Weight Loss Program
Most of my patients are either trying to lose weight, improve their cholesterol, and/or trying to live a healthier lifestyle with a better diet. For the past 20 years I have tried all sorts of things to help them, and none have had long term success. We have tried various diets, pills (phen-fen being a spectacular failure), and surgery. None, with the possible exception of surgery, have given any significant long term success. I’m hoping I have found something that will be useful.
We recently started offering a diet and wellness program called Cornerstone Wellness. This program is physician supervised, and based on the patient’s needs, preferences, and lifestyle. The program itself is based on the most recent scientific findings in weight loss. Although calories in still equal calories out (see my Health Tips Article for more info on this), it’s actually a little more complicated than that.
The Mechanics of Weight Loss
When the body is deprived of energy, it will preferentially break down lean body mass (i.e. muscle) and try to leave the fat stores intact. When weight is gained back, it will be gained preferentially as fat. That is why yoyo dieting is so bad, after a few cycles of dieting you may weigh the same, but you will generally have much more fat compared to muscle than you had before. To make things even worse, your basal metabolic rate (the minimum amount of energy you need, AKA resting rate) is tied to lean body mass. So if you weigh 200 lbs, and 100lbs are lean body mass, you will need to eat a lot less to maintain that weight, than if 150 lbs of that was lean body mass.
So how can you lose fat preferentially? One way to do this is by eating lots of protein. Protein protects the muscle, and is a natural appetite suppressant. The Adkins’s diet has lots of protein, and people who follow this do lose weight, and their cholesterol will usually get better, even though that diet is very high in fat. The problem is that people feel bad on that diet, and they find it difficult to stay on this long term, the diet is just too limiting.
In addition, we need fiber and the other good things (bioactive food components like antioxidants and phytochemicals) we get from fruits and vegetables. What we don’t really need are starches (but they taste so good….)! There is one other consideration. Most tissues of the body require a continuous supply of protein and amino acids, and muscle is the only reservoir. When we eat protein, most of it goes to replenish that muscle that has been broken down since the last time we ate some protein.
The Ideal Diet
So what are we looking for in a diet? We want lots of (preferably low fat) protein, with frequent meals, lots of fruits and vegetables and only enough starch so you don’t feel deprived. This diet should be low in calories, but individualized for each person. We should be looking towards losing fat, not pounds. It needs to be easy to follow, and not too expensive. It needs to be safe for everyone, especially diabetics, patients with heart disease, patients who have had weight loss surgery, children, elderly, and women who may become pregnant while on the program. It should have a maintenance program that can be followed once the dieter has reached their goal. And the program should be with real food, so the dieter can learn to eat correctly for the rest of his life. Since Cornerstone Wellness fits all those criteria, I decided to give it a try.
I tried it myself for a month. Those of you, who know me, know I live a crazy schedule. Between seeing patients, doing the business aspects of the practice, learning new medical techniques, taking care of my 2 teenagers, etc, I don’t have time for complicated diets. I found the diet very easy to follow, and was even able to incorporate it into our family meals. My exercise level stayed the same, and I had 10 restaurant meals (meetings) during that month. I lost 5 lbs, did not feel hungry, and I wasn’t cranky. Needless to say, I was hooked.
Our patient results have been similar. They all have reported feeling energetic and well, and found this diet not difficult to follow. We started this the weekend before Thanksgiving, so we don’t have much data yet, but these results are for a diet done over the holidays. , For the first 11 patients their first month results are as follows:
Average age 47 (range from 24 to 63)
2 males, 9 females
Average starting weight 198 (range from 137 to 300)
Average weight loss 5.4 lbs (range from 3 to 8)
Fat loss ranged from 0.1 to 5.3 lbs. A few lost more fat pounds than total pounds, meaning they actually increased their lean body mass!
Given the fact that there are lots of starch temptations from Thanksgiving through to Christmas and most people gain weight during this time, I think we did exceedingly well. Most importantly, everyone wanted to continue the diet, they all felt they were benefiting.
Details About the Diet
When you come in for a consultation, you will get weighed, measured, and have a body fat analysis done via the BioAnalogics ELG system. We’ll discuss what you think would be a reasonable exercise program to follow (need to build that muscle!). That gets put into the computer, and we’ll give you a diet to follow. The diet will contain 2 protein shakes, a snack, and 2 meals. Meals are given in exchanges, i.e. so many protein, fat, starch, vegetable and fruit exchanges. These exchanges can be moved around (I had to do that to be able to eat in restaurants), but the daily total should come out right. We see you monthly to remeasure you so we can track you progress, and revise the diet, if necessary. Your goal will be measured in loss of excess body fat, as opposed to pounds.
The protein shakes are made from whey and immature green pea. They are mixed with milk (or other liquid) and fruit to make a smoothie. Since you mix your own, lactose intolerant persons can use lactose free mild to prevent the gassiness and bloating found in many other shakes. They are a high quality source of protein, with a good mixture of essential amino acids, and contain 23 grams of protein, 31 if mixed with milk. This is an important source of low calorie, low carbohydrate protein. In addition, the protein powder contains 50-400% RDA vitamins, including plenty of vitamin D.
In addition, everyone gets an Omega 3 (fish oil) supplement. Omega 3 is an essential fatty acid which the body cannot produce on its own. Omega 3 oils combat inflammation, lowers triglycerides, and helps with many medical and psychiatric illnesses. These are medical grade supplements refined to have the lowest possible levels of mercury and other toxins. It is also enteric coated to prevent fishy burps. Taking these will also help keep the skin, hair and nails in better shape while dieting.
The final supplement is called MetAssist. This is taken 3 times daily, before meals. This helps regulate insulin levels, blood sugar levels, prevent carbohydrate craving, and promote fat loss. It contains several things, including hydroxycitric acid or HCA which limits the body’s conversion of excess blood sugar to fat as well as regulating appetite. Chromium helps insulin function better to get excess glucose into the cells. Green Tea has fat burning properties as well as potent antioxidant substances.
As far as the cost is concerned –
We see you once a month for an office visit, and you will need to pay your copay. We will bill your insurance for the visit. If you do not have insurance, or if you have an HMO and I’m not your primary doctor, the initial visit will be $75. The supplements cost $200 + tax/month and are not covered by insurance. If you have a flexible spending account however, you can usually use it to pay for the supplements, as this is a medical treatment.
We are very excited about this program, and hope it will be helpful to many people. I will continue to update this page as we get more data on our patients.
Copyright 2010 Jasmine Moghissi, MD,PC.