From a patient

Sometimes I feel that doctors say too much, write too much, lecture too much. Sometimes it is better just to say nothing and to listen to our patients, or for perspective patients to hear from other patients, who have been down in the trenches and struggled successfully with weight loss. These patients give a different perspective than I, as a doctor, give.
So here is a recent email I received from a patient of mine. She has lost about 80 lbs, she has about 70 lbs more to lose. But as a doctor who has seen so many patients make this journey, I know she is going to be a success story. How do I know this? Because she is in a routine of eating that she is comfortable with, that she knows she can live with for many many months, that also makes her lose weight steadily. Because we have discussed so many other issues in her life that impact her eating, and she is successfully coping most of the time (no one is ever perfect). And most importantly I know that she will never give up, even when she has set backs.
SO here is what she wrote:
(her name is taken out from here.)
To:Dr Constable
Sept 30 at 4:07 AM
Since I posted it on Instagram, I thought I’d share what I captioned this photo (photo not shown here):

“I have struggled so much over the years with pcos. Weight gain, messy hormones, no confidence, and just feeling lost and upset in my own body. A year ago I committed to making a real change. I’m so grateful my amazing doctor nutritionist (Balance medical weight loss!), and my incredible support system. It’s so much more than weight loss. It feels like I finally have life back.”

I really don’t have the right words to thank you for how far you’ve brought me and how excited I am to see how much farther I go. You’ve taught me balance and how to eat and cook and how to do this the right way and it’s impacting every other aspect of my life in a positive way. And I’m only about halfway to goal! It’s just going to keep getting better.

Thank you for your guidance and kindness in the process. It’s one of the first times in my life that I have felt strong, beautiful, and proud of my body.

(her name deleted)

> Sent from my iPhone

WHAT CAN I EAT ON YOUR PROGRAM

This is the question I get the most: what is the diet, what will I be eating? Will I be starving? Will I feel faint?

So First let me start by telling you what you will NOT be eating on our BALANCE program.
You will NOT be starving, you will not be eating a 500 or 600 or 700 calorie (or any very low calorie) diet. You will NOT feel faint. You will NOT be eating meals out of a box, a package, a powder, or a shake. In fact you will not be eating any pre made meals at all, you will be eating real food you buy in a grocery store and it will not be diet food which is loaded with unhealthy chemicals which your body cannot process, and makes you bloat. This is not a generic one size fits all program, so everyone that needs to lose 5 or 10 or 200 pounds is not on the same program.

This is NOT the Atkins diet or any variation of the Atkins diet, it is not the Mediterranean diet, the Ornish diet, the South Beach diet, the grapefruit diet, the Special K diet, or any other formula that you see or read about. Why? Because having treated patients for years, formulas dont work. we are not all the same; we dont all have the same amount of hunger hormone, we dont all have the same imbalance in hormones, we dont all process food the same way. There is no once size fits all formula.

Each time you come in you will NOT get a shot per visit. You will not walk out with hundreds of dollars and bags of homeopathic pills that you don’t really understand, spend a fortune on, and most of the time do nothing. Homeopathic medicines can be wonderful, but often these supplements are not needed and are prescribed inappropriately. They will not solve your problem in most cases. If the doctor feels they are appropriate, she will suggest them and explain to you the medical basis for needing these.

What you WILL receive in our program is a diet designed for you, and all meals are composed of real food you buy in any grocery store. You will eat three healthy meals, and 2 to 3 optional snacks.This program will be based on the results of a very comprehensive blood test which will tell us your internal medical profile, as well as your hormone status. The diet you will receive here will vary enormously from one patient to the next. You will never count calories, because all calories are not the same. We change your diet individually when needed as you go through the program, always when you hit a plateau, which is expected to occur when you lose 8 to 11% of your body weight. You WILL feel great, because nothing feels better than to eliminate all the junk and imbalance in your diet, and replace it with nourishment your body craves.

Your fee also includes an education, at each visit you will get a teaching lesson, usually dealing with your particular challenge, or some subject the doctor feels is appropriate, such as understanding how your hormones work and why they cause you to feel hungry and gain weight, how to balance them, and how to maintain this balance. Do you know how ghrelins, thylakoids, leptins, insulin, Hgb A1C, and cortisol affect your weight? Why are high insulin levels linked to depression? What is the glycemic index and why should you care? What sugars should you be concerned about when you read a food label, what is the difference between Agave syrup and honey (hint they are both natural but dont affect your weight the same way), why does stress cause hunger and how can you handle this? What is the difference between alpha omega 3 fats and alpha omega 6 fats and why should you know about this? Do you have Irritable bowel syndrome, what is this, and how can your diet affect and even cure this? You will learn all about these subjects and so much more.(Put on your seat belt, you are in for a good time.)

