INTRODUCTION

Let m e tell you a story abou t fat.

"Have you ever seen such a th ing?" asked my patient Usa as she came in for
an appointmen t one rainy day several years ago. "It's worse th an when I was
pregna nt . At least th en I had a ba by inside . But look at me now. This is just

gross!"
Usa was sweet, sassy-and seriously desperate. With one swift glance I im
mediately understood wh y. At the age of fifty-one, she was burdened wit h an ab
solutely enormous floppy a nd lumpy fold of belly fat. She patted it and grimaced
as she shifted uncomfortably in her chair.
" Don't worry. I have seen such a thing.. " I to ld her, and she visibly relaxed in
relief. "So many times before. in fact, that there's a n ame for it: a panniculus. It's
caused by the kin d of fat in your body that's yellow and unhealthy, I call it Me
Do na ld 's fat. "
'" do n 't ca re if yo u call it Burge r King fat or Wendy's fat!" she joked. "Just get
rid of it, please!"
Because Lisa's panniculus was SO d ispr oportionate to th e rest of h er pe ti te
frame, he r only option, unlike for mo st of my pa tients, was a d rastic one, and we
scheduled a tummy tuck.
On the day of h er su rgery, after I made m y in it ial incision, the su rgical resi
dents and the anesthesio logist wa tch ed benignly, expecting yet anothe r routine
procedu re. The n th ey pee red over at Lisa's abdomen, and I hea rd th em gasp
aloud.
" I ha ve

1/(!V(!r

seen anyt h ing like that before," the anes th esiologist to ld me,

hi s eyes ro un d with shock o ver hi s sur gical mask as he looked at th e mounds of

brig ht yellow fat in Usa's abdom en . As I explained what it was, you cou ld ha ve
h ea rd a p in d rop in th at su rgical su ite.
The more I explain ed th e differenc e between Lisa's yellow fat and the good
kind of b rown fat that makes a body look an d feel health y and vibrant, the more
I rea lized how man y mt spercepnons there are about fat-even in th e we ll
educat ed medical co m mu ni ty.
Co ntrary to po p ular belief, you see, fat is the key to a n ice flat be lly. And fat
is the key to a youth ful-looki ng face an d body, as well.
But h ere's the crucial eleme n t to unlock ing the power of fat. Not all fat is the

INTR O D U C TI O N

same. The fat that keeps you looking and feeling vibrant is not the unh ealth y
old, soft, and mushy yellow fat like the astonishing amo unt (ten pou nds!) I
plucked out of Lisa during h er operation. I can tell you from my decades of sur
gical experience that the re is a fat that is healthy and h ighly desirable. It is what
I call brown fat. Brow n fat is firm and resilient and gives our bodies a youthful
shape-it keeps our cheeks round and our butts in place.
This book will prove to you that once you understand the difference between
brown fat and yellow fat, you can make the changes in how you eat and how you
move to get rid of th e bad and replace it with the good , no matt er what your age.
The Brown Fat R~lution is the first book to show you how to use your own
fat to dramatically rejuvena te you r face and bod y.

VOLUME = GOOD BROW N FAT = YO UT H

When you hea r th e words "plastic surgeon," what immediately comes to mind ?
If you're like man y consumers, you probably think about someth ing like face
lifts or liposuction or even a television show like Extreme MaktfJYe(.
As a plastic surgeon , I've realized th at it takes a lot mo re than just expensive
surgery for my patients to achieve th e best results th ey're hoping for. I've spent
my enti re professional life looking at shape and contour, coupling thi s knowl
edge with a firm understanding of science an d physiology so I can do the best
job possible, moving fat around to create beauty and youth in th e face and body.
As a physician, I've studied n utrition and metabolic functions for over th ree
decades. And as a bodybuilder for more than two decades, I've learned how to
literally co nfuse my metabolism so that my muscles continue to strengthen
even while fat is never deposited in my body.
I've also had many years of experience listen ing to women 's hopes and
needs, learn ing to understand them bett er so I can help the m look and feel the
best the y possibly can. What I hear, over and over again , from th ese patient s are
stateme nts like "I'm eating the same and exercising the same way as I've done
for the last twenty years, but my waist just keeps getti ng bigger," or "I do n' t look
th e way I feel inside. In fact, I'm starting to look like my mother."
I tell th em that all the money in t he world can buy you as many medical pro
cedures as you want, but it can never buy you a truly healthy, beautiful body.
I also tell them th at, without quest ion, the most important an ti-aging con
cept for me is the fanguageo(vofume. (All plastic surgery stems from thi s notion,
as the Greek word plasti kos means "to Sha pe.")
2

IN TRODU CTI ON

It's vol ume that gives faces thei r youthful contours and soft curves. It's vol
ume that makes us look young and rou nded .
And it's good bro wn fat that gives you the volume you want. in the places
you want it!
Brown fat is typical of youthful curves and excellent nutrition and health.
Yellow fat is typical of age and poor nutrition; it creates the characteristic face
and body shapes that we associate with aging, such as a round lower abdomen.
jiggly arms, and soft, enlarged breasts.
That there is such a no ticeable difference between brown fat and yellow fat
was highligh ted in a fron t-page a rticle by science reporter Gina Kalata, pub
lished in The New York Times o n April 8, 2009, entitled "Ca lorie-Burning Fat?
Stu dies Say You Have It." This article d iscussed the results of several d ifferent re
search stud ies, whos e results were published in the New Eng/al/d toumat o(Medi
cine (360 , no. 15 (2009]: 1500- 1508), th at scientifically doc um en ted the ro le of
brown fat cells . These studies concentrated o n th e th ermo gen ic, or heat
burning. properties of brown fat found deep in the body. This type of brown fat
was previously th ought to be vestigial in adult humans; it had been thou gh t to
control temperature only in small m am mals and infants. The conclusions of the
studies were no t only that the re are d ifferent types of fat in the body, but t hat
deep brown fat ca n bu m mo re calories than yellow fat. particularly when trig
gered by cold temperatures.
Researchers were elated by these findings , as the hope is that eventually
some completely new fonn of weight-loss drug may be developed-tackling ex
cess fat intemallv, on a cellular level, by stimulating these thermogenic proper
ties of deep brown fat, rather than by tack ling caloric consumption.
And I was elated because t hese studies were a strictly controlled , scientific
valida tion of th ree of my clinical im pressio ns: that there are different types of fat
in the body; that the mo re brown fat yo u have, the leaner yo u tend to be; and
that different types of fat ca n be modulated by lifestyle, d iet, and exercise so that
yo u can co nvert yellow fat in to brown fat.
These findings are thrilling if not revolutionary for those who study and wor k
wit h fat , as they further our understanding of what fat is-that there is a spectru m
of fat in th e body, that d ifferent kind s of fat have different properties, an d that as
pects of our be havior (diet, exercise, medications) can affect ou r fat stores.
Th ese stud ies concentrated on studyi ng deep brown fat under the micro
scope at the cell ular level, specifically on stimulating certain brown fat cells in
the neck, u ppe r back, and alo ng the sp ine to regulate energy metabolism. These
fat cells contain hi gh concentrations of mitochondria, the energy boosters of the

INTRODUCTION

cells. The mitochondria ramp up the meta bolism of these fat cells. and the iron
they contain gives the fat cells their brown hue .
I. on the other hand. have spent nearly thirty years working with thousands
of bodies, during wh ich time I've learn ed that no t all skin is t he same-and not
all fat is, either. I see th is every time I perform any surgical procedure. The brown
(at that I see appears through ou t th e body. usually in th e subcuta neous plane
(immediately below th e skin's surface). This subcutaneous brown fat gets its dis
tinctive hue due to the dense network of connective tissue and blood vessels
cou rsing through its well-proportioned fat cells, making it light brown or tan. It
is tightly encased with Iascta (connective tissue), dense, and it firmly adheres to
the underlying muscle or bone as well as the overlying skin .
In contrast, the yellow fat I see is vivid in colo r. blobby and shapeless, and
greasy to the touch .
Yellow fat is crummy-qua lity (at. Brown fat is good-quality fat. And the qual
ity of you r fat can not be overestimated . The better you r fat, the bette r you loo k
and feel.
Having spent so many years working with subcutaneous brown fat to recon
tour the body, I instantly realized th at thi s brown fat has several similar cbarac
teristlcs to th e brown fat found deeper in th e body as described in the recen t
stud ies. Namely, that lean people (With a lower body mass index , or B~ I ) have
more brown fat than yellow fat, and tha t brown fat is directly related to control
of you r blood sugar.
While my goals and the goals of these scientists are th e same-to use ou r
own body's fat to reshape and revitallze-cour met hods of harnessing brown fat's
power are different. The brown-fat researchers look forward to developing a drug
to control thi s functionally active brown fat, wh ich would be an incred ible
breakthrough for the health of millions of overweight people. But because their
studies are still so new, these researchers have understandably adm itted that de
veloping any sort of drug to trigger dee p brown fat's the rmogenic prope rties is
still years away-and that it might actually be impossible to create one.
The happy news is that the Brown Fat Revolution is available right now, and
it works. I have spent years developing this program to help you replace your
old, un healt hy yellow fat with new, health y brown fat that is th e hallmark of
youth ful volume.

