The secret of losing weight revealed by W8MD – Free ebook
Prab R. Tumpati, MDPrab R Tumpati, MD
Founder of W8MD Weight Loss, Sleep and MedSpa Centers
It was a cold winter day in late 2010 when I was in my internal medicine office seeing patients. As part of this internal medicine practice in suburban Philadelphia where I used to work on a part time basis, I used to do some disability physical examinations for about a day a week. The rest of my time was spent working in a different office as a sleep medicine physician dealing with various sleep problems such as sleep apnea, insomnia and the over 80 other sleep problems.
DISABILITY EXAM > SLEEP APNEA > WEIGHT LOSS
As I found out from conducting a few disability physicals, most of those seeking disability had some underlying weight, and sleep related issues in addition to depression, and musculo-skeletal problems such as back pain. On that day, I had the pleasure of seeing an overweight African American lady who is about 5 feet six inches tall weighing in over 250 pounds with a BMI of over 40(considered morbidly obese), has some chronic depression, unable to get up in the morning, not refreshed when she wakes up, and had some back pain. Upon further questioning, she admitted loud snoring, excessive daytime sleepiness, dry mouth, nocturia (need to go to the bathroom in the middle of the night to urinate), and waking up choking occasionally – classic symptoms of sleep apnea.
After I took care of her disability paper work, I explained to the patient that she might benefit from further sleep evaluation by a sleep medicine physician of which I am one, and if she so wishes, she may consider the sleep clinic where I used to work the rest of my time in a different part of the suburban Philadelphia area.
A few weeks later, I again had the pleasure of seeing the same patient, this time in my sleep medicine office for further evaluation of her sleep problems, specifically to rule out sleep apnea. After conducting the sleep studies, it was indeed determined that she did have a severe case of sleep apnea and was offered CPAP (Continuous Positive Airway Pressure). Recognizing the underlying weight issues with a BMI of over 40 as a risk factor for her sleep apnea, I began offering her weight loss advice which basically involved what an average physician would tell their patients – eat less, exercise more! Going a step further than most physicians, I even gave her a printed diet sheet and thought I was more thorough than an average physician in doing so.
EAT LESS, EXERCISE MORE!
Unfortunately, my empty advice of “eat less and exercise more” did not translate in to any meaningful weight loss, and on the contrary, might have even offended the patient a bit as she is already aware of it. Just like most physicians and the general public, I thought people that gain weight were just not exercising enough, eating too much leading to their weight gain and they just have to try harder to lose weight. This approach of blaming the victim for obesity is not only useless for weight loss, but can even be harmful as we discuss this further in the next few chapters of the book.
As we follow all our sleep apnea patients within the first 1-3 months for monitoring their compliance with CPAP usage, she came back promptly in about 6 weeks for a compliance check. Hoping that she would have lost some weight with my weight loss advice of a printed diet sheet, and eat less, exercise more message, I was a bit surprised that she did not lose any weight at all. I realized losing weight is not as simple as knowing “eat less, exercise more” or handing out a diet sheet like most physicians!
PHILADELPHIA TO DALLAS TEXAS FOR WEIGHT LOSS
Upon further questioning about her plans to lose weight, she said she is going to Dallas, Texas to lose weight. As it raised my curiosity as to why she would travel from Philadelphia, PA to Dallas, TX to lose weight, I asked her what made her go to Dallas. She said there is this doctor in Dallas that has a weight loss program that can help her lose weight. I asked her if that doctor was a bariatric surgeon, and she said no, a medical physician, who has a medical weight loss program and also that her daughter lives there! As it intrigued my curiosity further, I asked her if she would share the name of this physician so I can learn more about this program.
After I came home that day, I starting doing some more research on this medical weight loss doctor and his weight loss program! After some basic Google searching, I found out that this physician is in fact a Pulmonologist who also has a weight loss program that is primarily based on the HCG diet protocol. After I reviewed the HCG protocol and the evidence for and against this diet, and the controversy that surrounds the HCG protocol (that HCG might not be underlying reason for weight loss but the very restrictive diet although supporters of this controversial diet argue HCG makes one tolerate such a low calorie diet), I decided it is not something I would advocate for my patients until I know more about it.
More importantly, this has triggered my interest in this field and upon some more research, I found out there is a new specialty called obesity medicine also called bariatric medicine. Just a couple of weeks latter, I was in my New York Sleep Center which we just acquired a few months earlier.
