Brandy and Alexis talk about the emotional connection people have to food after listening to Jimmy Moore’s Podcast ‘Livin’ La Vida Low-Carb’. Alexis starts building her foundation of psychological thrillers starting with Hannibal.

As always, thank you for listening. 

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Brandy and Alexis practice what they preach and dive right into a review of one the scariest movies of all time. One full of religion, vomit and of course, death.

SKATEMD

SkateMD is a Northern California based 501(c)(3) non-profit organization with a mission to heal hearts by spreading kindness and skateboarding to special populations of children facing developmental, physical, emotional or family challenges.

DONATE

Working Wardobe

YWCA has three unique clothing banks offering free, business-appropriate attire to women experiencing homelessness in need of clothing for interviews or new jobs. 
Learn more about Working Wardrobe HERE

As always, thank you for listening. 

You can email us at forfatssakepodcast@gmail.com
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Brandy and Alexis answer a patients email with more questions. They also discuss upcoming events and announce a special surprise segment for future minisodes.

SKATEMD

SkateMD is a Northern California based 501(c)(3) non-profit organization with a mission to heal hearts by spreading kindness and skateboarding to special populations of children facing developmental, physical, emotional or family challenges.

DONATE

Working Wardobe

YWCA has three unique clothing banks offering free, business-appropriate attire to women experiencing homelessness in need of clothing for interviews or new jobs. 
Learn more about Working Wardrobe HERE

As always, thank you for listening. 

You can email us at forfatssakepodcast@gmail.com
Share your stories, questions or comments.

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Brandy and Alexis talk statistics around bariatric surgery, implications and complications. How does medical weight loss work with surgical patients to help them reach their goals?

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As always, thank you for listening. 

Going backwards a bit, Brandy and Alexis go over low carb diets and how to get started right now. They also answer questions from listeners about probiotics, bacon and being a vegan.

As always, thank you for listening. 

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Date: January 30th, 2019

I left off last time telling you about my past decision to lose some weight. I restricted calories, avoided fat, skipped meals, deprived myself of tasty foods, and expected fast results. Never mind that the results were temporary AND unhealthy! Most, if not all, of my weight loss in those days was water and muscle.  

Refusing to go back to my old dieting ways, I now promise myself:

I will not count calories or points, 
I will not weigh myself several times a day, 
I will not deprive myself of certain foods, and 
I will not beat myself up for any “failures.”  

So, how am I going to drop some pounds?  

Well, I challenged any thoughts long ago that being overweight was a personality flaw. I dismiss any notion that heavy people are just undisciplined or “lazy”, and I know that any quick weight-loss program that promises long-term results is a lie. But, despite years of on and off dieting, I knew nothing at that time about obesity as a disease.

Fortunately, as a partner and behavioral therapist at Three Health, I have access to Medical Director Brandy Wiltermuth’s medical expertise. I already knew that my old way of dieting did not work to sustain weight loss, and most of what I thoughtI knew was old and faulty information at that!  

Brandy has the courage to take on the diet industry and tell the truth: The only way to lose weight and KEEP IT OFF is through individualized, medically-driven, holistic programs that treat the mind, the body, and the spirit. Everyone is different, and every patient requires an individualized program based on his or her personal medical conditions and profile. 

“Dieting” is not a one-size-fits-all program!  

Brandy’s experience in the science of weight loss is deep and insightful. She drew charts to help me understand how macronutrients work in mybody, making it easy for me to understand what works and what doesn’t work for mybody. There is a big difference between being told what I need to eat rather than what I can’t, and Brandy designed an easy-to-follow nutritional plan for me to follow. 

I was adamant that I love my social lifestyle and traveling, and she listened. In fact, I have no desire to curtail any activities; therefore, she has helped make it easy to go to restaurants and friends’ homes for dinner.

I was also adamant that my “dietary needs” not be obvious, and they aren’t. I have been following this plan (not to the letter and, yet, no guilt), and I have lost about eight (8) pounds in a month. 

