Eggs: For years, people had been told to avoid eggs because of their cholesterol levels. But today’s research shows that eating two eggs a day has not been linked to higher blood cholesterol levels. And other studies have shown that people who eat an egg-based breakfast tend to lose more weight than people who eat a carb-based one.

Apples: Want to minimize hunger while cutting calories? Studies show people who ate an apple before a meal ate less, so this fruit makes a perfect appetizer! Enjoy yours with the skin on to get the most satiating effect from the 4 to 5 grams of filling fiber per fruit.

Nuts: It is true that nuts are high in calories and (good) fat, so portion control is key, but in the right amounts, eating nuts on a daily basis can help balance out blood sugar spikes that can lead to cravings.

Seafood: If you usually eat red meat or chicken, try upping your seafood intake to several meals a week. Salmon, tuna, shrimp, scallops, crab, and the like are great low-calorie, lean protein sources that are also quick and easy to cook.

Edamame: Soybean pods, called edamame in Japanese cuisine, make a great protein-rich choice for a snack or side dish. Simply boil the pods for a few minutes and sprinkle them with a dash of sea salt when hot. Pop the tasty beans from the pod and enjoy.

Yogurt: Yogurt is a food for weight loss you should always have in your fridge. Opt for Greek style or organic yogurts over the more common commercial varieties that are too often loaded with high-fructose corn syrup, artificial colors, and artificial flavors.

Sushi: If you’re dining out or picking up something quick, sushi is an excellent option. But not all choices are created equal. Opt for selections featuring cooked or raw fish and/or veggies and avoid creamy or tempura fried items.

Beans: Beans of all types are one of the best foods for weight loss because they are loaded with fiber and protein, which makes them very satisfying while being lower in calories than meat. Try replacing the ground beef or other meat in your usual recipes with beans for a tasty vegetarian-style meal, or serve them on the side in place of potatoes or rice.

Portobello mushrooms: Portobello mushrooms add a great meaty texture to meals with fewer fat and calories. Try substituting a large grilled portobello in place of the standard burger, slice them up in meatless stir-fries, or swap half of the ground meat in recipes with finely chopped portobellos, instead.

Seaweed: Seaweed, another staple in Japanese and other Asian cuisines, is packed with nutrition. Studies show eating nutrient-dense foods like seaweed can actually help control your appetite and reduce food cravings. Look for pre-made seaweed salad in Asian markets or restaurants, or pick up some dried seaweed in sheet, granule, or powdered form for cooking at home.

There you have it, my top 10 best foods for weight loss. Some are likely very familiar while others may be new to you. Stock up on and work these foods into your daily menu on a regular basis to increase your weight loss success!

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

Understand Your Programming: The reason why women gain weight more easily and lose weight more slowly than men is largely biological. Long before the modern day (and before reliable birth control), nature designed women’s bodies to have and nurse babies every other year or so for most of their adult life, which takes a whole lot of calories. In ancient times, the ability to easily store fat and hold onto it was a critical part of making sure women’s bodies were up to the task. Men’s bodies, on the other hand, were designed to build muscle quickly so they could fulfill their role as the hunters and warriors. While you can’t change this programming, understanding it can help you outsmart this ancient genetic code.

Stay On Top of It: It’s far better for women to take action when they have five or 10 pounds to lose than to wait until the numbers reach into the double or triple digits. Why? If excess weight is allowed to accumulate and hang around too long, it can become your body’s new “set point,” or a weight that your body aims for. That’s why losing excess weight quickly after a pregnancy or other event is key – they longer you wait, the harder it will be.

Control Your Food Intake: Because women’s bodies store fat more easily and lose it more slowly, it’s important to nip the process in the bud by aiming to keep the number of calories you eat and the number of calories you burn about equal each day. It takes literally just a few minutes to eat a 600-calorie hamburger, but it will take hours of exercise to burn it off, for example. If you aren’t planning an extended hike during the day you eat the hamburger, the excess calories will go straight into fat stores. That’s why it’s better for women to not eat excess calories in the first place than to try to burn them off later.

Get Professional Help: The reality is losing weight is not an easy or simple thing to do. Women who want to lose weight safely, healthfully, and permanently should forget fad diets and turn to a medical professional who specializes in weight issues, like the ones at The Center for Medical Weight Loss. Physicians can rule out any medical cause of weight gain and, if needed, prescribe medications such as appetite suppressants or liquid diets to help. Behavioral counseling and body composition monitoring complete the picture and help ensure the best chances of success.

In short, women face special challenges when it comes to losing weight. But by following these weight loss tips for women, it is possible to not only lose the weight, but to keep it off for good.

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

It’s the One You Can Do: Most of my patients don’t love exercise and haven’t exercised in a long, long time. If this sounds familiar, the best place to start is with something you are physically capable of doing and to work up from there. If you’ve been inactive, before starting any new physical fitness program please remember it’s critical to have a complete medical checkup first and to review your plan with a medical professional.

It’s the One You Will Do: There is no use choosing a weight loss exercise routine that you don’t like to do and therefore are unlikely to look forward to or stick with long term. Think back to your childhood. What types of play did you like best? There are so many options. Swim, walk, hike, bike, play a team sport, or even play one of the new interactive video game systems like Wii, PlayStation Move, or Xbox Kinect. Whatever you choose, the best exercise to lose weight is always an activity you will truly enjoy.

It Depends on Your Age: Our metabolisms and body composition change over time, so it’s also important to consider your age when choosing exercises to lose weight. People in their 20s should focus mostly on resistance training, which will build muscle stores and increase metabolism. During your 30s and 40s, a plan that is evenly split between resistance training and cardio (fat burning) is the way to go. If you are over age 50 and have an hour to work out, it is best to do 45 minutes of cardio and 15 minutes of weights/resistance exercises. The cardiovascular activities help to prevent heart attacks and strokes, so they are more highly recommended in people over age 50. If you have a history of cardiovascular disease or a strong family history of heart disease, you should start cardiovascular activities as soon as possible regardless of your age.

It’s Not Just “Exercise:” The word exercise may conjure up mental images of aerobic classes, weight lifting machines, or running laps. But while those certainly are weight loss exercises, for many people it helps to stop thinking of exercise as something you do for a certain period of time so many times per week, and start thinking of it as the choices between inactivity and activity we make every day, all day long. Stand during the soccer match instead of sit. Pace while you talk on the phone rather than relax. Park at the farthest spot in the lot. Take the groceries into the house one bag at a time. Get the idea? Any movement is good movement and it all adds up.

There you have it, my advice for choosing the best exercise for weight loss for you! Above all, get started, keep going, and make whatever you choose part of your daily routine.

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

Stay Away From Halloween Candy

All those “snack sized” goodies may look harmless, but the truth is they can easily tack a few hundred extra calories onto your daily total. So while you may be thinking it’s “just a taste,” all those bites here and there can total up to a pound or more of weight gain a week! Better to take a pass on the candy and watch the scale head in the other direction, instead.

Burn Calories Getting Things Done

Rather than dreading all those fall tasks that need doing, like putting away the patio set or raking up fallen leaves, see them as a chance to get active and get something done at the same time. De-clutter your closets, clean up the flower or vegetable garden, put away your summer clothes and get out your sweaters, or even redecorate for the season – all the while burning calories and fat!

Enjoy All the Fresh Seasonal Foods

Harvest time is a perfect time to add more fresh, seasonal foods to your menu and great, healthy choices abound. Visit a produce stand or farmer’s market and stock up on crisp apples and pears, savory pumpkin, fresh cranberries, filling sweet potatoes, and all the other fabulous fall foods. Spaghetti squash makes a great substitute for pasta, for example. Dig in!

Don’t Wait Until New Year’s

One of the best easy ways to lose weight this fall is to make today the day you get started! Many people make the mistake of “waiting” for the holidays to be over, only to find themselves ringing in the New Year several pounds heavier as a result. Wouldn’t you rather start next year well on your way toward your weight loss goal, instead?

There you have it: Four easy ways to lose weight this fall. Put them into practice today and you can start seeing results as soon as next week!

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

Start a Food Journal: Studies show that people who write down what they eat are much more successful when it comes to weight loss, making this an excellent tip to lose weight. Why? Most people tend to underestimate the number of calories they eat by several hundred calories a day. Writing down what you eat before you eat it also helps make your food choices more conscious. Chances are you’ll take a pass on that “extra” doughnut in the office break room, for example, when you realize it will add 490 calories and 18 grams of fat to your daily total.

Eat More Whole Foods: Aim to eat the majority of your foods in as close to their natural form as possible, and you’ll painlessly trim even more empty calories from your diet without hunger. One easy way to do so is to ask yourself, “Was this food available 200 years ago?” If not, chances are it’s a highly processed, prepackaged food. Such items typically contain lots of calories, sugar, salt, and fat but little nutritional value. Reach for fresh fruits and veggies, lean protein, beans, seafood, brown rice, broth-based soups, and truly whole grain breads like rye, pumpernickel, or 100 percent whole wheat. Such whole foods are more filling, have fewer calories, and are packed with nutrition, making them excellent choices for weight loss.

Stop Drinking Your Calories: Replacing your usual beverage with water is another tip to lose weight you should try. By cutting or eliminating your intake of soda pop, juice, milk, or alcoholic beverages, you’ll shave hundreds more calories off your daily total. Avoid diet drinks too, which may not have any calories but have been shown to increase cravings and appetite. If you must have caffeine, green tea is the best choice, though unsweetened coffee or black tea (hot or iced) is fine in moderation. When in doubt, stick with nature’s perfect zero-calorie beverage – water!

Get 7 Hours of Sleep: Did you know that sleeping more is a tip to lose weight? Yes, that’s right! Studies have shown that people who don’t get at least 7 hours of sleep per night gain weight more easily because lack of sleep leads to higher cortisone and stress hormone levels, which in turn lead to increased appetite and cravings. Break the cycle by making sure you are getting quality shuteye, including going to bed and getting up at roughly the same time every day.

There you have it – four tips to lose weight that you can easily put into action today! Use them to get started or to continue on your path toward your weight loss goal.

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

Metformin, a prescription medication which comes in pill form and is taken several times a day to help those with diabetes control blood sugar, may help even those without diabetes control their weight, especially people who struggle with binge eating or who eat a lot of sugary foods.

Metformin works by helping to even out blood sugar levels and preventing the high spikes that trigger insulin to be released in large amounts into the blood to help cells take up the excess sugar.

For many people who don’t technically have diabetes it is still possible that conditions such as metabolic syndrome or pre-diabetes are interfering with the body’s ability to process sugar in the blood. The drug can help them by breaking the vicious cycle of blood sugar spikes, excess insulin, and the resulting blood sugar low that sets off an almost uncontrollable drive to eat as the body’s natural way to restore blood sugar levels to normal.

It’s important to note that Metformin itself doesn’t lead to weight loss, and that taking this medication alone isn’t the answer to the complex illness of obesity. Like other prescription medications for weight loss, it’s simply a tool that for some people, makes the process a bit easier.

The only way to know if Metformin might help with weight loss for you is to have your fasting and oral glucose tolerance levels tested by a medical professional. If the results indicate your body is having trouble processing blood sugar, the medication could help.

Another way to mimic the effects of Metformin weight loss is to eat small, frequent high protein meals throughout the day, rather than three larger meals. Doing so helps keep blood sugar levels steady, which in turn prevents the cravings triggered by blood sugar spikes and crashes.

If you suspect your blood sugar levels may be playing a role in your appetite and weight, see a doctor trained in such issues like the ones at The Center for Medical Weight Loss. Together you can put together an individualized plan for tackling your weight issues that will work long term, whatever the source of the problem might be.

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

Some people do tout apple cider vinegar for weight loss either in liquid form or in so called “diet supplements.” But does the claim that apple cider vinegar aids weight loss hold any merit?

While a handful of small scientific studies have found vinegar in all forms may have a slight effect on weight and other health concerns, they are a far cry from saying so without a doubt or that vinegar alone is a solution to excess weight.

It’s also important to note that when studies did see some correlation, it was a modest amount, not pounds and pounds of weight loss. And you should keep in mind that like any alternative or natural treatment, apple cider vinegar may interact with some prescription medications, so check with your doctor first.

Some experts theorize that vinegar, which contains acetic acid, may help stabilize blood sugar and/or play a role in appetite suppression. But again, it’s important to remember these are just theories and more studies are needed to back up those claims or to determine how much of an effect it has.

Interestingly, if you are going to try adding apple cider vinegar to your diet, you’re better off going with the liquid version from your local supermarket than buying apple cider supplements. One 2005 study analyzed several brands of such supplements and found they contained little, if any, apple cider vinegar and none in the amounts listed on the package. Like all unregulated weight loss supplements, I’d steer clear because of their potential to contain potentially harmful substances.

However, it’s unlikely that two teaspoons of apple cider vinegar a day mixed into a cup of juice or water will harm your health, but it also won’t be a miracle weight loss cure. If you’re looking to add more vinegar to your diet, consider drizzling it on salads or using it more often in your cooking, instead.

In fact, instead of turning to apple cider vinegar for weight loss, why not do something that has been shown to help promote weight loss – eat more fresh apples! A recent study found that people who ate three apples a day lost more weight than those who didn’t.

Remember, apple cider vinegar is not an easy fix for the complicated problems surrounding obesity. To make real progress in your weight loss goals, consider working with a medical professional trained to address the nutritional, physical, and emotional dynamics at play like we do at The Center for Medical Weight Loss, and you’re likely to see much better results.

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

It depends. At The Center for Medical Weight Loss, we do put some patients on a medically supervised liquid diet to help them jump-start their weight loss and also to help patients with binge eating or food addiction issues “take a break” from food so they can step back and examine their food triggers.

However, unlike a cabbage soup or juice diet, or other fad liquid diets, a medically supervised liquid diet provides 100 percent of the nutrition – including protein – that your body needs despite the low calories it contains.

So unlike those other liquid diets, a prescription liquid diet won’t trigger the body’s starvation response and yo-yo weight gain like the other types will. Without the balanced nutrition and high protein levels a prescription liquid diet contains, a 20-pound weight loss is likely to lead to a 30-pound weight gain later on.

For people with binge eating or food addiction issues, a medically supervised liquid diet combined with behavioral counseling can help a person recognize and break the powerful food triggers that have lead to his or her weight issues and finally break free from patterns that are 20, 30, or even 40 years in the making.

Another advantage of a medically supervised liquid diet is the speed at which it works. On such a plan, a person can lose weight as rapidly as someone who has had bariatric surgery, but without the surgical risks or life-long dietary restrictions.

For example, one of my patients lost 250 pounds in thirteen months, going from 450 pounds down to 200. He not only felt and looked better, but he was also able to reduce the amount of medications he was taking from 19 down to three.

During that time we monitored his progress on a weekly basis and also worked on breaking the patterns that triggered his binge eating. Today he has successfully kept the weight off and continues to check in occasionally, especially when signs of his eating addiction start to return.

Many patients fear that they will struggle with hunger on a liquid diet, but we have found that for 80 percent of those who try them, the hunger disappears after just a few days and many say it’s almost a relief to take a break from their food addiction. For those who continue to struggle with hunger, a prescription appetite suppressant can be helpful.

If you think a prescription liquid diet may be for you, make sure to seek professional help and follow a nutritionally sound, medically supervised plan, such as that offered at The Center for Medical Weight Loss, that combines the liquid diet with behavioral counseling and support so you can break bad patterns for good.

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

In short, when it comes to weight loss – or, more accurately, fat loss – no. Detox diets for weight loss are not the answer.

These extremely low-calorie detox diet plans don’t begin to offer the nutrition your body needs, which will trigger a starvation response that in turn encourages your body to drop water weight and muscle mass but preserve fat stores at all costs if followed for any length of time.

Another popular claim is that detox diets cleanse out your colon and digestive tract, eliminating excess weight in the form of built up feces and toxins. Again, nothing could be further from the truth. A person simply cannot be remotely healthy and also have pounds of build up in their digestive tract. This is something only seen when someone is at the end of their life and very, very ill.

Likewise, these so-called detoxifying diets may come complete with a “mystery concoction” of potions to drink during the fast. Such products can be anything from simply sugar and vitamins to a potentially dangerous blend of herbal and/or illegal medications.

So don’t be fooled. The average overweight or obese American’s weight is not in the form of excess toxins, it’s in the form of excess fat. So following a plan whose goal is to eliminate fat – not toxins – is the solution.

Of course, eating a balanced diet of nutritious foods will help you feel better and is less toxic compared to a diet made up of fast food and processed food. Drinking plenty of plain water will also help you feel and look better. But fasting, at least for the purpose of weight loss, won’t. (Fasting for the purpose of spiritual reasons is an entirely different matter, and not to be confused with detox diets or weight loss.)

For those with food addictions or a lot of weight to lose, following a high-quality, medically supervised liquid diet can provide quick weight loss without triggering a starvation response, and also help someone break away from unhealthy foods and eating patterns.

We offer such a plan to the patients in The Center for Medical Weight Loss program who would benefit from it, along with many other proven and effective techniques to help you lose excess fat and improve your overall health at the same time – a much safer and more effective method than a detox diet for weight loss.

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

The answer is no, and yes.

No, supplements, weight loss aids, and the like cannot burn belly fat.  And no, spot exercises can’t target just this trouble zone.

But yes, you can lose abdominal fat by following a balanced, low-calorie, high-protein, high-nutrition diet paired with regular exercise and behavioral counseling.

Let me explain a bit more. Many weight loss products and aids promise a quick and easy fix, which is appealing, but in the long run these products don’t deliver, can lead to muscle loss and rebound weight gain, and in the worst case scenario be hazardous to your health. My advice? Stay away.

What will work is what I have described above and what we do at The Center for Medical Weight Loss. Our customized weight loss plans tailored just for you and supervised by a medical professional trained in the issues of weight loss will help you lose weight – including belly fat – while preserving muscle. In addition, counseling helps you to break old patterns and learn how to not just lose the weight, but keep it off for good.

Losing excess belly fat is a good goal because excess weight around the middle has been linked to a whole host of serious medical conditions including metabolic syndrome, diabetes, heart disease, high blood pressure, and more.

But you can’t just spot lose belly fat. You must reduce your overall body fat stores, which if you are someone who stores weight around the middle is where most of your fat loss will come from and where 50 percent of the body fat most people carry is located.

Body composition monitoring, which is a key part of our plan, allows you to monitor not only how much weight you are losing but how much of it is fat, muscle, or water and exactly where those losses are coming from. Knowing all that is essential to knowing that you actually are accomplishing your goal – to lose belly fat along with reducing overall body fat.

So, if you’re concerned about belly fat loss and want to get rid of it in a healthy and permanent way, don’t reach for a pill or potion. Give us a call and let us show you how to do it without endangering your health.

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

Of course not only are the weight loss forums free and available 24 hours a day, they’re also filled with people who have the same hopes, dreams, goals, struggles, and triumphs as you – people on the very same journey and medical weight loss plan.

For example, here’s part of a recent exchange in the weight loss forums about coping with cravings:

PageantQueen: “How long should one be on the program before the cravings go away? Any helpful tips on cutting the urge to fulfill the “taste” for a certain food? Thank you in advance for any insight.”

Tarotknits: “My weakness is cheeseburgers… I love them…that is one of my problems, I’ve been addicted to food all my life. I’m an emotional eater. Happy, sad, it all revolved around food… The phrase I ask myself every time I have one of these cravings is ‘Would you rather have a cheeseburger, or a heart attack?’ I pick staying on the diet every time.”

PageantQueen: “…Hang in there and you are right, I will keep thinking to myself, ‘would you rather have a cheeseburger or a heart attack?’”

As you can see, such exchanges can help everyone involved. In fact, studies have shown that support from online weight loss forums can be as effective, or sometimes even more so, than those closest to you.

While that may sound surprising, the reality is sometimes those in your inner circle may be almost too close to support you during your weight loss journey. Perhaps they have a weight issue themselves, or a food addiction, unhealthy patterns, or even just that they have never faced a weight issue themselves – things that may leave them unable to be of much support or truly understand what you are experiencing.

Of course not everything you read in a weight loss forum will be good advice, or even helpful. So like anything, you’ll need to use your own judgment or check in with others for a second opinion if something doesn’t ring true.

But for the most part I think you’ll find reading and participating in the weight loss forums to be an enriching and educational experience, another tool to turn to that can help you gain awareness and perspective about your goals. So if you haven’t already, stop by and check them out today. I think you’ll be glad you did.

And who knows when what you have to say will also be just what someone else needed to hear. It works both ways!

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

These weight loss success stories from real people just like you, complete with before and after weight loss photos, are a great way to motivate yourself on a day when you wonder if you’ll ever meet your goal. The CMWL weight loss success stories can inspire you to stay on track during a rough moment, or just encourage you that others have done what you aim to do – and you can too!

We have weight loss success stories from all types of folks, from those who just wanted to lose a few pounds to people who have overcome obesity-related illnesses and improved their health, to everything in between.

One thing you’ll notice many of these weight loss success stories have in common is that they approached managing their weight as a long-term, chronic health condition, not as a cosmetic quick fix.

Perhaps like you, many have spent years on the yo-yo diet cycle, losing weight on one diet after another only to have it return. I think for many of our weight loss success stories, realizing and accepting that losing weight and then working to keep it from creeping back on is a lifetime, long-term goal that they will always have to pay attention to and work toward. This is what helps them finally lose the excess weight once and for all.

Like diabetes, obesity isn’t something you can “cure.” Your genetic tendency toward weight gain, struggles with emotional eating, learned bad habits, medical conditions that may be contributing to weight issues, and more will always be there. Knowing your own unique challenges and staying on top of them is the key to winning your personal battle of the bulge and becoming your own weight loss success story.

As I’ve said before, losing the weight is only the start of the journey. Keeping it off is the more important goal. So this time, instead of feeling like you have failed if 10 pounds creeps back on or if you slip up and go off the medical weight loss plan, be ready to take action to get back on track.

If you do, you’ll soon not only be reading about others who have successfully lost weight and kept it off, you’ll be one of them!

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

That said, getting active is all about getting started so, in that spirit, here are some of my top summer fitness tips:

Join a Walking Club: Walking clubs and events are a favorite summer workout activity in many cities. Check around and see if there are any walk/runs scheduled in your area. These low-key walks aren’t about being the fastest, or even necessarily about finishing, and you’re likely to see folks of all ages, shapes, sizes, and fitness levels participating, which can me less intimidating than marathons, for example. Not only are these fun walks a great way to get out and enjoy new scenery, they’re also a great place to find possible walking buddies for future excursions.

Hit the Pool: While you’re at it, have a look at what’s going on at the local pool when seeking a summer workout. Many facilities offer fitness classes like water aerobics and the like, which are a perfect fit for those with back pain, arthritis, or trouble exercising “on land.” Water not only keeps you cool while you work out, it also helps offset the effects of gravity and provides gentle resistance while burning a surprisingly high number of calories. For this reason, walking in a pool is another good summer fitness tip and helps break up the same-old, same-old summer workout routine for those who like to walk.

Go Paddleboarding: A summer workout activity several of my patients have taken up recently is called paddleboarding. It’s similar to wakeboarding, but much easier. You stand on a specially designed board and then paddle along on calm water, such as a bay or lake. This summer workout option is great for building balance, gets you out on the water, and I am told is not difficult to master.

Take a Hike: Summertime is a great time to explore the great outdoors as a family or on your own. Combine hiking with camping (but watch out for unhealthy camping food choices) or just plan a day hike. Chances are there are beautiful sights to see not too far from where you live, or make it an adventure and travel to a location you’ve always wanted to visit but haven’t yet. (Grand Canyon, anyone?)

Team Up: Team sports like softball, baseball, and soccer provide more great summer workout opportunities. For those who don’t like to exercise alone or who have a competitive drive, these summer workout activities can be great motivators to get and stay active. Scheduled practices also help make sure you’re doing so on a regular basis. Seek out a sport that fits your fitness level and interest so that you’re sure to enjoy being part of a team.