As our sleep center needed to get more patients, I started marketing our services to local physicians. Since I did not know too many physicians in Brooklyn, New York, as I was from Philadelphia, PA, I had to rely on my internet research to find nearby medical offices. On this Saturday morning, I wanted to present our services to a nearby cardiology clinic which was extremely busy. It took almost an hour for the secretary to even say hello to me and I asked her a simple question – “if they had a patient that needed sleep studies, where do they normally send them?” She said they have sleep center right upstairs to their practice.
Realizing I just wasted an hour not knowing there is a sleep center right upstairs to this cardiology practice, most likely owned by them, I had to quickly find another medical office where I can present the services provided by our sleep center. As I had an iphone, I searched on an app on the phone called Aroundme and put in the key word weight loss doctors thinking that all the overweight or obese patients that these weight loss doctors serve also tend to have underlying sleep problems such as sleep apnea.
I found a weight loss clinic that is just a couple of blocks to where I was located, thanks to the location accuracy of the smart phone, and I decided to go in and meet the doctor there, introduce myself and present our sleep center services. As I drove the couple blocks to find this place, I realized it was a family practice physician who decided to add a medical weight loss program to their office.
After speaking to this lovely lady physician, I realized she started this weight loss program after attending a few conferences but she did not get any formal training in this field although there are some training programs available. After seeing her practice and with my experience with the above patient that was willing to travel from Philadelphia to Dallas for weight loss, I wanted to see if I can obtain some training in this new field as most of my sleep clinic patients tend to be overweight or obese.
I came home that day and started searching for training programs in this new field of obesity medicine or bariatric medicine. After a lot research, I found there are two ways I can get some training – one by attending a few conferences like this other weight loss doctor that I just met in Brooklyn did, or obtain a formal training for which the opportunities were far fewer and limited.
Since I did not want to leave my family and the current practice arrangements, I was looking for a CME based program that is not only thorough but also allows me to learn the science and art of obesity medicine without disturbing my current practice. Fortunately, there was a program that was starting in about a week called Bariatric Medicine Fellowship by one of the most recognized physician organizations in this field called ASBP (American Society of Bariatric Physicians, a 50 plus year old organization of medical weight loss physicians).
BARIATRIC MEDICINE TRAINING
Although it was a bit expensive to join this program with significant ongoing costs, it seemed it is the best fit for me – it was structured well, with a lot of CME based modules and is going to give me an opportunity to learn the science and art of obesity medicine thoroughly and most importantly, I did not have to stop doing what I do in terms of my work as a sleep medicine and internal medicine physician.Obesity
I decided to join this baritric medicine fellowship in order to get additional training the experiences of which I will share in the next few chapters. That was the beginning of this incredible journey of helping patients lose weight. Before I close this chapter, I wanted to share my experience in the early 2014, after about 3.5 years of my encounter with the sleep apnea patient that has gone from Philadelphia to Dallas to lose weight with a medical weight loss doctor.
DALLAS TEXAS TO NEW YORK CITY
In early 2014, I was seeing patients in our Brooklyn, New York office when I had the pleasure of seeing this middle aged Caucasian gentleman who is a tad overweight but not obese, has a bit of a Southern accent to his speech. I asked him “you seem to have a bit of a Southern accept, where are you from sir?” He said “I am from Dallas, Texas”. I said “did you just move here to New York City?”. He said, no, I just came to lose weight! It came full circle!
Prab R Tumpati, MD – Founder, W8MD Medical Weight Loss Centers of America.
In the next few chapters, we will learn about The W8MD’s 8 Secrets To Losing Weight Fast – Things They Do Not Want You To Know!
Did The Failed Food Pyramid Mislead Us?
In 1992, The United States depart of Agriculture (USDA) released the now withdrawn food guide pyramid. Compiled by nutritionists, psychologists, compiled by USDA with the understanding that dietary fat was the basis of obesity and reducing the dietary fat from 40% to about 35% percent would reduce the obesity.
The food pyramid was constructed with very little scientific evidence and significant carbohydrates, especially the ones with high glycemic index were allowed to be consumed.