While my “self-care” program worked for many years, time does not stand still. Just as my thinking had changed over the years, so had my body. Again, excess weight is not a personality flaw!  

As a partner at Three Health, and by following Brandy’s guidelines, I truly understand that everyone’s life situation is totally unique, which is why it is important to understand each patient’s lifestyle and situation. What I learned first-hand is that each person’s bio-metrics, medical test results, and medical condition play a huge part in healthy, sustainable weight loss.  

I don’t ever want to go back to the days where I put myself last or feel my needs are not important. As I have said before, I vowed I would never treat myself the way I did in my teens and twenties. I changed my self-talk, which changed my self-esteem, and now I practice self-care in all areas by including this new way of eating. 

I am taking care of myself by getting the right medical and professional advice for myweight issue because this nutritional program is unlike any “diet” I have ever been on. My health is one of my most valuable assets (as your health is to you), and I feel I am protecting it by losing weight in a healthy way, both physically and emotionally. You can do it too. 

Until next time, take care of yourself and yourbody’s needs,

Marlene Sexton LMFT

This week Brandy and Alexis talk more about ketogenic diet and also the highly debated topic of calories. We tell you why calories in/ calories out is an outdated, completely wrong directive fed to us but he food industry and everyone has been duped. Stay tuned for more updates about upcoming events as well.

SKATEMD
SkateMD is a Northern California based 501(c)(3) non-profit organization with a mission to heal hearts by spreading kindness and skateboarding to special populations of children facing developmental, physical, emotional or family challenges.

DONATE

Working Wardobe
YWCA has three unique clothing banks offering free, business-appropriate attire to women experiencing homelessness in need of clothing for interviews or new jobs. 
Learn more about Working Wardrobe HERE

As always, thank you for listening. 

You can email us at forfatssakepodcast@gmail.com
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Date: January 23rd, 2019

In Part 3, I left off by mentioning a dilemma I have. I promise I will get to it, but first let me give you a bit more of my story.  

When my husband and I were blessed with two daughters, it hit me how important it was to model the behaviors I wanted our daughters to learn. This meant I would not make disparaging remarks about my body, and I would also no longer comment on other people’s bodies. I knew I could not change a society that tolerates weight bias, but I could have teachable moments with our girls to help them avoid the pitfalls of negative body image.

I also had to keep learning about and practicing a healthy relationship with food, which, as you know, is quite a challenge given the food culture we live in. There was a time when I saw food as my worst enemy; I know others who see it as their best friend, always there for them when they “need it.” Although I no longer see food as my enemy, I also can’t reconcile with some our cultural views about food. 

For example, all of us use food to describe things in our everyday conversations: “That test was a piece of cake,” or “She’s a smart cookie.” Food is even referred to as love(think Papa Murphy’s “Love at 425 degrees”). We often see food depicted as “medicine” by ads that encourage eating sweets after a stressful day, or magazines and TV shows that focus on food as entertainment. In fact, product placement on TV shows and subliminal advertising are intended to make us snack while watching our favorite programs and reinforcing our belief through character roles that we should be thin. 

We may be encouraged by our friends and family to lose weight, but then any effort is sabotaged when the host insists we eat the dessert they made “especially for us.” While I recognize that many families are going hungry, it is because of a lack of food, not choices. If you want to see a four-year-old have a meltdown (and who does?), look what happens when he or she is asked to pick out one candy bar or a box of cereal from the abundant choices in front of them! I read that we make about 250 food choices a day, but with social media, online ads, and programs like the Food Network, we can’t count how many food “messages” we get daily. Again, living in our culture is a challenge when it comes to eating healthy.

Although I gave up “dieting” when my kids were little, I had yo-yoed for years because that’s how diets work, right? You might lose 10 pounds, keep it off for a while, gain back 12 pounds, and then diet again. That cycle can continue until you have lost literally hundreds of pounds and have spent years and years depriving yourself, beating yourself up for “blowing it,” and thinking about your weight all day! Before I made changes, I weighed myself two or three times a day to determine my“worth.” I know how dieting and weight can easily become your “life” and believe me, it is not a good life!