INTR O D U CTI O N

WH Y BROWN FAT IS EV EN MORE IMPORTA NT AS Y O U

GRO W OLDER

The quality of your body fat changes naturally with age, from youn&- light brown
fat to old yellow fat. For women going through pertmenopause and beyond,
when the hormonally triggered changes they expe rience can be as bewildering
and debilitating as puberty once was, the volume distribution or placement of
their body fat will change as they age, too . This is the reason why so many of my
patients over the age of forty have pointed to their bellies, telling me that
they've grown a pooch seemi ngly overnight, and then begged me, as Usa did, to
he lp the m.
Ofte n, before t hey've come to see me, these patients have t ried just about
everyt h ing. First th ey pan ic. Then they start starving th emselves. Then th ey
work themselves into a frenzy in th e gym.
But what ha ppe ns? They feel awful and look worse. Their skin loses its luster,
so th eir faces look gaunt and pinched . Instead of getting more energy from exer
cise, th ey're exhausted and crabby all the ti me. They've ove rexerdsed so much
th at, believe it or no t, th eir faces are literally paying the price. Although th ey
had good intentions and the discipline to make a strong com mitme nt to hea lth,
they unwittingly chose the wrong strategy towa rd their fat, so it became impos
sible for them to achieve their goals.
All btcallSt they thought fat was tile ~Iemy.
When your body has the right proportions of good brown fat, you will al
ways look youthful. The flip side, of course, is that if you r body has the wrong
proportions of bad yellow fat, you will always look soft, flabby, and old before
your time.
Unders tanding the difference between brown and yellow fat is the hea rt of
th is boo k, because how you look as you age is not based on your weight. Thin
does not always t ranslate to looking young, because shape and contour define
yout h. Instead, your youthfulness is based on your propo rtions, and how your
hormon es determine where brown an d yellow fat shifts In you r body as you
grow older.
In ot her words, when you follow th e plans in TIle Brown Fat Revolution, you' ll
realize th at what they ta rget is your shape. You 'll not only lose weight, but you' ll
regain the shapeliness that is th e ha llma rk of youth.
When your shape is firm, lifted, and curvy, supported by the good brown fat
you're soon going to have, you will always look younger. Once you start follow-

INTR OD U C T IO N

tng the unique Eating and Exercise Plans in this book, you will never need a sur
geon to get rid of your unhealthy yellow fat the way Lisa needed me.
The principles you'll read about will help you main tain t he best balance of
fat and muscle, and keep as high a proportion of brown fat to yellow fat as pos
sible in order to hold on to the curves of femininity and th e firmn ess an d lift of
yout h. no matter what your age. And because this good brown fat will firmly
suppo rt your skin. making it more youthful th roughout you r body, you' ll also

see th e following:
Your face will show imp roved tone and contour.
Your arms will loo k more toned due to the loss of yellow fat and the for
mation of well-toned, firm muscles. Your belly will flatt en due to decreased
intern al yellow fat.
Your upper back will be smoothe r, and th e area where your arms join your
back will no longer be pufftng over the sides of your bra.
If you have cellulite, it will definitely show a marked improvement once

the skin there is supported with healthy, firm young fat. and not mushy,
old yellow fat.
You will literally de-age yourself, solely by the way you eat an d exercise.
Not on ly will you improve you r health , you'lI enhance your beauty at th e
same time .

WHY THIS BOOK IS UNIQUE

Most an ti-age books talk about the need for exercise and good skin care. But they
concentrate on eithe r t he healt h benefits of exercise (such as using it along with
d iet to help you try to lose weight ), or on the beau tifying aspects of your appear
ance (With. for example, a certain kind of skin-care regimen). Many exercise
books are written by certified traine rs who concen t rate onl y on movement and
some kind of diet, without un derstand ing the entire picture of physiology and
metabolism-and certa in ly not the difference between yellow and brown fat.
Many nutritionists write books because they want to help you lose weight, but
although they understand metabolic functions, they don't usually understand
the crucial role of yellow and brown fat, eithe r. Even more important, many nu

I N TR O D U C T I O N

tr ttton tsts do not design programs to specifically shape the body in addition to
helping you lose weight . They design program s so that you' ll lose fat and overall
weight.
The reason for thi s is that most medical professionals don't think of fat th e
same way I do, as wanting to understand fat and the language of volume has
shaped my entire career. I first became interested in the bod y's fat when I studied
anatomy in medical school, and my interest progressed during my three decades
of experience in shaping bodies with a scalpel and my two hands.
I'm assuming that anybody who reads my book wants to lose weight. But
that's not enoug h for me-I want you to lose weight and look more youthful and
more vibrant at th e same time. Believe me, it can be do ne. Making tremendous,
noticeable cha nges to your health and to your appearan ce is no longer an et
ther/or situatio n.
Unlike most of my colleagues, I know what you need to do to not on ly feel
better an d lose weight-but also look incred ible. The bette r you look, the better
you' re going to feel, which will keep you on the program until it's second nature.
My goal with thi s book is to have you completely rethink you r att itude to
ward fat, and understand that young, health y brown fat is a good th ing.

HOW THIS BOO K WO R KS

The Brown Fat Revolution will give you a concise explanation of th e external and

internal changes to your fat (and the rest of your bod y) as you age, coupled with
a no-fail plan showing you how to use this knowledge to combat aging. You'll
learn that what you eat has a direct effect on th e qWl/ity of you r fat, and how you
exercise has a direct effect on the qllantityof your fat. You'll get rid of bad yellow
fat not by dieting or starvi ng or spending end less, fru itless hours in t he gym, but
by alternating Protein Days with Carbohydrate Days, and increasing your me
tabolism with lean muscle.
Because hormones have the most profound effect on how our bod ies age,
each part of this book contai ns sections on two categor ies: Hormone Category I
(ages th irty to fifty) and Hormone Category II (fifty an d older). Cha pte rs 2 an d 3
will go into greater detail about hormones and th e aging process. Armed wit h
this information, you can then turn to the section of the book that is most ap
plicable to your unique needs, and for quicker results you can target the areas of
your body where th e bad yellow fat has accumulated.

INTROO UC TI O N

In part 1 you get the primer on fat, based on my thirty years of clinical expe
rience studying the human body, as well as details of how your body ages.
Part 2 explains how the Eating Plan wo rks, and why eating fat is good for
you-as long as it's th e right kind of fat. Once you start follow ing th is plan,
you 'll actuall y be eating a lot more while weigh ing less. Optima l nourish me nt
will give you skin th at glows, an d a face that retains its youth ful curves instead
of looking haggard and aged.
Part 3 is all about replacing bad yellow fat with good brown fat through a rev
olutionary, time-efficient Exercise Plan that proves you can become fit and
strong without spending hours each day on exercise.
Combin ing the Eating Plan with the Exercise Plan will provide maximum
benefits. You won 't be hungry, plus you'll raise your metabolism to a steady level
so you won't gain weight. You'll no longer bu ild up deposits of bad yellow fat, so
you will quickly see results as a healt hy underpinning of dense brown fat hel ps
im prove skin to ne, decrease wrin kles, and minimize cellulite. On ce you learn
how to SCUlpt and strengthen your body without pu nish ing your face, you'll be
able to mai ntain this healthy, glowtng, toned, firm skin without needing expe n
sive procedures.

TH E B R OWN FAT REVOLUTION IS A PLAN FOR LIFE

Let me tell you another story about fat. My OW" fat.
I had been a competitive ballroom dance r as a teena ger, eventually becom in g
the Natio nal Jun ior Latin and International Champion, but once I got into med
ical school, I stopped dancing. For the next twenty-two years. as I finished my
med ical training and opened my practice, I did nothing physical.
KaT did I pay close attention to what I put in my mout h, or how m uch . On a
typical day, I'd fin ish m y hours of grueling surgery and I'd be Illlngry. I'd go into
th e hospital lounge, look in g for the usual plate of coo kies and ot her trea ts. But I
wou ldn 't eat just a coo kie or two to take the edge off my hunger-I'd eat half a
box while wait ing for my n urse, Dede, to get me a steak sandw ich and a few
Hostess 500 Balls that I'd hide from my colleagues.
Or I'd h it the Mallomars. 1was so addicted to them that if you'd told me back
then that I'd lose my craving, I'd have looked at you as if you 'd grown another
head!
I was still fairly thi n, but I was developing a Pillsbury Doughboy belly. I didn't

IN T R O D U C T IO N

feel great , either. My temper was short. I yelled at my staff for the most innocu
ous reasons. Something had to give.
That's when, at age forty, I sta rted to work out. I found a gym some distance
away so no one I knew wou ld see me. My first day, one of the t raine rs-a gym
nast named Rick---came in, and I asked him to work with me.
But I still wasn 't really con centrating. because the only time I could schedule
our sessions was in the early morning, which is when I did my surge ries, and I
felt so guilty because I wasn 't working.
Finally, Rick got fed up . "Wh at the hell 's up with your he asked. "If you
can't devote one hour two or three lousy times a week to yourself, you have a pa
thetic life."
I laughed to cover up my mortification, because I knew he was right. But it
still took a few more months before I trul y began to change my thinking. I was
done with quick fixes and qua ck diets . I was on a mission-to develop a program
that would keep me fit, make me healthy again , and have the astonishing side
benefit of completely changing the way I looked . A program that would wo rk,
that would continue to improve my health and appearance-for life.
I was also determined to make the Brown Fat Revolution foolproof. With this
program no longer will you feel a sense of depravation and obligation-you'll
feel empowered and positive once you see how easy it is to reverse the effects of
bad yellow fat and start replacing it with good brown fat. Because the steps are
clearly listed, you won 't have to think abo ut what to eat or how to exercise. If
you stick to the prog ram, you ca"not fail.
Good brown fat is t ransfo rmanve. With it, you 'll be able to rebu ild, replen
ish, restore, and recontour you r body, put the bloom back on your skin, an d add
vitality back to your life.
My mission is not just to dimin ish your overall fat vo lume, but to help you
replace it wit h a healt hy and attract ive volume of high-q uality fat , a fat tha t
looks brown due to its in he rent architectu re. A fat that is akin to the brown fat
th at is presently under scientific investiga tio n as a means of controlling weight.
Th is is a very promising role for those fat cells once thou ght to be t he enem y of
obesity!