As you can see from the food pyramid image 2.1, the idea behind the food pyramid is that Americans eat too much fat, and that fat is what is making them fatty! In order to reduce fat intake, the USDA’s solution was to increase grain based starch intake! The following is a statement from the Food Pyramid: The Pyramid focuses on fat because most American’s diets are too high in fat! Following the Pyramid will help keep your intake of total fat and saturated fat low! A diet low in fat will reduce your chances of getting certain diseases and help you maintain a healthy weight.
The medical community and even the scientific community for the most part went along with this thinking that fat must be bad for you as cholesterol is known to be a cardiovascular risk factor and they assumed that fat and cholesterol go together so low fat must be good for you. Is there any evidence to prove this or was this just an assumption that was latter proven to be completely wrong?
Before we discuss what went so awfully wrong with the food pyramid, why it was a complete disaster to the health and well being of Americans, and why it was withdrawn, let us discuss what really happens when we consume diet rich in starches.
Every time we consume foods that contain starches, the bodies digestive system breaks the sugars, both simple and complex sugars, in to either glucose or fructose for the most part. As soon as glucose is absorbed in to the blood stream through the portal vein (a vein that takes nutrients to the liver), the bodies pancreas is stimulated to produce a hormone called “insulin”.
The faster the absorption of glucose in to the blood stream, the higher the demand on the pancreas to produce insulin. So, what this means is the simpler starches without much fiber such as the sugars, and refined carbohydrates put more demands on the pancreas as these sugars come really quickly in to the blood stream.Glycemic index
The amount of insulin the body has to produce after consuming any foood item can be measured indirectly based on the glycemic index of foods. So, for example, table sugar has a glycemic index of 70 while glucose has a glycemic index of 100. White rice can have a glycemic index of 85-90% while brown rice may have a glycemic index of 56%. All foods can be classified based on their glycemic index.
While glycemic index only takes the individual food item in to consideration, glycemic load, on the other hand, looks at both the glycemic index, and quantities consumed so we get a better understanding on how much insulin being asked to be produced and how fast.
SUGAR RUSH AND CRASH
The rapid raise in blood sugars after you eat a starchy meal is termed “sugar rush”. While this initial phase of sugar rush might feel good for most people, the second phase of this process happens a few hours later.
After the sudden rise in blood glucose leading to sudden rise in insulin, the body starts utilizing the blood glucose and starts converting that in to excess body fat. The key hormone that controls this process of “body building” through a process called “lipogenesis” is the hormone insulin.
DID WE MISUNDERSTAND THE ROLE OF INSULIN?
If there is one hormone that is the most misunderstood by the regular medical community as to its role, it is insulin. The reason insulin was misunderstood lies in how we traditionally looked at the role of insulin. We all were told through medical school that insulin controls blood sugar. Most medical students and physicians stop there and move on without realizing how insulin is controlling blood sugar.
HOW DOES INSULIN CONTROL BLOOD SUGAR?
Although most physicians including some endocrinologists, do not realize what insulin is doing to the blood sugar or how insulin controls blood sugar. If you think about it, insulin basically controls blood sugars by helping the bodies fat cells to take it in and store as future source of energy. In other words, insulin is one of the most anabolic hormones know to man as it controls fatty acid metabolism like no other hormone in the human body.
So, if a person is consuming foods that are causing a huge insulin response, especially the low fat foods as promoted by the food pyramid, their insulin response is going to be very high leading to sugar rush, crash and eventual development of insulin resistance.
METABOLIC STARVATIONAcanthosis Nigricans neck lines sign of insulin resistance skin tags and insulin resistance neck lines sign of insulin resistance
This process of stimulating insulin production not only makes a person gain weight and gain weight quickly, but it can also lead to a phenomenon called metabolic starvation. Metabolic starvation is a peculiar state that happens in insulin resistant individuals.
IS OVEREATING A RESULT OF INSULIN RESISTANCE?
It is extremely important to understand how this process of insulin resistance plays in to the whole “overeating”, “sugar cravings”, “sweet tooth”, “stress eating”, and explains the eating habits commonly seen in overweight or obese individuals that are also insulin resistant.
COMEPNSATION TO INSULIN RESISTANCE
The bodies natural compensation to insulin resistance is to increase the production of insulin putting a lot of stress on the person’s pancreas, increase the risk of diabetes type 2. More importantly, this increased insulin is what then causes a cascade of events called metabolic starvation, overeating, and cravings for carbohydrates.Overweight kids become overweight adults
You can think of insulin as a fat storage and fat burning switch. If the insulin levels are high(which is majority of all American adults as it affects up to 71%), one is stuck in fat storage only mode.