Patients come here to lose as little as 5 pounds and as much as 200 pounds. Most of our patients are referred here by physicians, because we have a very high success rate, not only at shedding those unwanted pounds, but also helping many get off medications such as lipid meds, diabetic meds, and cholesterol meds. But just as many people find us through friends or the internet and just want to learn, and feel healthier, have more energy.
Our average weight loss is between 75lbs to 100 lbs, but many people only need to lose 5 to 10 lbs. The important aspect of our program is that you not only will lose the weight, but you will also have a thorough understanding of your body, knowledge you did not have prior to coming to our clinic; this information will help you maintain your shedded pounds permanently. Weight loss is what you want, but permanent weight loss is what we want for you.

why is this so hard?

It should be simple, right, just eat less calories than you burn; eat healthy food, exercise, and you will lose the pounds. It sounds straightforward, very clean, very easy. Your doctor has told you a dozen times, just eat a little less, exercise a little more, and your going to lose weight. So you try to follow these instructions, you cut back, take the stairs more often, go to the gymn, and then you get on the scale; nothing is happening, body weight is not budging; it does not work.
Look around America, something like 95% of all adults are overweight, over 40% are obese, depending on which statistics you read. It adds up to a lot of people struggling. Weight loss is not easy.
So really, why is this so hard? As a physician that specializes in weight loss, and has treated hundreds of patients, I will tell you that the answer is because weight loss is not simple. It is actually really hard and really complicated. And the reason is, that your body has many many mechanisms to prevent you from losing weight, and many mechanisms to make you gain weight. Your body does not know that your obesity is unhealthy, it has no emotional IQ to understand that you are unhappy, that overweight or obesity is affecting your life, your job, your energy. What your body does have is a set point, an internal thermostat of what it “thinks” your normal weight is, which is a two to three pound range, and it wants you to stay exactly at this point.
How does your body manipulate you to prevent weight loss? The answer is that there are many mechanisms; one example is that there are cells in your body which secrete a nasty hormone called a Ghrelin, which travels to the brain, and tells you that you are hungry, or have cravings, or have the munchies. There is a different hormone which slows down your metabolism, so if you eat less, you burn less calories. Yet another hormone makes your cells insulin resistant, so carbs you eat go straight into fat and do not get used by, for example, by muscle cells; and then it turns out that there are many different types of fat cells, that gobble up calories, so you gain weight really easily. To make matters worse, researchers are constantly discovering new chemicals and hormones in your body, that prevent you from losing weight.
And then to make the entire process even more confusing, we are all different in terms of how we metabolize food. I am certain you have friends that can go out and devour three slices of pizza or more, followed by a few beers, and never seem to gain an ounce; while if you eat one slim piece of thin crust pizza, on the scale the next day you will see a one to two pound weight gain. It’s hard, it’s confusing, and it’s not fair.
So is it hopeless, can your dream of being a slim and healthy person become a reality? The answer is yes. But it begins with you deciding you are ready to make a change, a commitment to yourself and your body, and that at times it will not be easy. Here at Balance Medical Weight Loss, we will analyze your internal body chemistry with a very comprehensive blood test, we will design a food program individualized to you (all your meals will be bought in a grocery store, not in boxes or powders from us) and we will hold your hand every step of the way. You will get an education in our program, on subjects like what are Ghrelins and Leptins, Thylakoids, the glycemic index, and how to manage the constant triggers around you, like holidays, birthdays, traveling, and stresses. We can help you, but it has to be your decision, you have to be mentally ready to make a change. When you are ready for this, please call us, we are here and waiting.

Permanent Weight Loss

Our goal here at Balance Medical Weight Loss, is not only for you to lose weight, but to lose it permanently. You cannot be standing on your grave, and still be dieting. So how do you do this, lose weight permanently? You do this in two ways: learning how to eat correctly for YOUR body, and making a commitment to changing how you eat and approach food permanently.
Just today I got a letter from a local endocrinologist medical doctor, regarding a patient who lost about 190 pounds in our program, about 10 years ago. I remember this man I shall name Scott (not his real name) like it was yesterday; He came in dragging himself along, with the help of a walker, which had wheels, and which he leaned on heavily; he was almost 200 lbs overweight, was an insulin dependent diabetic on 75 units of insulin at night, and more at meal time; he had heart disease and was on a blood thinner called Coumadin because of his high risk of getting blood clots; he looked tired, with a defeated look on his face because he felt locked into a body that he could not control and which made him feel awful all the time. His legs were swollen with varicosities, he had high blood pressure, and he slept badly in a chair at night, because lying down made him short of breath. My staff did not like him because he was rude and cranky. (who wouldn’t be with all those diseases going on inside.)