Whatever you do this summer, make sure you’re making staying active a priority. A little movement every day is better than a one-time attempt, so plan to get started and stick with it. Incorporating some summer fitness tips into your routine means that by summer’s end, you are sure to see a big improvement in your fitness level, energy, stamina, reduced stress, better sleep, and many more health benefits associated with an active lifestyle. Enjoy!

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

Of course, there are certain parameters you should follow but, in general, if you enjoy a glass of wine or a beer or a mixed drink now and again, it doesn’t mean you have to stop drinking altogether in order to lose weight.

In fact, for reasons we don’t clearly understand, studies seem to suggest that people with a moderate alcohol intake (one drink a day for women, two drinks a day for men) have fewer odds of having a weight problem, not more, despite the empty calories alcohol contains.

I have some theories of why this may be, including that perhaps these people have a lower stress level or might eat a healthier “Mediterranean style” diet. Or it could be that their balanced alcohol consumption is part of an overall tendency toward doing nothing in excess, or that perhaps alcohol may contain certain chemical compounds that in small amounts are helpful in weight regulation. (A moderate alcohol intake has been linked to reduced risk of heart disease and other health issues, as well.)

Naturally, I don’t recommend someone who doesn’t currently drink to start drinking as a way to control his or her weight. Likewise, I wouldn’t recommend someone with a history of binge drinking or alcoholism to try to drink moderately. In these cases avoiding alcohol intake rather than increasing it would be the way to go.

But if you are someone who occasionally enjoys having a drink, you don’t need to change the habit as long as you observe a few commonsense practices.

First, like with any food or drink, be sure to factor the calories from alcohol that you consume into your overall daily intake and make sure the calories from alcohol aren’t so many that they are edging out healthier foods you should be eating more of.

Second, be choosy about what types or drinks you partake of. A glass of wine or a wine spritzer, for example, has hundreds of fewer calories from alcohol than a pina colada. A light beer is a better choice than a margarita. A gin with diet tonic water has far fewer calories than a daiquiri, and so on.

In short, if you drink alcohol in moderation and are mindful of your choices, it is possible to lose weight without having to become a teetotaler.

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

While at first glance these results seem like a no-brainer – of course being physically fit and having a good fitness level in your 40s reduces your risk of heart disease in your 50s or 60s – they are a good reminder that the best way to prevent your body from breaking down as you age is to take good care of it along the way.

But what does that really mean? In addition to eating a low-calorie, high-quality diet filled with nutritious foods, it also means being active on an everyday and ongoing basis to maintain a good fitness level, and taking care of oneself emotionally, too.

I do worry somewhat that people who maybe haven’t taken such great care of themselves and find that at midlife they aren’t so fit could take this study to mean that it’s too late for them to avoid heart disease and other health problems associated with obesity.

Nothing could be further from the truth! It is never too late to do something to improve your immediate and long-term health, no matter how long or badly it’s been neglected. In fact, it’s never too late, even when you already have heart disease or some other serious illness.

Time and time again I have seen patients who are seriously overweight and who haven’t exercised in decades turn things around and go from being 50+ pounds overweight and mostly sedentary to slimming down and participating in marathons within a year!

And the same can be true for you, too, if you seize the day and make today the last day you neglect your physical or emotional health. Instead, make the conscious decision to take charge of your health and fitness level, no matter where you are at. Make today the last day you live like “the average American” and start living like “the uncommonly healthy American.”

Look for ways to be more active, not less active. Choose the nutritious food on the menu, rather than the high-fat, high-calorie one. Make eating out a special event rather than an everyday one. Park in the furthest spot from the store entrance instead of the closest one. Say no to adding another thing “to-do” to the schedule and enjoy a bubble bath or some other relaxing time instead. Cope with stress by talking to a friend or walking around the block instead of with a trip through the drive thru, etc.

Doing so will provide your best chance of enjoying a lifetime of good health, a high quality life vs. one filled with illness and suffering, and a higher fitness level. It may mean doing things differently than you have been, and doing things differently than most people do, but the end results will be well worth it, I assure you!

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

In short, I don’t think so. While I admire that the effort was an attempt to make understanding good nutrition easier (one criticism of the former Food Pyramid model, which some said was too complicated), it almost simplifies things too much.

For example, the “My Plate” model focuses on how much the servings on your plate should be made up of things like protein, dairy, fruits, veggies, and grains.

In addition, the recommendations also include some general guidelines such as eating less but enjoying your food more, watching portion sizes, filling half of your plate with fruits and vegetables, making half of the grains you eat whole grains, switching to 1% or fat-free milk, reducing sodium intake, and replacing sugary drinks with water.

This super simple approach could backfire, for instance, if someone considers broccoli swimming in cheese sauce to be an acceptable vegetable option, or that chicken fried steak counts as a protein choice. While those foods do contain vegetables and protein, they are hardly “healthy” or low-calorie choices, even in 1/4-plate portions.

Likewise, I think the MyPlate model is too general and doesn’t compensate for the different nutritional needs of children vs. teens vs. adults vs. seniors, for example, or for men and women, or for those with medical conditions like diabetes or heart disease.

Another issue I have with the MyPlate approach is that even a nutritionist would likely struggle to come up with simple yet healthy meals that would fit this mixed plate recommendation for each and every meal of the day. Plus, the model doesn’t specify how big of a plate they are talking about. And yet studies have shown that the trend toward serving up meals on larger and larger plates and other oversized dinnerware is playing a role in obesity.

I wouldn’t be surprised to see MyPlate soon replaced with yet another model for eating well, as the Four Food Groups and the Food Pyramid have been. It’s a shame that despite millions of dollars in funds and some of the best minds in the field of nutrition participating in its development, it’s likely to do nothing to offset America’s growing obesity epidemic.

If you want to lose weight and fight obesity, my advice would be to skip general recommendations like this one and to make an appointment with a team of physicians, dietitians, and other experts like those at The Center for Medical Weight Loss who specialize in and really understand weight issues and can develop a program tailored just for you.

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

In general, when one is cutting calories it can be difficult to get everything your body needs from the food you eat, even if you’re eating a low-calorie diet made up of wholesome, nutritious foods.

For this reason, I do recommend my patients take a regular multivitamin every day. Doing so ensures that they won’t be missing out on any trace vitamins and minerals their bodies need.

However, it’s important that any vitamin one takes is a high quality one made by a reputable company. Ask your doctor to recommend one. Prescription prenatal vitamins are a good option even when one isn’t pregnant because these vitamins are screened by the FDA and do contain what the label claims in the correct amounts.

Be wary of vitamins that contain many times more the amount of the RDA recommendations, or ones that claim to aid in weight loss or have added herbal components. More isn’t necessarily better when it comes to vitamins, and if you take other over-the-counter or prescription medications, it’s especially important to avoid herbal ingredients that could negatively interact with your other medications.

Like other supplements, vitamins fall outside of the regulatory system the FDA has for prescription medications, which means some vitamins may not contain what they claim to, or the binder and other ingredients used in the pills may not dissolve in your digestive tract easily, meaning the vitamins “pass” right through without being absorbed.

At the Center for Medical Weight Loss, we give some of our patients vitamin shots. Unlike a pill, the injected vitamins and minerals go straight into the bloodstream where we know for sure they are readily absorbed. This is another option for some, especially those on a very low-calorie diet.

And finally, don’t be fooled into thinking a vitamin pill can make up for what a poor diet misses. It’s always better for vitamins and minerals to come in the form of food whenever possible. Likewise, foods contain many other compounds a healthy body needs as well.

So in short, aim to eat a high-quality, low-calorie diet filled with fresh whole foods like vegetables, fruits, whole grains, and lean proteins, and then back that up with a daily multivitamin to be sure you aren’t missing anything. Doing so will provide the best odds that you are getting all of the nutrition your body needs while losing weight and for the long term.

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

I know many of my patients have mentioned that their weight problems began once they started a job that was mostly sedentary, and I believe it. After all, if one sits for 8 hours a day in an office, and sits while they commute to and from work as well, that adds up to a whole lot of inactive time.

While I don’t suggest you search for a more active job (unless you want to!) I would urge you to think about the many possible ways you can make a desk job more active.

Even small changes like standing instead of sitting whenever possible, walking over to a co-worker’s desk to speak with him or her in person rather than via e-mail, and taking the stairs in place of an elevator add up.

If possible, break up your workday with a series of five-minute walks throughout the day. If you work in a large office space, a few laps around the place should do, or if needed, take a break and head outside for a lap or two around the block. These mini-exercise sessions not only boost your metabolism throughout the day, the added circulation and blood flow they provide will also wake you up and help keep you mentally alert as well.

Likewise, make lunch time and other breaks active ones. Do some window shopping. Bring your bike to work. Or try to organize a walking buddy system with co-workers!

If your company has an on-site gym that makes things even easier, but even without such luxuries there are plenty of mini-exercise routines you can do right at your desk that involve stretching, lifting, or using your own body weight to build strength and burn calories.

Another way to add activity to a sedentary job is to learn to fidget. Believe it or not, some experts believe those “naturally thin” people who seem to eat all they want and never gain weight do so because if you watch them closely, they are always moving even when they are sitting down! Tapping their pencil, shifting from one side to another, and wiggling their toes may not look like much, but the small movements are just enough to burn another calorie or two a minute, which add up over an 8-hour day.

In short, try to think of exercise time as all the time, not just something you do for 30 minutes once a day. While you may not want to trade your current job for one that involves non-stop physical labor, it doesn’t have to mean that you can’t be active even if you have an inactive job. It just requires a little creativity and conscious effort to make sure your day spent as a “desk potato” doesn’t end up foiling your medical weight loss goals.

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

It’s a welcome development for people like me who are concerned with health and wellness. In fact, in my own household we regularly play what I call “exer-games” as a way to spend family time together and be active at the same time.

Now, studies are showing that such games not only encourage activity in the virtual realm, but that about 60 percent of those who play such video games at home go on to participate in the same sports and activities in the “real world.” It’s an exciting development.

If you haven’t seen them, the new generation of video game systems no longer depend on joysticks and control to play the game; they operate on the player’s own body movements. There are several brands, including Wii, PlayStation Move, or Xbox Kinect. It’s possible to play golf, tennis, or baseball; wakeboard; bowl; box; duel; take dance classes; learn yoga; and try dozens of other activities right in your own living room no matter what the weather or season.

In addition, most games can be connected via online networks so you can compete and play the games with others in real time around the country or even around the world!

One of the best things about these games is that they are so engaging, you don’t even feel like you’re “exercising” as you hop, jump, skip, run, and scoot your character across the screen. But sure enough, while you play you’re burning calories and, in many cases, getting a good cardiovascular workout as well!

Researcher Bruce Bailey, Ph.D., a Brigham Young University exercise scientist, says the games can burn up to 5 calories a minute compared to the 1 calorie a minute our bodies typically burn at rest – the equivalent of walking on a treadmill.

So while I never thought I’d be recommending that my patients play more video games, in this case I highly encourage adding such games to your and your family’s activity tool chest.

Just remember to get out in the “real world” and stay active, too!

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

Here are six ways you can get a jump-start on your weight loss goals:

Forget What You Know About Dieting: First, realize that much of what you have heard about losing weight is likely completely off the mark. In general “dieting” doesn’t work because our bodies are designed to slow our metabolisms and conserve fat when calories are cut – not to shed fat. That’s why fad diets or starving yourself doesn’t work – this makes it harder to lose weight, not easier, in the long run. Likewise, forget pills, potions, diet sodas, frozen entrees, and processed packaged “diet” foods. The best way to lose weight and keep it off is to follow a high-protein, reduced-calorie, nutritionally balanced meal plan made from real foods including plenty of “fill you up” foods in the form of fresh vegetables and fruits – or in other words, how most Americans don’t eat!

Hire an Expert: Nobody would try to manage a complex illness like diabetes or cancer on his or her own, nor should one try to tackle a weight issue without help from a board-certified physician trained in weight issues who can guide you toward your goals based upon your unique health situation. Obesity is a medical condition, not a cosmetic problem, and it needs to be addressed as such. Too many “diet” programs just focus on losing weight quickly, rather than on tackling the core issues contributing to the problem in the first place.

Keep Track: Studies show that people who get in the habit of keeping a food diary, counting calories, weighing in on a regular basis, and journaling about what they are experiencing along the way are far more likely to lose weight and keep it off than those who don’t. So make it a point to get in the habit of writing down what you’re doing, what your goals are, and how things are going. Then share this data with your weight loss coach so the two of you can help you stay accountable – both while you are losing the weight and on a regular basis even after you’ve met your goal.

Make it About You: The reality is that weight issues can be caused by a variety of factors from genetics to underlying medical conditions to food addictions, so there is no one-size-fits-all approach to losing weight. What worked for a neighbor or relative may be completely wrong for you. You’ll get the best results from a plan that is tailored individually for you – like the ones we develop for each patient at The Center for Medical Weight Loss. Your plan should look at what you eat to how you move to lifestyle changes that will help you break patterns that are contributing to your weight issues.

Get Exercise Without “Exercising”: Living an active lifestyle overall is far more important than spending an hour at the gym every day. Start looking for little ways to add movement and burn calories into your daily routine, from parking further away at the store or work, to taking the stairs, to going for a walk to unwind instead of watching TV, to carrying groceries in one bag at a time instead of in as few trips as possible. Looking for the “hard” way to do the things you already have to do anyway can add up to the equivalent of 30 minutes or more of exercise per day, without ever “exercising!”

Think Big Picture: Remember, it’s not just about losing the pounds, it’s about breaking the weight loss/gain cycle for good. So instead of making losing weight quickly your focus, make it about losing that weight for good. That means really examining all of the things that led to your weight problems in the first place and taking steps to relearn the way you live. Keep in mind that reaching your goal weight is just the first part of the journey. The second part is continuing to live in a way that keeps that weight from coming right back.

This summer, why not tackle your weight issues once and for all, not just for the swimsuit season? That way you won’t find yourself looking for another “quick solution” next year.

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

Recently she started promoting a weight loss product called “Rescue Me” by Organic Liaison. It sounds simple enough – just add a capful of the concentrated all-natural, organic elixir to a glass of water and sip on it throughout the day.

Doing so is supposed to reduce appetite, replenish essential vitamins and minerals, and help increase energy. In fact, after Alley claimed the product helped her shed 60 pounds, QVC sold out of the formula in just 15 minutes!

Like many “weight loss aids” the exact ingredients in the formula are not clearly listed.  Recently a weight loss specialist named Dr. Ilana Bragin at the Methodist Dallas Medical Center analyzed the contents as part of a television investigation into the product’s claims. What she found was shocking – the product, made from a variety of fruit juices, was mostly sugar! Of the vitamins and minerals it did contain, none have ever been scientifically proven to reduce appetite or increase energy.

I’m not surprised, and I have a feeling that instead of solving her weight issues for good, Alley has once again looked for a quick fix for her weight issues rather than a long-term solution and that the weight will be back.

As the multi-billion dollar diet product market proves, there is a huge demand for a effortless, easy, and quick weight loss solution. And because these products are categorized as supplements, they fall outside of the FDA’s realm of testing and quality control to establish if the product’s claims are true or even safe.

My advice? Don’t waste your money on Alley’s new diet solution. If you want to lose weight and more importantly, keep it off, seek out a proven medically supervised weight loss program that combines solid nutrition, regular exercise, and behavioral counseling that approaches weight issues as a long-term chronic issue, not a one-time fix.

In fact, I have a feeling there’s actually another explanation for Alley’s recent 60-pound weight loss – her participation in the popular “Dancing With The Stars” program, which had her training up to 12 hours a day! While I wouldn’t suggest anyone embark on such a strenuous regime to lose weight, I do find it interesting that this much more obvious explanation for her weight loss isn’t mentioned in the infomercial.

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

As I have said before, I am not a fan of banning any food completely, even sweet foods. Of course, like other “not so healthy” choices, moderation is the key. Sugar itself isn’t the problem, it’s how much sugar we eat.

Several hundred years ago, even the most wealthy people – royalty – consumed about 6 pounds of sugar a year. Today, in comparison, the average American consumes well over 100 pounds per year!

Most of that sugar isn’t in pure sugar form so many people may not even be aware of how much sugar they are actually consuming. Instead, it’s hidden in sweet drinks, baked goods, even in foods you wouldn’t suspect like ketchup and crackers!

In fact, one way food manufacturers keep “nonfat” foods tasting so good is that they often add more sugar to make up for the lost fat. Such bait and switch tactics may mislead people to think they are eating “healthy” when in reality they aren’t.

Foods labeled “contains no high-fructose corn syrup” are a more recent addition to this marketing game. And while I am not a fan of high-fructose corn syrup, it’s important to remember that foods containing mostly natural cane sugar instead aren’t exactly “healthy” either.

The “organic” label can also be deceiving when it comes to sugar. Sugar is indeed a natural substance as I saw firsthand when I visited a sugar plantation on a recent trip to Jamaica. However, just because sugar is natural doesn’t mean it’s good for you, especially in large quantities.

The fact is sugar, even raw natural cane sugar, contains no nutritional value whatsoever. No vitamins. No minerals. It’s just calories –  empty calories to the tune of 16 calories per teaspoon. While some calories in the form of sugar aren’t bad, those calories could be coming from foods that do have nutritional value instead.

The problem with sugar goes beyond just empty calories. Too much sugar can be downright dangerous. Recent research has linked a diet high in sugar with the development of non-alcoholic fatty liver disease, now the leading cause of liver failure.

For those with metabolic syndrome, pre-diabetes, or insulin resistance, a high sugar diet is a recipe for disaster, since it can increase the risk of serious illnesses from heart disease to type 2 diabetes.

There is also some research that suggests sugar can increase cravings and appetite, something that is counterproductive to losing weight or maintaining a healthy weight.

So in short, you don’t have to give up sugar altogether to lose weight or keep it off, but you will need to eat sugar in moderation. Keep an eye out for hidden sugar in the foods you eat, and when you do add sugar to something, do so sparingly. That way you can have your cake (occasionally) and eat it too!

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

So after you’ve gone to all that hard work to lose the weight, what can you do to keep it from coming back? Here are my top 7 tips:

Stay Accountable: Even after my patients reach their goal weight, I continue to see them several times a year. Why? So we can make sure they aren’t regaining the weight they’ve lost; if they are, we come up with a plan to reverse the trend. Having someone to check in with long after the weight is gone can help keep it from coming back.

Act Like a Loser: Studies have shown that people who continue to practice habits like weighing in once a week, tracking their calories in a journal, and other changes that helped them lose the weight are also more likely to avoid gaining it back again.

Stick with Your Fitness Plan: Once you lose weight, exercise becomes your ally in keeping it off. Exercise helps boost your metabolism and also preserve lean muscle tissue – both of which keep your body burning more calories per minute, every minute of the day. So be sure to keep exercising – get at least the equivalent of 5 hours a week if you are a woman, or 3 hours a week if you are a man.

Beware Emotional Eating: When I notice one of my patients is starting to regain weight, once we talk we discover it’s often because of a stressful life situation like a lost job, a sick family member, or the loss of a relationship has led them to overeat. Just like eating for emotional reasons didn’t work before you lost the weight, it still won’t work after. Staying aware of your emotional state and taking steps to manage difficult times with something other than food will help you avoid this weight regain trap.

Get Your Zzzzs: Studies show that people who don’t sleep well or enough gain weight easier than those who get enough rest. While we are still trying to understand why, it seems sleep helps control a complex range of hormones and chemical reactions within your body to keep things in balance. So make getting good sleep and enough of it a top priority!

Avoid Backsliding: Once the weight is gone, many people make the mistake of going right back to their old habits – habits that led to their weight problem in the first place. Be careful not to make the same mistake. If you have a trigger food, for example, continue to avoid having it at home where it can tempt you to overeat. Make a list of the old habits you had that didn’t work before and vow to not let them creep back into your life.

Dine In: The food served at restaurants often has far more calories and the portions are far bigger than what you eat at home, so continue to limit eating out to once or twice a week, and have a plan of attack for choosing the healthiest options from the menu even then. Continue to plan your meals and prepare them at home most of the time as a way to stay in control of your calorie intake.

That’s it – seven doable ways you can keep the weight off after you’ve worked so hard to lose it!

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

Calorie Amnesia: Studies show people tend to underestimate their calorie intake by 40 percent or more if they try to keep a running tally in their heads. An easy way to counteract this is to get in the habit of writing down everything you eat in a journal or log as you eat it. Doing so not only helps you keep accurate track of your calorie intake, it also makes you more conscious of your actions and may help you walk past the candy dish at the office rather than stop.

Cutting Back: Another mistake I see time and again is people trying to eat in the same old way, but less of it. By this I mean they will order the kids meal at the drive thru instead of the adult version, or get a small soda pop instead of the 64-ounce one. And while those are good moves, they’d be far better off to learn to eat in a whole new way than to try to subsist on skimpy portions of unhealthy foods. Make it your goal to reach for foods that are high in bulk but low in calories so you can cut calories without hunger.

Skimping on Sleep: If you struggle with your weight, how you sleep may be as much to blame as how you eat. Studies show that many Americans are sleep deprived, and that people who don’t get enough rest gain weight easier. So make it a goal to get at least 7 hours of shuteye a night. If you are having trouble sleeping, bring it up with your doctor and take steps to get better quality sleep such as sticking to a regular schedule or investing in a more comfortable mattress.

Overlooking Medical Concerns: Did you know there are many medical conditions and medications that can contribute to weight gain? It’s true! That’s why taking your total health into consideration when embarking on a weight loss plan is so important. Otherwise you may find yourself making all the right moves, but not addressing the core issue. We often find that a medical condition is playing a role in our patient’s weight issues and that addressing the health concern or switching problem medications is often the key to breaking their battle with their weight.

Being a Couch Potato: While cutting calories and changing the way you eat is critical to losing weight, it’s only part of the story. When people continue to live a sedentary lifestyle, their overall progress will be slowed or stalled dramatically even if they change their diet. If you’re in the habit of unwinding after a day of work in front of the computer or television, try going for a walk or even spending the evening out and about instead. The more you can move, the easier and faster losing the weight is going to be.

We’d love to hear about your own roadblocks – and how you’re working to overcome them – on our Message Boards.

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

Why? Time and time again I see that children, like adults, learn more from what they see than what they hear – or, as the saying goes, actions speak louder than words.

If your kids see you eating well, exercising, coping with your emotions in a healthy way, and choosing activities like going for a walk over watching television, they’re learning about living a healthy life by example, and that is far more effective than any lecture or talk could ever be. When you are the parent, it’s all about being a role model. The earlier you start, the better.

What if you haven’t been such a good example, or you’ve maybe even taught your child some bad habits like preferring high-calorie, high-fat, highly processed foods and living a sedentary lifestyle? Luckily, it’s never too late to turn things around for you or for them. As your diet and lifestyle improves, so will that of the whole family – adults and children alike.

This is especially important in families with a genetic tendency toward obesity. While you can’t change your genes, like someone with a family history of cancer who gets regular check-ups and avoids risky behaviors, you can take steps to help your loved ones counteract their predisposition toward gaining weight.

In my own household, I’ve worked hard to not only teach my children how to eat and live in a healthy way, I’ve also tried to lead by example to instill healthy habits. One simple example is that in my household, the beverage we drink more than anything else by far is water.

Now, when my children visit a friend’s house, their parents are often amazed to report that my kids not only turn down soda pop but they actually ask for water instead. Not because I told them to, but because they actually prefer it!

So if you need more of a reason than your own health and well-being to commit to a healthier lifestyle, do it for your family. It’ll pay off for years to come!

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

Maybe it started when Mom would bake cookies or take you out for ice cream when you did well in school, or when going out to eat was the family’s way of celebrating birthdays and other special occasions, or at some other time.

The problem is, rewarding oneself for an accomplishment (or commiserating over a failure) with calories usually means reaching for high-calorie, low-nutrition foods you really don’t need.

