By Maureen Callahan, M.S., R.D
October 04, 2010

Physician Howard Shapiro's weight-loss regimen has been touted in Vogue and on "Good Morning America"; his clients include top fashion models and business executives. Yet the biggest fans of Dr. Shapiro's Picture Perfect Weight Loss plan are New York's finest: Together, these police officers and firefighters have shed a whopping 2,544 pounds. Firefighter Michael Carter and his wife, Marion, for instance, lost 110 pounds. Firefighter Dean Pappas lost 28 pounds. And the first group of 15 police officers indoctrinated to Picture Perfect back in 1995 dropped a total of 684 pounds. What's the secret? Pictures—lots of them. Shapiro uses full-color comparisons to teach his "look and lose" strategy. Gorgeous pictures zero in on foods with high-calorie price tags and stack them up next to huge quantities of more-healthful selections with the same calorie tab. Imagine: on the left, a full-page photo of a pint of premium fudge-chunk ice cream; on the right, its caloric equivalent: 4 pints of sorbet or 42 low-calorie frozen chocolate-mousse bars. Another example: 3 ounces of battered and fried Japanese chicken tempura pitted against 1 cup of miso soup, 1 cup Japanese salad, and a 12-ounce helping of sushi and sashimi. The idea is to help dieters understand the calorie repercussions of food choices. Mindless nibbling may never be the same.

Incredible photography will draw dieters into this book and make the process of choosing the right foods seem downright friendly. But the loose approach to retraining eating habits is probably not a fail-safe method, at least not for all dieters. Maybe it's nitpicking, but the all-you-can-eat, fat-free-frozen-dessert strategy seems to send a mixed message. Yes, most of these treats are low-calorie, but they don't always satisfy as well as their full-fat counterparts. And you can still do a lot of damage if you eat too much of these foods. In fact, some nutritionists might suggest that a good piece of chocolate or the occasional scoop of full-fat ice cream could be more satisfying than a vat of the fat-free stuff on a daily basis. Still, there's a lot of practical advice in Shapiro's two books that is sure to connect dieters with the basic principles of weight loss.

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Basic principles:

It's all about change and choice. The ultimate goal is to choose lower-calorie, healthful foods the majority of the time. There's no diet plan per se, no right or wrong choices. In fact, if the higher-fat option is the one you feel like having one day, then go for it. The thinking is that you must gradually change your relationship with food so that lower-calorie foods are your main choice. When that happens, the pounds naturally disappear.

How the diet works:

It's not really a diet but a strategy. Shapiro calls it FAT, or Food Awareness Training. If you become aware of what different choices provide in calories, you can change your relationship with food. Nothing is set in stone.

What you can eat:

Nothing is taboo. Shapiro offers his own food pyramid to steer dieters to the most healthful selections. At the base are fruits and vegetables, "any and all, as much as possible, as often as possible." Whole grains are preferred over refined products. For protein, Shapiro recommends soy, legumes, and seafood. Nuts, seeds, healthful oils, and avocados are the allowed fats. For dessert: hard candies and fat-free frozen desserts. There's also an "Anytime List" of foods to eat in unlimited amounts: all fruits and veggies; soups; fat-free condiments; fat-free dressings and dips (to go with those free veggies); hard candy; and fat-free frozen desserts like yogurt, fudge bars, and sorbet.

Does the diet take and keep weight off?

No clinical studies from peer-reviewed medical journals. But Shapiro reports his own findings from clients who have successfully lost weight on the plan.

Is the diet healthy?

Probably. But since the plan is pretty loose, the overall nutritional quality of the diet will vary from dieter to dieter. Best bet for parents: The newest book, Picture Perfect Weight Loss 30 Day Plan (Rodale, 2002), offers some great advice for dealing with childhood obesity.

What do the experts say?

"The pictures are beautiful," says John Foreyt, Ph.D., a renowned weight-control expert from Baylor College of Medicine. "And they illustrate healthful food choices. But most dieters need more than pictures." Foreyt thinks that telling people to forget about watching portions isn't good advice even when all the selections are low-calorie. "Studies show that counting calories is one of the best behavioral weight-loss strategies there is," he says. "I think most of us have to count calories and watch portion sizes if we're going to be successful at weight loss." Registered dietitian Dawn Jackson, a spokesperson for the American Dietetic Association who specializes in weight loss and exercise counseling at the Wellness Institute at Northwestern Memorial Hospital in Chicago, frequently leafs through Shapiro's book with her weight-loss clients. "It's a great way to teach people about food choices," she says. "It gets the message across about calories."

Who should consider the diet?

Artists, creative types, and visual learners; dieters who can't abide calorie counting or strict regimens. Meat lovers might find it difficult to embrace soy burgers and tofu. But, hey, New York's police and firefighters certainly made the switch—so it is possible.

Bottom line:

What a great idea! Dr. Shapiro's simple behavioral strategies and eye-opening visual comparisons are just the ticket for some dieters. But to be honest, a lot of overweight people already know that Ben & Jerry's isn't diet food. And it's going to take more detailed and individualized diet advice, as well as some serious hand holding, to help those folks overhaul their eating habits.
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