Most of my patients are either trying to lose weight, improve their cholesterol, and/or trying to live a healthier lifestyle with a better diet. For the past 25 years I have tried all sorts of things to help them, and rarely have we had long term success. We have tried various diets, pills (phen-fen being a spectacular failure), and surgery. None have consistently given significant long term success.
We offer a diet and wellness program called Cornerstone Wellness. This program is physician supervised, and based on the patient’s needs, preferences, and lifestyle. The program itself is based on the most recent scientific findings in weight loss. See our page Supplement Facts to help explain why we trust the companies we carry.
The Mechanics of Weight Loss
Since for most of human existence our problem has been too little food, the body aggressively guards its fat stores. Therefore, when the body is deprived of energy it will preferentially break down lean body mass (i.e. muscle) and try to leave the fat stores intact. When weight is gained back, it will be gained preferentially as fat. That one of the reasons why yoyo dieting is so bad. After a few cycles of dieting you may weigh the same, but your body composition will be different as you will generally have much more fat compared to muscle than you had before. To make things even worse, there is evidence that your basal metabolic rate (the minimum amount of energy you need, AKA resting rate) can be permanently lowered after losing large amounts of weight. This makes it even more important to do this carefully!
Please see my article on why we get fat for more information on the mechanics of obesity and weight loss.
How can you lose fat preferentially? One way to do this is by eating lots of protein. Protein protects the muscle, and is a natural appetite suppressant. The Adkins’s diet has lots of protein, and people who follow this do lose weight, and their cholesterol will usually get better, even though that diet is very high in fat. The problem is that many people find it difficult to follow that diet long term.
But we also need fiber and the other good things (bioactive food components like antioxidants and phytochemicals) we get from vegetables. Most importantly, they fuel the microbiome and provide important micronutrients we can’t get from other sources. What we don’t really need are starches (but they taste so good….)! There is one other consideration. Most tissues of the body require a continuous supply of protein and amino acids, and muscle is the only reservoir. When we eat protein, it goes to replenish that muscle that has been broken down since the last time we ate some protein. Too much protein, however, appears to be just wasted, it gets broken down and converted to glucose (raising out blood sugar)
The Ideal Diet
What are we looking for in a diet? We want a decent amount of (but not too much) protein, lots of vegetable, not too much fruit, and minimal amounts of starch. This diet should be low in calories, but individualized for each person. We should be looking towards losing fat, not pounds. It needs to be easy to follow, and not too expensive. It needs to be safe for everyone, especially diabetics, patients with heart disease, patients who have had weight loss surgery, children, elderly, and women who may become pregnant while on the program. It should have a maintenance program that can be followed once the dieter has reached their goal. And the program should be with real food, so the dieter can learn to eat correctly for the rest of his life. Cornerstone Wellness fits all those criteria.
Those of you who know me, know I live a crazy schedule. Between seeing patients, doing the business aspects of the practice, learning new medical techniques, and taking care of my family, I don’t have time for complicated diets. So I figured, if I can follow the diet, most anyone can. I found the diet very easy to follow, and was even able to incorporate it into our family meals. In the first month, my exercise level stayed the same, and I had 10 restaurant meals (meetings) during that month. I lost 5 lbs, did not feel hungry, and I wasn’t cranky. Needless to say, I was hooked.
Our patient results have been similar. They all have reported feeling energetic and well, and found this diet not difficult to follow. We have modified the diet over the past several years, lowering the starch intake, and increasing allowed fats (yes, you read that right). We have found people feel well, lose weight, and their cholesterol and sugar values usually improve by significant amounts. We have also become more adept at individualizing the program to account for differences in medical conditions and lifestyles of our patients.
Details About the Diet
When you come in for a consultation, you will get weighed and measured. We’ll discuss what you think would be a reasonable exercise program to follow (need to build that muscle!). Based on our discussion, we will recommend the specifics of the diet for you. The basic diet will contain 1-2 protein shakes and 1-2 meals. You are given a list of how much of each type of each food to eat daily, i.e. how much protein, fat, starch, and vegetables. These exchanges can be moved around (I had to do that to be able to eat in restaurants), but the daily total should come out right. We see you monthly to remeasure you so we can track you progress, and revise the diet, if necessary.
The protein shakes are made from whey and immature green pea. Since you mix your own, we will decide together what type of liquid and additions will work best for you. They are a high quality source of protein, with a good mixture of essential amino acids, and contain 23 grams of protein. This is an important source of low calorie, low carbohydrate protein. In addition, the protein powder contains 50-400% RDA vitamins, including plenty of vitamin D.
In addition, everyone gets an Omega 3 (fish oil) supplement. Omega 3 is an essential fatty acid which the body cannot produce on its own. Omega 3 oils combat inflammation, lower triglycerides, and help with many medical and psychiatric illnesses. These are medical grade supplements refined to have the lowest possible levels of mercury and other toxins. They are one of (if not the) purest fish oils on the market, and you should not have any fishy burps. Taking these will also help keep the skin, hair and nails in better shape while dieting.
The final supplement is called MetAssist. This is taken 3 times daily, before meals. It helps regulate insulin levels, blood sugar levels, prevent carbohydrate craving, and promote fat loss. It contains several things, including hydroxycitric acid or HCA which limits the body’s conversion of excess blood sugar to fat as well as regulating appetite. Chromium helps insulin function better to get excess glucose into the cells. Green Tea has fat burning properties as well as potent antioxidant substances.
As far as the cost is concerned –
We see you once a month for an office visit, and you will need to pay your copay. We will bill your insurance for the visit. If you do not have insurance, or if you have an HMO and I’m not your primary doctor, the visits will generally cost $100-$150. The supplements cost around $200/month and are not covered by insurance. If you have a flexible spending account however, you can usually use it to pay for the supplements, as this is a medical treatment.
We are constantly revising and updating the program as more information becomes available about the science of weight loss. We also factor in the experience of our patients to customize and improve the program. We have had great results so far, and expect them to get even better as we continue to improve the program.
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