That’s why learning to reward yourself in new ways is an important part of taking off weight and keeping it off long-term.

At first, like any new habit, it may seem artificial. It will take time to break the nearly automatic response you may have learned and been practicing for years. But if you look at it in a positive light, it can become a fun, enjoyable, and stimulating challenge!

One way to get started is to make a list of non-calorie rewards you personally would enjoy so that when the time comes to celebrate an achievement, you have a list of reward ideas ready and waiting.

Perhaps that might be a massage, bubble bath, overnight getaway, time with friends, some new music, an interactive video game, a trip to the book store, an afternoon spent pursuing antique shops, or a hike along the beach!

As you can see, there are many, many possible ways to reward yourself (or soothe difficult emotions) that are actually even better than ice cream! And the list above is just a beginning to get your creative juices flowing.

Just like food, doing things you enjoy lights up the “reward center” in the brain, releasing natural hormones similar to opiates and creating a sense of happiness and well being.

Another nice perk of non-food rewards is that they don’t leave you feeling stuffed, uncomfortable, sluggish, nauseous, or filled with regret afterward like binging on high-calorie nutritionally empty foods can.

So go ahead – start rewarding yourself in a new way. I have a feeling that once you give it a try, you’ll be hooked!

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

Eat Slowly: If you eat on the go, while you are distracted by something else, or in a hurry, your brain doesn’t register that you’ve had a satisfying meal. So make mealtime a special time. Sit down at the table. Turn off the television, radio, or computer. Avoid eating in the car or on the run. Really focus on enjoying and savoring your food.

Have a Plan: Take the time to plot out your mealtime strategy once a week so you know what you’ll be eating every day for breakfast, lunch, dinner, and snacks. Then make a trip to the store or farmers’ market to purchase the items you’ll need. Prep produce and other ingredients ahead of time so pulling a meal together is quick and easy. And finally, make sure you follow through and eat what you have planned as planned so you stay ahead of hunger.

Write It Down: Get in the habit of recording each and every thing you eat right in a small notebook or journal after you eat it throughout the day. This will make you more mindful of what you are eating. Studies show that if people try to keep a running tally in their head, they often underestimate their calorie intake by as much as 40 percent!

Eat Before You Eat: Start each meal with a filling “appetizer” such as a raw cut-up apple, a green salad with low-fat dressing, or a serving of broth-based soup. Studies show people who do so feel full more quickly and eat less calories.

Don’t Wing It: Flying by the seat of your pants when trying to lose weight is never a good strategy. It leaves you far too open to impulsive, last-minute decisions like stopping at the fast food drive-thru or grazing on whatever high calorie food is on hand. Make it a point to set yourself up for success – not failure – each and every day, and chances are you’ll find losing weight to be relatively hunger-free!

As you can see, going on a “diet” doesn’t have to mean starving yourself. Just the opposite! You should aim to stay one step ahead of hunger at all times both while losing the excess weight and also when you are working to keep it off. Doing so will greatly help keep cravings and binges at bay and also ensure your metabolism is going strong despite the fewer calories you are taking in.

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

Surprised? I find many people are when they hear me say this. For years we’ve heard a lot about weight and calories, exercise, fat, carbs, and even trendy fad diets – but something that seems to be overlooked all too often is how all the seemingly small choices we make on a daily basis affect our weight.

I have a favorite saying that goes like this, “Losing weight is easy. Keeping it off is hard.”

Once again, this statement often takes people off-guard. Of course there is no doubt that losing weight takes considerable dedication and effort, and when people are starting their journey, the last thing they probably want to think about is that after the weight is gone, the challenge has really just begun.

But facing this reality, examining one’s problem behaviors, and learning new ways to approach life is all part of successfully leaving excess weight behind once and for all.

For example, perhaps you know someone who has successfully lost weight multiple times only to return to his or her old ways once the diet is “over” and slowly but steadily regain the weight. Maybe that person is even you!

Just like the old ways didn’t work before that person lost the weight – using food as a way to cope with stress, having trigger foods around when you know you can’t eat them in moderation, spending more time on the couch than out and about, failing to plan ahead so you find yourself opting for the drive-thru when hunger hits – these old ways won’t suddenly start working any better once the weight is lost.

But sometimes these actions and reactions are so ingrained, they become almost invisible to us. That’s where behavioral counseling comes in. Invisible patterns are made visible, and you and someone who can see things more clearly from the outside can make a plan to handle these same old situations in a brand new way that will work.

For example, one patient of mine, a man in his 50s, lost 200 pounds about 8 years ago. I continue to see him on an occasional basis to check in on how he’s doing and make sure the weight isn’t creeping back on. Sure enough, his weight tends to fluctuate by 20 to 30 pounds per year, and when we start to see that he’s regaining weight, we sit down together and figure out why and what to do about it.

Recently his father was admitted into a nursing home and he was under a lot of stress because of the situation. Sure enough, his weight started going up. We looked at why and discovered he had returned to eating a lot of dairy products, something that he used to comfort himself in the past. Likewise he’d stopped walking on his treadmill, saying he “didn’t have time.”

When I pointed out some of these things, knowing him so well over the years, it clicked and he realized he was returning to old patterns – patterns that didn’t work. Sure enough, after he became aware of what he was doing, he was able to stop the cycle and get his weight back to where he wanted it to be.

Remember, obesity is a complex disease process, not a sign of weakness or insecurity. Learning about yourself, what works for you and what works against you, is a big part of managing any disease.

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

How? Follow these five principles:

1. Eat Frequent Small Meals: Don’t let more than four hours pass between meals, and make it a goal to always eat before you feel hungry. Once hunger hits, it’s much more difficult to make good choices – but if you eat right before then, chances are you’ll find it easier to stick with your plan.

2. Get Adequate Sleep: This advice may come as a bit of a surprise, but research has shown that people who don’t get enough sleep are more susceptible to cravings and binge eating. So be sure you get seven to eight hours of sleep every night. Because good quality sleep is dependent on consistency, it’s best to stick as close as possible to the same schedule every day, as well. Try to avoid varying the time you go to bed or get up each day by much.

3. Make Sure You’re Moving: Regular exercise also helps control hunger, believe it or not! For the first week or two after starting a new workout routine, it’s common to feel more hungry, but stick with it and this will pass. After the second week you should start noticing a reduced appetite.

4. Reach for Whole Foods: Aim to make whole foods – foods in as close to their natural state as possible – the majority of what you eat. An orange, for example, has far fewer calories than a glass of orange juice, and the fiber it contains fills you up better. Avoid processed, junk, or convenience foods whenever possible. These are often little more than empty calories, and the salt, fat, or sugar they can contain can spur hunger instead of satisfy it.

5. Pair Protein and Fiber: Think of fiber and protein as your one-two punch against hunger. Both help you feel full and satisfied longer than simple carbs or fats. For example, have a bowl of salad greens topped with a serving of low-fat cottage cheese; pair a cup of cut-up strawberries with a serving of low-fat yogurt; or try some hummus on whole wheat crackers. Think high bulk, low calorie!

As you’ll find if you put these five principles into play this week, it’s definitely possible to lose weight without feeling deprived.

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

Check In: If it’s been awhile since you’ve been active, be sure to check in with your doctor. He or she can help you make a plan for an activity that’s a good match for your current physical abilities and explain when and how to recognize when it’s time to increase the intensity. Even five minutes a day is a good start. It’s more important to do it than to overdo it.

Make a Plan: Spend some time thinking about when you’ll exercise, what you’ll need, and even what some of the possible obstacles will be. The more you visualize yourself being active in your mind, the better prepared you’ll be.

Choose Something You Like: Even if you have never been a “natural” exerciser, there are sure to be some activities you’ll enjoy more than others. Think back to what you did for “play” as a child. Ride bikes? Swim? Climb rocks? Play tennis? If you choose something you enjoy, you’ll be more likely to look forward to it than dread it.

Know Yourself: Are you a creature of habit who finds it comforting to do the same thing day after day, or do you need variety to keep yourself interested? Are you more likely to be active in the morning, at lunch, or at night? Work with your natural tendencies to keep yourself on task.

Put It In Your Calendar: You won’t exercise if you don’t make time for it. It may seem artificial but many of my patients say making an appointment or penciling out time in their calendar for fitness helps them make sure it gets done. And once you’ve made the appointment, stick with it just like you would a doctor’s visit or other commitment.
Just Get Started: Sometimes the hardest part is just getting started. So even if you don’t “feel like” exercising on a certain day, just tell yourself you’re going to get dressed and do it for five minutes instead of procrastinating or thinking about it. Chances are once you get going, you’ll keep going. And if not, you will know you gave it a try.
Don’t Blow the Budget: One mistake I see patients make over and over again is to sign up for an expensive gym membership, buy a treadmill, or spend a lot of money when they first start a fitness routine so they feel like they are “doing something.” But often that something never gets used or ends up being a poor choice. My advice is to buy a good pair of shoes and maybe some workout clothes to start and leave it at that. Once you’re walking or doing something else for a month or more, then make the bigger financial commitment if you still want to.
Put the Past Behind You: Maybe you’ve tried to get active and failed before. Maybe you had a bad experience as a child with sports. Maybe someone has told you that you’re not coordinated or athletic. If this is the case, recognize those past experiences but don’t let them stop you from giving fitness another try.

Get In the Habit: It takes anywhere from 21 days to 3 months to start a new habit, so make a commitment to stick with your new routine at least that long before you quit, even if it feels awkward or forced at first. In time, the positive benefits of moving more – better sleep, more energy, a lower stress level, easier weight loss – will likely keep you motivated. In time you may even find that your workout has become such a key part of your routine that you aren’t even tempted to skip it!

So go ahead – get going! Your new fitness routine is an essential part of moving toward the healthier life you deserve.

Dr. Michael Kaplan
Founder and Chief Medical Officer
The Center for Medical Weight Loss

Here are my recommendations for healthy snacking on the go:

Have a Plan: As they say, the best defense is a good offense. As you plan your weekly meals, be sure to take snacks into consideration too, so you have what you need on hand when you need it.

Don’t Get Hungry: Once you are already hungry, it’s almost impossible to make wise snacking choices. Try to time your snacks so that you’re having them before you get out-of-control hungry, and avoid going without food for longer than four hours no matter how busy your day is. Think of snacks as hunger prevention!

Skip the Junk: Junk foods like chips, crackers, cookies, cake, ice cream, and the like are not the types of snack we’re talking about and should be avoided. I don’t even recommend non-fat or baked versions of these foods. They usually don’t contain fewer calories and they are just too similar to “the real thing” for those who struggle with binge eating.

Eat Regular Meals: Many of my patients report eating just one big meal a day and grazing otherwise. No wonder their snacking is out of control! Making sure you take the time to eat a sensible breakfast, lunch, and dinner will keep your metabolism humming along all day and also help prevent impulse snacking.

Beware Empty Calories: Not all snacks are created equal. Foods that just fill you up but provide no real nutritional value just aren’t as satisfying as nutritious, whole foods. Be sure to read labels carefully. Some supposedly “healthy” snack bars are actually not much better than eating a candy bar! Don’t be fooled.

Go Natural: Nature has provided plenty of great snacking options in the form of fruits and vegetables. And many even come in their own wrapper, making them easily portable as well. Whenever possible, opt for snacks in as close to their natural state as possible.

Fiber and Protein are Your Friends: Low calorie, high-fiber and low-fat, high-protein foods are also great snacking choices because these foods fill you up and help you feel full longer than carb-based snacks. Combine the two for a winning one-two snack combo.

There it is – the secret to healthy snacking. Stick with these seven principles and I think you’ll find smart snacking just might turn into one of your best weight loss allies!

Dr. Michael Kaplan
Founder and Chief Medical Officer
The Center for Medical Weight Loss

Actually, there are several prescription medications currently available for this purpose. Of course they aren’t “magic pills” that will allow you to eat whatever you want, not exercise, and still lose weight. But in combination with a balanced nutritional plan, regular exercise, and a solid counseling approach that addresses any behaviors contributing to the problem, they can be quite helpful.

One word of caution: Do not try to purchase any of these medications on the black market or through Internet pharmacies. Many times the pills sold illegally are not what they are advertised to be. At best they may have no active ingredients. At worst, they could contain any number of harmful ingredients or possibly be fatal. Herbal medications and supplements can be equally dangerous. Don’t take the risk!

Remember, the only safe place to get weight loss medications is by prescription from a licensed medical professional who is monitoring you for possible side effects and interactions with other medications or other medical conditions.

Some medications work by suppressing appetite, some work by stimulating your energy levels, some block the absorption of fat in the digestive tract, and others work by minimizing the drive to binge eat.

Some people will take a single medication, others may need a combination. Once again, only a medical provider who is trained in the use of such medications should determine which medications are best for your particular situation and at what dosage. This is not a do-it-yourself project!

So what medications are available? Here is a list of the most common:

Phentermine: This medication helps reduce cravings and control hunger by blocking certain pathways in the brain. It is most effective in the first six months, after which the effect diminishes. At that time it may be necessary to take a break from the medication or switch to an alternative medication. Once taken as part of the Fen-Phen combo, it’s not to be confused with fenfluramine or dexfenfluramine, which were linked to heart problems and taken off the market. This medication has been shown to be safe and effective when taken on its own. It is not believed to be addictive.

Phendimetrizine: This medication is a stimulant that suppresses appetite and increases energy. In rare cases it has been linked to dependence or addiction.

Tenuate: This medication works by suppressing appetite, making it easier for some people to adjust to eating smaller portions. It is most effective in the first month of use. It may be alternated with other appetite suppressants as its effectiveness diminishes.

Xenical: Once available by prescription only, this medication is now also available over-the-counter under the brand name Alli. The medication blocks the absorption of 20 to 25 percent of the fat passing through the digestive tract so that the fat – and calories – are not absorbed. One must be careful to follow a low-fat diet while on this medication to avoid unpleasant digestive distress, as eating too much fat can lead to sudden, urgent, and uncontrollable bowel movements.

Wellbutrin: This medication also used for smoking cessation and anxiety has been shown to be associated with weight loss in some patients.

Byetta: This injectible medication used for the management of diabetes has shown to have weight loss as a side effect, making it a good choice for some who are overweight and also diabetic.

Once more, please do not take this information and try to obtain these medications on your own. If you think weight loss medications may be of help to you, consult a physician. If your doctor is not familiar with their use, call The Center for Medical Weight Loss. We’d be happy to work with you and your doctor to tailor a safe and effective weight loss plan created just for you.
Dr. Michael Kaplan
Founder and Chief Medical Officer
The Center for Medical Weight Loss

How? Perhaps the most important step is to stop looking at weight loss as a destination and start thinking of it as a lifelong journey, instead.

What we may not like to admit is that obesity is a chronic disease, and there is no easy one-time cure or fix for this medical condition. Likewise, so-called “quick weight loss” plans that leave you with less lean muscle and more body fat in the end may seem to work in the short-term, but in the long run they just leave you with a slower metabolism and no new skills to keep the weight off. That’s not a good position to be in.

The truth is, getting to one’s goal weight is really the first step, not the end of the weight journey. The longer road and the one that is much more important to focus on is to keep the weight from coming back once you’ve worked so hard to lose it.

If you are far from your goal weight at the moment or were seeing that as your destination, you may not like the way this sounds. “What?” you may be thinking. “You mean there’s MORE to it than this?” or, “You mean I’ll never be able to stop thinking about or working on my weight?”

I know it may not be what you want to hear. But in order to break the gain-loss-gain-loss-gain cycle once and for all, it’s critical to make peace with this information.

Likewise, all of the healthy lifestyle and behavior changes you’re making to lose the weight aren’t something you’ll want to stop doing once the weight is lost, either.

Continuing to monitor your calories, weighing yourself on a regular basis, being mindful of emotional eating, journaling, exercising on a regular basis – these are all habits you’ll want to keep doing even when it seems like you don’t need them anymore.

If you stop, the weight is sure to creep back on. Not overnight, but gradually over a year or so and, before you know it, you’ll likely find yourself back in the same place you started – or maybe even weighing more.

Another very helpful way to break the yo-yo diet cycle is to reach out for help and support. If you have someone to be accountable to, and to turn to when you’re struggling, it’s far more likely you’ll stop weight regain early, when you have gained five pounds rather than 40, or 50, or 100.

That’s why we continue to see patients who have lost the weight they wanted to lose several times a year afterwards. We’ve found such check-ins provide the chance to catch any problems early and help keep people focused on their ongoing journey.

Maybe even knowing they’ll be back in a month or two to weigh in helps some say no to the banana split and choose to have a banana instead!

So this time, as you set your goal weight, be sure to also make keeping off any weight you lose part of your goal, too. Once you do, I have a feeling your yo-yo dieting days will be done for good!

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

You probably know some “naturally thin” people in your own life. The ones who never exercise, seem to eat anything they want, and yet not gain weight. Likewise, you probably know people (maybe yourself!) that seem to gain weight very easily, even if they exercise more and eat less than the “naturally thin” folks.

The difference seems to be genetics. For reasons we have yet to fully understand, some people are just better at gaining weight than others. I’d even venture to say as much as 80 percent of weight issues include a genetic component.

At one time, in the centuries when grocery stores and fast food drive-thrus didn’t exist, being able to gain weight easily was a genetic advantage. In a feast or famine world, those who could pack on the pounds when food was abundant were more likely to make it through the lean times when food was scarce.

Unfortunately today – when food is cheap, plentiful, and easily available all year round – this same genetic code is now a distinct disadvantage, not just cosmetically but also health-wise.

Not fair, one may say. And it’s true, it isn’t fair. But just like some people are much more likely to get heart disease or cancer, those with a genetic tendency toward easy weight gain are better off accepting the facts and taking the steps needed to counteract their genetic code than to deny it or rebel against it.

Like someone with an increased genetic risk of another disease, you may need to be much more diligent about your weight than most. You’ll likely have to exercise more and watch your calories more closely than others. You may have to see a doctor more frequently about your weight and even possibly even take medication to keep it in check.

But like the people who know they are at a higher risk for cancer that eat well, take excellent care of themselves, and see the doctor for regular screening exams, the extra effort is far better than ignoring the facts and then facing a grueling (or losing) fight for their life against cancer as a result.

Also, like those who are genetically more prone to cancer, being genetically prone to obesity is not a character flaw, your “fault,” a sign of a weak will, or any of the many other shame and blame stigmas that these folks are subjected to.

It may not be a choice, but that doesn’t mean you have to just give in or give up. You can take action to counter your genetics and escape your fate. It may take more effort. It may not be as easy. But it will be worth it.

Also, it’s not something you have to do alone. Like any serious medical threat, managing obesity is something I believe should be done under a doctor’s care, by someone trained in the complex issues at hand, and who can help you navigate your way to the best possible outcome like we do at The Center for Medical Weight Loss.

Someone wouldn’t dream of trying to avoid and monitor their cancer risk on their own, for example, and neither should someone with a genetic tendency toward weight gain.

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

In the study. researchers found that super-athletic men in their 50s who had exercised strenuously all their lives (we’re talking about former Olympic athletes and ultra-marathon types) actually seemed to have heart damage as a result.

However, I have a feeling there are very few people with a weight problem who fit into this category, so before one takes the leap that this study means starting an exercise routine could be bad for them, too, I’d like to suggest the opposite.

For the most part, the patients I see in my clinic report that they don’t really like to exercise and that they’ve never considered themselves athletic. Perhaps they had a bad experience with team sports early in childhood, or pushed themselves to do the latest exercise craze when they didn’t really enjoy it. Whatever the reason, they tend to say they’d rather do almost anything but exercise.

Sometimes, a patient will report that at one time they were very athletic and that something in their life changed that prevented them from continuing to be active: the birth of a child, a sports injury, getting a “desk job” after college, or some other reason. These people often say they miss physical activity but feel that “those days are over” for them.

In both cases I encourage my patients to give physical activity another try. They key is to start where you are and to gradually work up to where you want to be. Any movement is better than no movement – even five minutes if that’s what you can do comfortably.

Exercise alone won’t necessarily lead to weight loss (you’ll need to cut calorie intake, too) but it will make losing weight easier as lean muscle builds and boosts your metabolism, burning more calories 24 hours a day. And where being more active will really pay off is in helping to keep the weight you’ve lost from coming back over the long run.

Another important component to being active is to find an activity that you personally enjoy. Something that doesn’t “feel” like exercise, but like fun! That might be walking, biking, swimming, dance, yoga, joining a community sports team, roller skating, interactive video games, or even just taking the stairs instead of the elevator, parking further away in parking lots, and carrying groceries in one bag at a time.

I can guarantee if you choose a form of exercise you dread or that makes you feel self-conscious or awkward, it won’t last. So why make yourself miserable and set yourself up for failure?

And lastly there is one nugget of wisdom to take from this study: Be moderate. Don’t push yourself to exercise for hours on end or to a level where you feel like you couldn’t do one more thing. Aim for the middle road instead where you get your heart pumping but you end your workout feeling better, not worse, than when you started.

Chances are, if you give it a few weeks, the positive benefits of being active – like an increased energy level and reduced stress level – will be so worth it that you’ll gladly stick with your new habit. So don’t use this study as an excuse not to get moving. Get going today!

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

While it is true that to get different results, one does need to do things differently, those changes don’t necessarily have to be monumental ones to get results.

Here are five small changes I recommend that can make a big difference:

Sneak In Movement: Increasing your physical activity doesn’t have to mean joining a gym or setting aside an hour a day to workout. Instead, you can get the equivalent of spending 30 minutes on a treadmill by doing things like pacing back and forth as you talk on the phone rather than sit, walking one extra stop on the bus or subway route, or parking in the furthest spot in the parking lot. Those five minutes here and five minutes there throughout the day add up with very little extra effort!

Cook More Creatively: Another place that small changes to your normal routine can really add up is in the kitchen. Simple swaps like replacing cooking with butter with non-stick spray, using herbs in place of fat to add flavor, or bumping up the produce portions in every meal can go a long way toward cutting calories relatively painlessly.

Nix Liquid Calories: Sometimes it’s not what we’re eating that leads to weight gain, it’s what we’re drinking. Research shows people tend to greatly underestimate the number of liquid calories they consume in a day. Specialty coffee drinks, soda pop, whole milk, alcoholic beverages, and even 100 percent fruit juice are all packed with hundreds of easily eliminated calories.

Lighten Up One Meal: Aim to keep one meal a day under 200 calories as part of your plan to cut overall daily calorie intake. While it can be any meal you like, I recommend trying this at breakfast as most people seem to find that meal to be one they can easily lighten up. Think high bulk, low calorie. Make an egg white omelet with ½ cup egg whites, ¼ cup sliced mushrooms, half of a green pepper diced, and 2 tablespoons diced onion paired with one cup of skim milk, for example. Or cook a half cup of oatmeal with water and top it with one cup of sliced berries or other fruit.

Snack on Fruit: If your usual snack consists of something like crackers, chips, or sweets, try replacing that with an apple, a banana, an orange, or a cup of watermelon chunks instead. The fiber in fruit helps keep you feeling full longer, and the fact that many fruits come wrapped in their own package makes them easy to take along on the go. Add an exotic twist by trying out new fruits such as papaya, mango, or kiwi. Once you get in the habit, you’ll likely find that fruit’s naturally sweet taste hits the snacking spot.

There they are – 5 simple ways you can move more and eat less – no torture required!

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

Why are we so interested? Preliminary research suggests this special kind of fat, found mostly at the back of the neck and along the base of the spine, seems to be connected with helping control and regulate one’s metabolism and weight.

What we’re finding is that “naturally thin” people seem to have a higher percentage of brown fat than those who struggle with their weight. We aren’t sure yet if it’s a genetic luck of the draw, something about how these people live that increases brown fat stores, or a little bit of both.

Something else we are trying to figure out is how we can help people’s bodies make and store more brown fat, so they too can reap the benefits of this so-called “good body fat.”