INTR O D UC T IO N

1.
THE SCIENCE BEHIND
THE BROWN FAT
REVOLUTION

Fat is your friend .

I'm determ ined to hel p you rethink what you r fat is. It might take some time
to wrap your mind around that idea , but the simp le t ruth is t hat everyone needs
fat. Not a diet that's fat-free . Not a diet that's low-fat. Not a die t fueled by the no
tio n of ""II get fat if I eat fat. "
You need good. nutritious, healthful fats in you r food. And you need good.
finn . resilient brown fat in your body-not the old yellow fat that's basically
mush-for not just optimum health but op timum beauty, too. The difference
between young fat and old fat is like the difference between a smooth rou nd
plum and a wrinkled prune. One is dense, smooth, a nd rounded, and th e o ther

is not .
Furthermo re, the recently pub lished studies on deep, functional brown fal
provide clear evide nce th at , ironica lly, the an swer to t he obesity epidemic may
be mo re straigh t forward tha n forme rly th ought. For t hese scientists, the an swer
lies in the fat cell itself!
So let's take a loo k at the crucial role of fat-and what you can do about get
ting rid of old yellow fat and replacing it with new brown fat .

W E'RE OBSESSED WITH FAT-BUT FOR ALL

THE WRONG R EAS O N S

Too many peo ple in o ur country are becomi ng alarm ingly obese. Coo kboo ks
and hea lth books and talk shows and magazine articles are co nstantly bo mbard
in g us with images and facts abou t th e fat that causes diseases-and kills. Th ere
is, in fact , a particula r m indse t where it's all too easy to see fat as the enem y with
out und erstanding ho w and why th e right kind of fat is so im portant. And be-

THE SC I E NC E B E HIN D T H E BR O W N FAT REVOLUTION

cause many people do not understand what nutrients the bod y need s and when
to eat them, they e nd up eating all the wrong thi ngs, and put on mo re weight.
Or they beco me alarmingly thin, some how thinking that sta rving themselves of
all fat is the only way to ach ieve that
super
flat belly a nd those jutting cheek
MICHELLE OBAMA HAS GREAT FAT;
bones.
MADONNA DOESN 'T
But the rigllt fat in the right areas is
Michelle Obama has an amazing body-not becau se it's
a good thing. It's an intrinsic part of
got the most ama zing shape , but because she's amazingly
average, with exactly the right amount of good brown fat
in herface and body.

It's interesting to take a look at her figure, as she's got

broad shoulders, a small bust, and a small waist. yet wide
hips, an ample butt, and long legs. She's not skinny, and
she's not fat-she's firm and toned, with exceptionally well
defined uppe r arms. She exudes health and vitality. Her
posture is perfect and she carries herselfwith elegance and
grace. Most of all, she's a woman comfortable in her own
skin.
Compare Michelle's lovely strong curves with Madon na's
angular, supermusded and almost terrifyingly buff body.
Althoug h Madonna is only frve years Michelle's senior, she
looks much older, because she has almost no body fat at all.
Unlessshe's carefully lit in photographs, she can look harsh,
haggard, and tired .
In ot her words, Michelle Obama has got great fat.
Madonna doesn 't. That doesn't mean I don't admire
Madonna for her singing and dan cing talent, her stagger
ing discipline, her work ethic, and her seemingly inex
haustible energy a nd stamina. Personally, I believe that if
Madonna stopped her compu lsively long workouts (a re
ported minimum of tour hours a day) and gained about fif
tee n pounds, she would look so spectacu lar she'd knock
your socks off.

your body. If you want to feel good and

look good, it's essential to have a body
where all systems are funct ioning at
optim um levels, both phy sically an d
mentally.
Just as impo rtan t: understanding
that ea ting the right kind of fat will not
make you fatte r.
That is, you will not get fatte r if you
eat the kind of fat that's good for your
bod y; eat it at the right t imes during
the day, along with carbohydrates, to
keep your metabolism on an even keel;
and don't eat so much of it that your
body au to mat ically stores it instead of
burning it off.
So when did we ma ke t he switch
from looki ng at ado rable little babies
with rolls of fat on their thighs, want
ing to blow on their dumpling bellies
to make them pea) with laughter ... to
being afraid to eat properly and obsess
ing about every calorie we put in our
mouths, even as we st ruggle to main
tai n a healthy weight or a figure with
curves where we want them?
I've spent many hours trying to fig

ure out when fat became a four-jetter word.J dea rly rem ember th e day when the
daughte r of a fam ily friend was over, and my wife and I were watching a Marilyn
Monroe movie. This teena ger had never seen Marilyn in he r prime before. And
T H E B ROW N F AT R E VOLUTI O N BA SI C S

what was the girl's respo nse? That Marilyn was sexy, or beautiful. or vulnerable?
I wish ! Instead, she said, "Oh my God. She's so fat!"
It was a disheartening moment, I have to say, as Marilyn's glorious curves a re
certa inly not wha t I'd cons ider to be "fat. " And , as someone who's devo ted his
life to opt imum hea lth , it pains me to look at images of seriously un derweight
and undernourished Hollywood stars, with t heir toothpick legs, pin-th in arms ,
and cheeks that are rounded due not to good brown fat but to the miracles of
modern med icine, which has created the kind of substances that ca n be injected
or inserted into them to plump them up. I'm left wondering how these stars can
continue to function with such patently unhealthy bodies-and what kind of
role models they are for the women of the world.
Frankly, I think thin is bad. Youcan 't be a stick and be healthy. And the older
you get, the more aging thi s gaunt thinness becomes.
I have an intimate knowledge of the danger of thinness, because as a plastic
surgeon, I deal with it on a daily basis. From my potn t of view, what I do for a ltv
ing is plump up thin faces, and put implants in areas of the body perceived by
their owners to be too thin, whether their cheeks or their jaws, their breasts or
their butts. Not that any of this is wrong , of course. But what, really, is the heart
of the issue?
It's fat, of course!

FAT B A S ICS

Your body int rinsically knows , within the mod ulation of its metabo lism, how
m uch fat it needs to funct ion. Anyt hing beyond that will be stored for future
use, to supp ly energy whe n needed .
Your body prefers to sto re ene rgy as fat , as a dire ct result of tens of th ou sands
of years of evo lutio n. Early huma ns had tro ub le finding food , especially calo rie
dense food . Plus they were in constant motion as th ey wen t hunting every day.
As fat is calorie dense, with nine kilocalories per gram (carbohydra tes and pro
tein each have four kilocalories per gram), it became th e most efficient way to
provide t he sto red energy our a ncesto rs needed for su rvival.
Fast-forward to th e present , whe n we're no longer hunter/gat herers and have
every conceivable food at our fingerti ps. While we've evolved enough to create
art and m usic and send a ma n to the moo n, the human bod y's tec hnology has
not evo lved at the same pace. It still thin ks it's goi ng to have 10 hunt for its next
mea l, so it will always hoa rd all excess calories in the form of fat-if you let it.

THE SC I ENCE BE HI N D T HE BR O W N FA T RE V O L U TIO N

,.

WHY YOU NEED FAT

Fat is necessary for several basic bod ily functions. Your body needs a certain
amount of fat to store t he vitamins A, D, E, and K, which are necessary to mai n
tain the health of your cell membranes and its walls, as well as the ove rall hea lth
of skin, bones, and the immune and clotting systems. Bodies must also have fat
for the brain and the neuro-system, so nerves can fire prope rly and communi
cate with each other. This is why It's so impo rtant for babies to have a lot of fat
in their diets ; without it, their brains won 't develop properly,
With only a minimal amount of fat in your body, you won 't feel very well
and you'll look horrible. Your skin will be dull, your imm un e system will be
comp rom ised, and you r ene rgy level will be nonexistent.
I've seen the hor rifying effects of a superstnct no-fat diet in the bodybuilders
who train at my gym. In th e weeks before a competition, these guys starve the m
selves to make th eir muscles look more ripped. Not onl y is this unhealth y, but
th eir faces become so drawn and pale, it 's not an exaggerat ion to say tha t th ey
look like th ey're dyi ng. Their brain s are so starved for fat a nd carbohydrates tha t
their synapses a ren't firing properly. They tell me th ey feel like they're out of
control. Basically, t hey a re, as they lite rally can't think st raight .
A BOUT INSULIN , GLYCOGEN ,

AND WHAT CAUSES YELLOW FAT

Since your body will always store excess calo ries as fat, if you eat too muc h of
any food that is converted into fat, it's converted into the kind of bad yellow fat
you don't want.
Think of your food as coal being added to a furnace . If you add too much
coal, the fire gets too ho t and then burns out. If there's always way too m uch
coa l, the bottom of the pile will beco me powdered and useless, similar to low
quality yellow fat.
Whe neve r you eat ca rbo hyd rates, you r body secretes ins ulin, the hor mone
that regulates blood sugar, t o maintain an even blood-sug ar level. Insu lin wants
excess sugars out of th e blood, so it immed iately spikes a nd then falls to move
t he excess someplace less ha rmful- like your fat cells. You r yellow fat cells.
An additiona l part of t he process has 10 do with glycogen, th e na me for your
body's initi al stores of carbohydrates. Most glycogen is store d in the liver and
muscles, and released when your body needs it. In other words , glycogen is an
energy source that is im mediately available so your brain can function well and
your muscles can move where you want them to.
lf you eat the right amount of food, your body will not need to store any ex-