I spent years repairing my self-esteem and body image by changing my relationship with food.  I became conscious of why I was eating and began to understand I needed healthy foods in order to feel well. But, I also stopped thinking I had committed a felony if I ate a piece of cheesecake!

I then started self-monitoring to determine if I was hungry or maybe just bored or stressed. I developed skills to manage difficult emotions, and I became assertive and no longer worried if people would still like me if I disappointed them. I no longer allowed strangers, acquaintances, friends, or family to comment on my weight or body. 

I can’t put into words how freeing this revelation was to me, but it did not happen overnight. I had to work at it. Remember, being overweight, (or unhappy, stressed, and so on) is hard, and changing is hard. I chose my “hard” and worked toward self-acceptance and self-worth; I wouldn’t go back to my old ways for anything!  

But, finally, here is my dilemma:

I have been a therapist for almost 25 years, and you can imagine it requires a lot of sitting. A few years ago menopause hit; my metabolism and body shape changed. And although I absolutely love my job, I commute over two hours each way, which interferes with my well-established self-care plan of meal planning, healthy eating, fun exercise, and focused meditation for stress. 

Like you, I want to maintain good health and prevent diseases that come from being overweight. Once I started to feel good about my body, I gave up weighing myself and learned to create good feelings by my thoughts and actions, not by the scale. I decided to determine my weight by my energy and how my clothes feel, which was going well until I got curious and started using InBody, a device that measures body fat, lean muscle, etc., a much more accurate tool for determining healthy weight. Long story short, I found out I need to lose weight and build some muscle! I don’t need to lose much weight, but the idea of depriving myself, counting calories, weigh-ins, good food/bad food, and so on terrifies me. I refuse to go back to those days! But, and this is big, my health is very important to me.  

How do I lose weight without falling back into the “dieting cycle”? Stay tuned. Next time, I will tell you how I am working on this issue.

In the meantime, take care of YOU!

Marlene 

As always, thank you for listening.

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Date: January 16th, 2019

My last blog left off with a promise to describe how I learned to value myself and change my life. But first, I must explain how the subconscious can help you achieve your goals or keep you from them. 

As a cognitive-behavioral therapist, I work on the theory that our thoughts create our emotions and then behavior follows. To simplify this theory, picture the brain wanting to keep all things congruent and “in line”—thoughts, feelings, and behaviors. For example, when you have a thought, the subconscious gives you the appropriatefeeling for the thought. It won’t argue with you, it just says, “Okay, here’s the appropriate feeling.” 

So, if I wake up in the morning and say to myself, “Today is going to suck! I have so much to do and not enough time to do it,” my subconscious says, “Okay, here is a feeling of dread.” It does notsay, “It’s cool, you really don’t have much to do and you can get it all done.” Dread would be the appropriate feeling for my original thought. 

But, the subconscious does not stop there! It now wants me to be “right,” and it narrows my focus and attention to that which confirms my belief, whatever it is. I might start seeing other things that need to be done that I don’t have time for, rather than the things I have already accomplished. Thanks to my subconscious, I only focus on what confirms my belief and then a behavior follows.  

We have to understand that behaviors are usually learned and are dependent on our personalities, our values, or how we were raised. In my case, I used to get overwhelmed and suffer “paralysis by analysis” and just give up, confirming my belief that I am incapable of success. Others might compensate by working harder and faster, and some might break things down into smaller chunks, prioritize, or ask others for help.   

So, if I tell myself that I am not worthy of good things, my subconscious says, “Ok, here’s some shame or self-disgust that goes with your thought.” The shame or self-disgust then leads me to behave in ways that are congruent with those thoughts and feelings. For example, I may accept poor behavior from others as well as myself, which makes for more negative thoughts, feelings, and behaviors.

The good newsis it works the other way, too. I have learned that if I give myself positive subconscious feedback, all of a sudden I change the way I think, and my behaviors then affirm those messages and change the way I react to others’ behaviors, as well.