Today, the endocrinologist tells me, in her letter, he has maintained his 190 Lbs weight loss (and it has been more than 10 years). She states that his Hemoglobin A1C is down to 5.6 so he not only is cured of his diabetes, he is not even pre-diabetic. He is off all insulin; He has blood work with a low LDL and hi HDL which means his heart is very protected with good fats and the bad fats are no longer at a level for risk of a heart attack; he exercises daily, which seems unbelievable given that he could barely walk before; AND he just had 13 lbs of skin surgically removed because he has lost so much weight that he had to get rid of all this dead skin. His life has changed, he is so much happier, and he not only will live longer, he will live a much higher quality of life; his grandson sent me a letter, thanking me for saving his grandfather.
But the bottom line is that Scott has not only made a life style change, he has made a permanent commitment to never going back to his old way of eating. But it is not hard, he never feels hungry, he has more energy, he does not want to go back to the old toxic foods, because his precious health is worth everything. He has lived this first hand, and he is never going back down that road.
So if you are reading this, maybe you don’t have all these terrible diseases that Scott used to have. Maybe you are just struggling with your weight and are, for now, otherwise healthy. But being overweight and obese is eventually NOT healthy. You need to learn what to eat, and you need to learn what works for you personally. And this is what we really focus on here at Balance Medical Weight Loss, finding the right food program for you; we will work on this, we will help you every step of the way, and you will learn how your body works, which is absolutely not the same for everybody. And finally, what I care most about is that once the weight is gone, you never have to go back and do this again. This must be a permanent weight loss.

what percentage of patients in the Balance Medical Weight Loss Program lose weight?

A patient called our office this past week, to inquire about the program. At the end of the conversation with my staff, she asked, “what percentage of patients in your program lose weight?” When I heard this question, I was stunned; I thought about it for a moment, and then told my consultant to tell her “all of our patients lose weight.” When you come to our office, you are paying for a service, and the service we give you is to teach you what to eat, and how to lose weight; if we did not give you this service, we would not be in business, so yes, all of our patients lose weight.

I frequently read new articles on the subject of weight loss; I see these in almost every magazine and newspaper, books, blogs, twitters, online comments and on and on, and am fascinated by the so called “experts” idea of how to lose weight; there is the 30 day weight loss plan. Why thirty days, I wonder, why not 25, or fifty? Why any time deadline at all? Are patients who need to lose 200 lbs on the same time line as those who need to lose 20 lbs? It makes absolutely no sense to me.
Then there is the low carb, hi fat and hi protein diet, the all complex carbs diet, the boot camp exercise 2 to 4 hours a day diet, the eat less than 600 calories per day, and on and on, all the plans out there. Then there are specific recommendations, such as eat piles of nuts, eat no nuts, eat complex grains three to five times per day; never eat starches at all; eat all the fat and protein you want as long as you eat no carbs, count your calories, dont count calories, avoid watermelon and pineapple. It is so confusing, it is a wonder anyone ever loses any weight at all.

So this is what I want to say about weight loss. Medical care and treatment, in the end is very simple; it either works or it does not work. I would tell you if you are on a program and you are not losing weight, then the program is incorrect. IF you have lost a lot of weight on a program and then regained it all, that is not a success. Success is losing it and keeping it off. In our program, I cannot fudge the results we get, I have no magical power over the scale you step on, that will show you have lost weight. The reason our office is so busy, is because the patients here are losing weight, and consistently.

Secondly, there is no formula for weight loss. Cutting out all carbs, eating piles of nuts, eating lots of complex carbs, eating no carbs at all, none of these formulas will work. Why? Because each one of us is unique and different in how we metabolize food. A diabetic is different from a non diabetic. A 60 year old is different from a 20 year old. A patient with PCOS is different from a woman who does not have this. And this is probably the biggest reason that most weight loss programs fail. Because there is no generic formula, no one size fits all weight loss plan. There is only you.

Patients like you come to our office, because you want to know what program will work for you personally. And this is exactly what we give you; and we make changes to this program, as needed, as you lose weight. We help you through plateaus, challenges in your life involving food, answer questions, and teach you an enormous amount of information.
So if you are looking for gimmicks, juices, general ideas and generic formulas, do not come to our clinic. It is not what we do. But if you are looking to find the right answer for your personal body, we invite you to join. And you will be eating healthy foods, from the grocery store. It does not matter if you need to lose 5 lbs or 300 lbs, we have patients in all sizes, and we will help you. This is a program about true weight loss, and permanent weight loss. You have to be ready to make the commitment to your health, and you will have to be mindful about what you eat. But if you are wondering that same question, what percentage of patients in the Balance Weight Loss Program lose weight, the answer is all of our patients lose weight.