By VICTOR S. SIERPINA

If you have struggled as many do to lose weight, you might feel frustrated, ashamed or guilty that no matter what, those pounds seem to hang onto you like a too tight inner tube or a rear end cushion. Here is some encouraging news from Dr. Gerry Mullin, Associate Professor of Johns Hopkins Department of Gastroenterology: It is not your fault.

Dr. Mullin has just written a popular new book, “The Gut Balance Revolution,” that turns traditional approaches to weight loss on their head. From beginning to end, he emphasizes the importance of perseverance. He should know. He was a 290-pound high school senior who was told he could never live his dream of getting into medical school because of his obesity. Motivated, he eventually lost 120 pounds, without bariatric surgery, and eventually ended up as a faculty member at one of our country’s most prestigious medical schools. His formula for weight loss success presaged current new research on the effects of our gut bacteria or microbiome on metabolism, obesity and health.

Did you know that if your were cesarean section born, had multiple antibiotics as a child for colds and ear infections, were fed a diet low in natural probiotics from fermented foods like yogurt, or ate mostly food low in fiber containing prebiotics which are primarily present in plant foods, you are at increased risk of obesity? Not only that, the mix of those altered bacteria in your gut have altered your metabolism of carbohydrates into high levels of fat promoting short chain fatty acids that promote obesity.

Whew! It’s not my fault, what a relief. So many of my patients complain they can’t lose weight past a certain set point, no matter how much they starve themselves and increase exercise. As you well know from hard experience, it is more than the balance of calories in and calories out.

What to do? While space here does not allow, I will give you the basic principles of Dr. Mullin’s weight loss program. I recommend that if you want to take a new approach to weight loss, get a copy of this highly readable and scientifically based book. It will cost you a bit more than a fast food dinner for the family, but is well worth it. With this program, you don’t need to take the risk of diet pills, hormones, diuretics, herbs, radical low carb, low gluten, extremely low calorie diets and other unproven or unsustainable weight loss therapies.

His program is structured around rebalancing your gut bacteria (who really are to blame!):

Phase 1: Reboot — Weed your inner garden and rev up your metabolism with super foods. This is a 30-day program with reduced carbs, sugars, artificial sweeteners and other foods that promote growth of unhealthy bacteria.

Recommended foods include: Eggs, chia seeds, cinnamon, berries, green tea, ginger, avocado, quinoa, cayenne pepper and whey protein.

Phase 2: Rebalance — Reseed and fertilize your inner garden with additional super foods. These are foods that promote a healthy mix of gut bacteria such as: Oats, asparagus, beans, kale, miso, yogurt, kefir, kimchi, turmeric and vinegar.

Phase 3: Renew — Keep your friendly flora (microbiome) and you healthy for life. Sustainable weight loss is always our goal. Stay with: Salmon, olive oil, apples, dark chocolate, greens, flaxseed, nuts, coffee, broccoli and artichokes.

Dr. Mullins concludes his book with healthy practical advice including food charts, meal plans, shopping lists, recipes and other weight loss tips.

What do you have to lose? Remember to persevere.

Dr. Victor S. Sierpina is the WD and Laura Nell Nicholson Family Professor of Integrative Medicine and Professor of Family Medicine at UTMB.