Once I started listening for, and challenging, negative thoughts, I was surprised how often I was berating myself. It was constant! I also found that most of my thoughts were based on “faulty information.” For example, my weight did not determine my character. I did not have to “buy into” what others said about my body. I had a voice, and over time (not over night) I learned to use it. I started to read about and practice setting boundaries and limits. Again, big changes in whom I attracted into my life. More importantly, I started feeling better about myself!  

One of the ironies is that I believed it was “wrong” to feel good about myself. I feared people would see me as conceited or self-absorbed. Many people, especially women, believe this and yet they want their children to feel good about themselves. How can it be wrongfor me to feel good about myself, yet make this a goal for my daughters? I decided it was o.k., even desirable, for me to feel good about myself. And guess what? The world is still spinning just fine!

Again, as I felt better about myself, I started attracting more functional, confident people into my life, and one of those people was my husband. After more than 40 years together, I can say with confidence, he would have never put up with a person who put herself down constantly or did not treat herself well. He said it would break his heart to hear me say negative things about myself. I can understand how he feels because it would break my heart to see my daughters stand in front of a mirror and say hateful things about themselves.  

After practicing self-care, self-awareness, boundary setting, assertiveness, and limits for many years, I am now faced with a dilemma! In the next blog I will talk about the TRUE need to lose weight. This desire is not based on what others want for me, but what I want for myself—the desire to maintain my good health. Stay tuned, there’s more to come!

Take care and be kind to yourself, 

Marlene 

As always, thank you for listening.

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Date: January 11th, 2019

In my previous blog, I discussed the dynamics that lead to my “very diminished,” aka non-existent self-esteem and body image. Writing that blog was difficult because it meant going back to a time 45 years ago that was confusing and painful for me. You see, I have come a long way since then, and I worked hard to put it all behind me and make it just part of my story. However difficult it was, I am also proud of myself for creating a life I wantto lead, and I am here to tell you it can be done. 

Long ago, I saw a meme on Facebook that simply said, “Being overweight is hard, and losing weight is hard. Choose your hard.” I wish I had seen that decades earlier! I would have applied it to many of life’s difficulties, including those that were not weight related. 

Here is more of my story:

I was in my early twenties. I believed I was not good enough, and I should be grateful if anybody paid any attention to me. It did not matter to me how they conducted themselves, what their values or beliefs might be, or even what goals they had. If they liked me, I liked them and despite any red flags, I would fit them into my life. Looking back, I can see I had a high tolerance for poor behavior.  

What I know now but didn’t know then was “like attracts like.” To put it in more dynamic terms, we attract people who confirm our beliefs. In other words, if I don’t feel good about myself, I will attract people who (a) don’t feel good about themselves, thus giving us something in common or (b) they also don’t feel good about me; again, something in common! 

My self-loathing not only manifested in the company I kept, it prevented me from taking care of myself. Oh, I showered and dressed well (at least by 70s standards) but, frankly, that was so I would not offend others. I allowed “friends” to stand me up on commitments they had made, and it was “no problem” if they called for a favor (e.g., rides, bail, shoulder to cry on) at two o’clock in the morning. I skipped meals to help others, I ate junk food to appease, I put my own plans on hold to cover for co-workers so they could do something fun, and so on. There seemed to be no end to my “generosity” and need to please!  It felt good to be needed, but it came with a steep price. For starters, I was exhausted. Exhausted from taking care of others, but also exhausted from feeling so bad about myself.  

Honestly, I am not sure if I had a weight problem then or not. The number on the scale said I was “within the range” of a healthy weight and despite pictures that show otherwise, I was certain I was overweight and unattractive. (We now know BMI is not accurate in determining a healthy weight). But, back to being exhausted. 