After 3-5 hours after having a meal, most of the carbohydrates are completely absorbed from the gut, and stored away as fat, but that same fat is unavailable to the persons needs when they need to burn their fat leading to a state of “starvation”, intense hunger as their sugars are dropping to 30-40’s, “jittery feeling” and intense urge to eat starchy foods – a king of a survival response to this insulin resistance is overeating as the person’s sugars are dropping and fat is locked away due to high levels of basal insulin due to insulin resistance.
IS BLAMING THE OBESE BLAMING THE VICTIM?
If you really understand the role insulin resistance plays in causing this “metabolic starvation”, “overeating”, “sugar cravings”, craving starchy or sugary foods, you would realize that the insulin resistant overweight or obese person is just responding to their body as eating then becomes a survival mechanism.
BUT WE WERE TOLD CALORIES IN CALORIES OUT, EAT LESS EXERCISE MORE BY OUR GOVERNMENT – ISN’T IT MY FAULT TO OVEREAT AND GAIN ALL THIS WEIGHT?
If you understand what this internal starvation (where fat stores are unavailable to you due to high insulin levels), then you realize the person has only a few limited options to get additional energy really quick in between the meals.
3 NOT SO GOOD OPTIONS IN BETWEEN THE MEALS
For a person who is insulin resistant (which is most US overweight adults and many overweight or obese kids), 3-5 hours after a meal, the 3 options they have in order to get additional energy when fat stores are locked away are the following:
- Option one: eat something starchy, or drink something starchy quick and this is what most people do as their blood sugars are dropping and they feel like they need to eat or drink something starchy. It is not their weakness, or lack of control that is making them do this but rather a biological survival response to lower blood glucose levels. So, blaming these individuals or kids is the last thing you want to do when they are just responding to intense biological urge to eat as a survival mechanism. If you just give in to the governments over simplistic, mathematical formula of energy balance, eat less, exercise more, and think it is a weakness, you are mistaken!
- Option 2: the second option the body has in between the meals for an insulin resistant individual when their fat is locked away is break down their own muscle protein. This happens to a huge number of the population who basically eat one or two large meals and skip meals thinking that they are conserving calories and helping themselves reduce their overall intake. Unfortunately, skipping meals and eating large portions at a time does not help and can even be harmful due to the same issue of losing muscle tissue which in turn leads to slower metabolism.
- The last option the boy has in between the meals in an insulin resistant individual is “death” due to hypoglycemia. However, the body has 4 different hormones to raise blood sugar including the stress hormones such as cortisol, glucagon, growth hormone, and only one hormone (insulin) to lower blood sugar. Since death is not an option the body chooses, the survival instincts kick in and have a person eat, or break down their own muscle.
So, in other words in an insulin resistant individual, if you eat something starchy, the same process repeats itself, and if you ignore, you lose muscle. You are doomed if you do and doomed if you don’t. So, the key is to change the insulin resistance.obesity effects
SO, HOW DID FOOD PYRAMID CONTRIBUTE TO THIS PROBLEM?
By advocating that fats must somehow be bad, with no scientific evidence that they are, the USDA’s failed food pyramid not only put us on a path to this vicious cycle of high glycemic load foods, leading to insulin resistance, with subsequent overeating, sugar cravings, increased weight gain, and almost 500 percent increase in the incidence of type 2 diabetes in the last 50 years or so. In fact, it is projected that the incidence of type 2 diabetes is going to go up as much as another 500 percent in as little as the next 20 years!
IS TYPE 2 DIABETES GENETIC?
Not much, the genetic component in type 2 diabetes is very minor, about 10 percent, the rest is considered acquired due to insulin resistance.
WHAT IS THE DIFFERENCE BETWEEN TYPE 1 AND TYPE 2 DIABETES?
In type 1, you do not produce insulin and in type 2, a person is insulin resistant, so they are not responding to insulin leading to compensatory increase in insulin.
ARE HIGH INSULIN LEVELS CAUSING MY OVEREATING?
Yes, high insulin levels at baseline is what causes a person to overeat, crave carbohydrates, and eat the wrong foods for the most part as these insulin resistant individuals are in a state of “metabolic starvation”
I DO NOT HAVE DIABETES, CAN I BE INSULIN RESISTANT?