THE BROWN FAT REV OLUT I ON BAS I CS

cess calories, which are always stored as fat. fnstead, it will store th e calories only
as glycogen. Whe n glycogen storage is exceeded, the extra glucose is deposited
as fat. At first , it's deposited in to good, brown fat cells. Healthy brown fat tissue
is well contained in a framework of fascia, whic h keeps fat in a tight d uste r sup
po rtin g th e overlying skin an d finnl y attached to the und erlying muscles. There
is a defined level at which fat tissue can maintain a hom eostatic relat ionship
with the surrounding fascia, blood supply, an d lymphatic drainage-th e th ree
work toget her to create the shapes of youth in the face and body.
Now, fat cells do not increase in number as we gain weight. They only get
larger. If you overeat, eat poorly, or don 't exercise, excess fat inc reases in volume.
As th e fascia stret ches, the fat sta rts to fall off the muscles and does not butt ress
the skin with th e same ttrmness. If th e cells become too enlarged, the fascia
st retches along with the con nective tissue ho lding the cells together and thin
ning of the nu trien t blood vessels cannot contain the cell volume and th e shape
and tone, so they start to look loose and yellow-shapeless. The scale of fat qual
ity is a contin uu m, from brown to yellow. Yellow fat is brown fat turned bad.
So if you eat too much, your insu lin will keep on desperately tryi ng to get th e
excess sugars out of your blood , and you'll never be able to deplete you r glyco
gen stores to trigger th e conversion process from bad yellow fat to good brown
fat. Instead, you'll just get fatt er and fatte r in an endless cycle of blood-sugar

highs and lows followed by increased storage of yellow fat .

As you' ll learn in chapte r 4, figurin g ou t the balan ce of glycogen storage (to
prevent excess co nsu med calories being stored as fat) with glycogen availabili ty
(to give you energy and to avoid any breakdown of your muscles) will be th e
founda tion of you r Eating Plan. Mobilizing glycogen for energy use is deter
mi ned mo re by diet than by exercise.
The evo lutionary "excess calo ries automatically get stored as fat" phenome
non is th e basis of unders tanding yo-yo dieting. If you stick to a very calorie- and
fat-restrictive diet, you r body will automatically dick into sta rvatio n mode , less
en ing its daily caloric nee d. Yet even when you sta rt to eat normally again , your
body will remain less efficient at processing th e nutrient s, and you'll quic kly
gain weight , and then some. Then you go back to a superrestrtcttve diet to lose
the weigh t, and th e vicious cycle of yo-yo dieting spirals out of control.
In addi tion , th ose who work out like crazy but don't eat properly will shrink
In an unhealthy fashion; since they rapidly de plete their glycogen , they end up
burning both fat and muscle for ene rgy. Their bodies read the lack of glycogen as
starvation, so their metabolism slows dow n, too . And t hose who work out like
crazy but eat too much do not lose weight because as their glycogen is replen-

TH E SC IENCE BEHIND T H E B ROWN FAT RE V OLUTI O N

"

Ish ed , th eir appetites in crea se. As soon as th ey replenish th eir glycogen stores,
an y excess ca lories tu rn in to yellow fat.
You r body weigh t is not th e o n ly ind icato r that you may h ave a lot of bad yellow
fat . Someti mes th ose who arc on ly very slightly overweigh t, who appear to be in ex
cellen t health, who have n ormal blood wo rk an d blood pressure and n o inclination
toward type 2 diabetes, ha ve too- h igh yellow fat stores . Yetthe da mage that's going
on hasn't been noticed yet because it 's all imano l. It's like a car that stalls suddenly
for n o apparent reason, and you 've got no idea the engi ne is about to blow u p!
CONVERTING YELLOW FAT T O B ROWN FA T

Since yo u know that once your glycogen sto res are all filled up, any o ther
ca lories th at come into th e body are going to automatically be stored as yellow
fat, t he trick is to keep th is glycogen sto rage level as close to even as poss ible.
Have too little fat and carbohydrates, and you'll go into starvation mod e. Have
too much and you'll develop too much yellow fat.
What you wa nt instead is he althy brown fat .
When you add fue l slowly and continuously, the fire in yo ur body's furnace
will bum eve n ly and steadily. Ou r bodies are designed to bu m fat preferentially,
so if the ba d yellow fat beco mes the most available form of fuel-in o ther words,
when you can use it u p ins tead of sto ring it-it will keep on getting bu rned up.
Instead of losing muscle, h ealthy bro wn fat , and bo ne, as h appens o n mo st re
strictive d iets, all you'll lose is your bad yellow fat.
At th e same tim e, when yo u eat n utri tionally sou nd foods like comp lex ca r
bo hyd rates , yo ur body's need for the fat it must ha ve for cell functi on s remains
stable. With a constant and even co nce n tratio n o f glycogen in the muscles and
liver, th e body now thinks th at glu cose is n o longer n eeded , so it 's n ot immedi
ately stored as ba d yellow fat.
O u r bodies "ma ke brown fat the same way we ma ke all our tissues healthy
anywhere. So ins tead of just thinking about losing pounds as you would d ur ing a
typical weight-loss d iet, I want you to be thinking about fat replacement, too-as
in replacing yellow fat with dense brown fat.
That's beca use, as you know, th e right volu me In th e righ t p lace is wha t makes
you look sha pely and youthful. Brown fat is not about weight-it's about shape.
WHAT DO YELLOW FAT AND BROWN FAT LOOK LI KE ?

..

From my pe rspec tive as a surgeon with thirty yea rs o f experience cutti n g into
bodies of a ll shapes an d sizes, it's immediately ap paren t th at yellow fat and
brown fat look and feel and behave very di fferently.

THE BROWN FAT REVO LUTION BASICS

If you look at yellow fat un der a microscope, it 's all white. It appears to have
large vacuoles, which are large spaces inside a cell. The cell walls are stretched
an d there's very little fibrous tissue or blood vessels.
When I cut through yellow fat du ring surgery, t here 's little to no bleed ing ,
which is very unhealthy; it's an indicator of how bad eating habits have a visible
effect on the health of your tissues, even when you can 't see them on the sur
face. Seeing yellow fat on the inside is like seeing the leathery, wrinkled skin on
the outside of a woman .....ho smokes and tans too much.
When I'm performi"g surgery on a healthy female patien t, nowever-sone who'j
nourished herselfwell and exercised ottm-I don 't see yellow fat. I set! firm brown fat in
certai" arras ofthe body-the arras that define the patients gender.

Your body has well-defined areas where fat cells are located: on top of the
muscles (subcu taneous, deep fat), in the abdomen (In tra-abdomi nal fat), and in
the organs (like the fat in the liver, for example). We're born with the number of
fat cells, or adipocytes, that we'll carry through life; these cells can get larger or
smaller as you gain or lose weight , but they can 't multiply.
In each area, there is a predetermined network of connective tissue to organ
ize and form the fat cells, a certain number of blood vessels to supply the fat with
nutrients, and a certain number oflymphancs to drain the fatty tissue. If the size
of the fat cells does not overwhelm the network of connective tissue; if the blood
supply keeps up with the metabolism of each cell so it functions at the optimal
metabolic rate; and if the size of the cells does not overwhelm the lymphatic
drai nage channels, you have brown fat.
Brown fat gets its color from thick, fibrous tissue between its cells, as well as
coun tless blood vessels. As a result, it looks brown-more of a ta n color, act u
ally-because blood is constantly supp lying and rep lenishing th e fibrous tissue
and fat.
In addition, brown fat is compact and shapely. It looks youthful (because it
is). Brown fat adhe res t ightly to the overlying skin and underlying mu scles. This
cohesive relation shi p of skin, fat, and muscle defines yout h!
With yellow fat, on the other hand, the network of connective tissue is over
stretched due to the eno rmous fat cells, the equally stretched blood vessels course
scant ily th rough th e cells,and cell membranes are loose and sometimes fragmented
due to sluggish cellular metabolism that gets little nourishment because there's no
blood to supply it. Yellow fat actually feels greasy as a result. Nor does it support the
overlying skin or have the resilience to help contour the underlying muscles. It's
blobby, with no defined volume. Or rather, its volume tran slates to old!
You can easily get an idea of what old yellow fat loo ks like every time you see

THE SC I E NC E B E H I N D THE BROWN FAT RE VOLUTION

..

a raw steak . When raw, th e thick lumps of fat on the end are a dense, opaque
white. It's got a very specific kind of greasy feel to it whe n you tou ch It .
On a raw chicken, yellow fat is definitely bright yellow, and in big clumps
that you can pull out of the cavity or trim near the tail. Many chickens, though,
don't hav e a lot of visible yellow fat anymore, as they've been bred to be extra
lean . Which is a good thing for you .
(Moral of the story: Always trim your meat. The kind of fat that's bad for you
looks pretty gross on the outside-and you don't wan t it on you r insid es!)
Y ELLOW FAT IS P ERV A S IV E, TOO