Currently the only product I know of that has been shown in scientific studies to help increase brown fat is a sweet pepper-based supplement called Capsiate Natura made by the Ajinomoto Co. We carry this supplement at The Center for Medical Weight Loss and recommend it to many of our patients as part of their overall weight loss program.

Of course, just taking this supplement won’t solve one’s weight issues, no matter how much we wish that were the case! But when paired with a balanced reduced-calorie eating plan, increased exercise, behavioral changes, and increased support, it does seem to aid in the process, as well as help people keep the weight off long-term.

Why peppers seem to boost metabolism or brown fat stores is yet to be fully understood, but we do know that people who live in areas of the world with a spicy diet do tend to have fewer weight issues.

Another recent study speculated that turning down the heat at home or in the office might also help build brown fat stores.

In time, perhaps science will develop a prescription medication that will build brown fat and allow everyone to be able to eat like those “naturally thin” people who never seem to gain weight, even if they eat things like five slices of pizza at lunch!

But for now, it still boils down to a multifaceted, several-pronged attack on excess weight. Stay tuned for more on brown fat. I have a feeling you’ll be hearing much more about this special type of fat in the years to come.

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

The results don’t surprise me – it’s something I’ve seen in my patients time and again. As the excess pounds start to come off, they walk into my office with a renewed spring in their step and a big smile on their face.

I think the connection between mood and weight goes far beyond a cosmetic “looking good means feeling good” phenomenon. It gets right to the root of living a balanced life.

Instead of a diet of processed junk food, people on a healthy meal plan are finally getting the nutrition their bodies need. Regular physical activity helps fight stress and provides the daily movement our bodies (and minds) also crave. Interestingly, the study also found that the improved mood wasn’t linked to losing a lot of weight, or something that didn’t happen until one met his or her weight goal. The happier outlook began almost immediately!

A perfect example of this is a female patient in her late 30s who came to me when she just couldn’t seem to shake the excess baby weight she’d gained during her pregnancies. The obesity was weighing on her both physically and mentally.

A few weeks into the program she came into my office beaming from ear to ear. “Guess what?” she asked. And before I could even reply she burst out, “I got a promotion at work!”

The joy and confidence she was feeling was clearly visible, and I believe it was that renewed zest for life that led to the promotion and improved mood rather than the modest amount of weight she had dropped at that point.

Today she’s reached her goal weight and her sunny outlook on life remains. She says she feels better, moves easier, has more energy, sleeps better, and even has more patience as a parent.

Taking care of oneself and one’s body is fundamental to so many aspects of life, not just physical appearance. So while obtaining a certain dress size or looking better in a swimsuit may be an initial motivator to start a weight loss program, in the end many people find those things end up just being icing on the cake. The real reward is in feeling great and enjoying a life well lived.

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

Researchers recently came up with the title after reviewing the rates of type 2 diabetes from across the United States. The results showed about 12 percent of those living in “The Diabetes Belt” had the illness, compared to the average of 8.5 percent nationwide.

States with the highest diabetes rates include Alabama, Arkansas, Florida, Georgia, Kentucky, Louisiana, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, West Virginia, and Mississippi.

Experts speculated there were a number of reasons why people living in the Southeast had higher diabetes rates, including an inactive lifestyle, so-called “Southern cooking” which includes a lot of high-fat, high-calorie foods, lack of access to medical care, and a cultural acceptance of being overweight or obese.

I have seen firsthand that many of my patients who live or grew up in this part of the country often have a different attitude about being overweight. Rather than viewing it as a negative thing, many say they like being heavy or feel that they are more attractive with a “few extra pounds.”

And while this is great for their body image, I think the troubling thing is they seem to be in denial about the impact those extra pounds may be having on their health.

It’s also no coincidence that this part of the country also has some of the nation’s highest rates of obesity, as the two conditions often come in pairs. People living in the Southeast also have higher rates of other obesity-related illnesses like heart disease and stroke.

The good news is that about 80 percent of the time, even a modest weight loss of about 20 pounds can lead to a dramatic improvement for those with type 2 diabetes. I have seen many of my patients be able to come off medication and begin to manage their diabetes with a combination of diet and exercise in just a matter of weeks.

So no matter where you live, what you weigh, or whether or not you already have type 2 diabetes, it’s never too late to do something about it. Even better, it won’t take a 100-pound weight loss or months on end to start to see the results of your efforts. You’ll dramatically start to improve your health almost immediately.

Losing weight when you have a medical condition like diabetes is especially tricky, and you should be sure to do so under the care of a medical professional. If your doctor doesn’t have good answers for you about how you can start moving your weight in the right direction, give The Center for Medical Weight Loss a call. We’ll be happy to work with you and your doctor to tackle your weight issues safely and effectively, dramatically improving your overall health in the process.

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

Here are some of my favorite spring fitness ideas:

Walk it Off: As I have said before, walking is an ideal workout and is something that you can do anytime, anywhere, with very little cost or equipment. Now that nicer weather is here (or on its way), take in an outdoor stroll and admire some spring blooms. Not as nice outside as you’d like? Walk at the mall or shopping center and admire the new spring fashions!

Take a Hike: Hiking is another great spring activity and one you can enjoy with family or friends. Search online or pick up a trail guide for hiking locations near where you live. Pay attention to distances and difficulty levels to choose one that’s right for you.

Set a Goal: Spring is also a great time to make getting ready for a summer or fall marathon, half marathon, or fun run part of your goal. For some people, having the deadline of such an event is a great motivator to keep moving toward their weight loss goal.

Join the Club: Many cities and towns have walking groups or clubs, so look around for such opportunities in your area. These 1, 2, and 5 k events are social and fun and can be a great way to meet like-minded fitness buddies to walk with at other times, as well.

Spruce Up the Yard: Get some exercise while getting your garden in shape for the new season. Tasks like raking leaves, mowing the grass, planting flowers, and hauling yard debris all add up to calories burned!

Go for a Spin: Biking is another fun fitness activity that goes well with nicer spring weather. So get your bike out, give it a tune up, and pedal your way to fitness.

Remember, if it has been a while since you’ve been active or if you have a serious medical condition to take into consideration, be sure to check in with your doctor before starting a new fitness routine or activity. It’s better to gradually work up to a more active lifestyle than to overdo it and end up with an injury, discouraged, or worse.

At the same time, don’t let a lack of mobility stop you. Aim to add five minutes of activity to your day at first, and then when that feels comfortable, add five more minutes. I’ve seen many of my patients go from almost complete immobility to regaining their independence, and you can too. There are even exercises you can do while sitting or lying in bed that can build strength and help you work your way from where you are now to where you want to be.

So go ahead – spring forward and let the new season become your excuse to get active!

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

One health benefit of eating high-fiber foods is that they encourage a healthy gastrointestinal (GI) tract because much of the fiber passes through the large and small intestines intact. This so-called “roughage” is good for all sorts of health issues from colon cancer to diverticulitis to irritable bowel syndrome (IBS).

In addition, we’re just starting to understand the role a healthy GI tract plays in everything from your immune system to aging. A high-fiber diet seems to encourage the “good bugs” in your GI tract to flourish, helping them keep so-called “bad bugs” in balance.

Fiber, and especially the type known as soluble fiber, has also been linked to a reduced risk of heart disease, stroke, and diabetes, all major illnesses also linked to obesity and the typical high-fat, low-fiber American diet.

Fiber is also great for people trying to lose weight because most foods high in fiber are also naturally low in calories, meaning they help you feel full and satisfied without adding up. That’s why foods rich in fiber can be a dieter’s best friend, helping to fight off hunger and cravings.

Women should aim for a fiber intake of between 21 and 25 grams per day, while men should shoot for 30 to 38 grams. Check food labels to discover the fiber content of the foods you eat, or choose some from the following list of great fiber picks:

Food                                                    Serving Size                Grams of fiber

Split Peas, cooked                                1 cup                            16.3

Lentils, cooked                                      1 cup                            15.6

Black beans, cooked                            1 cup                            15.0

Artichoke, cooked                               1 medium                    10.3

Peas, cooked                                           1 cup                            8.8

Raspberries                                              1 cup                            8.0

Apple, with skin                                      1 medium                   4.4

Spaghetti, whole wheat, cooked       1 cup                            6.2

Pearl barley, cooked                             1 cup                            6.0

Pear, with skin                                          1 medium                     5.5

Bran flakes                                                  ¾ cup                           5.3

Broccoli, steamed                                    1 cup                            5.1

Oatmeal, cooked, all kinds                    1 cup                            4.0

Source: U.S. Dept of Agriculture, National Nutrient Database

As you can see, there are many tasty high-fiber choices. Get creative about pairing them up and you can do even better! Try starting your day with oatmeal or bran flakes and raspberries, for example, or make a satisfying soup with black beans and pearl barley.

This week, start making a conscious effort to boost your fiber intake, and I have a feeling you’ll find sticking to your weight loss goals a whole lot easier and more satisfying!

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

BAI has been getting a lot of press lately and is being touted by some as “better than BMI.” While I believe it’s good to have another tool in the healthy weight loss arsenal, unfortunately I don’t believe this one is user-friendly enough to be of much use outside of a clinical trial setting.

In a nutshell, BAI measures how much of a person’s weight comes from fat, as compared to muscle, bone, and water. Like other forms of body composition analysis, this provides a much better picture of how healthy or unhealthy one’s body weight is – or more specifically, how healthy or unhealthy one’s body fat percentage is.

For example, people who are very athletic may look like they weigh more than they should, just based upon height and weight, because lean muscle weighs more than fat. Picture a bodybuilder, and you get the idea.

Of course, most of the time when someone is overweight, the problem is that extra weight comes from fat, not muscle. This is where weighing more than one should becomes hazardous to one’s health.

More rarely, someone could be a healthy weight according to the number on the scale, but actually have a higher percentage of body fat than he or she really should. People in this category could be lulled into a false sense of security about their health risks if they just consider how many pounds they weigh, and not where that weight comes from.

While I like that this new measure focuses on body fat versus body weight – something I have long promoted – the problem I see with the BAI is that it is prone to error in everyday use. The hip measurement needs to be taken from a very specific location that’s awkward to measure by oneself, and then that number is run through a rather complex formula to determine the result.

At The Center for Medical Weight Loss, we do a detailed body composition analysis as part of our initial consultation. The machines we use to determine body composition are highly accurate (much more so than home body composition scales), and are the same as those used by professional sports teams and others to determine one’s fitness, muscle, and body fat level. The resulting detailed four page analysis lays out exactly where one’s body weight comes from, what that means, and how it could affect one’s health.

So if you’re concerned about your weight and how it may be affecting your health, I’d highly suggest a body composition analysis by a medical professional over trying to figure out one’s BAI, what it means, and what to do about it on your own.

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

But what is it? First, it’s not a weight loss plan or “diet” in that sense. It’s a way of eating that people living in the Mediterranean region of the world have been following for centuries.

In a nutshell, it’s how people in this and other regions of the world ate before there were grocery stores, fast food restaurants, or frozen and canned “ready to eat” meals. People ate what was fresh and in season – often foods they or their neighbors or family grew, raised, or caught. Foods were often eaten within a day or two of harvest, unless there was a way to dry or preserve them otherwise.

Seafood is a big staple in this “diet,” as the Mediterranean has long had a rich fishing industry. Poultry and eggs are next, and red meat is eaten sparingly, usually on special occasions surrounding a “feast” or celebration.

Fresh, seasonal produce rotates in and out throughout the year – spinach in spring, tomatoes in summer, squash in the fall, root veggies in winter, etc. – and it isn’t uncommon for meals to feature more fruit and vegetables than meat. Breads and pastas are made with freshly milled whole grain; beans and other legumes are often served in place of meat; fat primarily comes from olive oil and other monounsaturated sources; and a glass of red wine typically accompanies the meal. Fresh fruit drizzled with honey might top off the meal, serving as a naturally sweet “dessert.”

Portion sizes are small because the focus is more on quality, freshness, and taste than on eating large volumes of bland food. Friends and family sit and linger over the meal, rather than gobble down food quickly on the go.

The latest version of the USDA dietary guidelines is largely based upon this way of eating, and many health experts recommend we go back to this “simpler” diet because of its health benefits. Studies show that people living in the Mediterranean area today – and still eating in this time-tested fashion – have some of the lowest rates of heart disease, diabetes, cancer, and other serious illnesses in the world.

One quick and easy way I advise patients to start heading in this direction is to ask themselves, “Was this food available 100 or 200 years ago?” If not, there’s probably a better choice available. For example, cheese puffs were not, but carrot sticks were. So carrot sticks would be a better snack option than cheese puffs. And of course, they are!

In the United States, we’ve lost touch with these simple dietary principles, and I believe our skyrocketing obesity rates and related illnesses are the result. Pre-made and pre-packaged foods may be convenient, but we’re paying for that convenience with our health.

I urge you to give this ancient way of eating a try. It may mean more planning, shopping at local farmers’ markets or health food stores, cooking from scratch and at home, and slowing down a bit, but I have a feeling that once you give eating fresh, wholesome, natural foods a try, you’ll wonder how you ever ate anything else!

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

First, it’s important to know that not all fat is created equal. Maybe you’ve heard of “good” fat and “bad” fat, and there really are such things. Understanding the difference can help you make sure the fat you do eat is the “right kind” of fat and in the right amounts.

It’s also important to remember that your body needs some fat as it is essential in many bodily functions such as hormone production, so cutting fat intake completely is not good. However, it’s unlikely that anyone in American is suffering from a lack of fat intake. Chances are most people are already eating enough or, more likely, too much and of the wrong types.

In a nutshell, good fats are unsaturated fats – also sometimes called monounsaturated and polyunsaturated fats. Research indicates that these fats help lower “bad” cholesterol (LDL) in the blood and increase “good” cholesterol (HDL), leading to a reduced risk of heart disease and other health problems.

Some sources of these “good fats” include olive oil, canola oil, fatty fish like salmon, avocados, nuts, and beans.

“Bad” fats, on the other hand, are saturated fats and trans fats. These fats act in the body in exactly the opposite way as “good” fats. Research suggests they increase “bad” cholesterol and reduce “good” cholesterol in the blood. Eating too much of this type of fat has been linked to an increased risk of heart disease, stroke, and other serious illnesses.

Sources of saturated fats include butter, red meat, cheese, whole fat dairy products, sour cream, ice cream, shortening, stick margarine, coconut milk, coconut oil, palm kernel oil, cocoa butter, and palm oil. Many processed foods are high in saturated fats including fried foods, non-dairy whipped topping, cakes, cookies, and other prepackaged, prepared, and fast food. Restaurants also tend to use a lot of saturated fats to add flavor to foods, drenching a rib eye steak (or even boneless chicken breast!) in butter before grilling it, for example.

So how much fat should you eat? According to The American Heart Association guidelines, fat calories should not account for more than 25-35 percent of your daily calorie intake. Of that, no more than 7 percent should come from saturated fat, and 1 percent or less from trans fat. The majority, 17 to 27 percent, should come from unsaturated fat sources.

Chances are, like most Americans, you’re currently eating too much of the “bad” fat and not enough “good” fat. Awareness and some simple changes can flip flop the two in a healthier direction.

So, for example, if you usually cook with butter or vegetable oil, switch to an olive oil or canola oil spray instead. Dip bread in olive oil rather than use butter. Have avocado on your sandwich instead of mayo. Eat a handful of nuts as a snack instead of potato chips.

Then, cut overall fat intake with some creative cooking tips. Here are some ideas to try:

• Use fresh or dried herbs to add flavor to food instead of fat.
• Mist foods with olive or canola oil spray rather than pour it from a bottle.
• Choose extra lean cuts of meat and trim all visible fat off meat before cooking.
• Grill, broil, bake, braise, steam, poach, slow-cook, or microwave foods instead of frying.
• Sauté with non-stick spray or broth instead of oil.
• Drain fat well from cooked meat.
• Substitute beans or soy for meat.
• Choose vegetarian, turkey, or chicken sausage over beef or pork.
• Cook with egg whites rather than whole eggs.
• Replace whole-fat dairy products with low-fat or fat-free versions.

And be sure to keep in mind that “good” and “bad” fats all contain the same number of calories – 120 per tablespoon. So even though some fats are good for you, they should still be eaten sparingly and their calories factored into your overall daily tally.

There is it – the skinny on fat!

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

Most of the time, cravings aren’t driven by physical hunger, but by psychological hunger. In fact I would dare say that’s probably the case more than 80 percent of the time. Still, cravings can feel very urgent and real, almost overpowering. Here’s what I advise my patients do when a craving hits:

Check In: Ask yourself what the craving is really for. Is it about chocolate (or whatever the food may be)? Or is it a craving for something no food can really provide – more time for yourself, a lowered stress level, eliminating unpleasant emotions, escaping a difficult circumstance, simple boredom, facing the fear of reaching your goal? Understanding what you really want, and realizing that food won’t make that happen, can help break a craving’s grip and get you in touch with what you really do need.

Buy Some Time: Cravings are often strong in the moment, but actually pass rather quickly if not acted upon. When a craving hits, tell yourself you’re going to wait 20 minutes, and then see if you still want the food. Chances are you won’t.

Distract Yourself: Along the same lines, rather than focus on the craving, which can make it even more tempting and powerful, do your best to switch gears. Make a phone call, take a brisk walk, write in your journal, repeat a mantra in your head that helps you refocus on your goals, or engage in a game.

Quench Your Thirst: Sometimes, a craving is actually about being thirsty, not hungry. See if drinking a glass of water or some hot or iced tea does the trick. But beware of reaching for artificially sweetened beverages, soda pop, juice, and the like – they can actually stimulate your appetite and intensify cravings.

Decode the Clues: Often, a craving can be triggered by some unconscious or entrenched automatic response you may not even be aware of. One example may be popcorn and movies. For some people, the two are so closely linked that going to the movies automatically equals eating a bucket of popcorn – even if the popcorn doesn’t really taste very good! The same can happen based upon a certain time of day (mid-afternoon or late night), an activity usually associated with snacking or eating (watching TV), a particular location (a trip to the mall), etc. Stop and think about whether you’re really hungry or whether your environment may simply be triggering you to want to eat. If you have to, spend time away from a trigger location or activity until you think you have the craving under control.

Test It Out: Ask yourself if it’s true hunger that’s causing the craving. Ask yourself these questions: When was the last time you ate? Are you experiencing real hunger pangs? Will any food do, or is your craving for something in particular? If it’s real hunger, it’s likely been some time since you ate last, which means an apple will hit the spot just as much as ice cream. If not, it’s probably not true hunger.

Stay Ahead of It: Set yourself up for success by being very mindful to not skip meals or put yourself in difficult situations where you’ll be more susceptible to cravings. Be sure you’re eating lots of low-calorie/high-bulk foods and drinking plenty of water. Hedge your bet by making sure you’ve always got a healthy option close at hand. Preventing cravings is much easier than dealing with them.

Count the Cost: Sometimes it can help to remind yourself that giving into a craving can actually lead to more cravings, setting off a possible binge cycle by stretching out your stomach and triggering hormones that increase appetite. Do you really want to put yourself in that position? Probably not.

Get On With It: When all else fails and you find you’ve given into a craving, resist the urge to beat yourself up or let it lead to days, weeks, or months of binging. Simply chalk it up to a lesson learned, refocus on your goals, and get back on the plan. Losing weight is more about persistence than perfection – so don’t let a craving lead to giving up on your goals!

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

And while it’s true that salt itself is calorie-free and doesn’t contribute to weight gain, the fact is that some of the biggest sodium sources are unhealthy picks like fast food and junk food, so cutting back on salt likely means you’ll also be cutting back on some foods that are high in calories anyway.

A recent study published in the American Journal of Clinical Nutrition looked at American’s salt consumption and found that it hasn’t changed much since the 1950s, hovering at around 3,700 mg a day on average. This may mistakenly lead one to believe salt intake isn’t a growing health issue.

However, one needs to keep in mind that it was during the 1950s that the prepackaged, processed, canned, and frozen food bonanza began, along with the once-quaint drive thru and the trend toward fast food. As a result, salt intake was high then in comparison to decades past, and it remains high today.

Since the 1950s another thing has increased – hypertension, or high blood pressure – and the resulting heart disease and strokes it can lead to if unchecked. Increased salt intake – and increased obesity rates – also contributed to this negative health trend, researchers said.

I highly suggest that my patients limit their daily salt intake to 1500 mg or less, the current recommendation of the American Heart Association and the upper limit recommended by the USDA for those at risk of heart disease, or roughly 7 out of every 10 adults.

So start checking food labels for the sodium content in packaged foods, and avoid those with high sodium or choose a low-sodium version whenever possible. (Canned soup, for example, can contain 1,200 mg of sodium per serving!) Try using more herbs or herb blends to add flavor to your food, rather than salt. And prepare meals at home, from scratch, whenever possible.

Also be on the lookout for these surprising sodium sources: soda pop and diet soda pop; canned chili; canned tomato sauce, bacon, and other cured meats; hot dogs and sausage; dry cereal; Parmesan cheese; frozen TV dinners; pancake mixes; olives; soy sauce; pickles and pickled foods; and canned vegetables.

Reducing your sodium intake may even help you shed a few pounds of “water weight” bloat, as well. While it’s not actual fat loss, you may find yourself feeling more comfortable in your clothes.

So go ahead – pass on the salt. Your heart will thank you!

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

Why? There are many reasons including that it’s inexpensive, easy to do anywhere, perfect for people who haven’t worked out in awhile, and it cuts one’s risk of all types of health conditions like heart disease, stroke, diabetes, depression, insomnia, arthritis, back pain, and more!

Now a new study gives another good reason – walking may be one of the best ways to ensure you live a long, healthy, and active life.

In the study, researchers reviewed data from nine large, long-term aging studies that included a total of nearly 35,000 people, ages 65 and up. Along with other information, these studies had recorded information on walking speed and survival rates.

What the researchers found was that after age and gender, the next best predictor whether a person would be alive 5 or 10 years later, or not, was how fast the person could walk down a hallway or a few yards. The researchers were quick to point out that it wasn’t necessarily that those who walked faster lived longer, but that the ability to walk at a reasonable pace seemed to indicate the person was in overall better health than someone who could not.

I have seen this in my own practice, as well, and have observed that walking seems to be a “use it or lose it” skill. The more immobile one is, the more likely his or her health is headed toward life in a wheelchair or walker, and a decline in health overall.

The good news is the best way to prevent that fate is to simply start walking more. Whatever your current ability, from just a few steps to a mile or more, start where you are, and in time you’ll find that you can go further and walk longer.

It’s important not to walk beyond what’s comfortable, or to try to go from not walking much to walking a marathon in one day. It’s better to gradually build up your endurance, say adding 5 minutes a day, than to push yourself and possibly end up with an injury or setback.

When the weather is good, walking outside is always enjoyable. But don’t stop there. When the weather is too hot, cold, or wet, look for places where you can walk indoors like a local shopping mall, or even walk in place at home along with a video or on a treadmill.

In fact, you can add lots of extra steps to your day without setting aside time for a “walk” at all. Simply choose the furthest parking spot from the door at work or when shopping, take the stairs instead of the elevator, or walk across the office to tell a coworker something rather than send an email. If you do this consistently, you can easily work the equivalent of a 30-minute walk right into your regular day.

Before you know it, you too will be walking your way to a slimmer, trimmer you and a healthier future!

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

Their promises sound tempting, but the FDA recently cracked down on a number of such supplements, issuing a warning that they may be ineffective at best and downright dangerous to your health at worst.

In particular, the agency is targeting weight loss products containing sibutramine, an appetite suppressant formerly available by prescription under the brand name Meridia. The FDA withdrew this medication from the market in 2010 after studies linked it to an increased risk of heart attack and stroke. Despite the danger, the agency said it has discovered “dozens of products” for sale as dietary supplements – sometimes listing the ingredient and sometimes not – marketed under various brand names.

It’s also important to note that even when it was still legally available by prescription, sibutramine wasn’t especially effective as an appetite suppressant or weight loss aid. There are other prescription medications still on the market that are safer and more effective.