Yes, you do not need to have diabetes to be insulin resistant. In fact, diabetes is like the tip of the iceberg of the spectrum of insulin resistance that affects up to 71% of the population, prediabetes, also called “metabolic syndrome”, that affects one in three all adults, and type 2 diabetes that affects up to 11% of the US adult population.Acanthosis Nigricans
WHAT CAUSES INSULIN RESISTANCE?
Although the precise mechanism as to what causes insulin resistance is yet to be fully delineated, it is becoming increasingly clear that the over consumption of excessively starchy foods, lack of physical activity, stress, lack of sleep, shift work, and a whole host of things are believed to contribute to a process that is all too common called “insulin resistance”.
WHAT IS INSULIN RESISTANCE?
Insulin Resistance which eventually leads to a whole host of metabolic problems.
Is insulin resistance causing your weight gain?
Insulin is the key hormone for fat gain and loss. After you eat carbohydrates, your blood sugar levels will increase. It is the insulin’s job to push the glucose into the cells where it is used for energy. Insulin also helps muscles, fat and liver cells store sugar that can be released when it is needed.
Each cell surface has insulin receptors which act like little doors that open and close to regulate the amount of blood sugar allowed to flow in.
If the body takes in too many simple sugars found in carbohydrates, the cells are bombarded with so much insulin that the “doors” begin to malfunction and shut down. If the doors aren’t open, the pancreas feels the need to produce even more insulin to push into the cells because it cannot perform its function to lower sugar levels, tending to leave the insulin floating in the blood stream. A vicious cycle is now in place resulting in a condition called Insulin resistance.
LIPOPROTIEN LIPASE AND HORMONE SENSITIVE LIPASE
For those that are medically knowledgeable, the two key enzymes that insulin controls at the cellular level are lipoprotein lipase and hormone sensitive lipase, one promoting fat breakdown and the other fat storage, both controlled by insulin. In a person whose basal insulin levels are high such as those that are insulin resistant (about 70% of all US adults), they are stuck in storage only mode for fat.
If you have excess weight especially around your tummy area, you may have an underlying metabolic process called insulin resistance that might be contributing to your weight gain.
Currently, up to 70 percent of the population of the United States have some degree of Insulin Resistance! One in three have Metabolic Syndrome or prediabetes – a later stage of insulin resistance.
HOW DOES INSULIN RESISTANCE CAUSE WEIGHT GAIN?
Every time your body takes carbohydrates, you need insulin. The glycemic indexes of foods determine how fast the sugar is absorbed into the blood stream. Over a time of eating high glycemic index diets such as white bread, white rice, potatoes, French fries, soft drinks etc, the body becomes insulin resistant. In order to compensate, our body produces more insulin. Insulin resistance inhibits our fat cells from giving up their stores of energy to let us lose weight.
The more overweight we are, the more insulin resistant we tend to become and can cause adverse health effects. The more insulin that is created leads to more fat cells to store it in, especially around the belly area, which causes less ability or desire to exercise so the glucose cannot be burned. Since abdominal fat produces harmful cytokines leading to body inflammation, it is imperative that reducing insulin resistance would be the key to reduce the risk of metabolic syndrome.
IS INSULIN RESISTANCE THE CAUSE OF BELLY WEIGHT?
Insulin resistance not only causes weight gain but also causes visceral fat, ie in the belly and upper part of the body – areas that are considered unhealthy.Unhealthy food
HOW DO ANIMALS GAIN WEIGHT QUICKLY IN A FARM?
If you ever been to a farm, you would understand that the key to making any animal to gain weight quickly is to feed them corn or grains which causes the insulin response, leading to increased hunger, and overeating on the part of the animal.
If you are one to blame the victim for obesity, you can take a big bull and say you are lazy, and you are overeating, have no control of your eating habits etc.Metabolic syndrome
DID THE USDA TAKE THE ANIMAL FOOD RECCOMENDATIONS AND CONVERT THEM TO HUMAN EQUIVALENT AND MADE IT LOOK HEALTHY?
It is no secret that that the USDA(United States Department of Agriculture) has a vested interest in promoting agriculture, and the most important product of agriculture in the United States which is corn. If you think about where all the corn that is produced in this country is going, you do not need to look no further than your local grocery store.