One of the biggest problems with yellow fat is that it's pervasive. It moves into
your vital organs, and part icularly into your abdo men area and around you r Intes
tines. This pervasiveness is basically why peop le who are overweight have so
many health problems. The qu ality of their tissues is poo r; thei r metabolism is
sluggish; and there's an increased demand on the heart and lungs. The body is in
chro nic overload, as if it's a t ruck dragging an entire house beh ind it all the time.
I was reminded of the pervasive ness of yellow fat when I was discussing it
with a patient recently, and she told me about an incident that happened to her
decades before, when she had gone to the hospital for some severe endocrine
problems and had shared a room with several other patients, including a mor
bidly obese woman. Th is woman urgently needed a liver biopsy, normally a sim
ple procedure done under local an esthesia, so one day the surgeon and his team
came into the room, drew the curtains around her bed , and sedated her. They
got to work, and then a few min utes later there was an ungodly crash . The sur
geon came stomping out, his face beet red, swearing at the top of his lungs.
What had happened? He'd been unable to find this woma n's liver. Her yellow fat
had com pletely obscured her interna l o rgans.
Anyway, this ho t-tempered surgeo n got so frust rated-inappropriately so, I
might add-tha t he knocked the inst ruments to t he floo r. But I could under
stand his frustration , because he wanted the best for this woman. He knew her
life was now at grave risk because she'd have to ha ve general an esthesia for a sim
ple biopsy.
The bottom line is, there is never going to be any need for yellow fat. We
don 't need it to give us ene rgy-we have glycogen and good brown fat for th at .
So beyo nd what you loo k like, it increases your need for insulin, makes you
pron e to diabetes, ma kes you feel sluggish, and may increase your risk du ring
medical procedures. It is intermingled with all tissues of you r body-your hea rt,
liver, everywhere. It's pretty gross.

2.

T H E B R O WN FAT RE V OL U TI O N B ASIC S

THE SKINNY ON FAT

Anyone who's seen a recent fashion show knows that th e runway models are so skinny you could seem
ingly blow them over like a feath er-but they've also got jiggly bottoms and wobbly thighs . Why? Be
cause they don 't eat enough, or they don 't eat properly when they do eat, and many don't exercise.
(Believe me, I'm not blaming them-l'm blaming the fashion industry.) So the tiny amount of fat these
models have is mushy yellow tat. These wo men are barely out of their teen s, a size 00, yet they're fat
and skinny at the same time.
Superskinny models are the visible embodiment of yellow fat versus brown fat. That they deprive
themselves of good nutrition mean s they don 't have good-qua lity tissue. Just as skin will reflect damage
done to it by smoking and excessive tanning and loo k old before its time, doing th e wrong things to
the tissues of your body will be visible, too. Poor-quality tissues, such as yellow fat, are going to look
and act a certain way whether there 's too much of them (as in an overweight person) or too little (as in
a severely underwe ight person).
Next time there's a Hollywood award show on TV, watch the actresses walking down the red car
pet-you know, the actresses who are lovely, gorgeous, talented, and starving. See who's very thin, yet
still has a little pooch in the front. That's bad yellow fat.
Even th ough these actresses often follow vigorous exercise reg imens, they don't know how to target
the excess yellow fat in their abdomens or butts and replace it with healthy brown fat. Their bodies are
desperate for any fat at all-so they' llhold on to whatever they can get. This is due to a condition called
lipodystrophy, the hormone-driven phenomenon responsible for areas of collected fat in certain areas
of the body. These areas are the most resistant areas to welqht loss, and need a little push-namely the
Brown Fat Revolution program .

Yellow fat ha s no pu rpo se except to , well, ha ng there and make you feel mis
erable and look older.
TOO LITTLE FAT

Whil e I can' t do much about the bod ybuil ders w ho are starving th emselves
befor e a com pet itio n, I can try to do so mething about the countless patients
wh o erroneously think that avoiding fat or severely restricting calo ries will help
th em get o r remain superthin .
!f you do n' t hav e en ough of th e good brown fat, yo u' ll get way too t hin- not
attractively lean, but scary skin ny !
Witho ut fat for energy, you 'll have m ini mal glycogen sto res in your body.
Then tf you decide to wo rk out , you'll dep lete all your stored glycogen, a nd your
m uscles won 't work prope rly. They' ll be too weak. And weak muscles can 't get

TH E SCIENCE B EH IND THE BROWN FAT R EV O L U T I O N

FR OM THE IN S ID E O UT: T HE IM PORTANCE OF NOURI S H ING YO U R CELLS

As I discussed in the introd uction, on April 9, 2009, several articles in The New England Journal of Medicine

discussed the thermogenic. or heet-peoduclnq, properties of brown fat cells found deep in the body. The
findings were particularly newsworthy because these researchers discovered that the thermogenic effects
of these fat cellscan beactivated in adu lt humans after long exposure to cold temperatures.
The researchers also showed that the number of thermogeni c brown fat cellsyou have, like the sub
cutaneous brown fat that I have studied and operated on for decades, is inversely proportional to yo ur
weight and your body mass index (which is a measure of fat, not just weig ht). leaner people have more
brown fat cells than overweiqht people.
Fat cells and all other cells are the basic building blocks of you r bod y. If these celts aren 't properly
nourished, it's going to show, pa rticularly in the luster of your skin and the shape of your muscles.
What you eat and the way you behave affects all cell functions. It's actual lyat the cellular level where
it's determined how you're going to age-and wh ere you r young fat is go ing to go. Furthermore, the
reasons why the right kind of exercising makes you look more youthful is because it stimulates and re
plenishes cells, improves blood flow, and more efficiently moves nutrients to where they are needed.
If you don't nourish your cells properly, it's as if you are creating a toxic situation in yo ur cells. Fortu

nately, replacing old yeflO'N fat with new brown fat is going to nurture your cells so they work at peak ef
ficiency.

stronger, so you won't put on any of the lean mus cle mass that ma kes you look
youthful and strong.
But the Brown Fat Revolutio n is designed to replenish th ese glycogen stores
th roughout the day, to keep the fuel burning evenly. Wh ich is why it's absolutely es
sentia l to eat a postworkout meal. as this will supply insta nt calories for your mu s
cles so they' ll be ab le no t o nly to replenish th emselves, but to prevent the stressed
muscles from can nibalizing o ther muscles after th e demands of th e workout.
With th e Eating Plan, yo u' ll keep your metabolism eve nly burning and
therefore wor king mos t efficiently, so your bod y won 't he converting calor ies
into fat deposits. lt wo n' t need to. And th at 's wh en the weight will fina lly come
off-a nd stay off.

FAT: IT'S ALL AB OUT T HE VOL UME

My son Blake used to be on his college d ive team, so he gets what m akes muscles
work and beco me shapely with the right kind of weight training; and after lis-

THE BROWN FAT RE VOLUTION BASICS

ten tng to me discuss my theories over the years, he gets metabolism and brown
and yellow fat.
"Fat is the language of volu me," he told me. "Because volume is created by
fat. "
And volume is what makes us loo k youthful.
If you close your eyes and envis ion a twenty-year-old face and a fifty-five
year-old face, then erase all the wrinkles from their skin, which face will appear
older?
The twenty-year-old face will be round and curvy, The fifty-five-year-old face
will be thinner and more angular. It'll look older due not to the amount of wrtn
kles, but to its shape, lost volume , and the distribution of fat.
Having the right amount of good brown fat tha t will keep you looking and
feeling youthful is like building a house with a strong and sturdy foundation .
You want a structurally sound house-and you want a structurally sound body,
too. If you don 't create a solid structure that will properly support what's built
upon it, anything you do to the surface will be cosmetic only. It's like painting a
house without priming it first-the paint will soon peel and flake, leaving the
raw wood exposed to the elements and ruining your house.

FAT AND Y OUR FACE

You need good brown fat supporting the tissues in your face to create a soft,
youthful look. Losing this fat as you grow older changes th e volume of your face,
making it look gaunt . Despite what cosmetics companies often claim, their
moisturizers and creams can treat only the outer layers of your skin-they can 't
treat the underlying tissues, so t here's not hing you can buy over the counter to
replace lost volume in you r face.
THE FAT AN D FAT P OCKETS O F YOUR FACE

What surgeons have learned is tha t you don' t have one solid sheet of fat un
der your skin, although it looks like tha t when you' re young. Instead, th ere are
several fat "poc kets" that all have their own in terna l aging clock. The differen t
pockets of fat gain and lose volume separately, and sag with gravity at differen t
rates--explaining why your face doesn't age unifo rmly.
Althoug h you have no control over how th ese pockets of fat in your face are
going to age, since you can't control the pull of gravity, you do have th e ultimate
contro l over how you affect them-by the way you behave. And the way not to

THE S C I E N C E B E H IN D T HE BROWN FAT R EV OLUTI O N

23

behave is by losing all you r good brown fat. As you know, brown fat creates vol
um e and plumps up skin to make you look youthful. So when you get rid of bad
yellow fat and replace it with dense brown fat, it will make a startli ng improve
ment to the shape of your face.
AGING FRO M T HE TOP DO WN