Unlike prescription drugs, which are regulated by the FDA, supplements are not. Because of this, it’s impossible to know exactly what ingredients a supplement contains or at what strength. Like sibutramine, the ingredients can react in dangerous way with other prescription or over-the-counter medications, and this danger may or may not be clearly listed on the product. Add to that the fact that many are manufactured or sold from overseas locations, and it’s easy to see that taking them is literally like playing a game of Russian roulette.

For example, not so long ago a patient whom I had been seeing came into my office complaining he didn’t feel well. After discovering his blood pressure was extremely high – easily within the range that could have caused him to have a stroke or heart attack – he  reluctantly admitted he had taken an herbal supplement that promised to aid in weight loss. It took nearly 24 hours for us to get his blood pressure back under control. Luckily, he didn’t suffer any ill effects, but he easily could have. It was a very scary 24 hours.

My advice? If you are tempted to try a weight loss supplement, take information about the product with you to your doctor before you buy. Together you can look into the product’s claims, see if the active ingredients may interact with any other medications you are currently taking, weigh it against any prescription medication alternatives, and make an informed decision. But resist the urge to play doctor yourself. If not, you could literally be taking your own life into your hands.

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

The study, published in the Feb. 28 issue of the Archives of Internal Medicine, asked 7,790 adults between the ages of 20 and 64 who had their body mass index measured if their doctor had ever mentioned their weight. Shockingly, only 45 percent of overweight and 66 percent of obese participants reported that their doctors had ever brought up the subject.

The results of this study don’t surprise me. Most people trust their doctor and look to him or her for health advice. And yet, far too many doctors are not having this important conversation. Why would doctors be overlooking this so-called “pink elephant” in their office? I suspect it is because most physicians receive little to no training in how to help patients lose weight.

When I was in medical school, for example, we spent more time studying malaria than we did obesity or nutrition. But you know what? I have yet to see a case of malaria, but once I started practicing medicine I found myself seeing patients with serious medical problems due to obesity every single day!

That reality drove me to learn more about obesity. Time after time I saw people with serious medical issues like high blood pressure, high cholesterol, type 2 diabetes, joint pain, and metabolic syndrome be able to reduce or discontinue their medications or have their health woes completely disappear within just a matter of weeks after starting a weight loss program.

Soon, my practice was thriving, and I wanted to share what I had found with other physicians, so they too could help people really get to the core of their health issues and assist them in living a longer, healthier life. The Center for Medical Weight Loss was born.

What we’ve found is that weight problems can stem from a multitude of sources – from genetics to food addiction – and because of this the approach to managing a weight issue must be tailored to each individual for the best success. The patient works with his or her doctor throughout the process. A complete medical history, detailed patient evaluation, nutrition plan, medication management, exercise recommendations, and ongoing support and counseling that helps our patients understand and learn how to conquer their weight loss challenges all add up to a program that works.

So if your doctor isn’t talking to you about your weight, bring it up at your next visit. And if he or she is at a loss of how to help, give The Center for Medical Weight Loss a call. We’d be happy to work with you and your doctor to overcome what may be the single largest threat to your health.

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

In general, I advise them to follow the current USDA dietary guidelines as far as what to eat. They were recently updated, so if you haven’t looked at them for awhile, it’s a good place to start.

Of course, these guidelines are not a one-size-fits-all solution. During our initial consultations and along their weight loss journey, my patients and I work together to tailor the dietary advice to their specific situation and needs, and make modifications if they have trigger foods, underlying medical conditions, and so on.

So rather than go into too much detail about what exactly to eat, I’d like to talk a bit more generally about some of the advice on eating well that I share with my patients.

Do Something Different: If you are usually a meat and potatoes eater or a bread and pasta lover, take a break from the usual fare as you begin your weight loss program. It’s often easier to learn new habits when you’re also eating new things. This is especially true for people who struggle with binge eating. Eating smaller portions of the same foods you’re eating now may just leave you feeling deprived versus eating fewer calories in a new way.

Bulk Up: When you’re losing weight, fiber is your friend because it helps you feel full and satisfied. Happily, most high-fiber foods are also fairly low in calories, making them a win-win for weight loss. Adding a cup of steamed or raw veggies to your lunch or dinner, a scoop of beans on the side, a serving of fruit at breakfast, an apple for a snack, or a cup of watermelon for dessert can really help break that feeling of you’re “not eating enough.” Brown rice and whole grain bread or pasta are also good fiber picks; just be sure to pay attention to calories and portion sizes.

Go Organic: Some of my patients report that going organic helps them improve their diet not only because they are eliminating potentially harmful pesticides and additives from their meals, but also because the higher cost of such foods taps into their frugal nature and makes them less likely to mindlessly eat out-of-control portions.

Try Being a Vegetarian or Semi-Vegetarian: Other patients have told me that switching from their usual meat-based diet to a vegetarian or semi-vegetarian one that’s still high in protein from fish, seafood, eggs, and beans is helpful. Some follow this type of plan every other day or just during the week, and have red meat on weekends as an easy way to eat healthier while cutting calories.

Get Some New Cookbooks: Another thing I encourage my patients to do is cook more at home, and from scratch. Visit the library or your local new or used bookstore and have a look at the cookbooks that focus on vegetarian, healthy, or low-calorie cooking. Some focus on creative “makeovers” for the dishes you know and love while others may take you in whole new directions, exposing you to dishes you have never tried but will find you really enjoy. Often, illustrated cookbooks with appealing images of these healthier meals can inspire your culinary bug.

Beware Liquid Calories: While you are thinking about the foods you eat, don’t forget to take into consideration the number of liquid calories you are consuming. Soda pop and alcoholic beverages are two obvious empty calorie sources, but even seemingly innocent options like fruit juice, milk, smoothies, and coffee drinks can be surprisingly calorie-dense. Artificially sweetened beverages may not have calories, but can lead to other health issues. Try drinking water or iced tea instead.

If You Think It’s Bad, It Probably Is: Lastly, trust your instincts. No matter what the packaging claims, it’s not a surprise that foods like ice cream, cookies, cakes, doughnuts, French fries, fried foods, fast food, chips, and the like are not great choices. I’m not saying you can’t have them sometimes and in moderation but, in general, try to reduce these types of foods and replace them with healthier options.

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

It’s an interesting question, and one well worth asking since 2 out of 3 Americans are either a little or a lot overweight. In fact, being overweight is almost more “normal” now than being at a healthy weight. But does that make it “ok” from a health standpoint?

Clearly, many studies have established that obesity and morbid obesity are linked to multiple health risks and a shortened lifespan. But what about 5, 10, or even 20 extra pounds? Are they dangerous, too?

The study reviewed the medical records of some 1.5 million adults in an attempt to find out. Researchers discovered that at least for those with European heritage, even being a few pounds overweight (with a BMI — or Body Mass Index — between 25 and 29) made it 13 percent more likely they would die during the study’s time frame than those who had a BMI in the ideal range of 22.5 to 24.9.

Compare that to a range of between 44 and 88 percent more likely if one was clinically obese (with a BMI between 30 and 39.9) or 250 percent for those who were morbidly obese (a BMI over 40).

In addition, who your relatives were also seems to play a role. For certain ethnic groups, like whites and Asians, the health risks of a few extra pounds seem to be greater than for other groups, such as those with an African or Latin American heritage. We are still trying to understand why this is so.

One thing I don’t like about this study is that it looked at BMI alone, not body composition. While BMI is a good number for determining if one is overweight, it only tells part of the story. Very athletic people, for example, can have very little body fat but still be technically “overweight” when one looks at BMI because lean muscle weighs more than fat. Likewise, someone could actually have a BMI in the ideal range yet also have a higher body fat percentage than he or she should.

I think a better question to ask might be: Is excess body fat risky for your health? When phrased this way, I think the research says, “Yes.” Excess body fat has been linked to a whole host of possible health risks, including something called metabolic syndrome, a collection of health issues like high cholesterol, high blood pressure, and pre-diabetes that all add up to a serious health crisis in the making.

I believe for optimal health, everyone should know his or her BMI and body composition numbers and strive to keep them in the ideal range rather than focus on weight alone.

Likewise, if someone is overweight, he or she should be careful to lose weight in a way that decreases body fat while preserving lean muscle, something we focus on with The Center for Medical Weight Loss program. Otherwise, dieting can lead to lean muscle and water loss, but not reduce body fat stores – leaving the person in a worse position, health-wise, than before!

In short, the numbers on the scale only tell part of the story. If you are interested in losing weight for optimal health, you need to know more than your height and weight. And you need to be sure that the weight you lose is coming from the right places – fat stores – and not the wrong ones.

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

By law, food labels list the number of calories per serving, the number of servings per package, the amount of macronutrients in the item (fat, protein, and carbohydrates) along with the amount of any significant vitamins or minerals, and a list of ingredients.

So of all the numbers and facts, which are the most important? Hands down my advice would be to pay the closest attention to calories and the number of servings per package. In general, when it comes to weight loss these are the most important numbers to know.

The number of servings per package is especially important because not keying into this number may lead you to believe something has fewer calories than it actually does. For example, a “small” bag of potato chips may list the calories at 274. But upon closer inspection the “snack size bag” actually contains 2 servings per package, for a total of 584 calories! To determine the entire bag’s true amount of fat grams, sodium, and the like, you’d also need to double those figures.

After that, take a look at the top five ingredients. Labeling law requires that ingredients must be labeled in order by amount. So if something like “sugar” or “high-fructose corn syrup” is in the top five, chances are the food isn’t a healthy choice regardless of the number of calories it contains.

Of course, people with medical conditions need to pay attention to the macronutrients too (fat, protein, and carbs). It’s especially important for those with diabetes, heart disease, high cholesterol, polycystic ovarian disease, and other pre-existing conditions to make sure they know how their nutritional needs differ when it comes to weight loss, something we take into account at The Center for Medical Weight Loss when designing a weight loss program for each client.

After calories, servings per package, and top ingredients, take a look at the sodium content in the package. Dietary guidelines recommend keeping sodium (a.k.a. salt) intake under 2,000 milligrams per day for most people, and under 1,500 for those with high blood pressure and certain other medical conditions.

Also check out the fat content per serving, as well as the “type” of fat it is: saturated, polyunsaturated, or monounsaturated. In general, saturated fat is known as “bad” fat, or the type that can increase heart disease risk, while the two other types are known as “good” fat, or the types believed to lower cholesterol and other heart disease risk factors. Aim to keep saturated fat intake as low as you can. At the same time, don’t be fooled by products labeled “low-fat,” “fat-free,” or other things that sound healthy into thinking that means they are healthy or you can eat as much as you like. Calories still count! And many times, these products contain just as much or even sometimes more calories and things like high-fructose corn syrup than the “regular” version.

For example, one well known brand of “snack bars” packages itself as a healthy option and a source of whole grains. Sounds good, right? But upon closer inspection, high-fructose corn syrup is the first ingredient! These bars are essentially the equivalent of a candy bar with added fiber.

Another such example is a popular soft drink with the words “now with antioxidants” across the front of the label. Don’t be fooled. It’s still soda pop, and the addition of antioxidants doesn’t even begin to make this a healthy choice.

Ironically, some of the healthiest food choices don’t come with a food label at all. Fresh fruits and vegetables are a perfect example! So keep that in mind, too. Foods that come in package, cans, boxes, or bags with labels are often highly processed and not as good of a choice, in general, as foods in their natural, single-ingredient state. So when in doubt, keep it simple.

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

The study by Washington University in St. Louis researchers looked at addiction and obesity trends from a national survey conducted in 1991 and 1992 and in 2001 and 2002, and found that women with a family history of alcoholism were 49 percent more likely to be obese than those without a family history of alcoholism. Men with a family history of alcoholism were also more likely to be obese, to a lesser degree.

The researchers speculate that rather than binging on alcohol, which carries a higher social stigma, people with a tendency toward addiction may be binging on the many high-calorie, high-fat, high-sugar foods available today instead.

Both alcohol and these so called “junk foods” stimulate a similar place in the brain known as the reward center, they say. Addictions to other things like sex, gambling, or even exercise also stem from this same reward center in the hypothalamus. New studies suggesting the same drugs used to treat an addiction to tobacco, alcohol, and drug addiction may also help reduce the cravings and binge eating behaviors further back up this possible connection.

I am not surprised at the study results and have long suspected there was a link between an addictive personality and obesity for some of my patients. For example, one man in his early 30s who recently started the program revealed during the course of our initial interviews that he had a pattern of binge drinking in the past, which he had “given up” when his children were born.

However, upon talking further, he revealed that his binge eating pattern emerged around the same time, and was surprised himself to connect the dots that what he had done was substitute an addiction for food for his prior addiction to alcohol.

In fact, substituting a healthy addiction, like to exercise or spirituality, for an unhealthy one is a common way to break addiction.

Many people who struggle with addiction report that their compulsive behaviors, like binge drinking or binge eating, often stem from an attempt to soothe stress or to cope with negative emotions. Overeating or drinking too much brings a temporary comfort or pleasure as it taps into the “reward center” in the brain. However, in the long term the compulsive behavior leads to other problems such as weight gain or difficulty in personal and work relationships.

If you suspect an addictive personality may be playing a role in your weight issues, there is hope. But to win your battle with the bulge it will need to be addressed with a program tailored to meet your individual needs, like the one offered by The Center for Medical Weight Loss. Without addressing these issues, calorie cutting and added exercise alone will likely not get to the core of the issue.

The good news is, once my patients start connecting these dots, I have seen time and time again that it all falls into place – and they are finally able to overcome their weight issues for good.

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

I find the study very interesting. What the researchers really found wasn’t that indoor heating was making people fat, but rather that people who spent a lot of time in climate-controlled buildings had a lower amount of so-called “brown fat” or brown adipose tissue when compared to those whose buildings were cooler.

We have much to learn yet about brown fat, but what we know so far is that people who have more of this particular type of body fat – found mostly in the neck and upper back area – seem to have higher metabolisms and are less likely to be overweight.

Or in other words, that person you know who is thin as a rail despite eating whatever he or she wants may just have a higher percentage of brown fat than you, not better willpower or even a healthier diet!

We still don’t know exactly what causes an accumulation of brown fat. It could be genetic or it could be something in the person’s environment or it could be a little of both. We hope to discover sometime in the near future how we can help people with low amounts of brown fat to build it.

But in the meantime, turning down the thermostat, as this study suggests, isn’t a bad place to start. The researchers theorized that the simple act of shivering, the body’s natural response to cold, may help increase brown fat.

This makes sense because when you shiver, your body converts energy into heat. Shivering burns a very small amount of extra calories per minute, but over time, day after day, this small amount can add up, similar to other recent studies that found weight gain and loss may be more about small everyday changes than big calorie cuts and torturous workout routines.

Of course, we aren’t talking about jumping into frozen lakes in the middle of the winter here. Instead, try turning your home or office thermostat down by a degree or two a day, say going from 70 down to 68. If done gradually, your body will acclimate to the lower temperature, and you’ll be much more comfortable in the process than if you try to go from 70 to 62 in just one day.

And remember, just like any other quick-and-easy weight loss solution, doing just this one thing alone is not going to lead to weight loss or allow you to eat whatever you want. To see real results you’ll need to pair this action with a balanced low-calorie diet plan, regular exercise, support, and behavioral changes in order to conquer your weight issues for good.

So until we discover a way to ensure everyone can enjoy the same benefits of brown fat as those who seem to come by it naturally, stick with the basics and you’ll get from where you are to where you want to be.

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

One example that comes to mind are the various programs touting the power of hCG. This hormone, human chorionic gonadotrophin, is generated by the placenta during pregnancy and is the same compound that causes a positive result on a pregnancy test.

Advocates claim this hormone stimulates metabolism, reduces appetite, balances hormones, and a variety of other things. But when you look closer, the diet plans that accompany these hGC programs are likely what leads to any weight loss. Many are dangerously low in calories, 500 or so a day, and do not meet even the minimum nutrition a person’s body needs.

Like anyone following a 500-calorie-a-day diet would, people on these plans do tend to lose weight rapidly, which leads them to believe the diet is working. Unfortunately what they are losing is mostly muscle and water, not fat. Worse, this severe calorie restriction triggers the body’s starvation response, slowing metabolism and leading to rebound weight gain once a person stops following the plan.

Even more sinister, there is a very real risk that the injections or oral suspension containing hCG that people are being given could carry HIV, hepatitis, or any number of pathogens that can be passed by bodily fluids because many of these “dietary aids” are being made from the urine of pregnant women who have not been screened for these illnesses.

Another weight loss “advance” that comes to mind is the so-called fat melting laser. When the devices first came out, I was contacted by a company promoting them and given a device for free to try it out. Like the plan above, the laser treatments were to be paired with a low-calorie diet, this time 800 calories per day.

When I compared two groups of volunteer patients, one who followed the diet and had the laser treatments and one who had the laser treatments alone, what we found was that those on the diet lost weight and inches while those having the laser treatments alone did not lose any weight or inches.

Once again, as much as I hoped it would work, these results led me to believe it wasn’t the laser but the calorie reduction that caused the weight loss and inches lost so I returned the device. Also like the plan mentioned above, the diet plan that accompanied the treatments was not a balanced one, nor did the program address any of the core issues contributing to the person’s weight issue.

And these are just two examples of many such plans, products, and devices currently on the market that promise a quick-and-easy weight loss solution. Don’t be fooled and don’t fall prey to the clever marketing for these expensive “solutions” that could endanger your health.

If you want to lose weight, it is possible. But don’t look for the easiest, quickest way. Take the steps needed to lose your excess weight healthfully, permanently, and safely. In the end you’ll get the results you want and, more importantly, results that will last.

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

If not, chances are you won’t succeed in getting there in real life either. That’s how strong of an asset or liability the power of mental imagery can be in your weight loss journey.

So if you picture yourself as you are now or, even worse, failing to reach your goal, it’s time to learn how to tap into the power of visualization. Or in other words, first you’ve got to see it before you can be it!

Professional athletes, medical students, artists, musicians, and people with all types of goals use visualization as a tool to help them succeed. For example, athletes see themselves scoring the goal or winning the game. Medical students get through grueling exams and other obstacles by imagining themselves in the profession of their dreams. Artists and singers report imagining themselves signing a contract years before it actually comes true.

Like them, you can also tap into the power of your subconscious to stay focused on your goal. Use these tips to get started:

Visualize It: Spend some time every day seeing yourself at your goal weight. The more real you can make the image the better. Picture yourself wearing a certain outfit or doing a certain activity you wish you could do now. These little details make the image more powerful and concrete.

Feel It: Take it a step further by feeling the joy of reaching your accomplishment. Picture yourself confidently and effortlessly making it happen. Imagine yourself having overcome all odds. Feel yourself lighter. Feel how easy you move. Feel the increased energy and vitality you have. Feel how good it feels to be at your ideal body weight!

Give Yourself the Present: During your visualizations, see these things happening in the present tense, happening now, or having already happened, not happening in the future. See yourself there. The subconscious mind – which does not distinguish between yesterday, today, and tomorrow – will take whatever image you feed it and work to make it happen.

Break It Down: Some of my patients report they have trouble imagining themselves at their goal weight. If this is the case for you, try breaking it down into smaller steps. Imagine yourself 5 pounds thinner, one or two clothing sizes smaller, halfway there, or whatever image feels right to you. In time, as you meet these challenges, the big picture will come into focus.

Steer the Image: If you find negative images creeping in during your visualization – of you failing to lose weight, for example, or if your mind drifts to past failures –acknowledge these thoughts, thank them for making themselves known, tell them you don’t need them anymore, and then imagine them losing their power. See yourself packing them away into a box labeled “recycling” and putting them out on the curb, or whatever image helps you let them go.

Write the Check: Reports say actor Jim Carrey wrote himself a $10 million dollar check with the words “for services rendered” in the memo line and carried it around in his wallet for years until his big break came. At the time he was about as far from being rich and famous as anyone could have possibly been. He’s since received payment for double that amount for a single film! In a similar way, you can copy your driver’s license and put in your goal weight or do something else to create a tangible item to carry with you on your journey. Then, as he did, don’t give up and do everything you can to make it happen until your dream comes true!

Like the dietary and lifestyle changes you are making, mental imagery may seem artificial at first. But don’t give up! Keep doing it day in and day out, and before you know it, it won’t be an imaginary image anymore – it will be your reality!

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

But for those who are trying to lose weight or maintain a weight loss, celebrating cupid’s holiday can be a challenge because it requires one to think outside the usual box of chocolates!

To help, I’ve thought of a few non-food ways to celebrate:

• Take a walk at sunset with your sweetheart.
• Enjoy some luxurious bath products with a yummy sweet scent like coconut or vanilla.
• Write a love letter or poem expressing how you feel.
• Make a recording of the songs that have special meaning to your partner.
• Get a bigger bouquet of flowers this year with the money you’d normally spend on chocolates.
• Give the gift of lingerie, or if your partner doesn’t care for lingerie get some luxuriously soft pajamas, slippers, or a robe.
• Give your sweetie a book of homemade “love” coupons for him or her to cash in throughout the coming year.
• Schedule a couples massage.
• Spend some time snuggling with the one you love.

Not with a special someone this year? Beware the temptation to soothe any disappointment or other difficult emotions you might be experiencing with food. Instead, push yourself to channel those feelings in a more positive direction: exercise, journal, or talk about your feelings, or take positive action in the direction you want your life to go (such as signing up for a medical weight loss program!).

Of course, even if you do have some chocolate or a few glasses of champagne, the world will not come to an end. In fact, if not celebrating with food seems too unromantic, go ahead and have a sweet treat in moderation, but keep it to just the holiday and get back on your usual plan the next day.

Most of all, remember that Valentine’s Day isn’t about chocolate. It’s about spending time with the person or people who are important to you and showing them how much they mean to you. So go ahead, shower them with affection – and let someone else have the empty calories this year!

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

But according to a British researcher, nearly 88 percent of those who make this resolution to lose weight will end up abandoning their plan to slim down by the end of February.

In fact, at The Center for Medical Weight Loss clinics across the country, we tend to see an increase in people signing up in February and March, not January. And when they do, they often tell us that they had tried to lose weight on their own or with a commercial weight loss program, but it wasn’t working.

This doesn’t surprise me. Losing weight is not impossible, but it is also not easy. Add to that factors such as a slow metabolism from past yo-yo dieting, menopause, medical conditions and medications that can cause weight gain, food addictions, and more, and it’s easy to see why so many people struggle to win their battle with the bulge.

Losing weight is not just about eating the right foods, counting calories, and exercising – although those do play a role – it’s also about understanding what is causing your weight issues and responding with a program tailored to meet those challenges. Weight loss is not a one-size-fits-all effort.

So if you have tried to lose weight and it isn’t working, that is a great time to give medical weight loss a try rather than giving up. We can help you sort out the complex factors at play in your particular case and guide you step-by-step along the way.

As part of our program, we do a detailed medical history and body composition analysis for each person, as well as review what medications they are on and order lab work to make sure that the patient’s thyroid and hormone levels are where they should be so we can create a program just for them.

Then we follow that up with a weekly one-on-one visit with a physician trained in weight issues. If needed, our physicians can prescribe nutritionally sound meal replacements and prescription appetite suppressants to help make losing weight safer and easier.

We have found time and time again that for our patients who have tried almost everything else, the medical weight loss approach works! Numerous patients have lost more than 100 pounds in less than a year and without surgery. Check out some of our success stories for inspiration.

So please, for the sake of your health, don’t give up. It is possible to lose the weight you want to lose once and for all and to get from where you are to where you want to be. We can show you how.

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

I believe such a network is critical to your success. Of course, a weight loss support team can’t lose the weight for you, but they can be there for you along the way. Here are some tips on finding and forming your team.

Consider Your Options: Think about who you know that you can rely on to be a cheerleader on your journey. Perhaps a spouse, close friend, family member, neighbor, co-worker, counselor, or medical professional. Make a list. The more people you can align to help you, the better.

