A man goes to see his doctor. He says that he feels like crap. The doctor examines him and find that he has a carrot in his left ear, a stick of celery in his right, and french fries up each of his nostrils.
The doctor says "Your problem is obvious. You're not eating right."
Why focus on obesity? Quite honestly, some of us (physicians) get tired of treating chronic diseases that are preventable. It's so much more satisfying to focus on health and help our patients to achieve optimal wellness. After all, maintenance of a healthy/appropriate weight is one of the most important things that one can do to stay on this planet longer. Just look at the documented benefits of weight loss on common chronic conditions (taken from the bariatric surgery literature):
As many of these conditions improve (or even resolve) with weight loss, the need for prescription medications can be reduced (or even eliminated). I've had patients that have been able to stop their blood pressure medications, Type II diabetics get off of insulin (and sometimes their oral medications), GERD (heartburn) patients bid "Farewell" to their little purple pills, etc.
No one wants to live like this:
To learn how to live a healthier life and achieve optimum wellness, read on.
NOTE: This first sections contain current/"enlightened" scientific teaching about how to lose weight and keep it off. You can read what we used to teach in the sections that follow.
Good Calories, Bad Calories Let's begin with my original brief review of the excellent SCIENCE book,by physicist-turned-science-journalist Gary Taubes (2008). Within the substance of my review are some excellent links that you should also check out. My review (in pdf format) can be found here. Read more about Gary Taubes (including an interview link) here.
[Most computers have Adobe Reader installed. If you cannot open this file, you can download the free reader program from the Adobe site here.]
How To Lose Weight (and keep it off): I originally created this as a powerpoint presentation, but as not every computer can open that type of file, hence I've converted it into .pdf format that also includes my notes for some of the slides. Click here to open the .pdf format. [If you already have Microsoft Powerpoint or its viewer installed on your computer, you may view my original presentation here.]
You can find the BMI chart described above here. Find your height along the vertical axis, then scan to the right until you find your where your current weight lies. Then, look to the top of the column to see your approximate BMI. For example, a 5'10" individual weighing 240 lbs has a BMI of 34. A healthy goal is to be below the weight listed for the BMI 25 for your height. In this example, goal is 174 lbs or below.
So, two of the keys to successful weight loss are 1) eating all of the time (e.g. every 2 1/2 hours) and 2) trying to keep your total effective (or net) carb count (sugars/starches) to under 100 grams per day in order to maintain ketosis/fat burning state. It's totally possible to accomplish this on one's own by learning how to read nutrition labels and doing the math. For example, here are some examples of low sugar foods (along with their nutritional information chart) from a recent Costco run:
To sum up: you must eat at least 6 times/day to keep your metabolism up (e.g. 5 small meals and 1 larger one). The body is a machine that runs on energy i.e. it requires fuel. Rather than think of those smaller meals as food, instead consider them as fuelings between 100-200 calories each, and keep them low in sugars/starches (protein is fine). Your one larger meal should consist of a protein source and 3 low sugar/starchy vegetables. Drink when you're thirsty and avoid sugary fluids (beware fruit juices as much as soda!).
This change in lifestyle is very important for us in order to maintain our ideal body weight for the rest of our lives. The people who tend to regain their weight tend to do so when they increase their sugar/starch intake without a concomittant increase in their activity levels. [As discussed in the lecture above, while exercise hinders rapid weight loss, once you're at your goal, exercise is very important for maintenance of optimum health. Recall that exercise demands sugar for fuel and the average male runner burns up approximately 125 Calories per mile. Hence, it takes about 2 miles of running to burn off one large (20 oz) non-diet soda that contains 65 grams of sugar/240 Calories! I don't see many of the kids today doing this which goes along way towards explaining the dramatic increase in childhood obesity.]
Exercise feels good. Make it fun. Make it interesting. It doesn't have to kill you and can help to handle life's stresses, as well. Consider early morning or evening walks - so very refreshing! On the other hand, if - for whatever reason - you're either unable or unwilling to exercise, it's important to keep your total daily sugars/starches low to maintain your healthy weight.
Take Shape For Life (TSFL)
Admittedly, counting carbs on one's own can be daunting, if not cumbersome to many. That's why I personally used the Take Shape For Life (TSFL) program using Medifast products and recommend it to my patients. Here's why:
In January 2012, I decided to become a coach for the Take Shape for Life (TSFL) program (using Medifast meals) because I found that some of my heaviest patients did so well on it. I had been referring my morbidly obese patients to another physician in the county [Ellyn Levine, M.D.] who had an excellent reputation for achieving weight loss in her patients without the need for gastric bypass surgery or lapbanding. However, her office was too far for many of my patients to travel and so she convinced me to learn the program in order to provide local help for my obese patients. I personally followed it, as well, dropping 45 pounds over a period of 3 months [Note: this is the equivalent of me carrying a 5 gallon water jug every day.] My GERD went away, as did much of my snoring, and I now have lots more energy. All told, I dropped from 240 pounds down to 174 pounds over course of 4 months without significant exercising. After attaining my goal, I began exercising again (weight training at home, cycling).