CORN STORES, NOT GROCERY STORES
Although an average grocery store stacks over 100,000 items on its shelves with all kinds of processed foods, if you flip the box and see what is inside by looking at the ingredients, you will be surprised as to what percentage of all those items are nothing but mostly corn with some flavoring, seasoning, coloring, and nicer pictures of models on the front. Most of these foods use various confusing ingredient names most of which are derivates of the corn syrup which as added to almost every processed food item.
If you are the industry, and you were told reduce the fat, what you would do is take the fat out, sell it elsewhere, add some corn syrup which is very cheap, highly subsidized (to the extent of 85% subsidy by some estimates) to make it palatable and sell it.
LOW FAT INCREASES GLYCEMIC INDEX AND GLYCEMIC LOAD
How does low fat foods contribute to increased glycemic index and glycemic load leading to insulin resistance? If you reduce the fat in any food, even before adding the corn syrup, the glycemic load of low fat foods is much higher than the whole food. For example, the glycemic index of 1% milk is much higher than the glycemic index of whole milk. If you doubt it, do a Google search and you would know this to be true.
The logic is simple in the increased glycemic index of reduced fat foods – if a food item has 33% of fat, carbohydrates, and protein, and now you take all the fat out, the relative percentage of the remaining two items, ie the carbohydrates and protein are not 50% each leading to higher glycemic index and load.
DID THE FEDERAL GOVERNMENT CHOOSE THE WRONG AGENCY TO MAKE THE FOOD PYRAMID?
If you know anything about conflict of interest, you would realize that USDA has a vested interest in promoting the marketing of all the agricultural produce, the bulk of which is corn, to the masses and it is enticing to make these foods that are produced to appear healthy by their low fat(read high starch) message!Insurance weight loss
ARE YOU SUGGESTING THAT THE USDA’S FOOD PYRAMID CAUSED THE OBESITY EPIDEMIC?
While the issue of what are all the factors that lead to the obesity epidemic is complex and cannot be settled that easy, it is believed widely in the obesity medicine community that USDA is completely wrong on its low fat message, especially looking at from an evolutionary perspective humans evolved for 2 million years as hunters and gatherers with a diet rich in fat and high qaulity animal protein. It is also believed that the low fat message was taken up by the industry in a big way and most processed foods were modified to be reduced fat which in most cases meant higher glycemic loads, leading to insulin resistance, overeating, and weight gain!
DID USDA TAKE THE SAME FOOD RECOMMENDATIONS THEY MAKE TO ANIMALS AND CONVERT THEM TO HUMAN FOOD EQUIVALENT?
In a documentary movie titled “The Perfect Human Diet”, the makers of the movie claim so that they took the animal food recommendations made by USDA, analyzed the macronutrient contents, and then looked at the human food recommendations made by USDA, looked at their macronutrient components and compared these two. To their surprise, the macronutrient components apparently were exactly the same.
The valid question that they raise is “how is it that these starchy, low fat foods cause these animals to gain weight quickly but they are somehow supposed to help humans lose weight or live healthy”
Also, if you understand how animals eat food, you would know that you cannot force an animal to overeat. You can only make food available to them. The animal chooses when to eat and how much to eat?
How can you then make the animal hungrier so it will overeat?
The key is to make the animal insulin resistant. That is exactly what they do to billions of animals that are farm raised for meat. And this process of insulin resistance leading to increased hunger, overeating, quick weight gain works so well that they know by how many days the chickens are going to take to weigh what!
Insulin resistance makes a person, animal or chicken hungrier so they will overeat! No pointing in blaming that chicken about lack of control or being lazy!Food pyramid
SHOULD USDA APOLOGIZE FOR THIER MISTAKE?
The USDA not only owes the American public an apology but an intense effort to undo the damage its failed message of low fat, high starch diet to the huge epidemic of obesity, diabetes, prediabetes, and more importantly, the prevailing notion of blaming the victim for obesity.
If you do not believe that USDA’s food pyramid was not contributing factor, and think people’s will power somehow went down in the last 30 years as something from Mars affected them, think again and take a look at these obesity trends since USDA’s food pyramid came out in the early 1990’s.
ARE THE NEW RECOMMENDATIONS ANY BETTER?
