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Forget About Your Stomach


WebMD Feature from "Esquire" Magazine

By Mehmet Oz, M.D., and Michael Roizen, M.D.

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New research about how we store fat will help you keep your hands off the muffins.

When we think about losing weight, most of us focus on two things: the food we eat and the stomach where it ends up. The first part makes sense. But the second part is misguided. It's not a big stomach that gives us our beer belly, but a layer of fat called the omentum, which hangs in front of our intestines and stomach. And it's how food interacts with our small intestine, not our stomach, that helps determine how big the omentum gets.

Let's start with the small intestine. The first thing to note is that it's where food is absorbed into the body. You can actually live without much of a stomach (think of all those people who get gastric-bypass surgery — their stomachs are reduced to the size of a walnut), but you cannot survive without a small intestine.

Maybe you knew that much. But here are three things you didn't know about your gut.

1. Marijuana is the future of medical weight loss. Okay, not really, but it's like this: The omentum, the flabby thing located near the stomach, is the most important part of your body's fat-delivery system. It stores fat for when you really need it — like when famine season is approaching (i.e., never). There are receptors in the omentum that cause people to want to eat; back in famine time, these receptors made people chow on ants, worms, seeds — anything that would help store extra fat for when food became scarce. Oddly, these same receptors in your brain sense marijuana, which is why you get the munchies when you smoke pot. (Hence their name: cannabinoid receptors.) Bad things can happen when they become stimulated by pot or stress: Not only does your omentum begin storing fat — making you fatter — it also instructs the liver to make more cholesterol, and it triggers your muscles to ignore the natural effects of insulin, which can cause diabetes. Researchers have found recently that some of us are genetically predisposed to having these receptors work against us, and scientists are currently working on new diet drugs that are rooted in the way illegal narcotics work. The good news? It's in the nature of the omentum to want to make itself disappear. If you eat well and exercise fairly consistently, you'll lose as much as two inches of omental fat in one month.

2. Eating fiber before 10 a.m. is easy and essential. Why is breakfast good for you? How can it be good for you to eat more food when you're dieting? Well, it's not, if that food is a bag of doughnuts. But if you have a high-fiber breakfast, the fiber will slow down the absorption and the movement of food through your intestines. It slams shut this valve at the end of the small intestine called the ileal brake — like the brake on a train that the conductor pulls. It literally closes, because the small bowel feels the fiber in it and doesn't want to let go of it, so the food moves more slowly through your system. And guess what? You're full for longer.

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