Me before (LEFT) and after (RIGHT) weight loss.
LEFT: January 31, 2012
RIGHT: December 23, 2012
LEFT: January 31, 2012
RIGHT: December 23, 2012
Take Shape for Life is a simple/easy-to-follow program designed to help change lifestyles in the long run. It's a great tool available to help our patients achieve optimum health. In the short run, it is a very effective weight loss regimen that follows the science. It is NOT an extreme diet program.With this program, participants eat 5 pre-packaged meals/day plus one "lean & green" meal that they prepare themselves (or eat at a restaurant). For people who require structure in their lives, this is an excellent approach.
The advantage of using Medifast pre-packaged meals is that they are already pre-measured meals (usually around 90-110 calories each and low sugar; they're also fortified with vitamins) so there really is no fretting about what to prepare. One consumes real foods, not a liquid diet - breakfast options include dry cereal, oatmeals, scrambled eggs and pancakes; lunch options include various soups, chili, sloppy joes and mac 'n cheese. The "in-between" meals can consist of various nutrition bars, brownies, shakes, and other items. Participants learn healthy eating habits. The plan makes it very easy to get used to eating every 2 1/2 hours.
Take Shape for Life is a very cost effective affordable program for most. To start with, there are no monthly coaching costs (found with so many popular programs). All you pay for is your food, which is ordered on a monthly basis. For approximately $11-12/day, you get five meals - it's hard to eat cheaper than that - plus the cost of making your lean & green meal. Average food cost is around $330/month per individual. [When I figured out my monthly food costs at supermarkets and restaurants, this turned out to be a real bargain for me. Do the math for yourself. Figure out what you spend on all food for a week (this includes everything - Ralphs/Vons supermarkets, restaurants, etc) and make your own comparision. Food is generally ordered on a monthly basis for convenience and to gain you free shipping of your orders. You might also take into consideration the costs of remaining obese (costs associated with several chronic diseases and possibly medications). For most of us, it's a no-brainer.]
For a quick overview of the TSFL program, read here.
For a comprehensive overview, I have annotated the TSFL Quick Start guide to include my coaching pearls to explain the program more fully. Click here to really understand ALL of the specifics of the plan.
You can also learn more at http://drpearson.tsfl.com. Be sure to watch the video in the lower left corner of the page. Another good corporate video that explains the program's beneifits can be found here.
As mentioned, losing weight is not the only goal, but it is the first one upon which we focus. To help keep it off, it's important that one develops what TSFL co-founder Dr. Wayne Scott Andersen calls "Habits of Health." Learn what motivates our day-to-day behaviors and it's possible to make intelligent decisions throughout life. This is essential to keeping the obesity hounds at bay and living life to its fullest. Dr. Andersen has written a book and an accompanying workbook on this subject. Studies show that people who develop these habits of health find it easier to maintain their weight loss. To help individuals get started on the road to optimum health, Dr. Andersen initiated a 30 day challenge that incorporates lessons from his books. Learn more about it here.
Striving to achieve optimum health is far better than dealing with the costs and complications of disease states, most of which are preventable through the maintenance of healthy habits. I want to help keep my patients healthy and disease free. Feel free to contact me if you or a friend is interested in the Take Shape for Life program.It's scientifically valid, easy to follow, inexpensive and - most important - it works. I personally coach all of my clients to help get them started on the right foot. Because I spend a good hour to an hour and a half usually, I do not perform these consultations during my regular office hours. Rather, I schedule them after hours or on weekends, either in person or via Skype.
Should you desire to pass any of this information along to a friend or family member, I put together a brochure describing the Take Shape for Life (TSFL) program (how it works and why I got involved). It includes a body mass index (BMI chart). This is the same brochure that patients find in my office. It can be downloaded in Adobe pdf format here. [Note that this was designed as a tri-fold brochure so you'll have to fold it appropriately.]
Note that I strongly advise interested individuals to go through a TSFL program coach rather than the other Medifast options. Medifast is the much larger parent company with 3 divisions:
- Medifast Direct: individuals purchase Medifast products on-line and follow a self-guided program with online support/tools. There is no personalized coaching.
- Medifast Weight Control Centers: These provide in-store counseling, but it is very expensive. One of my new patients informed me that she went through our local Medifast Clinic in order to lose 45 lbs. She was charged $900 and this did not include her food!
-Take Shape for Life: provides a free health care coach and mentoring to guide you to optimum health. [ TSFL reimburses coaches for their time so clients do not pay additional monthly coaching fees found so often with other programs.]