The problem with the food plate and food pattern is that nobody really understands the logic as it fails to capture the popular imagination, and the same people that drove the failed food pyramid are driving this message without any major changes. In fact, these diet panels that make these recommendations rarely have any obesity medicine trained physicians in them that understand how the metabolism, insulin resistance, stress, lack of sleep, shift work, and other factors contribute to the people’s choice of food.
COULD THERE BE AN ANTI-TRUST SITUATION IN THIS?
Although I am not an attorney, I can imagine that for the right trial lawyer, this might be a classic case of anti-trust as USDA should have absolved itself of making these diet recommendations to begin with given their vested interest in promoting corn and other agricultural produce!
Acanthosis of the neck
MY DOCTOR SAYS MY SUGARS ARE FINE. CAN I STILL BE INSULIN RESISTANT?
Yes, in fact, most physicians fail to recognize the earlier signs of insulin resistance such as increased abdominal circumference, upper body weight gain, changes in the neck with darker or thicker lines, sometimes skin tags, and other changes in the neck called Acanthosis Nigricans, and the weight gain itself is a sign of insulin resistance.
WHY IS MY DOCTOR NOT ABLE TO RECOGNIZE EARLY SIGNS OF INSULIN RESISTANCE?
Studies have shown that up to 94% of all physicians currently receive very little or no education in the field of obesity medicine, as they over simplify the logic, think it is as simple as “eat less, exercise more” and case closed. If the 94% of those that you traditionally turn to, your own primary care physician, get zero training in weight management, no wonder there is so much misinformation out there.
Metabolic Syndrome is a cluster of conditions including high blood pressure, high blood sugar levels, excess body fat, especially “belly fat”, or abnormal cholesterol levels; which, when they occur together, increase your risk of heart disease, stroke and diabetes.
The underlying process that contributes to the over eating, cravings, upper body weight gain, and eventual metabolic syndrome is called insulin resistance.
If you have metabolic syndrome or insulin resistance, aggressive lifestyle changes can delay or even prevent the development of many serious health problems.
Early lines on the neck with a skin tag!
ARE WE FIGHTING THE WRONG WAR?
What if we are fighting the wrong war? What if the real issue is insulin resistance which is what is causing the overeating, and the weight gain and fighting obesity, instead of fighting insulin resistance, is analogous to fire fighters fighting smoke(an effect of fire) as opposed to fighting fire(the real issue).
This might explain why most people fail in their efforts to losing weight! They are simply fighting the wrong war! Instead of fighting obesity, we should rather be fighting the underlying cause of obesity, which in most cases is insulin resistance!
DO YOU HAVE INSULIN RESISTANCE?
Affecting up to 2/3rd of the US population to some degree, the diagnosis of insulin resistance is fairly simple. Place a check next to any item that applies to you:
□ Do you have a family history of diabetes, being overweight, abnormal cholesterol such as high triglycerides, high blood pressure?
□ Do you crave sugary or starchy foods frequently or feel you are addicted to carbohydrates?
□ Is it difficult for you to lose weight, especially around your middle?
□ Is your waist over 35 inches in women or 40 inches in men?
□ Do you experience shakiness, difficulty thinking, or headaches (often in the afternoon) that go away after you eat?
□ Are you ten pounds or more over what you would call your “ideal” weight?
□ Do you exercise fewer than two times per week?
□ Do you have high blood pressure?
□ Do you have upper body or excess belly fat?
□ Do you have polycystic ovary syndrome?
□ Have you ever experienced Acanthosis Nigricans skin changes – velvety, mossy, flat, wart-like darkened skin on your neck or armpits or underneath your breasts?
Your Score: ________
If you answered yes to three or more of these questions, you are most likely insulin resistant!
HOW DOOES BELLY FAT LEAD TO HEALTH PROBLEMS?
Belly fat has been linked increased risk of cardiovascular disease, diabetes, stroke, and even increased risk of many types of cancers! Since belly fat is considered visceral or unhealthy fat that produces many pro-inflammatory chemicals leading to increased atherosclerosis and increased risk of many health problems as most human pathology starts with inflammation!Healthy diet
HOW CAN I TELL IF I HAVE EXCESS BELLY FAT?
This risk goes up with a waist size that is greater than 35 inches for women or greater than 40 inches for men. For Asians, the numbers are lower by about 5 inches in both men and women. To correctly measure your waist, stand and place a tape measure around your middle, just above your hipbones. Measure your waist just after you breathe out.