Spread the Word: Talk to those you want on your team and explain to them simply but clearly your plan, what you need to do, and how they can help. Try to do this early in your weight loss journey so everyone will know in advance what to expect.

Be Specific: The more concrete you can be about how people can help you, the better. For example, if going out to eat is too difficult for you, ask the people on your support team to avoid planning get-togethers centered on dining out for a while.

Fine Tune the Message: As you move along your weight loss journey, new challenges are bound to pop up. Be sure to communicate these new developments to others. For example: Realized you really can’t stay out of cookies (or whatever may be a problem food) in the cupboard like you thought you could? Ask your spouse to not buy them or bring them into the home.

Give Examples: It can be difficult for people who don’t struggle with their weight to understand the challenges involved. Try giving examples to help illustrate. For example, you could say, “If someone was an alcoholic, a friend wouldn’t suggest they meet in a bar to watch the game. It can feel like that to me to meet at a restaurant.” Explaining eating issues this way may help someone understand them better.

Know Who Can’t Give Support: Equally as important as knowing who is on your team is recognizing who can’t be, for whatever reason. One common cause might be that a person has similar food or weight issues he or she is avoiding themselves. It isn’t personal. You can’t change them. You’ll simply need to go ahead and do it without them. Recognizing this may help you prepare yourself for the reality that that particular person may not be able to be part of your support team, and to focus on reaching out to others who can instead.

Don’t Expect Perfection: There are bound to be slip-ups along your weight loss journey, both by you and your weight loss support team. Be kind to yourself and to them when this happens and focus on what you can learn, not what went wrong.

Show Your Appreciation: Be sure to let your team members know how and when they have helped. Such feedback will encourage them to stay the course with you. Thank-you cards, a quick voicemail, a heartfelt gesture, or sincere thanks are just a few ways to show how much their support means to you.

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

Similar to so-called “sin taxes” already in place on items such as tobacco and alcohol, such a tax could raise billions of dollars to help fight obesity, proponents argue. Increased prices, about 6 cents a can, might encourage consumers to reach for a healthier beverage option instead, they say.

With each American averaging 597 cans of soda a year and 306 million people in the U.S., that comes to 182,682,000,000 cans per year, creating a possible $10 billion in annual revenue to fight obesity. But would it work? Unfortunately, I don’t think it would make as much of an impact as we would like.

Such taxes sound good, but the reality is people will often just switch to a less expensive brand or find another way to get their fix than to give up the bad habit because of the cost. Such taxes also tend to hit those in the lowest economic classes the hardest, where the cost of switching to a healthier option is prohibitive.

The only way I could see such a tax making much of an impact is if all of the money generated by it was directed at educational campaigns to help people understand what all those sodas and sugary drinks are doing to their bodies, and what some better options might be. (Hint: It’s called water, and it’s free!)

Perhaps the money could also be used to subsidize the higher cost of eating healthier, and to make healthy options as quick, easy, and affordable as junk food.

Government policies could shift to support teaching children from kindergarten on about good nutrition and offering healthy options in school cafeterias, encouraging those on public assistance to buy quality foods rather than high calorie, low nutrition ones, and providing funding to help people who want to lose weight pay for programs that can help them do so.

Remember: The costs to society of obesity are staggering. Centers for Disease Control and Prevention experts estimate $147 billion dollars per year in medical expenses can be directly linked to obesity and its resulting health problems. That’s nearly $1 of every $10 spent on healthcare in the United States!

Clearly, something must be done both on an individual level and for society as a whole. It’s in all of our best interest to start shunning unhealthy products like soda pop and start living a healthier lifestyle, “sweet tax” or not. And it can start today with you!

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

Perhaps you remember the old “Four Food Groups” model or have seen the more recent “Food Pyramid” recommendations for how Americans should eat. Like them, this new recommendation, expected January 31, will attempt to simplify the complex science of nutrition into an easy-to-understand model of how Americans should be eating.

The changes aren’t expected to be dramatic, but will likely include some key improvements such as recommending people eat less red meat, more seafood, more whole grains, less refined and processed foods, more fiber, more plant-based foods like beans, more vegetables and fruit; lower their sodium intake by nearly half; and limit their intake of solid fats and added sugars, dubbed “SoFAS.”

In years past, powerful lobby groups have aimed to influence these recommendations in their favor, and some would say they have succeeded. I hope this time the government recommendations will be based solidly on the nutritional science and what truly is the very best way for people to eat for their health.

The reality is obesity is costing our government and society a lot of money in increased medical bills, not to mention individual suffering. But will changing the dietary guidelines really change how Americans eat?

Of course I hope it does, but I suspect it won’t. In order for these dietary guideline changes to really take hold, I believe the government and private industry will need to educate people on “why” these guidelines matter, and then to make eating this way as easy, affordable, and accessible as eating junk food or fast food.

It’s a tall order and it would take a combined effort. Political forces, school systems, businesses, public policy makers, and others would all need to work together to make the big changes needed in the way America currently eats to turn the obesity epidemic around.

If it were up to me, I’d probably take the recommendation even further than the government likely will. For example, I would recommend:

• Limiting red meat intake to no more than once a week.
• Making lean proteins like seafood, poultry, beans, and soy the “daily” protein sources.
• Replacing refined grains (white bread, pasta, and rice) with whole grains (100 percent whole wheat bread, whole grain pasta, brown rice).
• Replacing regular dairy products with low-fat milk, cheese, yogurt, and the like.
• Replacing butter and animal fats with plant-based oils like olive oil.
• Replacing frozen, canned, and boxed foods with foods prepared fresh and from scratch.
• Replacing all soft drinks and 5 or 10 percent “fruit juices” with water.
• Eating fried foods rarely, if at all.
• Replacing salt with herbs and other sodium-free seasonings.
• Eating more fresh and in-season fruits and vegetables.

In short, I’d recommend eating the way that they do in areas of the world where they have the lowest obesity rates and the lowest rates of diet-related health problems. It’s often called “The Mediterranean Diet,” and it’s the way people have eaten for well over 3,000 years.

In addition to recommending these dietary changes as a way to curb obesity and increase health, I’d also like to see people add the non-exercise approach to physical activity recommended by researcher James Levine, MD, called NEAT, or Non-Exercise Activity Thermogenesis, into their daily lives.

The concept is simple. Instead of looking for the easiest way to do things, choose the hardest. Park in the furthest spot in the parking lot. Take the stairs. Carry groceries into the house one bag at a time. Walk across the office and talk to a co-worker in person instead of sending an email. These and the thousands of other small changes Levine recommends can add the equivalent exercise of 30 minutes on a treadmill to a person’s day – without ever stepping foot in a gym!

Stay tuned to see what changes the government will recommend to the current dietary guidelines—but don’t wait until then to start making changes in your own life to lose weight, move more, and live a healthier life.

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

Perhaps the most striking was that of the 1,234 people surveyed, a full 90 percent said they felt they ate a healthy diet. However, when questioned about what exactly their dietary habits were (if they ate breakfast and, if so, what they ate, how many fruits and vegetables they ate a day, etc), it turned out that most were, in fact, not eating a very healthy or balanced diet.

Similar to national averages, about 35 percent of those polled were at a healthy weight, 36 percent were overweight, and 21 percent were clinically obese. That says to me that if more than half of those surveyed were overweight or obese, not everyone was eating as well as they thought they were.

The study also found that about 1 in 10 participants were out of touch with their weight, saying their weight was in a healthy range when in fact it wasn’t.

In general, most people surveyed were not eating nearly enough fruits and vegetables, drank too many sugary drinks (like soda), and seemed to be falling for marketing messages that claimed certain foods were “healthy” when in fact they really weren’t the best choices, nutritionally speaking.

So are you eating as healthy as you think? One of the first things we do when someone starts our medical weight loss program is analyze their current diet to see how well they are eating and what the possible trouble spots contributing to their weight gain might be.

What we often find is that people are eating more calories and larger portions than they think. They typically also eat more highly processed but nutritionally poor foods than they should, favoring ready-made or fast food to meals cooked from scratch using fresh ingredients. Empty calories from soda pop and other sweet drinks often are also a problem.

The danger of all of this is that many people’s health is at risk as a result, and they may not even be aware they are in danger. Many are on the verge of developing diabetes, or have diabetes already and don’t know it, and others suffer from metabolic syndrome, a collection of symptoms that increases one’s risk of heart disease, diabetes, and a whole host of medical problems.

So don’t kid yourself. What you eat does matter. It may take time and effort to change your diet and get used to eating in a new way, but most of my patients report that once they do, they feel better, look better, and have more energy, and that the way they used to eat doesn’t even seem appealing anymore. If they can do it, you can too!

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

First, while some herbal and over-the-counter products say that the caffeine and other ingredients they contain can suppress appetite and increase metabolism, the scientific evidence for such claims is shaky at best. I don’t recommend these so-called “weight loss enhancers” because it’s often unclear what ingredients they contain, or at what potency. Worse, they could possibly interact in a negative way with other over-the-counter or prescription medications or cause complications for those with certain health conditions. In short, save your money (and possibly your health) and steer clear of them.

Still, I don’t advocate total abstinence from caffeine either, nor do I think it might not have some small positive effect. But much more study is needed to see if caffeine itself has any thermogenic (metabolism boosting) effect or if it can suppress appetite or cravings. What is well known is that too much caffeine can lead to jitters, nervousness, and insomnia, among other negative side effects.

Caffeine is also a mild diuretic, which means it can cause water loss. On the medical weight loss program, we advocate the exact opposite—that our patients stay well hydrated because it helps lower a person’s overall fat percentage during weight loss, which is the real goal. Because any beverage containing caffeine may lead to a dehydrating effect, it’s important to balance that out by following up with an extra glass or two of water to compensate.

If someone wants a cup or two of coffee, green tea, or regular tea a day, I do not oppose it. It’s no secret that caffeine can give one an energy boost, which is exactly why so many people drink it. The big problem with caffeine is that those beverages are often accompanied by extra calories. Coffee loaded up with sugar and cream, for example. Or a latte or mocha drink from a coffee stand that contains several servings of whole milk, plenty of flavored syrup, and whipped cream—all adding up to 500 calories or more!

So if you are a coffee or tea drinker, try to drink your beverages “straight” without all of the extra bells and whistles. When you do, the drinks weigh in at zero calories. If you absolutely must doctor them up, stick to skim milk and a measured amount of real cane sugar and make sure to factor those calories into your daily intake.

If there is any caffeinated drink I would recommend, it would be green tea. Preliminary studies show this beverage does seem to promote weight loss beyond the simple caffeine effect. It has a naturally sweet taste and is a good source of antioxidants. Substituting green tea for your usual coffee or black tea would be a wise move.

And finally, remember that there is no “single solution” to weight loss. With or without caffeine, you still need to eat a balanced diet, get regular exercise, and address and overcome any behavioral factors that might be playing a role.

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

But somehow, it doesn’t seem to work out that way. In fact, as the number of artificial sweeteners and products made from them has increased, so have the obesity rates! If artificial sweeteners could help, one would expect the exact opposite to be true.

So why aren’t they helping? For reasons we have yet to understand, even though these sweeteners don’t contain any calories, the brain and body don’t seem to perceive them as having zero calories.

One theory is that these artificial sweeteners are somehow still processed by the body as if they did contain calories. Another theory is that the artificial sweeteners increase hunger and cravings, thus leading to a higher overall calorie intake. Either way, I don’t believe they help much with weight loss, and in fact may mislead people into thinking they are eating healthier than they really are.

Take, for example, the wide variety of artificially sweetened cake, cookies, and other products. They may not contain calories from sugar, but when you carefully read the labels, these foods often contain just as much fat and calories, or more, as the original version.

Diet sodas, artificially sweetened flavored waters, and the like are another weight loss mistake. The carbonation these beverages contain stretches the stomach and triggers a release of a hormone known as ghrelin, which increases hunger and cravings. I’d much rather see my patients reach for water to quench their thirst than any of these chemically laden beverages.

My advice? It’s far better to eat something made with real cane sugar in moderation and to factor the calories into your overall daily intake rather than to swap the real thing for something made with artificial sweeteners, thinking you can eat more because it has fewer calories. Unfortunately, as much as we wish it did, it just doesn’t seem to work that way.

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

Numerous studies have shown that making sure protein intake remains high when cutting calories for weight loss can help prevent muscle loss (which keeps metabolism high), satiate hunger, and reduce cravings and binges. Low-calorie, high-protein plans also encourage the body to tap fat stores rather than muscle to get by on fewer calories, making maintaining weight loss easier over time as well.

Keeping protein intake high when cutting calories also seems to help avoid triggering the “starvation response” that helped ancient man survive periods of feast and famine by shutting down metabolism and making weight loss harder, not easier.

Some good sources of lean protein include fish, shrimp, shellfish, chicken, turkey, lean and extra-lean beef, eggs, low-fat dairy products, soy, beans, peas, and lentils. Think of them as your weight loss superfoods. You should aim to include a lean protein source with every meal and snack.

Don’t be confused into thinking I am talking about an all protein or mostly protein diet, like some well-known plans advise. While they may work initially, I don’t feel they really help people learn how to eat in a way they realistically can maintain for the rest of their lives.

So, unlike plans that counsel people to eat mostly protein, at The Center for Medical Weight Loss I advise a balanced approach that includes protein, carbs, and fat in the proper proportions. This way, when people reach their weight loss goals and go on a maintenance plan, they have learned how to eat “real foods” in the right combination and can continue to do so going forward.

Of course, a low-calorie, high-protein diet alone is not going to solve a weight problem. That’s why we pair that with physical activity and counseling and behavioral changes. What you eat is only one piece of the puzzle. How you live and think are just as important in conquering a weight problem.

So remember, protein is your friend in the battle of the bulge. But in the end, losing weight is about so much more than cutting calories or a number on a scale. It’s about learning a new way to live and eat.

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

One patient that comes to mind is a man in his mid-50s who started the medical weight loss program with a BMI of 34. After losing the excess weight, he has maintained a BMI of 26 for more than two years.

An engineer by trade, he really took to the idea of monitoring his calorie intake and expenditures on a daily basis and devised a simple spreadsheet that allows him to do so. Once a week he also weighs himself and notes that information in the log.

Sure enough, the daily habit of recording what he eats and knowing how many calories he burns with exercise in addition to his baseline metabolism has made it relatively easy for him to keep the weight he’s lost from creeping back on. If a gain does occur, he’s able to take action when the amount is a few pounds, rather than after he’s unwittingly gained 20 pounds or more.

Now, one doesn’t have to be an engineer or use a spreadsheet to get the same results. A simple notebook or journal can also do the job, as can one of the many websites available that help a person track this type of information.

I like to think of such monitoring as your best defense against losing ground in the battle of the bulge. Multiple studies have shown that people who make monitoring their weight a daily habit are much more likely to lose and keep weight off in the long term.

Another way to think of it is like a checking account. One can keep a running estimate of the balance in his or her head, only to find that the $20 ATM withdrawal here or the $40 check they forgot they wrote suddenly adds to a big deficit thanks to bounced checks and added fees. The small expenses can be overlooked or forgotten much easier than one big purchase, making them all the easier to discount when doing the “approximate” budget in one’s head.

It’s the same with food. A few pieces of candy from the dish at the office here, an extra 200 calories here and there, are much more likely to trip up your weight loss and maintenance plan than an all-out calorie-buster because they are so easy to overlook.

Monitoring can also help one plan ahead. Many of my patients report they find it easier to adhere closely to a meal plan during the work week, when their time is more structured. Cutting out 100 or 200 calories per day allows them to “bank” extra calories for the weekend, when they are more likely to stray from their usual eating routine. They can enjoy a meal out, knowing that they have an extra 700 to 1400 calories to “play with” rather than fear that it will come back to haunt them later.

So if you aren’t doing so already, make a point to start recording everything you eat and drink each day, along with their calorie count. Also keep track of any additional physical activity you do, and how many calories you burned. Finally, weigh yourself every week and record that figure as well. Some people also find it helpful to journal about their emotions, moods, or anything that was difficult or contributed to going off their plan on a particular day.

At first, like any new habit, it may feel artificial. But keep at it, and in time it will become second nature. I can almost guarantee you’ll find you become much more aware of your actions, and that in turn will help keep you on track with your weight loss goals.

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

Hardly, and here’s why. Not so very long ago, humans lived in a feast or famine world. Food was difficult to come by, and sometimes was not available at all. To ensure survival, the human body coped with these cycles by going into “starvation mode” when calories were few and far between.

Fast forward to today, where many people try and fail to lose weight because they cut calories and inadvertently trigger this ancient survival mode. The body responds to a cut in calories by lowering metabolism, burning muscle instead of fat, hunkering down to preserve all the fat storage it can, and converting the few calories that do come in into more fat stores in case the famine will be a prolonged one.

When someone starts a fast, they may indeed drop a number of pounds very quickly, but the weight “loss” is most likely in the form of water and muscle, which is exactly the opposite of the long term goal – to lose fat.

Of course, nobody can subsist on such limited calories for long, and as soon as one gives up on the fast and goes back to regular eating, his or her now slower metabolism makes burning those calories that much harder. At the same time, body fat stores have increased and muscle stores (which are what fuels metabolism) have decreased, leaving the person in a worse position than before the fast.

Fasting can also send cravings and hunger through the roof, as the brain sends out the signal that the top priority is to find food, preferably high-calorie food, at all costs. Binging is often the result.

Like a snowball going downhill, the more times the cycle is repeated, the quicker the momentum builds and the “weight” lost during fasting quickly returns, and then some. Without realizing it these people on fasting diet plans are setting themselves up for long-term weight gain, not weight loss!

It’s true that some patients on The Center for Medical Weight Loss plan do follow a liquid diet initially, but it is a far cry from fasting. The liquid diet is nutritionally balanced and high in protein, unlike cabbage soup or fruit juice. Even though calories are reduced drastically, the body does not perceive it as a “famine” because its nutritional needs are being met.

On such a plan it is possible to drop weight as quickly as with a “fasting” diet, but without triggering the starvation mode and subsequent slower metabolism, muscle loss, fat gain, out-of-control cravings, and rebound weight gain as soon as one tries to eat “normally” once again.

So instead of trying to lose weight by going on a fast or fad diet on your own, give the scientifically based medical weight loss approach a try. We can promise that not only will you lose the unwanted weight quickly, but you’ll also put an end to the yo-yo dieting cycle for good. Best of all, you’ll also have help, support, and encouragement every step of the way.

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

The answer is both yes and no. Yes, you can and should try to eliminate high-fructose corn syrup (HFCS) from your diet as much as possible, but no, doing that alone probably won’t solve your struggle with excess pounds.

Let me explain first by starting with what HFCS is and where it comes from. HFCS was unheard of until the early 1970s when researchers developed a way to extract sugar from corn as a method to use up an overabundant corn supply. It all started with a new farm policy in the United States that promised to pay farmers a set price for corn no matter how much they grew. Around the same time, advances in farming equipment, new synthetic fertilizers, and hybrid strains of corn suddenly allowed farmers to get at least four times as much corn per acre.

The combination of guaranteed sales, larger plantings, and much higher yields led to a ready and easy supply of corn-based ingredients. This then spurred the development of a whole new industry based upon inexpensive and nutritionally empty but calorie-rich junk food products. Companies started to replace cane sugar, a naturally occurring substance, with the cheaper synthetic corn-based sweetener to cut costs and increase profits in all kinds of foods from soda pop to ketchup.

Like sugar, HFCS contains no nutritional value but does contain calories. Gram for gram the two are equivalent, weighing in at 4 calories per gram each.

Some research suggests a link between an increase in illnesses like diabetes and heart disease and the creation of this super sweet substance. Other experts claim the body processes HFCS differently than sugar, and that it could be contributing to the increasing obesity rates.

Princeton researchers, for example, said in a recent study that rats who consumed high-fructose corn syrup gained 48 percent more weight than rats who ate regular sugar, even though the calorie counts were the same.

Do you need HFCS in your diet for healthy, balanced nutrition? Obviously not! Even so, according to recent studies, the average American currently eats 63 pounds of HFCS a year. That is equal to 114,156 calories, or the equivalent of 33 pounds of weight gain!

So cutting high-fructose corn syrup (and other forms of empty calories) out of your diet is a smart strategy. And if you currently consume a lot of foods and beverages containing HFCS (like soda pop), cutting down will lead to a reduced calorie intake and weight loss.

But at the same time, don’t be fooled by clever marketing into thinking that just because a food doesn’t contain high-fructose corn syrup, it’s healthy or low-calorie. You still need to check calories and suggested serving sizes and factor these figures into your overall daily intake.

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

First of all, check in with your doctor. Depending on your current fitness level, health conditions, physical limitations, and other factors, certain fitness routines or exercising too aggressively might be dangerous. So check in with your doctor before you start a new fitness plan.

Second, start slow. The worst thing you can do it to try and go from nothing to 100 percent. I see far too many people make this mistake. While it’s true that a woman should aim for 5 hours of physical activity a week and men for 3 hours, I would never recommend you try to do it in the first week!

If you do, you’ll likely end up either discouraged, injured, or both. Instead, try to add five minutes of activity to your day, and when your body adjusts to that, add five more minutes. It’s not only less intimidating, but it helps you gradually build your endurance level and adjust to being more active.

Third, resist the urge to spend a lot of money on a gym membership or fitness equipment right away. Start out by buying yourself a good pair of walking shoes and maybe a new workout outfit. Once you work your way up to walking for 30 minutes at a time, then it’s time to consider joining the gym or buying a treadmill.

Fourth, remember that exercise alone will not solve a weight problem. Make sure you pair your new fitness routine with a sound low-calorie, high-nutrition food plan and counseling to address the psychological and behavioral factors involved in your weight problem.

Finally, remember it’s never too late. No matter how long it’s been or what shape you are in currently, there is always room for fitness in your life.

A perfect example is a man I met when he was in his late 40s who had a BMI over 40. He had not exercised in years and suffered from painful arthritis as a result of his weight. One day after he had lost about 40 pounds, he came into my office happier than I had ever seen him.

When I asked him why, he replied that over the last few months he had set the goal to walk down his long driveway to his mailbox. At first, he took along a lawn chair and walked as far as he could, stopping to rest along the way. Gradually he could go a little further, and a little further.

That morning he had walked all the way to the mailbox and back without stopping! It may not seem like a lot, but it was the start of his journey toward adding fitness into his life. And today, he’s well on his way to losing the excess weight and now walks for more than 30 minutes at a time without stopping.

Like him, you too can start and stick with a fitness routine and begin to live a healthier, fuller life.

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

This year, I’d like to suggest you make keeping off any weight you lose in 2011 your resolution. I like that resolution better than to “lose weight” because losing the weight is only part of the battle—keeping the weight off is really the way to make the resolution mean something.

Think of it this way: Even if you only lose 5 pounds in 2011 and keep it off, it’s better than losing 20 but gaining them all back. And chances are good that once you lose five pounds and keep them off, you’ll keep going.

So what can you do to keep off the weight that you lose in 2011? A lot! Here are my top five recommendations:

1. Take it in small steps: If you have a significant amount of weight to lose, it can seem overwhelming to get from where you are to where you want to be. And because it will take some time, it’s easy to get discouraged and give up if reaching the goal seems too far away. That’s why I recommend that you break the big goal up into smaller goals that are achievable in days or weeks, not months. Then be sure to celebrate your achievements along the way to keep your motivation level high.

2. Think of obesity as a chronic, not acute, issue: Far too many people seem to think of weight loss as a destination, rather than as an ongoing journey. This can lead to people abandoning the lifestyle and behavioral changes they have made to lose the weight, just when they need to stick with them the most to keep it off. This only leads to the lost weight (or more) returning as soon as they return to their old habits. That’s why at The Center for Medical Weight Loss we continue to check in with our patients long after they reach their weight loss goals and encourage them to weigh in on a regular basis, to make sure the weight doesn’t return.