I'm happy to address any questions/concerns at any time. Please feel free to contact me by e-mail (firstname.lastname@example.org), skype (drjpearson1), or leave a message for me at 760-445 -6487.
Ordering information: First, print and complete this registration form and send it to me. You can download an order form here that lists all of the food options. This form can be used to help place a phone order or can be faxed.
To place your first order online, go to the Shop TSFL page. [I put together a tutorial on how to place your online order here. Please note that the TSFL website has been updated since I created this, but it will give you an idea of what to do.]
Are you a health care provider or someone with an intense interest in helping others to lose weight and live healthier through Take Shape For Life? Look at this to learn the basics, then contact me to learn how to implement the program for your practice.
Start ignoring here (This is what we used
There is no question that how we feel about ourselves
influences our behavior in everyday life and no one is more pleased to
remind us of this fact than the companies who promote all sorts of weight
loss programs on the air waves or in the print media (But looks
aren't everything - maintaining one's appropriate weight is necessary
for the maintenance of good health. Obesity is steadily making it's move
to overtake tobacco as the #1 cause of medical problems in the U.S.). To the tune of about
$40 billion a year, weight loss is a national obsession and has become a
field of rapid growth within the health industry.
But who should one believe? Given the multitude of choices that include
everything from "heart healthy" diets to "A Twinkie a day
keeps the doctor away," is it any wonder that the American public
Let's begin with some simple facts:
After heredity (genes), an individual's weight is largely determined
by their balance of energy (calories). In other words, weight gain or loss
depends upon the quantity of calories consumed, in comparison to the
number of calories used ("burned up"). Specifically, an
individual can gain weight by eating more or exercising less (the
"couch potato" syndrome). Sound simple enough? [Actually,
it can get a bit more complicated - weíre skipping all of the stuff
about hormones (insulin) and chemicals in the brain (serotonin) for now.]
Fun with Fat Physics!
One pound of fat is equal to approximately 3500 calories. In order to
lose this amount over the course of a week, one would have to create a
negative balance of 500 calories per day. Rather than starve ourselves,
the healthier way to achieve this goal is to increase the level of your
activity through that "dirty" word called exercise.
Why? Because our bodies are finely-tuned machines with the ability to
monitor and regulate our metabolism (use of energy). Here's an
oversimplification: Imagine a sensor in our brains, much like a
thermostat. Our bodies are constantly burning up calories for things that
we don't even think about - our heart beating, lungs breathing, occasional
walking, etc.. Let's say that a body uses up to 1500 calories/day
essentially doing nothing more than basic life functions. If this
individual takes in only 1000 calories/day, he or she would lose 500
calories/day because of this "negative" energy balance.
Unfortunately, this lasts only for the first two or three weeks because
the "sensor" realizes "Hey, this jerk is trying to starve
me - I'd better conserve energy!" The thermostat-like mechanism then
resets itself to a lower number (for example 1000 calories expended per
day for those same basic functions). The 1000 calories/day coming in now
balances the 1000 calories/day being burned up, therefore, the weight loss
slows down or stops. Therefore, you have a better chance of losing
weight if you eat throughout the day, rather than dieting, if you eat
Also, exercise works by helping to reset that thermostat - usually to even
higher than the 1500 calories/day at baseline, let's say to 2000
calories/day. It is through this mechanism that weight loss can then be
A healthy weight loss prescription, then, consists of two components:
the meal plan and an exercise program. Neither needs to be very
complicated in order to be effective.
Incidentally, the Wall Street Journal
recently published an excellent article, "The
Diet that Works - what science tells us about successful weight loss"
by Tara Parker-Pope (April 22, 2003). I recommend that everybody read
this piece. (If the link doesn't work, I've scanned the article here.)
Eating to Lose Weight
If you do nothing else, simply reducing your daily fat intake will
result in weight loss. Learn how to read food packaging labels. Try
substituting lower fat foods for those that you normally consume. For
example, drink 2% milk instead of whole milk; frozen yogurt instead of ice
cream; eat leaner meats; use low-calorie mayonnaise and salad dressings.
These relatively easy substitutions alone can result in a 7-15 pound
weight loss over the course of a year.
Suggestion: try to think of food only in terms as a source
of fuel for your body, rather than as a source of recreation. Eat only
when you sense your body is hungry in response to low energy stores and
not just because youíre going to a movie or to "kill time."
"Eat to live - not live to
[Stephen Furst is an actor best
known for his obese roles in Animal House, St. Elsewhere, and Babylon 5.
He went from 320 lbs down to 170 lbs and now looks great - I listened to
him speak at the 2001 AOA (American Osteopathic Association)
meeting. Steve participated in a discussion for the American
Diabetes Association which can be found at http://www.diabetesforecastlive.com/edition1/index.html.
If you have a weight problem and about an hour of free time, I recommend listening to
this often humorous discussion on losing weight.]