Let's divide the face into four segments , so you can more clearly understand
how it ages: the forehead, th e eye area, the cheeks, and the central face (the lips
and chin, or perioral area, meaning around the mouth).
These four segments are all unique, especially in texture; the forehead skin is
fairly thick, while eyelid skin is more like silk, and cheek skin is smooth and
peachy. They age at different rates, because they're effected by different
processes. Foreheads and the perioral skin, for example. respond to the constant
movements of the muscles underneath; eyelids are affected by Wrinkling and by
fat; cheeks are affected by how the fat gradually slides down toward the jawline.
The key point is that the four segments usually age from tilt' top down. This is
relevant to understanding fat because what fillsyou r face with volume, what sup
port s your skin and creates the undulations of youth, is brown fat. With age, facial
fat descends, diminishes in quality, and becomes more yellow in consistency.
Improve the quality of you r facial fat, and your face will automatically look
better. Dense. toned brown fat hugs the bones an d muscles and intimately sup
po rts the overlying skin; lose the coa lescence of these tissues and you'll have a
face that t ruly shows its age.
Aging from the top down happens externally and int erna lly, on the top ical
level of your skin itself and to the underlying structure of fat, muscle. and bo ne.
Most often, you' ll first see wrinkles on the forehead, then on the eyelids, the n in
t he crows-feet area, the n th e cheeks, and then the nasolabial fold, or th e line
run n ing from your nose down to your lips.
As we get older, vertical lines-what I call th e elevens-start to appear be
tween your brows and in t he deepeni ng of the naso labial folds. You 'll also see
the eyebrows descending, t he cheeks losing sha peliness, and the ch in line be
com ing less defined and more jowly.
To me, th e ch eeks are the mo st interesting part of t he aging face, as well as
the most difficult part to correct withou t t he correction being obvious. That's be
cause the volume of th e cheek, the beautiful curve right ove r th e chee kbo ne in
the ap ple (referred to in medical terminology as an ogee curve), which the n de
scends down to the mou th segment, has nothing to do with skin. It has every
thing to do with {at.
2.

TH E B ROW N FAT RE V OL U TI ON BA SI CS

I like to call the aging of the cheek "devolution." The (at actu ally flattens out
and falls down, leaving a hollowing-out under the eye. The apple descends and
creates a jowl, as if it were dripping fat like wax melt ing down a candle.
Restoring the quantity and quality of the volume in your cheeks is what truly
creates a youthful contour, whether you're thirty or sevent y.

FAT AND Y O U R BODY

Aging from th e top down doesn' t just affect your face. Your en tire body starts to,
well, droop from th e neck down to you r torso an d even tua lly reach ing your an
kles and feet-primarily due , of course, to changes in (at dist ribution . But, as
you've figured out by now, only if you let It !
The controlling factor when it comes to the distribution of fat in the aging
process is your horm ones . They're responsible for the shape of your body,
whether it's 99, 150, or 250 pounds.
AB OUT H O RMON ES

Estrogen is the female hormone th at rules all oth er female hormones, partic
ularly during its profou nd fluctuations during pub erty, pregnancy, and peri
menopause/ menopause.
The amo unt of est rogen your body prod uces will define you r fat distribution.
It's that simp le-and the reason why men an d women put on weight differently.
When a young girl moves toward puberty and gets her first period, she'll start
to deposit (at in her thighs. During the ensuing decade s of fertili ty, (at will obvi
ously be distributed in the breasts and abdomen during pregnan cy. As estrogen
as well as progesterone levels begin to decline, changes in fat distribution be
come even more pronounced. At the same time , the ma le hormones, or andro
gens (which all women have), become more pronou nced, triggering th e
movement of fat to areas like the arms, th e fron t of th e neck, t he sides of th e
breasts, and the central abdomen.
Obviously, hormon al changes are happeni ng slowly over time, and t here's
no predicting how you'll (are dur ing your lifetime. But it must be said th at if
your health isn' t good, if you don 't eat well, and if you don 't exercise, cha nces
are much higher that you' ll suffer mo re extreme symptoms as menopause ap
proaches, because you 'll have less brown (at and more of the yellow (at that
wreaks havoc on your bod y.

TH E S CI E NC E B EH I N D T H E BRO W N FAT RE V OLUTI ON

,.

TH E RES T OF THE B OD Y AG E S , T O O

Wh y do we age?
Basically, all of the structures of our bodi es a re held together in a toned tasb
ion by clast ic fibers and collagen. Together, they make up the "scaffolding" of
what we call connect ive tissue. The matrix, or substance th at surrounds the elas
tic fibers and collagen, is made up of mucopolysacchartdcs, which are what hold
water in tissue. Think of it as th e fabric
or the netting in betw een cells. With

WHY " S POT REDUC ING "

IS A FALLACY

There's no such thing as "spot reducing "-but I can't tell

you how many of my patients think that if they do a lot of
crunches, their bellies are going to get thinner. Or that if
they do a lot of ann exercises, their arms will lose tat, too .
Your body is predisposed to put on fat in certain areas,
and from a physiological point of view, there's just not any
thing you can do about it. But-and this is the crucial bur
if you have good brown fat in the areas where fat tends to
be visible (likethe belly), you won't really notice it. It will lie
flat near your muscles. It will be dense and resilientand sup
portive, so you won't get that droopoess or poaching that
you associate with getting older. It will create the curves
and shadows of a healthy, att ractive body.

age, th e connective tissue loosens and

beco mes mo re lax.
Whil e th ere's nothing you can do
about the fact that collagen and elastin
are goin g to degrad e over time, you
can certa in ly retard th e process by liv
ing and eating well. A fifty-year-old
woman who's in good sha pe and
who's never smoked is m uch more
likely to look vibrant and youthful
than an overweight smo ker, du e to the
bette r quali ty of her con nect ive tissue.
It's wh y such a woman will have a
younger "Visual Age ~ than her over
weight, smoking counterpart who is
the same ch ronological age.
Ideally, you want to have a Visual

Age that is lower than your chronological age. You 'll certainly be able to do that
when you follow t he Eating and Exercise Plans in th is book.
How your skeleton holds up over the years is one of the basic mar kers of ag
ing. Bon es tend to demineralize an d therefore get softer ove r time , especially in
women. Th is can be exacerbated if you're calcium deficien t, leading to osteo
poros is. If the osteoporosis is extre me, you literally lose inches of height.
Your organs also wor k less productively as you age. This has noth ing to do
with fat. Believe me, if scientists could figure out how to stave off these inex
orable changes, we would all live a lot longer.

2.

TH E BR O WN FAT RE VO LU TI ON B A S IC S

AND NOW . . ONWARD TO T H E BROW N FAT

REVOLU TIO N

What is the essence of the Brown Fat Revolution?

When it co mes to fat, what do we all want to do? We want to co ntrol th e vol
ume of fat in our bodies as well as the quality of this fat. We also want to ha ve
faces and bodi es that are as hea lthy and youth ful-looking as possible.
So why d o people get fat? The princip le is simple: You put on fat when you
put more ene rgy into yo ur body (with food) than you put out (wit h energy ex
pended, as with exerci se). But the solution to managing fat in /fat out is not sim
ple at all-which is why o besity is at epidem ic leve ls. The average American
doesn't know how to eat well o r when, o r how much exercise to do a nd wh at ex
ercises will be best for th em .
The Brown Fat Revolution will show yo u that inst ead of th inking of fat as the
en emy, you can learn how to harness its power to reshape your body and im
prove your health.
The Eating Plan will teach yo u that wh en you eat specific kinds of foods (ei
ther carbo hyd rates o r protein ) at spec ific times durin g the da y, you won 't have
any excess carbohydrates lett in yo ur body to be co nverted into yellow fat.
Eating six. tim es a day will keep your blood sugar at an even level, so you will
avoid the peaks and valleys of cravings that lead to bingeing. Your body will
quickly com e to realize that more n utritious food will always be co ming every
few hours, so it will no longer be primed to store any excess as yellow fat. Calo
ries will automaticall y become good bro wn fat.
The Exercise Pla n will help you strengthen and sho re up the nonbulky muscl es
of your core-all the musc les that define a youthful silhouette. Lean musc le has
high energy requirements, so even at rest it will keep your metabolism elevated . (It's
as if you'll becreating a mu scle fumacel] Comb ine th e n ew, stro nger, leaner musc les
with the balanced approach to eating, and you will no t on ly get rid of your yellow
fat, but also strengthe n th e rest of your body as well as imp rove you r posture.
Th is syste m will wo rk even If you have declining hormone levels-the ho r
mones th at trigger more fat dep osits as you age. As yo u get older, yo ur bod y pref
erentially deposits fat in specific sites, most noticeably the abdomen, flanks,
outer thig hs, and u pper arms. (When this happens is de ter mined by yo ur gen es
and your gender.) But o nce you rep lace t hese hormone-triggered, "m idd le-age"
zones of yellow fat wit h dense and resilient brown fat , your body will once aga in
look you nger and more shapely.
Read o n, and you 'll see ho w the Brown Fat Revo lution will work fo r you .

THE SC IENCE BEH IND THE BROWN FAT REVOLUTION

2.
HOW YOU AGE-AND
HOW FAT PLAYS ITS
ROLE: HORMONE
CATEGORY I

Now that you understand the crucial role of fat. let's take a loo k at what's going
on ins ide your body-at the sh ifting patterns of your fat dist ribu tio n, and ot her

changes you'll experience as you age.

