The Skinny Book

Dr. Ayaz Virhi, author of “The Skinny Book,” proposes a 6-step methodology for weight management: the steps are medical screening, patient education, diet selection/exercise review, cognitive principles, behavioral issues and weight maintenance.

Step 1, Medical Screening

Before embarking on your weight loss journey you should ensure that you don’t have any medical conditions that are going to hinder your weight loss. To ensure this, you should go to your physician for a complete physical exam or CPE. Lab work will be needed which will be a complete blood count (CBC), lipid profile, thyroid level, fasting blood sugar, kidney function tests, and liver function tests (LFT’s).

Lab work can find a condition known as hypothyroidism that can cause people to become obese. It is a rare find but can be corrected if caught with a complete lab test. Laboratory work will also find out if your LDL cholesterol is elevated. If it is, that too is something that can be treated with medication if needed and it too can also be lowered with weight loss as well. Your HDL is your good cholesterol and you want that as high as possible. If it is below 40, that isn’t good. Exercise and weight loss will increase your HDL.

A blue latex gloved hand holding three test tubes one of the tubes is filled with bloodBlood work to start off with

Step 2, Patient Education 

Obesity is measured via the body mass index. Your BMI is equal to your weight in kilograms divided by your height in meters squared. Try an online BMI calculator to see where you stand. A BMI between 20-25 is normal, between 25-30 is overweight, between 30-40 is obese and over 40 is morbidly obese (severely at risk for many complications). BMI is not to be used for pregnant women, children and bodybuilders.

When you eat a meal your sugar and insulin levels increase. The sugar increases which then leads to the pancreases releasing insulin. The insulin then shuttles the sugar into cells including fat cells for the production of fat; however, if you can keep your sugar levels really low and insulin levels really low you can prevent the production of fat cells by not meeting the threshold needed to store fat.

That is how the low-carb/modified-carbs diets work so effectively. A really popular choice with Doctors is the modified-carb diet known as the South Beach Diet. A relative of mine also has gone on the South Beach Diet and is doing well on it.

Look at the graph below to see how a low carb/modified carb diet can help you achieve weight loss. Notice your sugar and insulin levels remain below the weight loss threshold.

A picture representing weight categories via characters each weighing according to their representative BMI which is listed underneath the block they are standing onBMI Chart
A chart depicting that if you keep insulin lower than your weight loss threshold, you can lose weightInsulin and sugar levels below weight loss threshold

Step 3, Diet Selection/Exercise 

There are two types of diets to select from, those that are quantitative and qualitative. The quantitative diet is one in which you count calories of the foods you eat. There isn’t elimination of any food groups as long as you are keeping an accurate calorie count. Food groups are to be consumed in a balanced manner.

With a qualitative diet you don’t count calories. Food group restriction or elimination is practiced instead of counting calories. Diets of the qualitative type are low-carbohydrate or modified-carbohydrate types.

A popular choice by Dr. Ayaz Virji of “The Skinny Book” is a qualitative diet known as the South Beach Diet. Studies done by reputable institutions have demonstrated the safety and success of modified-carb diets such as the South Beach Diet. Meal planning and selection with the South Beach Diet is done via the use of the glycemic index of foods. A high glycemic index food stimulates a lot of production of insulin while low glycemic index foods due the opposite. Lots of insulin leads to appetite stimulation, which we don’t want.

Foods with high glycemic index are foods such as rich, potatoes, white bread, and desserts. Foods with low glycemic index are cabbage, celery, broccoli, lettuce, and mushrooms. The diet also includes high protein sources and high quality fats such as those found in chicken, eggs, fish, low-fat cheese, and nuts.

A woman sitting in a meditative position on a rock at the beach with the sun setting in the horizonMeditation lowers cortisol a fat storing hormone

Step 4, Cognitive Principles 

Cognitive barrier exist to prevent weight loss. A cognitive barrier is a mental misperception that acts to twist or misalign your understanding of something. What results is self-deception and misinterpretation of the facts.

