two days per week (start with 15 minutes, work up to 45)
• Strength train 20 to 30 minutes two days per week
• Exercise after meals

There is also a section on which supplements do and do not work for weight control. Dr. Rivas states the following supplements do work:

• Yerba Mate: 225 milligrams per day
• L-tyrosine: 250 to 1,000 milligrams twice per day
• 5 HTP: 50 to 100 milligrams 20 minutes before each meal
• Green tea extract: 200 milligrams twice per day
• Mucana Pruriens: 50 milligrams twice per day

Nutritional Pros and Cons: The #1 problem with this book is no references are provided at all. Many times throughout the book, the author refers to research, yet he does not cite any of this research and the book doesn't even have an index. No references are listed to back Dr. Rivas' theory that cheating on the weekend boosts the metabolic rate, improving weight loss. Neither Dr. Rivas nor others have carried out controlled studies to test his weight loss plan. And this theory is not supported by a study conducted with participants in the National Weight Control Registry which found these successful "losers" do not cheat on the weekends, but rather indulge in "treats" in moderation consistently.

The dietary supplement recommendations in the book really concerned me. No contraindications were provided and again, this section was not referenced. According to the Natural Medicines Comprehensive Database:

The Cheater's Diet (continued)

• Yerba Mate is "possibly unsafe" during pregnancy and there is insufficient reliable evidence to rate it for obesity.
• There is no mention in the book that L-tyrosine may interfere with Levodopa or have additive effects with thyroid hormone medications.
• The thoroughly referenced NMCD rates 5 HTP as "possibly unsafe" with insufficient reliable evidence to rate it for obesity. 5 HTP may also interact with prescription meds.
• EGCG or green tea extract is also categorized as insufficient reliable evidence to rate for obesity and may react with dozens of medications including antiplatelet agents, diabetes meds, Tagamet, Clozaril, Diflucan, Lithium and many others.
• Finally, Mucana Pruriens are categorized by NMCD as "possibly unsafe" with adverse effects ranging from nausea and abdominal distention to hallucinations and paranoid delusions.

Another problem is there are no nutrition facts for either the menus or recipes in the book. There is also no mention of how to individualize the plan - it appears to be a one-size-fits-all approach. The plan is likely between 1,600 and 1,800 calories, which of course, may be too many calories for a very petite female or far too few for a muscular male (especially at the level of activity recommended).

Finally, there is no mention of working with a registered dietitian or any kind of nutrition professional, even in regards to diabetes and heart disease and no mention of exercise physiologists or trained fitness professionals. The book only refers to one kind of medical professional - physicians - and advises readers to turn to their doctor for oversight.

While the author fails to state that most physicians are not trained in nutrition science and exercise physiology, he at least acknowledges many physicians will only provide a simple "eat less, move more" solution. Yet instead of recommending working with a registered dietitian, he advises seeking out a bariatrician through the American Society of Bariatricians.

Bottom Line: Fortunately, Dr. Rivas does not agree with high-protein diets loaded with saturated fat or very low-fat diets consisting of refined grains. His overall approach to nutrition is healthful, emphasizing fruits, vegetables, whole grains, lean proteins, healthy fats and enjoying pleasurable foods. He also stresses the importance of physical activity and addressing emotional eating.

However, there is no cited research to support the theory that weekend cheating is the key to a boost in metabolic rate or success in either short term or long term weight management. A small daily splurge, a la the discretionary calories concept in the 2005 Dietary Guidelines is a much more logical approach.

In my opinion, the book's cons outweigh the pros. The basic approach is not research-focused, both the diet and exercise plans are one size fits all, the dietary supplement recommendations defy up to date science-based references and there are no guidelines for individualizing the plan and no team approach (e.g., physician as well as psychologist, registered dietitian, exercise physiologist, etc.).

Save your $18.95 and log onto MyPyramid.gov for a more individualized plan, complete with a daily (vs. 48 hour per week) splurge allowances.