Because the aging concerns of women in the child-bearing years are different
from those of women twenty years their seniors, there are two disti nct Eating
Plans for the Hormo ne I and Hormon e II categories, as you'll see in part 2.
Women in their thirties have faces that show t heir experience yet are still
stunningly youthful; the genetic traits that predispose t hem to certa in skin con

ditions, such as dark undereyecircles, usually have not yet appeared. Or. at least.
the re's no reason for their faces "ot to be youthfu l (unless the women have been
chain-smoki ng or bak ing in the sun every day). Althou gh getting older is not 0(
ten at the top of an y thirtysometh ing's to-do-wtth -enthustasm Jist, by tackling
the aging process ' lOW , you 'll not only replace yellow (at with firm brown (at, but
loo k and (eel you nge r (or m uch , m uch longer.
I often explain th is concept to my patients in t heir t hirties, but a lot of them
do n' t liste n- not until I add that it's inappropriate to treat things that do not ex
ist yet, such as in ject ing Botox into as-yet-to-appear wrin kles on thei r (oreheads.
And that how th eir faces look is directly related to their overall health and sense
of well-being.
For instanc e, (or patie nts in t heir th irt ies who eat crumm y food, dr ink too
m uch , smok e, and are hug ely stressed out, all the m lectables in the world will
not make a difference. The ana logy I use is: Imagine that you ignored the health
of your teet h until you were in your thirt ies. Wh at would the denti st do when
you appe ared in his office when you were thirty-t hree? A competent dentist
would never cover up th e rott en teeth with shiny ven eers. Instead, a good den
tist would teac h you about good dental health.

HO W Y OU A GE-AND HOW FAT PLAYS I TS ROLE : HORM O NE C A T EG O R Y I

,.

All the rejuvenating treatm ent s I offer my patient s are ineffectua l without
healthy living. Typical of those pati ent s is Miranda . She's thtrty-stx, has a good
but mgb -pressure job at a large corporation, and is busy dati ng and com pa ring
notes with he r girlfriends. She spends her summe r weekends at th e beach in th e
Hampton s and ma ny of her winter weekends skiing in Vermont, occasionally re
membering to use sunscreen. She often eats out in restaurant s, entertaining
clients , and has a glass or two of wine during these evenings . She wants to keep
her job, so she takes great cate to keep he r ene rgy up and look her best. She also
want s to ma intain he r edge and sexiness, as she would very much like to find Mr.
Right.
But she's doing all the wrong things. She-like most of her colleagues, or
friends who are stay-at-home moms-rushes to the gym several days a week, ex
ercising with lots of cardia (such as a high-intensity spinning class) and an abs
class. She skips breakfast every day, grabs lunch on the run (usually a nonfat yo
gurt ), barely touches fruit or vegetables, but drinks bottled water and coffee all
day long and scarfs down whatever vitamins her friends tell he r they've read
about. Because she often has to eat out for work, she rarely cooks for herself. In
fact, she likes to joke that her oven is a great place to store her shoes, as she never
uses it.
Miranda came to see me because she's concerned that he r skin looks "tired
and blah ," as she put it, and because she's worried that the "elevens" between
her eyebrows as well as her nasolabial folds are deepening, making her look an
gry and tense all the time .
Althou gh Miranda doesn 't know it yet, she's on the tip of the critical mass
iceberg, with her face undergoing subtle changes, most of which are no t yet vis
ible. Which is why she was not happy when I told her that, yes, a few inject ions
of Botox would tempo rarily erase the wrinkles on her forehead, an d a few sy
ringes of juvederm in jected into her nasolabial fold would help plump up the
area, but t hat they wouldn' t do an yth ing about th e bad yellow fat that's starting
to wreak ha voc in her face.
And that, in fact, if I used Botox and fillers, I'd be treatin g only her symp
toms-not t he cause of her complaint.
11 was time to coach Mirand a into a com plete lifestyle ch ange, one that
would restore her skin to optima l conditio n ; rehydrate her facial tissues, includ
ing her facial fat; optimize the volume relationsh ips of th e tissues of her face;
and he lp her un derstand th at she needed to treat her face and bod y as one unit.
I exp lained tha t she had the power to cont rol th e process en tirely through a
muc h more n utritious Eating Plan and a much shorter and easier Exercise Plan
3.

THE BROWN FAT REVOLUTION BASICS

that wou ld utt erly tra nsfor m her face and body, del ay the aging process, and
help her look the best she possibly cou ld-for the rest of her life. And that if she
followed t he plan, she would no longer need Botox or fillers, because the pos i
t ive cha nges she'd make wo uld enhance her face well beyond a level that could
be ac hieved with these treat ments alone.
Making this a program for life means taking the time for (and getting th e
emotional satisfaction from ) doing what you mean when you say "My body is
hugely valuable to me. I am going to respect and nourish my body now to keep
it alive and thriving for as long as I possibly can." It's a very different mtndset
than "You fix it and I'll forget about it. "
In fact, if you follow these Eating and Exercise Plans from the time you 're
thirty, you, like Miranda, will be sparing yourself the need for injectable fillers to
replace the lost vo lume in your face once you tum fifty. Women in their thirties
respond in credibly quickly to thi s plan . As long as you stay on it, once you r yel
low fat is t ransformed to brown fat, it ....ill remain as brown fat, keeping your face
and body firm and resilient , with strong. toned muscles.
You will, in essence, have created your own an ti-aging regimen by slowing
down the aging process , all on your own. Of course, you can't make yourself
have good brown fat that looks thirty forever, but you can certainly stave off the
unwelcome aspects of aging for far longer than you dreamed possible.
You won 't just look far younger than your chronological age-your internal
organs and your skin will be younger because, buoyed by their cushion of den se
brown fat, you 'll be in op timal hea lth .

HOW YOU AGE IN YOUR THIRTIES AND FORTIES

"Critical mass" is a term used to describe a tip pi ng poi nt for your body, and it
sta rts in your th irties. You will be un dergoing very slow, incre men ta l cha nges,
particula rly with th e yellow fat deep insid e your body, but they likely aren't yet
no ticeable, since your eye needs to see a certa in amou nt of critical mass 10 visu
ally con nect to it. Without th ese visual cues, it's har d to believe these cha nges
are tru ly ha ppening.
You 'll have experienced the critical-mass ph enomen on every time old
friends reconnect with you, eithe r in person or on a social networking site like
Facebook. The longe r the time spa n between the last time you saw them an d the
present, the more pronounced your reaction will be to their current appearance.
It can be jaw-droppingly scary to see old friends who appear to be aged well be-

HOW Y OU A GE-AND HOW FAT P L AYS ITS ROLE : HORM ONE CATEGORY I

yond the ir years, especially if t hey're the same age you are-and if your memo
ries of them a re of whe n they still had their youthful conto urs and strong. firm
bodies. If, however, you'd seen these people every week for the last twenty years,
you would be far less surprised at how they're aging.
Critical mass is also one of the reasons why it's so hard to convince women to
wear sunscreen religiously. Unless they get a bad bum, they don't see the skin
damage from the sun every day. It takes many years for spots, freckles, blotches,
and wrinkles to develop. By the time they do appear, the real damage has been
done-and undoing it is a lot more difficult than preventing the damage from
happeni ng in the first place.
So when you th in k about aging in you r thirties and forties, reme mbe r th at
you migh t not yet be seeing the visible effects of aging-but th ey' re lur king just
benea th the surface, ready to appear, if you don 't take actio n now.
CHAN GES TO YOUR C ELLS

Believe it or not, as soon as you're born, you start to die.

Your body is made up of trillions of cells, all with a set lifespan. How long
they're able to funct ion is called cell senesce nce , the bio logical equ ivalent of old
age. In a young cell, its metabolism is active and the waste products produced are
easily removed. In an old cell, its metabolism slows down and its ability to re
move waste also decreases , so this waste can back up into the cell itself, leading
to sluggishness. The cellular rate of reproduction decreases, and cell membranes
are prone to breaking down more easily as well.
Due to critical mass, cell senescence doesn't create a visua l change until it
reaches a certain threshold. At that point, all these changes at the primal. cellu
lar level have affected all your tissues , so you look different-and older.
The Brown Fat Revolution is designed to enhance cell metabolism, restore
some of the essential cell functions, and therefore be able to reverse some of
these visua l cha nges. Lucky you if you're in your thirties-this prog ram can de
lay the cha nges sign ifican tly, too.
CHANGE S TO YO UR FAT

During your th irties, your fat should still be firm, un less you a re quite over
weigh t. You may noti ce changes in your th ighs an d buttocks, as t hose are the ar
eas where fat will collect first.
In your forties, though, yo u'll start to see a softening of your lower abdome n,
where there are fewer muscles below the belly button than above it to support
the area. This is a result of yellow fat accumulating intra-abdominally.

