WHY SEE A DOCTOR FOR WEIGHT LOSS

There are so many weight loss programs available, to someone trying to lose weight it becomes overwhelming and confusing. And then of course there are financial and time issues. It costs more to see a doctor, and there can be a wait time, because the doctor is often running late dealing with complicated medical issues. No one enjoys sitting in a waiting room.
So why see a doctor?
The answer is, in a few words, that losing weight is not simple. Many think it is just about eating less calories. But this is not correct. Because all calories are not the same, eating 400 calories of ice cream is not the same as eating 400 calories of grilled fish. They do not trigger the same hormones and they do not affect your weight the same way.
Most importantly if you are overweight, something in your body is out of balance, and needs to get back into balance. This cannot be ignored, blood tests need to be done, and interpreted by someone who really understands how to put the “puzzle” together. Going to a program which does not order a blood test is never going to work for you.
Sometimes you need to take supplements. However, I am horrified by programs that give out mountains of supplements as though they were candy. “Take this one” they tell you, “because you have inflammation, insomnia, headaches, (or some other issue.)” My patients come in taking hordes of supplements that they do not understand, do not need and are often harmful.
There are two problems with dispensing supplements: first, they should not be casually dispensed by a “nutritionist coach” who has very limited knowledge of what they do or how they work. There should be a medical reason, diagnosed on blood test or with proven scientific evidence that they will help you with your problem. Secondly, supplements have side effects. Everyone knows that alpha omega 3 fats are good for you; these are the healthy fats you get in fish for example. But most people dont know why they are good for you. Even more important, large doses of alpha omega 3 fats can be toxic, to the liver, to the gut, to the pancreas. How much is toxic? How much should you be taking? The answer is that it depends on each person. This is why a professional with a thorough medical knowledge should be monitoring you and telling you what is right for your body. People who are diabetic need different amounts of insulin. People with elevated triglycerides need different amounts of omega 3 fats. Give too much of either and there can be medical trouble.
Designing diets is also complicated. Why? Because there is no one size fits all formula for weight loss. Programs all over America are looking for simplistic formulas. Algorithms are created. Everyone who needs to lose 50 lbs go on program A, everyone who needs to lose 40 lbs go on program B, and so on. This is never going to work. Each person is unique and needs to be evaluated individually. Weight loss requires a very complex treatment and to succeed you need the correct diet, but also treatment of many other factors, such as learning about your hunger hormones and how to keep these quiet, evaluation of sleep, management of stress, water intake, exercise, management of sarcopenia, and much more.
Furthermore, the program that works for you in the beginning of your weight loss journey, will not work straight to the end, because your body adapts. You hit a plateau or you gain a little weight and now you cannot get your weight moving again. A professional with an understanding of the complex hormonal systems in your body, which are structured to make sure you never lose weight, needs to adjust and change your diet program as you go.
IF you have tried other programs and not succeeded, or if you are really ready to lose weight permanently, we invite you to enroll in our program. The average weight loss here is 75 lbs, but we have many patients who want to lose 10 lbs and want to learn what they should be eating to be healthy and slim, and of course we have patients who need to lose 200 lbs or more.
It is up to you, consider all of this carefully, because your health really is your most precious asset, you will never regret the investment you make in it.
We look forward to hearing from you.

LET FAT PEOPLE DIE; THE ARE WEAK WILLED, INDULGENT AND LAZY, NOT SICK

No, these are not my words; they are from a broadcast done today, by a man named Mr.Michael Buerk who is a BBC news anchor. He goes on to say that obese people are weak willed and lazy, not ill, and that they should be allowed to die from the complications of obesity. Decent people such as himself and other thin English people should not have to pay for the obese. Diseases caused by obesity are costing the country billions of dollars which would be better used elsewhere.
I find these words and attitude amazing. What are Mr. Buerk’s credentials that empower him to make these judgements and comments on national television? Is he a medical doctor (no), a scientist (no), has he every been obese himself (no, again)? What then does he know about the disease of obesity?
As a physician who has treated hundreds of overweight and obese patients, the first thing I can assure Mr. Buerk is that I have never met a weak willed or lazy obese person.
Secondly, obesity is indeed a disease. It is caused by two major medical imbalances. The first is insulin resistance. Healthy cells are not able to take up sugars and carbohydrates, and so this energy goes directly into the fat cells. Think of eating cake, in an obese person, a good analogy is that there is path that goes directly from the mouth to the fat cell. When the obese person eats cake, he will always gain weight. In a healthy thin person, this same cake gets distributed by the blood to other cells, like muscle and brain cells. Because all the sugar gets taken up by healthy cells, there is none left to go into the fat cell. Thin people therefore do not gain weight when they eat carbs.
So, Mr. Buerk might answer me, the obese should just stop being so weak willed and just don’t eat cake (or other carbs.). But here is what he really does not understand. Being obese is also a neurological imbalance where the brain sends incorrect signals. Obese people crave the very food that poisons them.
Are we surprised that a heroin addict craves heroin? Would we ask a heroin addict to live in a room full of heroin and never touch it? But this is exactly what is going on in the brain of an obese or overweight person. They have powerful and constant cravings, hunger, the munchies for foods like cake, bread, alcohol, cookies and the like. These cravings are very very powerful. And with unhealthy food everywhere, it is a matter of time before an obese person will break down and eat something he or she should not. This inner struggle is real and it is strong, and a constant presence. If Mr. Buerk had ever been obese, he would know this.
Can this be treated and fixed. Yes! I do this every day all day long. I have hundreds of patients who have lost weight and kept it off permanently.
Obesity is indeed a disease. It is caused by imbalance in the fat cells as well as powerful and incorrect signals in the brain. It can be treated by professionals like myself who understand the disease. And, Mr. Buerk, it is not absolutely not due to indulgent people who are weak willed and lazy.