Cognitive therapy aimed at treating depressed people or those with anxiety seeks to retell a story to better represent the facts. There is a tendency, when down, to overly generalize or delete positive aspects of bad experiences when we want to feel bad about something.

A common cognitive behavior and barrier about weight loss is this attitude: “ I’ve failed so many times in the past, I’ll never lose weight.” When you do this you are emotionally responding to a past failed attempt and are distorting reality. To say you never do something is a strong statement. You may have approached dieting incorrectly or tried the wrong diets that lead to your results. There might be instances in your past where you lost weight on another diet or unintentionally. Remember, obesity is a disease and diabetes is a disease but losing weight and dieting effectively can overcome both of them.

A drawing of a head with the brain visible, parts of the brain are highlighted in red indicating disorder in the brainMind over Matter

Step 5, Behavior Principles 

There are environmental cues around us that shape your behavior, causing you to act in a particular way. Remember, Pavlov’s experiment? Every time he fed the dogs he rang a bell. After doing this for awhile, once he rang the bell the dogs would respond by salivating in preparation for the food that was to come. This is an example of the environment stimulating the dogs to act a certain way.

Colors can be used to manipulate the environment.  Soft, brightly colored things cause people to act in an upbeat fashion whereas dark, ashy colors and tones bring about depressing moods. Just like these cues affect you there are environmental cues that get you to think about food and consumption.

Examples of eating cues that may affect you are those feelings you get when you watch a McDonlads commercial for a Big Mac. The “Big Mac” attack then sets in. Fast food restaurants have been known to use colors that promote the intake of food. I’d do a little research on the psychology of environmental food intake. I found a few things from a short look: people eat because “they saw the food,” people eat because they “want to be around other people,” and people eat because “they are bored and wanted something to do while watching TV or reading.”

Even atmospherics influence food intake. In cold environments, people tend to consume more due to the body’s need to regulate its temperature. During hot temperatures, people tend to drink more. There are more variables that affect eating behavior; I suggest you read this pdf to learn more. <>

A blue written label that is labeled Learn to use it to your advantage, seeing food makes you hungry

Step 6, Weight Maintenance 

With weight maintenance on your mind you need to check your weight on a regular basis. Everyday has  been written to be most effective but it can be misleading, which can then lead to anxiety. Sometimes even while you are losing inches on your waist your weight may go up a pound or two before falling promptly. One method is to weight yourself three times per week and then average your weight for the week. Compare the week’s average to last week's. 

Another important part of weighing yourself is having a good scale. There are many cheap scales and they are not sufficient. It isn’t bad to have a scale that tells you your bodyfat either, but if you buy a bodyfat scale you don’t want to buy in inexpensive one because they are more likely not to work. A good website to find a decently priced scale (not too cheap) is I’ve had good experiences with their scales in the past. I have even tried their professional scale for healthcare workers and it was a $5,424.83 dollar scale, that scale is also sold by tanita and healthcare workers rely on it. I’ve also tried a cheaper tanita scale that was $500.00 and it too impressed me with the results.

A good scale is one that can tell the difference in pounds promptly. For example if the scale says you weight 200 pounds and then you drink a bottle of water that is 16 ounces, the scale, should you step back onto it after drinking the bottle of water, should read 201 pounds since you now have a pound of water in you. You'd be surprised at how many scales don't increase by a pound even after drinking a pound of water, which is sitting in your stomach. You don't want insensitive scales like that or cheap scales, a good scale for a serious dieter is well worth the effort.

My tanita scale records bodyfat and tells me how many pounds of muscle I even have in each of my limbs. This type of scale can help you determine if your muscle mass is balanced on each side of your body in addition it lets you know how your weight lifting is benefiting you! 

To get the most benefit from my web page on “The Skinny Book” it is important to purchase the book. I left interesting things out of this review that are in the book so it wouldn’t be too long but I suggest you read them by getting the book from Amazon. It has a lot to offer, I’ve read many dieting books and this one is one of the best. 

› The Skinny Book
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