In The Skinny: On Losing Weight Without Being Hungry, Dr. Louis J. Aronne says losing weight has nothing to do with willpower. He refuses to lay blame or make people feel bad because they haven't had success shedding pounds. Find out what he says is actually stopping people from losing weight, as well as his secrets for feeling full with fewer calories, after the jump.

Q: You say dieting is about fillpower and not willpower. Can you explain?

A: I think that we underestimate the willpower that people have. We're insulting people who have weight problems by implying that they don't have any, that that's why they are not successful. Some of the patients we see are some of the most successful people in the world. Saying they don't have willpower, that's not true, they are incredibly effective and successful in every sphere so how could it be that they just don't have willpower when it comes to their weight? It's because there is something physical going on. There's something going on that is more than meets the eye. To just keep pointing the finger at them and blaming them hasn't gotten us anywhere. So we've taken a completely different approach. Virtually every patient we see has failed elsewhere and it's surprising how often we're able to get people to succeed.

Q: What is the main reason behind your diet-plan's success?

A: We take a diagnostic approach. Instead of blaming people, we look for the reasons why they may not be succeeding. A classic example would be finding that somebody has a sleep disturbance. Someone who has sleep apnea can have tremendous difficulty losing weight and will tend to gain weight. If you don't diagnose the sleep apnea, no matter how much willpower the person has, they are fighting an overwhelming battle against a physical battle. What sleep apnea does is it shortens their sleep, it gives them an unbalanced sleep, they can never get into the deepest levels of sleep and so they have low levels of one hormone called Leptin and high levels of another called Ghrelin that makes them hungrier and as a result they continue to gain. If you diagnose the sleep problem and treat it effectively, it can make it a lot easier to lose weight.

Q: What about emotional eaters? Do you have specific advice for people who fall into this category?

A: There are a couple of ways that can be dealt with. I think that one of the things when it comes to emotional eating is that it can be difficult to prevent emotional eating, the question is how much do people eat when they are emotional eating. By following our plan, what we're trying to do is to get people to feel full sooner and to eat less. We refuse to make people feel badly because we recognize it's a coping mechanism. If you take away one coping mechanism, another one is going to pop up. People start drinking or start smoking. We don't insist that people get rid of that as a coping mechanism but what we try to do is deflect it to something else. We try to show them that they can feel just as good by exercising or eating fruits as if they are eating a cookie. Maybe not! But if they have a cookie at the end of a meal where they had a lot of vegetables and chicken and really felt good about it and then had two cookies, a lot of times they'll feel okay.

Q: When people fail on a diet plan, they often end up putting on even more weight than before. How do you help your patients stop this vicious yo-yo dieting cycle?

A: The first thing is we understand how yo-yo dieting occurs now. We understand what the nature of it is physically. We recognize that there are ways to intervene early on and try to abort the upswing in the yo-yo. Trying to force people down as far as possible is the type of thing that can promote yo-yo dieting. If you really try to hammer someone's weight down way beyond where they should go, we find that may make them more likely to have this rebound. So we spend a lot of time talking to people and explaining that they're going to hit a plateau and we may not be able to control it and if that happens that's kind of the way it is, don't worry about it, that's the best we can do rather than keep throwing things at them to keep forcing their weight lower and lower. We try to take the straight-forward approach of explanation that makes people understand it. We find that it goes a long way in terms of preventing it by not over-dieting someone. Then when it comes to weight re-gain, we look at it like a cardiologist looks at a heart attack. We want to see you right away. People should not be ashamed of weight regain.

Q: What have you learned about the plateau phenomenon that might help people to understand it better?

A: What research has shown is that as you lose weight, your fat cells shrink. Certain hormones that are produced, one in particular called Leptin which is produced by the fall cells, their production is reduced more rapidly than the shrinking of the fat cells. So as your fat cells begin to shrink, let's say your fat cell size goes down 50%, your Leptin level goes down say 80%. The levels of these hormones go down faster than the amount of fat in your body. It's kind of a good news/bad news story. Your hormone level going down faster is one reason people seem to get so much health benefit from weight loss. You lose 10% of your body weight, your blood pressure and blood sugar levels go down. There can be enormous health benefits from losing a little bit of weight. But at the same time, levels of these hormones get to levels like somebody who is almost in the normal weight range, even though their weight is still high. Even though you still have more fat on your body, your brain thinks your weight is normal because the level of the hormone may be approaching normal. The plateau is caused by lack of a hormone. It's physical, it's not something that's purely mental. Even people who have surgery run into this, instead of screaming at them, you measure levels of the hormone and they're going to be down. I have a box of tissues on my desk for people who come in crying because they're frustrated, they're upset. People are screaming at them, asking them why they aren't losing weight, but they're trying. It's like they're not being understood. A big part of the first part of the book is critical in trying to help people to understand themselves and see what's going on so that they have a new perspective on this problem. That's what people find is so appealing about coming to see us because they get this insight.

A: It's clearly vegetable-related. The kind of eating that we recommend to people is more of a style of eating, for instance, having your vegetables first. We're big believers that instead of telling people exactly what to do, if you start out with filling foods, which get the fullness mechanism going first that you're going to be a lot better off. You start off with your vegetables, then you have your healthy protein and then you have your carbs at the end of the meal. You're far better off if you do that. Otherwise, if you talk to people, they start out with a piece of bread, then they have some potatoes and meat and more potatoes and more meat and at the end they have three stringed beans a couple of bites of salad. I can't tell you how many years I used to hear 'I didn't have any room for my string beans. I was so full because I ate so many potatoes and such a big piece of meat.' So we started recommending that you can't eat your meat until you finish all your string beans and all of your salad. I know it sounds like something a strict mother would say but it's amazing how much it fills people up and gives them the kind of nutrition they need. For some people counting calories can leave you feeling empty. You just don't feel like you've had enough. For someone like that, this type of approach is a good way to go because it focuses on making sure you don't have those signals driving you out of your mind.

Q: What's the one food that people are most surprised to learn is actually bad for them?

A: They don't realize how many calories are in juice. Everybody thinks 'what could possibly be bad about juice?' While juice is fine for a lot of people, for people with weight issues, we find sometimes, especially for children, that you almost have to diagnose their juice drinking by taking it away.

Q: Would freshly squeezed be just as bad?

A: It's not that it's bad, but it has a lot of calories so while it may have vitamins and other health benefits, for someone who is obese, juice may not be a nutritional bargain.

Q: In terms of importance, what percentage is eating well and what percentage is exercise when it comes to weight loss success?

A: Exercise is a benefit no matter what your weight. There's health benefits, you feel better, no matter where you are in the situation. People who lose weight, usually the most effective way is to cut down on calorie intake first and then to start exercising because the main role of exercising is maintenance and to get to the lowest possible weight. If you have a certain amount of mental energy that you can focus on the problem, we think you should focus on cutting down on calorie intake first and the rest later.