I saw others feeling good about themselves and practicing self-care, but I didn’t know how they got there. Despite my early interest in psychology, I felt as if self-worth was out of reach. I believed profoundlythat we are products of our environment and we don’t have much control over our lives—things just happen. I thought others were “lucky” to have life go their way; I also held absolute beliefs, using words such as always, never, everybody, and nobody, to describe my life. I didn’t know I had options until one day I decided I could “try” to make improvements.  

I started reading articles on self-esteem, and I came to understand that what we say to ourselves matters. I made it a goal to stop criticizing myself. I listened to my self-talk and challenged my negative descriptions. This did not happen overnight, but with practice I could catch myself in a negative spin and challenge or stop my thoughts. My goal was to quit saying things to myself that I would not say to a friend. Then I decided that I would stop negating compliments and simply say, “Thank you.” 

Soon, I began augmenting compliments. If someone said they liked my blouse, I would get out of my comfort zone, risk being thought of as conceited, and say, “Thank you. I saw it and really liked the color.” I realized the world would not stop spinning if I were kind to myself. My confidence grew and, soon, my friendships changed. I started attracting more confident, functional people into my life, and I realized I could “keep up.”  I saw myself as more valuable and worthy of good things. And good things came.  

In the next blog, I will share with you how the subconscious works and how to tap into your strengths so good things come your way, too.

Stay tuned.

Peace and good health!

Marlene

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Date: January 2nd 2019

Welcome to my blog. I am a psychotherapist and partner at Three Health Medical Weight Loss Solutions, and I want to share with our current and future patients more about my own trials with weight and body image. My hope is that you will understand you are not alone, whatever your challenges might be. I am proof that positive change can happen, and I believe we have it within ourselves to create the life we want to lead. Here is my story:

As a young kid, I was considered skinny by my classmates and learned early that my body was a big part of what defined me; at least that’s what I believed. While growing up in the 60s, I had a friend who was the only “fat” girl in my class. I knew other kids teased and bullied her; however, it wasn’t something she and I ever talked about. Her shame was obvious and unspoken, and I realized that being overweight wasn’t okay.

When we’re young, one of the biggest influences in our lives is our same sex parent. He or she is the template for how we see ourselves, and his or her role in the family is how we tend to view our own role. 

For example, my mother and her friends often dieted, and although my mother was never overweight, I knew she worried about it. She and her friends compared themselves to other women, sometimes favorably, but sometimes not so favorably. I believed being overweight was “bad” and one needed to be “disciplined” to avoid gaining too much weight.

I was a year younger than most of my friends because I started school early.  I lagged behind them, not only emotionally, but physically as well. They were buying training bras while I still wore my brother’s t-shirts. Well-meaning mothers would say, “Your time will come,” and others encouraged me to do exercises that might help me develop more curves. No doubt my body began to define my character, and it wasn’t do a very good job at that!

Eventually, I developed curves, but things only got worse. Now it seemed those same critics worried I was going to gain too much weight. My mother’s friends often asked how much I weighed and friends and family said things like, “Be careful not to gain too much.” My aunt even promised to buy me a new wardrobe if I lost some weight, and a family I babysat for gave me a calorie counter book as a gift. 

Everyone seemed to be focused on mybody. My mother pointed out my peers who “looked good” in her eyes, but neither she nor anyone else spoke about my being healthy, kind, smart, funny, responsible, or passionate—all traits I thought I possessed. 

I began to associate being overweight with being in trouble, on par with smoking cigarettes or shoplifting. Whenever I saw an overweight person, I wondered how their family tolerated them; I knew my parents would be mad at me if I gained weight. Needless to say, this didn’t solve any of my own problems with weight.

Food and eating (or not eating) became problems for me. I never thought I had developed a full-blown eating disorder, but I thought I wasn’t far from it. Now that I am a therapist, I realize I really did have a disorder—I didn’t eat in front of others, I ate in private so I wouldn’t hear comments about what I was eating or how much. 

I oftentimes starved myself all day or tried different fad diets such as grapefruit and egg, cabbage soup, lemon and water, no carb, lettuce, and low fat. Does any of this sound familiar? I even joined a weight loss group and took an over-the-counter appetite suppressant. It seemed my earlier critics thought I was finally taking care of myself, while in reality I only weighed 125 pounds! (That’s a future blog).

