One of the most common complaints I hear from my patients is gaining weight or not being to be able to lose the weight despite dieting and exercise. There are many diet theories, weight loss protocols, medications and supplements. I am sure you have heard the advice that all you need to do is to make sure that your caloric intake is smaller than the number of calories you burn. Well, it is not that easy.
In my practice, I always start with comprehensive lab workup. In addition to the typical labs such as complete metabolic panel, blood count, and lipid profile, I am also assessing inflammatory and autoimmune markers, hormone levels, and thyroid panel. There might be other diagnostic studies indicated, such as digestive stool analysis, toxic metals, or adrenal profile.
Next step is to look at the dietary habits. I ask my patients to track everything they eat and drink for several days, so I can establish a baseline caloric and macronutrient intake (protein, carbohydrates, fats). Often, when I meet new clients, they tell me that their diet is great, and insist there must be another reason for their weight gain. I remember reviewing lab work with a new patient, revealing she was a diabetic. She was completely shocked, stating the lab result must be a mistake because she was a vegetarian, eating mostly whole grains, veggies and fruits. She said she typically eats 10 mangoes a day, thinking how great that was for her health. Except, each mango is about 35-50 gm of carbohydrates depending on its size. So even though her daily caloric intake was not terrible, about 2300 kcal, she consumed almost 400gm of carbohydrates per day!
Finally, we need to look at the person’s activity level. The good news is that you don’t have to spend 2 hours in the gym 7 days a week. The key is to find the activity you enjoy and a routine you can incorporate into your lifestyle. I have to admit, that I do not like exercise very much with the exception of yoga and perhaps rollerblading, which is hard to do in the heat of south Florida where I live. For the longest time, I would use the “I don’t have time to exercise” excuse because of my work as a nurse practitioner and a mom. In my twenties and thirties, anytime I needed to lose weight, I would get on a diet for couple of months, no exercise required. As we get older, our poor lifestyle choices along with metabolism changes, making losing and maintaining weight a lot harder.
Because we all are so different, the weight loss program will differ for each patient. I believe that only personalized approach can deliver the long-lasting results that people want. It is not about losing large amount of weight in a short period of time, but a protocol that will lead to sustainable healthy weight. We are offering lifestyle change that is targeted to your unique makeup and circumstance.
Learn more:
Obesity and Medical Risks
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2879283/
Obesity and Cancer
Are All Calories Equal?