WHAT ARE THE TWO WAYS I CAN ASSESS MY WEIGHT RELATED HEALTH RISK QUICKLY?
The two quick, self directed measures you can take to know your health risk quickly involve knowing your body mass index and your waist circumference as noted above.
WHAT ARE THE THREE THINGS WRONG WITH OUR DIET?
Human race has evolved as hunters and gatherers adapted to a diet of meat, eggs, nuts, fruits and vegetables. This diet, had relatively high quantities of protein, fat with unrefined carbohydrates along with antioxidants that come from coloured fruits and vegetables. Agriculture is a relatively recent development having been in existence for only about 10,000 years considered small in evolutionary perspective. As a result, humans have not fully adapted to eating a diet rich in grain based carbohydrate rich foods.
- Insulin Resistance or Metabolic Syndrome
The first and the most important factor is insulin resistance or metabolic syndrome. Affecting over two thirds of all adult Americans, Insulin Resistance is common and is believed to be a direct result of the now withdrawn Food Guide Pyramid as discussed above.
- Lack of Antioxidants
Second thing that happened to our diet that increases inflammation is lack of polyphenols and other antioxidants in the diet. Before the modern food processing era, our diet used to have more than 50 percent unprocessed and uncooked food items such as coloured fruits, vegetables, and other natural ingredients that are high in antioxidants such as polyphenols. Studies have shown that lack of polyphenols leads to increased inflammation in the body.
- Omega 3 to Omega 6 Ratio
The third thing that leads to increased inflammation is the ratio of Omega 3 to Omega 6 fatty acids used to be 1:1 but is now at 1:16 which also increases inflammation. Learn more. With the above 3 factors, the inflammation levels rise significantly thereby increasing the risk of many health problems including cardiovascular diseases, diabetes and even increased risk of certain types of cancers! in this context, it is important to remember that most human diseases start with inflammation.
Tips For Reducing Insulin Resistance
According to the American Diabetes Association, nearly two million new cases of diabetes were diagnosed in people aged 20 years and older in 2010. Since the grossly misleading food pyramid was introduced, the incidence of type 2 diabetes has gone up as much as 400 percent in the United States. Prediabetes, also called insulin resistance syndrome or metabolic syndrome, affects about a third of all Americans. If you have some extra weight around your waist, you might be insulin resistant
Get enough protein. If the body gets carbohydrates without enough protein, it goes into insulin resistance. Most people need about 30 grams of protein at each meal. One egg is about 7 grams. As we evolved as hunters and gatherers, we are designed to eat a non-grain based diet rich in protein, fruits, nuts and vegetables.W8MD Weight Loss, Sleep & MedSpa Services
Try to work more physical activity into your day. Both exercise and resistance training can help reduce your risk of diabetes, and also helps to control it once you have it.
Eat more fiber. Fiber helps reduce your risk of diabetes by improving your blood sugar control. Try more fruits, vegetables, beans, whole grains, nuts, and seeds.
Choose whole grains in small qauntity. When you do eat grains, look for the word “whole” in the ingredient list. Whole wheat, stone-ground whole wheat, brown rice, and oats are all whole-grain ingredients.
Eat fewer simple carbohydrates. These foods, with high glycemic index, break down quickly in the body, and can lead to rapid fluctuations in blood sugar levels.
Go easy on foods like white rice, white bread, white pasta, refined flours, candy, fruit juice, soda pop, and baked goods made with white flour. The key is to understand glycemic Index of foods and focus on low glycemic foods.
Get enough sleep. When you’re sleep deprived, your body drives you to eat more simple carbohydrates. Get at least 7-8 hours a night.
Get professional help if you think you might be insulin resistant or gaining weight in the middle or upper part of the body.
You probably tried many diets and wondering what really works and what does not for weight loss, what is really causing your weight gain, as you eat healthy but still cannot lose weight!
You might want to get help from physicians trained in Obesity Medicine that can help deal with the complex issues leading to weight gain.
Obesity Medicine physicians such as the W8MD Medical Weight Loss Centers of America’s weight loss physicians are familiar with insulin resistance, and other factors contributing to your weight gain, and will work with you to design a weight loss plan that is right for you.
THINK W8MD FOR W8LOSSW8MD Weight Loss, Sleep and MedSpa Team