3. Avoid gimmicks: It’s no coincidence that every year a whole new line of “easy” weight loss pills, potions, gadgets, and diet plans come out on January 1 just as people are resolving to lose weight. Don’t get taken. Losing weight isn’t impossible, but it isn’t easy either. So don’t be fooled by these plans to make little more than your wallet lighter! Remember, if a product claims that you need to do “nothing” to lose the weight, it will do exactly that—nothing.

4. Forget quick fixes: It sure would be great if you could lose all the weight you wanted in a very short time, but quick fixes rarely lead to long-term success. So don’t fall for plans that promise “fast results” but could put your health in danger. It took time to gain the weight and it will take time to lose it. Don’t look to some plan where you lose the weight by eliminating whole food groups or eating the same thing over and over as the answer. Chances are very good it won’t be.

5. Have a “Big Picture” plan: Losing weight and keeping it off isn’t a one-size-fits-all solution. It requires a multi-pronged plan of attack to make weight loss a reality. Exercising, eating right, changing old habits, learning new ones, or reaching out for support alone won’t do it, but put them all together and they can work wonders!

Bottom line: You can reach your weight loss goals in 2011 and, even better, you can ring in 2012 (and 2013 and beyond) without those extra pounds coming back! Let The Center for Medical Weight Loss show you how to tackle your weight problem once and for all and live the fullest, healthiest life possible.

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

Unlike appetite suppressants and other existing weight loss medications, Contrave works in a new way by combining two medications currently in use to treat nicotine and other addictions—naltrexone SR and bupropion SR­—into one.

It appears that the medication could help reduce cravings and binge eating episodes in people with food addictions, which affect around 1 in 20 people in the general population, and 1 in 3 in people with a BMI of 40 or higher.

The fact that studies show this medication appears to help people with food addiction gives credibility to the theory that food addiction plays a powerful role in obesity for some people. Like other addictions, food addiction goes beyond “willpower” or “logic” and leads people to engage in self destructive behaviors despite serious repercussions to their health, work, and personal relationships. No matter how much they may want or wish they could stop the behavior, it seems to be beyond their control.

For many of my patients, this seems to be the case. They may know they shouldn’t eat certain foods in the amounts or as often as they do, but they just can’t seem to help themselves. It’s as if ice cream (or whatever the food may be) has them under a powerful spell. A person with a food addiction can’t think it away, or rationalize it away.

There are many theories about why and how addictions develop, but it’s still an area of health we have yet to fully understand. What we do understand is that certain medications, such as the ones contained in Contrave, seem to help reduce the urgency and relentless drive of the addiction in question enough so that behavioral counseling, lifestyle changes, and ongoing support can take hold.

It’s important to keep in mind that taking a medication like Contrave alone will not make a weight issue go away. In studies, participants dropped around 5 percent more weight when taking the medication. It is only when the medication is used as part of an overall medically supervised weight loss program including a medically supervised liquid or high nutrition, low-calorie meal plan, behavioral counseling, exercise, and support that it can really make a difference.

I am also hopeful that the medication might help people who have lost the weight to keep it off because, again, it appears to reduce the frequency and intensity of a food addiction, which does not go away when the excess weight is lost.

As with other addictions, a food addiction is something that one will have for the rest of his or her life. An addiction follows fairly predictable patterns and should be viewed as something that will need to be managed over time as it waxes and wanes rather than as something that will be “cured” once and for all. I tell my patients with food addictions that keeping the addiction in check most of the time is what they should aim for. Unlike other addictions such as nicotine or alcohol, it’s not possible to go “cold turkey” with food and then avoid it forever after.

Compare it to an ex-smoker who was told he or she needs to smoke three but no more cigarettes a day to survive, or to a former alcoholic who must drink three drinks a day but no more, and you can start to see the challenge. But it is possible. We have seen patients with advanced food addiction break the cycle and regain control over their eating habits in our program, and it can happen for you, too.

That’s why I think even though Contrave isn’t a “magic bullet” for weight loss, it could be a great addition to the tool chest we have for dealing with food addiction. Stay tuned to see if the FDA agrees.

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

But it is possible to remain true to your goals during this time. These are some of the things I suggest to my patients during the holidays to help them stay on track:

1. Remember that the holidays only come once a year. In fact, Christmas (or any single day) isn’t the cause of weight problems, it’s how one eats every day that is the cause. Follow the plan most days and you’ll be fine.

2. If you are going to a holiday party, save your calories. Eat filling but low-calorie foods before the event, so you can enjoy a few extra items without blowing your calorie budget for the day. But avoid not eating anything all day – that just sets you up to overeat. Think high bulk, low calorie.

3. Carry along healthy snacks. If you have some fruit, veggies, or a protein bar to eat if hunger strikes while you are on the go, you’re a lot less likely to turn to fast food or some other unhealthy choice as a solution.

4. Don’t give up on exercise because of the added busyness of the season. If anything, you need to be sure to stay active more than ever! The extra calories burned with exercise are a great counterbalance to a few extra snacks here and there this time of year. And remember, exercise keeps your metabolism going strong too, burning more calories 24/7.

5. If you do overeat, avoid playing the blame and shame game. Simply chalk it up to experience and get right back on track. Don’t let all or nothing thinking lead to going off your plan for several days, weeks, or even indefinitely just because you slip up one day.

6. Be prepared for cravings. Overeating or eating certain foods you haven’t enjoyed while on the plan can lead to more intense cravings for a day or two afterward. Expect this to be the case and be ready to recognize but resist. Just stick with your usual plan and the cravings will quickly pass.

7. Avoid depriving yourself. If there is some holiday food that you really want, go ahead and have it (in moderation). Depriving yourself can lead to feelings of resentment that then lead to rebellion against the plan. You’re much more likely to stick to your plan and your goals if you view them as your ally, not your enemy.

Happy Holidays!

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

And it’s not just soda pop, with its high-fructose corn syrup and long list of artificial chemicals, that’s on my list of beverages to avoid, although it’s certainly at or near the very top. It’s no coincidence that the rising obesity and diabetes rates and the introduction and increase in popularity of soda pop follow a similar path on a graph.

Diet soda pops are another on my “don’t” list. They may not contain the same calories as the regular version, but they sure are chock-full of chemicals not found in nature, which won’t help your health or even keep you slim. In fact, in a study done years ago, researchers were amazed to discover that of the mice that were provided water, regular soda, or diet soda to drink along with unlimited food, it was the ones drinking diet soda who gained the most weight because while the drink contained no calories, it certainly seemed to increase the critter’s appetites!

I’m also not a fan of so-called “healthy” drinks like fruit juice. Not just “fruit flavored” juice, which is little more than high-fructose corn syrup, color, and artificial flavors, but also 100 percent fruit juice. I’d much rather see my patients drink water and eat an orange than have a glass of orange juice, which is really the calorie equivalent of eating five oranges minus the filling fiber that would accompany them.

Likewise milk, and certainly anything but skim milk, is another “healthy” beverage in question. Did you know that of all the animals on the planet, humans are the only ones who drink milk past the first year or so of life? And the milk of another species at that! It’s completely unnecessary.

Even flavored or plain seltzer waters are on my “don’t recommend it” list. Flavored ones often contain the same artificial sweeteners found in soda pop, and the carbonation in these beverages stretches the stomach, increasing appetite and cravings.

Unsweetened coffee or tea is ok in moderation, but it’s important to note that the caffeine these drinks contain can stimulate appetite and that both are mild diuretics that have a dehydrating effect on the body. If you must, reach for green tea, which has been linked to increasing metabolism and other health perks.

So what drink do I recommend? If you haven’t guessed, it’s pure, plain water. Water is nature’s perfect beverage, and by the way the only thing any other adult animals drink. So why is it often the very last thing we reach for?

Many of my patients tell me they don’t like the taste of water. For them, I recommend they slowly reacquaint their taste buds to water a few ounces at a time. It really is the fault of clever marketing that we consider water to be the lowliest of beverage options, when in fact it should be at the top of the list.

So if you don’t drink mostly water now, I’d encourage you to make that your goal. Gradually replace your current beverage of choice with H2O until it is the main or even only beverage you drink. Your health, and waistline, will benefit greatly.

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

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The good news is if you do have high blood pressure, losing weight and making lifestyle changes can remedy the issue about 80 percent of the time. The bad news is, if you ignore high blood pressure you could be setting yourself up for some big health problems in the future.

But first, what is high blood pressure and why is it so bad for you?

High blood pressure is similar to what happens when you put your thumb over a hose to make the water spray out. The constricted opening causes the liquid inside to come out with more force, or pressure.

When this is happening inside the body, the added pressure causes the heart to work harder and harder to pump blood, which is what circulates nutrients and oxygen to all of the cells of the body. As a result the heart becomes enlarged, gradually increasing in size. Over time, the heart becomes so big that the increased size causes the ventricles to collapse, a condition known as congestive heart failure. At the same time, the added pressure within the blood vessels leads to weakening of the walls of arteries and veins and can damage the delicate vascular structure in vital organs like your kidneys and eyes.

High blood pressure is often called “the silent killer” because while people don’t feel sick when they have high blood pressure, it’s nonetheless silently damaging their heart, cardiovascular system, kidneys, and other organs. In fact, many people can have high blood pressure for years, or even decades, without knowing it. But all that time, the damage described above is accumulating.

Excess weight and too much sodium in the diet are two prime causes of high blood pressure. That’s why losing weight and cutting back on salt intake can lead to big improvements.

The medications usually prescribed for high blood pressure can actually contribute to weight gain by stimulating appetite and reducing energy levels. Likewise, the diuretics (water pills) often prescribed in combination with high blood pressure medications can cause dehydration and lead to muscle loss and a slower metabolism.

That’s why we review the medications each patient is taking when they begin The Center for Medical Weight Loss (CMWL) program. Changing high blood pressure medications while the excess weight is lost can help alleviate these added factors complicating weight loss.

As weight comes off, we also monitor a patient’s overall health including his or her blood pressure, adjusting medication dosages as needed.

A case in point was a 33 year-old-man who had a BMI of 40 and was on a combination diuretic and high blood pressure medication when he came to see me. We switched his medication to one without a diuretic and he started the CMWL program. Within one week he had lost 10 pounds and over the next few weeks lost another 20. After those initial 30 pounds were lost, he was able to stop taking his high blood pressure medications altogether because the problem was gone! That quick and dramatic turnaround spurred him on to continue with the program and lose the rest of the excess weight, and today his blood pressure is completely normal — and he feels and looks great, too.

His experience is a perfect example of how a medical weight loss approach not only focuses on weight loss, but on improving the patient’s overall health picture, as well.

So if you haven’t had your blood pressure checked in some time, do so soon. And if you have high blood pressure, I’d urge you to do all you can to address the root cause — often excess weight and salt intake — so you can cross this serious health risk off your list of things to worry about now and in the future.

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

It’s something I think about all of the time, and here is what I believe: Like obesity itself, there are multiple causes that together add up to create the crisis.

One factor is the increasing trend toward eating out at traditional or fast food restaurants instead of eating meals at home. Likewise, when we do eat at home, it’s more often a pre-made, processed convenience meal than something prepared from scratch. In both cases these types of foods often contain far more fat, calories, salt, and sugar than meals prepared the “old-fashioned” way.

In fact, if you were able to peek into the kitchens at most restaurants, what you would find may just spoil your appetite! There’s a reason these foods taste better than food cooked at home – and the reason is often because the seemingly healthy stir-fried veggies were cooked with a half stick of butter, the grilled chicken was dipped in oil first, or the egg white breakfast burrito was fried in pure bacon fat!

Restaurants are also serving much larger portions of foods than they have in years past, hoping to out-serve their competitors and at the same time justify the higher price of eating out. In some cases a single meal can contain 2,000 calories or more – more than someone should eat all day, much less in a single meal.

Our tendency to choose sedentary activities like eating out or watching movies instead of more physical activities like going for a walk in the park or playing sports is also contributing to the obesity epidemic. Today many people spend most of their day sitting at a desk, followed by spending their free time sitting in restaurants, movie theaters, or on the couch. Unlike when we were children, activities like video games and surfing the Internet now replace old pastimes like playing tag or roller skating around the neighborhood.

Our commuter society is also playing a role. Today most cities and communities are designed so that you have to get everywhere by car, bus, or subway rather than by biking or on foot. Many people spend an hour or more in their cars going to and from work every day, time they could otherwise spend being active.

Likewise, the way we live has changed over the past few decades but our genes have not. In the no-so-distant past, humans had to spend most of their waking hours engaged in physical pursuits just to survive, and one had to expend as many calories either hunting or farming their food as the food itself contained!

Few people live this way today. Instead most people trade their time and mind for money they earn at a sedentary job that they then use to buy the plentiful and calorie-dense foods they eat and to pay for their shelter and basic necessities. For example, chopping firewood, which burns about 400 calories per hour, has been replaced by flipping a switch, which takes hardly any effort at all.

So if how the world is changing is causing the obesity problem, what’s the solution? Start by doing all you can to counter the trend. Cook meals from scratch and at home. Pack your lunch. Limit the number of times you eat out every week to two meals or less. Park as far as you can from the door in parking lots, rather than in the closest spot. Take the stairs instead of the elevator. Skip the movie this weekend and go for a hike instead. All of these small changes can really add up!

In short, society isn’t changing fast enough or in the right direction to prevent obesity, but you as an individual can make the changes needed to lose weight and keep it off.

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

So is this the end of the obesity problem? Will weight issues become a thing of the past? Hardly, and here’s why.

Lap bands work by constricting a person’s ability to swallow a lot of food at one time, forcing a person to eat smaller bites and more slowly. If they don’t, it can lead to vomiting. The restriction is achieved by placing a band around the entrance to the stomach and then “tightening” or “loosening” the band by injecting or removing saline solution within it to achieve the desired constraint.

The band is put in place laparoscopically, under general anesthesia, and requires the patient to spend a day in the hospital. After the surgery, follow-up visits every few months are required to manually adjust the saline levels within the band for the first several years. Even after the desired weight loss is achieved, the band remains inside the patient’s body and the port used for the saline adjustments can be felt just under the skin.

Like any surgery, lap band surgery carries risks including possible reaction to anesthesia and infections, as well as an ongoing risk of excessive vomiting, trouble swallowing, and other complications. One patient I met following his surgery had severe infections that required skin grafts and over a year of hospitalization, and other people have died from complications of the procedure.

Another thing to consider: Because the bands have only been in use for about 10 years, it is not yet known if they will need to be removed or replaced over a patient’s lifetime.

Also, weight loss is not a guarantee even with the band. If a patient does not change his or her lifestyle or eating behaviors that led to the weight problem, it is likely to continue or return after the initial weight loss, even with the band in place. Most of the time, the surgery is not accompanied by advice on behavioral modification or counseling for the psychological roles at play in overeating, so the patient is not equipped to deal with these changes.

Finally, there is the cost of the procedure, on average $15,000, which is currently not covered by insurance in most cases.

To me, all of this seems like an unacceptable amount of risk to take if what you are trying to do is lose 30 to 40 pounds, which is about the amount of weight someone with a BMI between 30 and 35 would need to shed.

Earlier in my career, I would often see patients who would come to me to have their bands adjusted after having had the procedure done elsewhere. Over and over what I saw was that the band had not provided the quick and easy weight loss solution they had hoped it would, the core issues that had contributed to their weight problems remained, and that many were unhappy with the results of the surgery, the restriction of their ability to swallow, and how the choice they had made had forever changed their lives.

The truth is a person could lose just as much weight, just as quickly, by following a medically supervised weight loss program that includes a high nutrition, low-calorie eating plan, behavioral modification, physical activity, and counseling to support the healthy lifestyle changes. And all of this could happen minus the risks to one’s health the surgical path includes.

In fact, on The Center for Medical Weight Loss’s program, a person with a BMI between 30 and 35 could reach their goal weight in as little as 8 to 12 weeks!

Of course there are circumstances where I would say having bariatric surgery is medically appropriate, and I do sometimes recommend it. That would be when a patient has a BMI of 35-40 or more, has horribly uncontrolled diabetes or high blood pressure, and has already tried and failed several times to lose the weight with a medically supervised program.

But in most cases, there are better options. So don’t be fooled: Lap band surgery is not a quick or easy fix.

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

See more of Dr. Kaplan’s thoughts on weight loss surgery on Woman’s Day.

Of course, even this man would not recommend anyone actually try to lose weight this way, but it is interesting and does reinforce the role calories play in weight gain and loss.

However, it’s not just how many calories one eats that matters when you look at weight loss from a health perspective, but also where those calories come from. I highly suspect eating nothing but Twinkies (or any nutritionally poor food such as fast food or junk food) for an extended period of time could lead to health problems like cancer. And of course, if one already had diabetes or pre-diabetes, eating a diet made up of nothing but Twinkies would be downright hazardous.

The goal of any good weight loss program should be not only weight loss but long-term success. At The Center for Medical Weight Loss, we take a multifaceted approach that combines a nutritionally rich, low-calorie diet plan with exercise, behavioral counseling, and, when needed, medication to ensure that our patients learn how to overcome their weight problems for good.

In fact, if someone absolutely feels that eating Twinkies is important to their leading a happy life, I will work hard to figure out a way that he or she can have a Twinkie (or whatever the food may be) once or twice a week.

That’s because I’ve never believed in diets that rely on eliminating any particular food or groups of food forever. I’ve found that if people know they can have the foods they like every once in a while as part of an overall healthy diet, they are much more likely to stick with the program and avoid feeling deprived or like they need to “sneak” foods or binge.

Remember, moderation – not elimination – is the best approach to having your Twinkie and losing weight too.

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

Obesity has a multifactorial effect on your health. Being obese can contribute in one way or another to diseases affecting all of the major systems and organs in the body. In fact, obesity can increase the risk of more than 50 health conditions including:

Cardiovascular problems: Hyperlipidemia, cor pulmonale (pulmonary heart disease), congestive heart failure, enlarged heart, varicose veins, pulmonary embolism.

Endocrine problems: Polycystic ovarian syndrome, menstrual disorder, infertility, adult onset (type 2) diabetes mellitus and its related complications like neuropathy, renal failure, extremity amputations, and blindness.

Gastrointestinal problems: Gastroesophageal reflux disease (GERD), fatty liver disease, gallstones, hernia, colon cancer, liver cancer, gallbladder cancer, rectal cancer, stomach cancer, esophageal cancer.

Kidney, urinary, or reproductive problems: Erectile dysfunction, urinary incontinence, chronic renal failure, hypogonadism, breast cancer, uterine cancer, cervical cancer, endometrial cancer, prostate cancer, infertility.

Skin and appendage problems: Stretch marks, lymphedema (swelling in arms or legs caused by a blockage in the lymphatic system), acanthosis nigricans (hyperpigmentation of the skin), cellulitis (a noncontagious spreading bacteria skin infection), carbuncles (pus-filled bumps that form under the skin), intertrigo (an inflammation of skin folds), wound infections.

Musculoskeletal problems: Immobility, hyperuricemia (excess uric acid in the blood), osteoarthritis, low back pain.

Neurologic problems: Stroke, meralgia paresthetica (compressed nerves in the outer thigh), headache, carpal tunnel syndrome, dementia.

Respiratory problems: Dyspnea (difficulty breathing), obstructive sleep apnea, obesity hypoventilation syndrome (also called Pickwickian syndrome, when poor breathing can lead to lower oxygen levels and higher carbon dioxide levels in the blood), asthma.

Psychological problems: Depression, low self-esteem, body dysmorphic disorder, social stigmatization.

As you can see, the argument could be made that obesity can contribute to almost all disease. It also seems to speed up the aging process, meaning that diseases occur sooner than they would have otherwise.

The good news is that even if you’re already experiencing health problems from obesity or if you have been overweight for some time, it’s never too late to lose weight and improve your health.

In fact, in many cases, losing weight may be all that is needed to eliminate the problem, and the need for any related medications or treatments. Just a 10 percent weight loss (20 out of 200 pounds), for example, can reduce the risk of diabetes or high blood pressure by as much as 80 percent!

A perfect case in point was a man I first met when he was in his late 40s and weighed in excess of 500 pounds. At that time he was on 19 prescription medications, had multiple health problems, had been house-bound for more than two years, and could not walk further than 4 feet at a time on his own.

He wanted bariatric surgery, but because of his weight and health problems we decided he needed to lose weight first, so we put him on The Center for Medical Weight Loss program. Just 15 months later, he’s not only lost 250 pounds without surgery, he’s off 15 of his medications, and can now walk ¼ mile without stopping! He tells me he feels like a whole different person and that his life has changed for the better.

So no matter what your weight or what health problems you may have as a result, just like him you can turn your health around simply by losing the excess weight.

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

I strongly disagree. While I do support possibly dangerous medications being taken off the table, I by no means think we should completely abandon the search for a possible pharmaceutical solution to the obesity epidemic.

Consider, for example, if science had given up on searching for safer and more effective treatments for cancer after the first few tries. Or if the search for a solution to diabetes had been declared an impossible task.

In a similar way, I think the future still holds immense promise for the development of new medications that could help those who struggle with their weight. It’s important to remember that like cancer or diabetes, obesity is a medical condition – a disease. So while diet and exercise will always play a key role in weight management, for some they alone are not a solution. In these cases, looking to science for additional help just makes sense.

Obesity occurs for many complex reasons we are only beginning to understand. One of these seems to be simple genetics. Some people just seem to gain weight more readily and hang onto fat stores better than others. In fact, in the not-so-distant past when famine and food scarcity were common facts of life, having the ability to gain weight and hang onto it was actually a genetic advantage.

But in 2010, that’s no longer the case. The same genes that were once a benefit are now, in the face of an easily accessible food supply and a sedentary lifestyle, a negative. People are dying today from too much food, not too little. Oh, the difference a few hundred years can make!

For others, gaining weight is not so easy, also for equally complex reasons we are just beginning to understand. For example, “naturally thin people” often have larger stores of a type of fat called brown fat. This fat seems to fuel metabolism. Imagine if science could somehow help those with a natural tendency toward weight gain to increase their brown fat stores, for example. Weight problems could become a thing of the past.

While we are a long way from there yet, it only makes sense for us to continue to look for ways to manage these genetic pathways and fight a disease that is affecting almost one in every three American adults. We physicians need as many tools as we can possibly have in our tool chest.

So while it is unfortunate that we’ve had a bad run lately when it comes to weight loss medications, I feel it would be irresponsible and even foolish for us to throw up our hands as a medical community and stop searching for solutions to a serious health problem so many are facing.

We can and we must continue to look for answers. And I believe they will come. In the meantime it’s time to let go of shame and blame and to treat obesity like the medical condition it is. By doing so we will be taking an important first step toward ending the obesity epidemic.

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

The holiday season can be a trying time for those who are losing weight, and perhaps no holiday is loaded with more food traditions than Thanksgiving.

I am of the philosophy that the holidays only come once a year, so I don’t advocate a strict no-participation approach. However, you also want to be sure that celebrating and enjoying one day doesn’t turn into going off your medical weight loss plan until after the New Year!

In general, if you are following any sort of weight loss program, it’s critical that you have a very strong plan in place going into the holidays to ensure you don’t lose sight of your goals.

For example, I’d recommend bringing one or two healthy dishes to any gatherings – perhaps some shrimp cocktail and a vegetable tray with low-fat dip. That way, you have at least a few dishes you know you’ll be able to turn to during the event.

In general, I’d recommend those actively losing weight to avoid the carb-loaded options (potatoes, stuffing, gravy, and desserts) if possible, or to keep portions to just a little bit. Reach mostly for turkey, vegetable side dishes, and fresh fruit for dessert.

If you are in medical weight loss maintenance mode, you can relax a bit more. Perhaps have a little of everything but again, keep it in moderation.

Remember to eat slowly and mindfully. Try not to make food your focus. Look to other things about the holiday to bring joy, such as visiting with family and friends. After all, part of life is making room for celebrations.