Just Married!

Always so great to hear from our patients. Here is an email I just received. This is why I love doing what I do. I think I have the greatest job in the world. I get to make people happy! (she lost 75 lbs).

Dear Dr. Constable,
Thank you so much for all you did to help me take control of my health and nutrition. Entering my fifth season as a triathlete, I’m feeling strong, eating better and changing habits. At 55 years old, I had the wedding of my dreams in rural Wisconsin, spending four action packed days with our family and closest friends. On our wedding day, I danced until the band packed up! Thank you for taking so much time with me and for never giving up.
Sincerely,
M.
(name removed for privacy)

WE ARE CHANGING

I just returned from a medical conference in Houston Texas. I sat with 2000 other doctors in a large conference room, listening to lectures on the latest results of researchers who study the physiology of Obesity and Overweight. The knowledge and understanding is evolving fast, and with new understanding, I change my practice, and how I treat my patients.
Most weight loss programs are one of two types: the low calorie based program. The philosophy behind this is that if you eat less calories than your body uses, you will lose weight. Very simple math: calories in versus calories out. Eat less, exercise more, and you will be thin. Unfortunately this does not work. Why? because all calories are not the same. Three hundred calories of chocolate ice cream does not affect your weight in the same way as 300 calories of grilled tuna. Overweight and obesity is not a problem of eating too many calories; it is a problem of too many calories going into the fat cells.

The other type of program is where the patient eats an extremely low carb diet, mostly all protein and vegetables, and then frequently, is given an appetite suppressant. Unfortunately this diet is a temporary, not a permanent fix. It does not address the problem. An extreme low carb diet is not sustainable. The minute the patient goes off this eating plan, he or she gains all the weight back and more. The patient feels defeated and frustrated. The low carb diet also does not work.

In our office, we use neither of these formulas. In fact we don’t use any formula at all for weight loss. Why? It turns out that every person who is overweight does not have the same problem. In our program we treat patients individually. We design food programs based on lab work, age, medical history, and other factors. Furthermore, as the patient progresses through the program, changes need to be made. Patients hit plateaus after losing 6 to 10% of their body weight, struggle with issues, have individual tastes, thus changes are essential to start the weight loss again.

When I complete a week or more of listening to lectures at a medical conferences, such as this one in Texas, I have acquired new information, and with this new medical knowledge, I devise new treatment plans for our patients, both in terms of the chemistry of food they will eat, the understanding and use of medications when appropriate, as well understanding of individual patient problems as they relate to being overweight.

Treating patients with the chronic disease of overweight and obesity is my interest and my passion. New knowledge guides me towards new treatments. How I treated patients one year ago, is different from what I do now, because there is new information, new treatment options, and new understandings. This is what I glean from medical conferences I attend. New medical research impacts me and thus impacts my patients, always in a positive way. In our program, we are always changing.

WHAT IS INSULIN RESISTANCE?

Insulin resistance is something you hear about every day, your doctor tells you that you have it, or that you are prediabeitc, or you read about it in magazines, or weight loss books..
Insulin resistance means your cells in many parts of the body do not respond to insulin. It is the reason most people struggle with weight loss and more commonly cannot lose weight.This is the most important concept to understanding weight and what makes it go up an down.
Lets do a basic review. When you eat any carbohydrate, not just starch, but fruit, milk, cookies, desserts, alcohol, these are all carbohydrates; they get made into sugar in the blood; Sugar triggers the release of insulin from the pancreas into the blood stream.
Once in the blood, the insulin travels to many places, like muscle cells, heart cells, liver cells, brain cells, and unlocks these cells; very much the way a key fits into and unlocks a lock. When the cells are unlocked, sugar can go into the cell and give it energy. This is the way it is suppose to work, in an insulin sensitive cell.
When you are insulin resistant, due to chronic imbalances in your diet (for most people) that lock is” rusty;” the key does not work well, the cell only partially gets unlocked by insulin.
As a result of a “rusty lock” the “door” gets opened just a “crack”, a small amount.this means, only a little bit of sugar can enter the cell and give it energy.
This is what insulin resistance means: which is that most cells cannot respond adequately to insulin, and because of this,much sugar that is in the blood stream cannot get into cells, Over time your blood sugar rises, and you become prediabetic and then diabetic.
What is the result of insulin resistance? the result is a lot of sugar is floating around in the blood and cannot get cells. So where does all this sugar go? It gets sucked up by fat cells, you gain weight, and the situation gets worse. You are fatter, and become more insulin resistant.

How do you fix this problem? You do NOT become less insulin resistant by eating less food, but by eating the CORRECT chemistry of food. What is the correct chemist try of food? This varies person to person, and this is why you need professional help. This is complicated, requires a thorough understanding of insulin, its chemistry, how to fix this, and all the many other hormones, not mentioned here that affect the interaction of insulin with cells in your body.(Examples; Resistin, Adiponectin, Cholecystikin, PYY, glucagon, and many others) I hope this gives you a glimpse of how all this works, and please come in and see us if you are ready for some expert help.