THE BR O WN FAT RE VOLUT ION BAS IC S

The abdomen Is const ructed with different layers of muscles; the transversus
abdomini s goes horizontally across the abdomen and keeps the bulge of t he in
tern al organs looking flat- but on ly if it's tight . In addition , th e area above the
belly button is anato mically weak and also prone to bulging. So as your hor
mones trigger cha nges to fat placement in your body, any anato mically weak ar
eas will be visible unless special attentton is paid to compensate for nature's bad
joke on female anatomy.
CHANGES T O Y O U R H O RM ON ES

Fortunately, when it comes to hormones and their effect on your fat, your
th irties are likely to be pretty much the same as your twenties . The big difference
will be that your fertility will start to decline precipito usly after the age of around
thirty-five . And, obviousl y, if you're having child ren, your pregnanctes will
cause monumental shifts in honnone production.
ljke most women, you'll start notidng perimenopausal symptoms in your
forties. Youcan blame thi s on declining levels of estrogen and progestero ne, par
ticularly when you find yourself wide-awake in the middle of the night due to
unplanned and unwanted mood swings and hot flashes (the first one of these
can be an extremely unwelcome shock). Or when you wonde r why your skin is
breaking out even as you r period is becoming irregular, or why your pants do n't
fit even though you're eating the same way you have since you gradua ted from
college. Amo ng t hese and other symptoms, estrogen and progesterone are also
signali ng the fat in your body to shift arou nd whe re it's least wanted .
In your thirties, your en ergy levels shoul d still be strong and your metabo
lism pretty much unch anged from your twenties. In your forties, your metabo
lism starts a very gradual slowdown. You might realize that th e five pou nds you
could have easily lost on ly a few years ago simply won 't budge. And if you
haven 't been taking good care of yourself by eating well and exercising properly
over the years, th e forties is th e decade where it will all start to catch up with
you. Natu rally, it will always catch up to you at some point, no matter what , but
this will happen much earlier for th ose who 've taken the least amount of care of
themselves.
That said, from my experience as a plastic surgeo n, I find the forties to be the
decade where women are obsessed wit h everyth ing but th emselves. (Altho ugh
man y women are having children in th eir thirties, they' re still very active and
con cerned abou t t heir looks.) They're Instead taking care of their ch ildren, th eir
careers, or bot h.

H O W YO U A GE-AND H O W FAT PLAYS ITS R O L E : H ORM ONE C AT EGO RY I

33

CHANGE S T O Y O U R FA C E

The th irties are when faces start to lose their dazzle. They might not be very
wrinkled yet, but the skin text ure is beginning to change.
In your thi rties and fort ies, th e four differen t zones of you r face probably
look someth ing like th is:
FOREHEAD Since you age from the top down, your forehead will start to
show deepeni ng wrinkles when you're in you r th irties, as well as show th e lines
tha t look like "elevens" between the eyebrows (the glabellar lines).
EY E AREA Crows-feet will start to appear in the comer of the eyes. The real
changes here happen in the forties, when my patients universa lly say, "I loo k
tired." They look tired because they have bags and deep discoloratio n around
th eir eyes due to poo r skin quality there. Their eyelids may start drooping
slightly as well as become more crepey.
CHEEKS This area usually looks good throughout your thirti es, but starts
losing volume in the upper chee k first. Asthi s fat conti nues to descend, not only
does the entire upper chee kbo ne area start to look more hollow and gaunt, but
all tha t volume has to go somewhere, and it does. It slides down to you r jawline,
where it appears as something nobody want s: the jowl!
C ENTRA L FAC E The central facial zone is the area outlined by the na
solabial folds, which are the lines or folds t hat exte nd from th e sides of your nos
trils down to th e corners of your mouth.
Women in their th irties d on 't usually see many changes arou nd th eir lips un
less they are heavy smokers; these wrinkles start appearing in the forties. This is
also when the nasolabial fold area starts to become more pronounced as it be
comes segmented from the cheeks.
CHANGE S T O Y OU R B O DY

In your thirties, your fat is starti ng to slowly shift to your hips and th ighs.
And because thi s is th e decade when many women have childre n, you may also
have problems with restoring muscle tone to your abdomen after pregnan cy. If
you 're in good shape an d eat well, however, you sho uldn' t be seeing very many
changes to your overall body shape ot he r than those produced by pregnancy.
The forties are when changes really start to happen, as you r yellow fat moves
into the uppe r arms, around your breasts, an d in to the buttocks as well as the
hips and thighs that you were starting to noti ce in your thirties.
For both decades, posture is also extremel y important, as if you sit with
hunched shoulders, you' ll automatically look older.

34

T H E B ROW N FAT RE V OLU TI ON B A SI C S

B REASTS

Women in th eir forties

\\;11

note with dismay that their breasts

ma y not be as finn as th ey used to be. You might see a redistribution of fat so that
there 's more volu me on the outside,
makin g your breasts loo k flatter and
ABOUT Y OU R FASC IA
droop toward your arm s when you lie
down.
Every muscle is encased in a layer of tissue called fascia.
ARMS In your thirties, whatever
Muscle on its own doesn't have a structure-that structure
you do to firm up you r arms will show
is provided by the fascia, which holds your muscles in the
up beautifully, so this is the ideal time
proper position next to your bones. You can see what it
to start working with bungee cords
looks like next time you' re cutting a raw chicken; when you
and/or light hand weights.
take the meat off the bone, that hard stuff that you can't
As you enter your forties you' ll no
tice your triceps sta rting to look a little
fleshy -looking an d less defined, lead
ing to that d readed upper-ann sag
what man y of my pat ients call bat
Wings.
HANDS Your hand s should still
look good , unl ess you spend a lot of
tim e in the sun, wh ich will give you
age spots, freckles, and a loss of skin
elasticity.
BACK Your back sho uld still look

pull is the fascia.

Think of fascia as being like skin, especially since you can
actually improve the quality of your fascia with good nutri
tion and with exercises that increase lean muscle mass. tm
proper nutrition and lack of movement will stretch your
fascia out of shape-and once it does, it will take a long
time, perhaps even several months, to snap back.
Healthy fascia also has a better relationship with the
muscle itself, so that the muscle will be firmer within the
casing of the fascia-ccreatinq a shape and contour tha t
looksas it did when you were much younger. Thisis partic
ularly noticeable in your butt; strengthen the glutes and
you'll help support your fascia and keep everything lifted.

good in your thirties and forties.

ABDOMINA L AREA Everyon e's
abdominal m uscles are different; you
may have naturally stro ng obliques (the m uscles at the sides of your waist),
while your sister may have less de fin ition at her wai stline. Llke most women of
all ages, though, you' ll tend to have weak lower abs (unless you're a dancer or do
a lot of core-intensive exercise; there are specific exercises for the lower abs in

pa rt 3).
In your for ties, however, the lower abdominal area will show even mo re
mar ked changes, as three things happen to create th e dreaded "pooch": Weak
muscl es continu e to get weaker; horm on al changes trigger ext ra fat deposits; a nd
th e fat collects in th e abdomen and aroun d th e intestines, wh ich starts to push
th e abdo men outward In the weakest area (which is, un fort un ately, the lower ab
domen).

HO W YOU AG E-AND H O W FA T PL A Y S I T S ROLE : HORMONE CATEGORY I

,.

Dealing with thi s abdom inal fat is a must-the Eating Plan in part 2 directly
targets subcutaneous fat volume, an d lower abdominal weakness is reversed
wit h th e Core Curriculum prog ram in part 3. When you develop a strong mus
cular wall, it will keep this area flat despite the intern al, hor mon ally driven
changes to fat, an d despite the variations in your diet th roughout t he day.
BU T TOC KS Unfortunately, th e gluteal muscles (or glutes) begin to fall when
you're in your th irties, and once the skin has been stretched out in the in
fragluteal fold, where your buttocks meet you r thighs, it's a challenge to get it
back to th e youthful relat ionship where t he lower butt is well demarcated from
th e back of the thi gh, creating the ever-desirable roun ded "bubble" look.
Fortunately, you can lessen t he drooping and loss of sha peliness by doing fo
cused exercises, as you' ll see in part 3.
THIGHS You'll probabl y retain your flexibility and firm thighs in your th ir
ties, but tha t's also the time when you begin to deposit more (at, usually in th e
lateral (outside, or saddlebags) and medial (inside) thighs. These fat deposits will
become more pronounced in your forties.
KNEE S If you exercise regularly, you r knees should look prett y good. If you
don 't, in your forties they will gradually start to lose definition and become
rounded, with pockets of fat on either side of your kneecaps.
C ALV ES Calves, as a rule. do not collect fat. (Ankles only collect fat with
obesity, so th ey're not applicab le to th e scope of thi s boo k.) The definition of
your calves is geneti cally determined, but since they are comprised of a beautiful
diamo nd-shaped complex of two muscles, when the y are well defined , they bal
ance the thi ghs and make th e leg look young .

,.

TH E B ROW N F AT R EV O L U T IO N B A S IC S

CHANGES T O Y OU R BODY A FT E R PREGNANCY

When you have children , your body undergoes some of the most amazing changes you'll ever live
through, and it's certainly worth the aching feet. swollen ankles, and humongous belly so you can have
a hea lthy baby. But the nine months of preg nancy also wreak havoc on the fascia an d muscles of the ab
domen.
As a result, in my practice, most of my patie nts come to see me after th ey're don e having children.

They need my advice because they've tried everything but aren' t able to get a flat abd omen despit e do
ing over a hundred crunches a day. At the same tim e, they ca n't shed much of th eir postpregn ancy
weight, having reached a platea u that simply will no t bu dge. Worse, this weight is found in the areas
where soft yellow fat is already prone to collect-in the midsection of th e body, the abd omen, but
tocks, and thighs. And since add ed weight in these areas makes a body look '"matronly," these patients
are d istraught about thei r postpregnancy shape, and are absolutely determi ned to look sexy and young
again. All they talk to me about is the shape of their breasts and the droop of their abdomens, despi te
their frequent stints doing cardio in the gym and their highly restrictive d iets. As a result. they are shred
ded of body fat. have no volume in their sagging breasts, and have flat but loose-skinned abd om ens
and thin, ga unt faces that look much olde r tha n their chronological ages.
Ifthese co mplaints sound fam iliar, the Brown Fat Revolution willgive you your body back.

H O W Y O U A G E-AND HO W FA T P LAY S IT S R O LE : H ORM ONE C A T EGO RY I

"