No matter what, you just want to make sure you get right back to business as usual the next day. If you do overeat, don’t let yourself slip into guilt or shame. Expect that the next day or two following the holiday could be more challenging if you’ve stretched out your stomach or eaten foods that may trigger further cravings. But be strong! Within a day or two this will pass and you’ll be glad you didn’t abandon your goals.

Remember, weight problems don’t come from one day. They come from the pattern day after day. So even if you do eat more than you planned, the key is not letting it become a trend. Simply chalk it up to being human and refocus on your goals.

Lastly, I’d recommend you take a low-key approach when it comes to talking about your diet with others during the day. Sometimes this only draws attention, scrutiny, or uncomfortable discussions you may not want. It’s possible that if you don’t mention it and just stick with your goals, others won’t even notice what or how much you’re eating (or not eating!).

Happy Thanksgiving!

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

Some 2,000 Dallas-area study participants were shown images ranging from heavy to thin, and were asked to choose which they felt most closely matched their own body type as well as which they felt was most appealing. Researchers expected most to choose the “ideal weight” images – but were surprised to find that close to one in 10 people chose the photos that were on the plus side.

Now don’t get me wrong. I think people feeling good about themselves and accepting their bodies is a good thing. But when that acceptance includes being at a weight that increases their risk of serious long-term health problems, I think that goes beyond having a healthy body image and into denial.

So while two out of three American adults are overweight or obese and being heavy is in many ways “the new normal,” it’s important to keep in mind that there is a lot of good science that establishes obesity as being clearly unhealthy.

For starters, obesity has been linked to an increased risk of diabetes, heart disease, stroke, breathing problems, gallbladder disease, arthritis, certain cancers, and increased risks during pregnancy, and has been clearly linked to a reduced life expectancy, among other negatives.

Think of it as not unlike the time when smoking cigarettes was common and even fashionable. Just because “everyone else was doing it” didn’t change the fact that tobacco use may lead to lung cancer, emphysema, and other major health problems.

I do think it is important to remember that body weight and body mass index (BMI) only tell part of the story. Body fat is an equally important part of the equation. Super fit and muscular athletes, for example, can often register by weight and BMI alone as obese. However, I don’t think the subjects of this study were looking at images of body builders.

So while it’s true that in our society being overweight is quickly becoming more common than being at average body weight, that doesn’t mean that this is a healthy step forward for individuals or society. Our sedentary, fast food eating ways are not an advance!

Bottom line: There is nothing more valuable than good health. Being obese shortens one’s lifespan and can also lead to a greatly reduced quality of life, without a doubt.

So if you’ve been feeling like obesity “isn’t so bad” or that “everyone else is overweight, why should I worry about it?” think again. Just like tobacco use lead to cancer no matter how accepted it was, being obese will more likely than not lead to serious health consequences.

So while it’s important to remember that your weight doesn’t define who you are or your value, it can be dangerous nonetheless. You owe it to yourself and those you love to strive to be as healthy as you can.

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

The answer to both is, “Yes.”

Unlike food allergies (like the well-known peanut allergy) that can lead to acute reactions like difficulty breathing, food sensitivities are much more subtle and are related to a part of the immune system we don’t fully understand.

With a food sensitivity, the body reacts to certain foods with inflammation when the food enters the digestive system. Symptoms can vary but can include digestive distress, headaches, and fatigue. But because we eat some 20 plus foods each and every day, figuring out exactly which one may be causing the problem can be difficult or impossible on one’s own.

That’s why patients at The Center for Medical Weight Loss who complain of symptoms that may indicate food sensitivity are given a simple blood test that looks for an inflammatory response between dozens of common foods.

Often, we’ll discover these patients indeed have a reaction to a food or foods they’re eating on a regular basis, many times even a “healthy” food. The test also reveals an extensive list of “safe” foods that don’t cause a reaction. From there, we can tailor the patient’s diet plan accordingly.

Now it’s important to note that we don’t believe that eliminating foods one is sensitive to will on its own lead to weight loss. But knowing which foods one is sensitive to can help.

In fact, I myself am a case in point. For years I was unable to get my body fat percentage under 20 percent, even with careful attention to diet and exercise. In addition, I struggled with abdominal pain that had been diagnosed as Crohn’s disease and had been taking powerful medications for more than nine years.

Then, a food sensitivity test revealed I was highly sensitive to tomatoes and grapes of all things! Lo and behold, I often ate tomato-based sauces and fresh tomatoes as well as enjoyed the occasional glass of wine.

After I eliminated these foods from my diet, I was able to reduce my body fat percentage to 15 percent and my abdominal distress was also eliminated to the point that my doctor said I could stop taking the medication within a matter of months. That was over a year and a half ago now, and I am happy to report that the stomach problems that plagued me for years have not returned!

Interestingly we’ve found that when we eliminate foods a person is sensitive to from their diet for several months, they often “lose” the sensitivity and can then resume eating the foods that formerly caused them problems. Likewise, new sensitivities can develop, which are identified with new testing every so often.

In addition to improving one’s overall health, I also believe that knowing what foods one is sensitive to helps in weight loss and control simply by increasing awareness of what one is eating, and forces a person to examine ingredient lists much more closely.

So if you have been struggling with abdominal pain, fatigue, migraines, or other symptoms, a simple food sensitivity test may be just the ticket to feeling much better and getting your diet on the right track.

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

I find the news truly alarming, if not surprising, considering the nation’s obesity rates and lifestyle habits, and I hope that we will collectively take action to prevent this prediction from coming to pass.

Type 2 diabetes, sometimes called adult-onset diabetes, is a largely preventable disease. More often than not, its onset is triggered by excess body weight, lack of exercise, and a diet filled with empty calorie, highly processed foods. Unfortunately, there three factors describe the typical American experience far too often.

Type 2 diabetes is a horrible condition to live with, and it is linked to much more than imbalanced blood sugar levels. People with diabetes are at a 10 times greater risk of having a heart attack or stroke, as well as much more likely to suffer from diabetes-related complications like blindness, kidney failure, a weakened immune system, wound infections, and otherwise preventable limb amputations.

The illness takes a horrible toll on individuals and society as a whole in increased illness, medical costs, days off work, and more. Luckily, it’s not too late to change the direction our nation’s health is heading, but it will take effort on all levels to make that happen: government, employers, school, and individuals.

For example, government could help by encouraging existing and developing cities to be more bike- and pedestrian-friendly, so physical activity could easily become part of someone’s day rather than another thing to schedule in. Likewise, increased taxes on unhealthy foods might help encourage people to make healthier choices in much the same way as additional taxes on tobacco products have prompted many smokers to finally quit.

Employers could help by providing on-site gyms or gym memberships to employees. Changing and shower facilities on site would also help make biking, walking, or jogging to work more possible. Employee programs that reward smart lifestyle choices could also help.

Schools could help by making sure cafeterias and vending machines offer students nutritious, high-quality food instead of junk food. Physical education programs could be expanded, rather than cut. Parents could get involved to make sure their child’s school is promoting healthy lifestyle choices.

And finally, individuals could help by taking charge of their health and lifestyle to either prevent diabetes from developing or to do all they can to manage it and keep it in check if it does. At The Center for Medical Weight Loss, we guide our patients with diabetes and those on their way to developing it toward this path every step of the way.

Once someone has diabetes, it can’t be reversed but by losing weight, sticking within the recommended calorie intake, and adding physical activity to his or her daily routine, it can be managed with diet and lifestyle rather than with medications. In fact, 8 out of 10 people with type 2 diabetes could manage their condition with lifestyle changes and weight loss, saving money on medications and avoiding possible side effects as well.

In short, this report is a call to action that our culture needs to take very seriously. How about you? Do you or someone you love have diabetes? One in four people with diabetes don’t even know it, leaving them at serious risk for a dangerous progression of damage. I challenge you to take charge of your future health today, before it’s too late. You don’t have to become a statistic.

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

The DSM4 lists multiple criteria for diagnosing food addiction, but if you would answer this question, “If you have a favorite food in the house when you go to bed at night, do you feel like it’s calling to you?” with a “yes,” it’s likely that you may be.

About 5 percent of the general population suffers from food addiction. For those with a body mass index (BMI) over 40, the number jumps to 33 percent.

Like other addictions, a food addiction never goes away completely. But with the right support and conscious effort, it can be controlled most of the time. Unlike other addictions such as tobacco, alcohol, or drugs, it isn’t possible to break the addiction by going “cold turkey” and avoiding food altogether for life. That approach simply isn’t possible!

At The Center for Medical Weight Loss, we help patients suffering from food addiction in multiple ways. First, we help these patients recognize and accept that they have a problem with food. Next, we help them lose weight to minimize their cravings driving the addiction. Third, when needed, we turn to tools like appetite suppressants and meal replacements to help the patient regain control over the role food plays in his or her life. And finally, we help our patients avoid tempting situations and learn to cope with emotions in ways other than eating and provide ongoing support as they make these big changes.

As discussed before, one of the biggest challenges of food addiction is that food isn’t something you can avoid entirely. So it takes extra effort and support to learn to manage your relationship with food in a new way. The best that we can hope for is that 90 percent of the time, the food addiction will be under control. And when it isn’t, it helps to have someone to turn to who really understands food addiction and a place to fall back on to get back on track, like we provide our patients at The Center for Medical Weight Loss.

It’s important for people with food addiction to remember that there will be occasional setbacks or relapses, and that when they do occur the solution is not to give in to depression, guilt, and shame and continue, but to reach out and ask for help getting back on track.

A case in point is one patient I started seeing when he was 44 years old. He had a BMI in the 60s and his weight had been out of control for years. He revealed that he was addicted to milk and milk products and was drinking 6 to7 gallons of whole milk a day. We traced his addiction back to childhood experiences where he soothed his emotions related to living in an abusive family by turning to milk and cake. When he developed type 2 diabetes, he gave up the cake but continued to drink milk in excess. Today he is 50 years old and has a BMI of 35. He avoids milk and milk products entirely, and walks on a treadmill every day as a new way to cope with stress and difficult emotions.

Like him, you too can break free from food addiction. But don’t try to go it alone. Get support from a medical expert who truly understands food addiction and how to control it, and who will continue to support you as you face future challenges.

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

Of course, in times when humans lived as hunter-gatherers and a steady supply of food was never a guarantee, this mechanism worked very well in helping one survive until the next meal could be found or caught. In fact, at one time, being able to gain weight quickly and hold onto it was a distinct genetic advantage!

Of course today, thanks to supermarkets, drive-thrus, and other conveniences, finding food isn’t quite the challenge it used to be. But unfortunately, our genetic programming has not adapted to this new environment and is still operating under the assumption that food is scarce and difficult to come by. So the very same genes that once worked in our favor today work against us when it comes to losing weight.

While we can’t change this ancient programming, understanding this natural cycle is one key to understanding how to lose weight and keep it off and is a major focus of The Center for Medical Weight Loss philosophy. Our goal is to understand and work with the body’s natural tendencies, as well as outsmart this “prehistoric” genetic programming that remains, to help people lose weight safely, successfully, and permanently.

That’s why I am so excited by the results of a recent study that found the same ingredient in hot peppers that makes our palates burn may also help boost metabolism! The supplement, called Capsiate Natura and manufactured by Ajinomoto Co., contains a compound found in hot peppers known as dihydrocapsiate. Research showed that when the prescription-only supplement was taken as directed, it could increase the metabolic rate enough to burn an extra 50 calories a day.

At first glance, 50 calories may not seem like much. And if one planned to take only the supplement and do nothing else, it wouldn’t be a very effective weight loss approach.

But, when combined with a plan that reduces calorie intake, the metabolism-boosting effect of the supplement could not only aid in weight loss, but may also help offset the body’s natural tendency to slow the metabolism in response to a reduced calorie intake. Additionally, it could be useful in the maintenance phase to prevent weight from creeping back on. And I think that’s very exciting!

How? Let’s take a big picture view. Over the long term, those added 50 calories a day burned can really add up. For example, in one month those calories add up to one half pound. In one year, that’s six pounds! So that’s an additional six pounds of weight loss or prevented regain one could achieve by adding this weight management tool to an overall medical weight loss plan.

Other studies have linked increasing the amount of hot peppers in one’s diet to a similar effect, but unless you have a cast-iron stomach and a taste for fiery foods, it’s unlikely you’d be able to eat the equivalent of the 10 hot peppers a day’s worth of the compound the supplement contains.

Likewise, over-the-counter hot pepper supplements aren’t processed in the same stomach-soothing way as the prescription supplement and can lead to digestive distress. And because over-the-counter supplements aren’t regulated by the FDA, how much of the ingredient they actually contain, if any at all, is not guaranteed.

For both these reasons, I believe and often recommend Capsiate Natura as part of the overall weight management program for my patients to purchase.

Again, weight problems are multifaceted, and there will never be one magic solution, pill, or potion that effortlessly melts the fat away. We may not like it, but the reality is people with a genetic tendency to gain weight will always have to work hard at fighting this programming. But with the right tools like this supplement and a medically proven weight loss program that works, physicians like myself can help even the most genetically “challenged” weight gainers face this ancient but outdated programming and win the battle of the bulge!

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

It’s called body composition, and it’s something we pay very close attention to on The Center for Medical Weight Loss program. In fact, it’s one of the first things we determine when someone starts the program, and it’s something we track closely every step of the way. Why? Weight loss is about a lot more than the numbers on the scale. By taking a bigger picture approach we can help make sure it’s fat that people are losing, not water weight or muscle.

With many diet programs, especially ones where the weight comes off quickly but comes back on just as fast, what’s really being lost is water weight and muscle. Muscle loss is especially bad because muscle tissue takes five to 10 times the amount of energy to maintain as fat does. Or, in other words, the more muscle you have, the more calories your metabolism burns every minute of the day whether you’re exercising, sleeping, or even reading a book.

In reverse, if one loses muscle and water when dieting, their body fat percentage is actually increasing, and since fat takes less energy (a.k.a. calories) to support than muscle, the result is a slower and slower metabolism with each dieting cycle. Think of it as losing all the wrong kind of weight.

For many of my patients, understanding the role body composition plays in weight loss helps them to break free from the yo-yo diet cycle for good. For example, one woman who came to me had gained a lot of weight after menopause. Despite trying several programs where she lost the weight, she had been unable to keep it off. When she understood that she actually needed to focus on losing fat while preserving muscle, she started to look at everything differently. It wasn’t just about what she was eating anymore, it was suddenly about diet and exercise. Once she added daily movement to her routine, she found the weight not only came off, but it has stayed off. She finally understood how important it is to be physically active to prevent long-term fat accumulation.

Preserving muscle tissue as one ages is especially important for weight management because it becomes more and more difficult to build muscle tissue past the age of 30 years old. Since it is so difficult, and sometimes impossible, to increase muscle tissue after that, it’s even more critical to make sure your weight loss program isn’t reducing the muscle mass you have.

Another reason to pay attention to both the weight lost and where it’s coming from is because with any program that cuts calories, the body’s natural response to dieting is to react as if there is a famine – slowing down metabolism and doing all it can to hang onto fat stores. While this may have served our ancient ancestors who didn’t have access to our steady and plentiful food supply, it works against us in our modern struggles with weight.

We’re always tracking where the weight loss is coming from in The Center for Medical Weight Loss program. Our number one goal is always to reduce overall body fat, not just pounds. That’s why we monitor body composition so closely, and all of our programs are formulated to promote fat loss, not muscle loss. Over the long term, losing fat while preserving muscle is the key to breaking the yo-yo dieting cycle and keeping the weight off for good.

So remember, it’s not just how much you lose, it’s also where that loss comes from that matters.

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

Here’s the gist of the studies, which were published in Nature Genetics: One reviewed 46 previous studies on the topic of genes and weight and found 18 new genetic regions associated with BMI (body-mass index), as well as confirmed 14 genetic regions previously linked to metabolism, appetite, and other weight gain factors. The second study reviewed 32 previous studies and found links between 13 genes and a genetic tendency to gain weight around the abdomen, which greatly increases risk of  metabolic syndrome and conditions such as heart disease and diabetes. The bottom line of both studies: The more of these genes a person had, the more likely he or she was to struggle with weight.

I’ve definitely seen examples of these findings in real life. For instance, one medical student I knew would eat a huge breakfast, followed by five slices of pizza for lunch, and then an enormous dinner. And yet I noticed despite his calorie intake he never seemed to gain an ounce.

Likewise, I have had patients who were very overweight, but claimed to not eat much more than others in their family, like siblings, who did not have a weight issue. When monitored it indeed proved to be true. Despite their similar environment and eating the same foods at every meal, one person would gain weight while another didn’t.

Another patient I knew reported her weight started to skyrocket at puberty. When we examined her more closely, we found that she had a very large non-cancerous ovarian tumor that was wreaking havoc on her hormones. After surgery to remove the growth, her body weight dropped dramatically.

The bottom line is that calories and activity level are just two factors of many that determine a person’s body weight. Other studies have found that a person with one obese parent has a 40 percent higher chance of being obese. Someone with two obese parents has an 80 percent greater chance.

So what does this mean if you happen to be one of those people who seem to gain weight more easily than others? Should you just give up and accept your fate? Is it inevitable that you will gain weight no matter what you do? Absolutely not! But it does mean that like anyone with a genetic tendency toward a certain medical condition, you will need to be extra vigilant about monitoring your health and take steps to avoid your genetic predisposition getting the better of you.

One just needs to look at other genetic conditions for a case in point. A small number of people have a genetic tendency toward extremely high cholesterol levels. If they took no steps to manage their condition, by the time they were in the 20s they could already be suffering life-threatening heart disease and would almost certainly die at a young age. Yet, if these same people knew early on of the risk and took steps to manage their cholesterol along with close medical supervision and medication if needed, they could control their cholesterol levels and lead a long and healthy life.

That’s why I feel it is so critical for people to recognize obesity as a medical condition. They need to let go of stigmas that say it’s about lack of willpower or some kind of personal shortcoming, and to stop risking their health with diet plans that offer a temporary quick fix but don’t really address the core issues. Like any chronic health condition, obesity can be managed with the proper medically supervised diet and exercise program combined with medical treatment for any underlying health or hormonal issues that may be playing a role in weight gain.

So no matter how many times you have tried to lose weight, don’t lose hope. But also, don’t try to do it alone. Just like you wouldn’t try to treat heart disease on your own, you shouldn’t try to tackle a complex and possibly life-threatening health problem like obesity yourself either.

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

First, unlike weight loss plans that take a one-size-fits-all approach, a medically based weight loss program is tailored to each individual patient’s needs and health circumstances. For instance, I recently saw a patient who, despite following a commercial weight loss program, was gaining weight every week instead of losing it. I was able to diagnose a slow thyroid in this patient that was affecting her metabolism and ability to lose weight.

I also saw a second patient in recent weeks who could not lose weight on her own despite not having a history of overeating or abusing food. We determined that she had polycystic ovarian syndrome, which was slowing her metabolism. With prescription medication treatment geared toward the hormone imbalance, this patient has successfully lost 31 pounds in 7 weeks time. She is still under my care and, happily, has been losing an average 3+ pounds weekly since treating the metabolic abnormality.

One of the first steps in medical weight loss plan is a complete medical workup that answers such important questions as:

• Are hormonal levels in balance?
• Is there possibly an underlying medical condition causing the weight gain?
• Are the medications this patient takes for other medical conditions playing a role?
• Could a food sensitivity be to blame?
• Are there genetic factors at play?
• Does the patient have behavioral patterns that need to change? and so on.

Second, medical weight loss approaches obesity as a chronic health condition that can be managed, treated, and monitored over time. The goal isn’t simply to lose a certain amount of weight as quickly as possible; it’s also to address the core underlying issues that are contributing to the weight issue so that the weight loss happens safely and permanently.

Weight gain and loss are much more complex than just eating certain foods or exercising a certain amount of time each week. While medical weight loss will include a nutritional and fitness plan, it goes far beyond that to include big picture solutions to the genetic, medical, and behavioral factors contributing to the patient’s weight gain (and loss) as well.

A third key difference of medical weight loss is that as medical professionals, we doctors have access to tools, such as appetite suppressants, that can make losing weight and keeping it off easier and much more effective. We’re also armed with the latest information on research into the complex causes and treatments for obesity and weight problems.

A fourth difference is the amount of ongoing support, monitoring, and one-on-one individual attention a medical weight loss program provides before, during, and after the excess weight is lost in a safe and controlled way. Routine check-ups once the program is successful assure that any future weight gain is caught and addressed early – before it becomes a threat to the patient’s health and well-being.

Finally, for patients whose weight is playing a role in other health conditions such as diabetes or heart disease, a medically supervised program provides close connection and communication between the medical weight loss doctor and all of the other medical professionals the patient may see. They can communicate about the patient’s overall health management plan, assuring that it’s all working together toward the goal of improving the patient’s health now and in the future.

When all of these factors are taken into account, it’s clear that a medical approach to weight loss provides advantages unavailable with any other weight management plan – and can succeed where other weight loss plans often fail.

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

We all get stuck in patterns. It’s a part of life. We have to make choices about how we live, including what we do for a living, how we dress, how much we exercise, and what we eat. The familiarity of those choices, whether they’re good or not so good for us, provides some level of comfort and consistency in our lives.

But let’s talk about the not-so-good choices for a moment. Many of these choices are contributing to the overweight and obesity epidemic in America, which in turn are leading to illness. We can stop this pattern, but it requires getting started on a new path. I know, it’s not easy! But it’s necessary, and I think you will find it very personally fulfilling in the end.

Consider the story of one of my patients. He was a CEO and also owned his own private accounting business, and definitely would be considered a workaholic. After his initial visit to The Center for Medical Weight Loss, we predicted that this patient would lose at least 3 pounds a week on our medical weight loss program.

The patient followed my recommendations concerning food and exercise, but was only losing ½ a pound a week. Then the accounting season ended, and he went on a cruise vacation – where he lost 5 pounds that week! It was, of course, very curious that the patient lost so much weight while on vacation – especially on a cruise, where people often overeat and may gain weight.

What caused him to actually lose more weight on vacation? We determined that in his regular life, the patient only slept about 3 to 4 hours a night – but on vacation, he was sleeping 8 to 9 hours a night. His normal lack of sleep was changing the hormonal make-up of his body, causing weight gain as well as lack of ability to lose weight.

Though difficult with his busy lifestyle, the patient decided to decrease his workload so he could continue to get 6 to 7 hours of sleep each night. As a result, he started to lose the 3+ pounds weekly and was able to reach his goal weight. Continuing a healthy lifestyle that includes enough sleep each night has been necessary for this patient to keep off the weight long-term.

The moral of the story? Getting started with lifestyle changes doesn’t mean you have to take everything on at once. All you need to do is make the decision to take one step in a new direction. Then you’ll take another, and another. And before you know it, you’re on your way to a whole new focus on living more healthfully.

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss

I also realized that most of my patients who suffered from preventable diseases had one thing in common – they were all overweight or obese. I realized that if I were able to treat their weight issues, then the other conditions would improve or disappear altogether. And I learned that weight loss was more than just proper diet and exercise. Weight is a medical issue, both physiological and psychological, and it needs to be treated as such. No two people are alike, and that is reflected in a person’s ability to lose weight and keep it off in the long-term.

As the founder of The Center for Medical Weight Loss and its Chief Medical Officer, I treat the root causes of overweight and obesity with a safe, medically-proven approach. Since the program started, I have seen countless patients lose hundreds of pounds, get off their meds, and gain back control of their lives. I couldn’t be more thankful for being able to help my patients make lifestyle changes that give them a whole new outlook on what they can accomplish in life.

And now, I get to share my passion and knowledge with you through this new blog. There’s so much to talk about when it comes to weight loss, and I can’t wait to start the conversation with you. Please don’t be shy about adding your questions, thoughts, or ideas to the comments section of each post. I’ll do my best to provide you with facts and answers to help you get started and stay on your weight loss journey.

Dr. Michael Kaplan

Founder and Chief Medical Officer

The Center for Medical Weight Loss