This foolishness went on for years. Over time my inner voice became more critical, and I spent hours contemplating my failures and flaws. When I looked in the mirror, I found only hateful things to say about my own body and judged my character by how my clothes felt. My days were considered good or bad by what the scale read, and whether I thought I was a good or bad person was based on what I ate. 

If I couldn’t find anything good to say about myself, why should anyone else? When someone said, “That color looks good on you,” I responded with, “I think it makes me look seasick.” And “Your hair is so shiny” was met with, “Oh, it’s probably just greasy.” By the time I was 20, my self-esteem had hit rock bottom, which showed through self-sabotage, dysfunctional relationships, and minimal self-care. Things had gone from bad to worse, but I knew I had to do something to change the way I thought about food and about myself—critics be damned.

In my next blog, I will discuss how I learned to value myself and changed the course of my life. Stay tuned!

Wishing you good health and a positive self-image! 

– Marlene 

As always, thank you for listening.

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Brandy and Alexis read listener emails and answer questions about body shaming, blood sugar and boundaries. Brandy talks her way out the ambulance.

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We often see patients who take care of others first. Then, if there are time and energy, themselves. At Three Health, we believe self-care is crucial to achieving and maintaining weight loss, and we are here to assist you in developing your own self-care plan.

To put it simply, we encourage our patients to treat themselves as kindly as they treat their friends and loved ones. Often, this is not as simple as it sounds. Self-care requires time-management skills, assertiveness, personal insights, and occasional relationship changes. Generally, this requires us to take a step back and assess if we are draining our personal “resources.”  At Three Health, we are excited to help our patients learn to replenish their energy and balance their lives. 

We also find that people are inclined to replenish their reserves by using unhealthy coping strategies such as over-eating, misusing alcohol, participating in risk-taking behaviors, or other self-destructive techniques to manage challenging emotions.  However, these strategies only bring temporary relief and a damaging cycle begins.

Many of life’s stressors are created or exacerbated when we are not focused on self-care and balance. Stress can come in one or more “areas of life,” meaning we can create stress in our lives by not balancing our PHYSICAL, EMOTIONAL, INTELLECTUAL, SPIRITUAL, AND FINANCIAL needs. We all know people who take care of themselves physically but pay no attention to their emotional needs. Others may have great financial resources but are in terrible physical shape. Ignoring any of these areas will create an imbalance, which in turn, creates stress.  

At Three Health, we focus on the whole person: mind, body, and spirit. Let us help you to create your best life! You deserve it!  

Visit our website Three Health.

By Marlene Sexton, LMFT 

                                                                                 Jim John

It is not uncommon to be excited and motivated at the start of a lifestyle change. The difficulty comes in sustaining that motivation.

Profound weight loss requires developing new habits and changing your relationship with food. This can be difficult given the food culture in which we live. Most of us have been taught to use food for comfort or to show love.

We get several THOUSAND messages a day to eat. These messages can be subliminal, as in product placement in TV shows, print advertising, or even in our language (we call people “sweetie pie” or describe others as a “smart cookie”.) We also learn to reward (or punish) with food. Have you ever been told, “If you are good, we will stop and get ice-cream”? Maybe you’ve heard, “If you don’t finish your dinner, you can’t have dessert.” These messages condition us to see food as other than fuel for our bodies. No wonder diets are so hard to stick to!

At Three Health, we have taken a “lifestyle” approach rather than a “dieting” approach. A diet eventually ends when a person has reached their goal weight, or more often when a person loses motivation to continue. This leads to harmful “yo-yo” dieting.

So, we know what leads to losing weight only to gain it back; let’s take a look at some strategies for steady and sustainable weight loss.

One key to successful weight loss is to set realistic goals. Lifestyle changes do not happen overnight, so setting attainable goals leads to real success. Progress markers such as noticing your clothes are looser or that you can take the stairs more easily indicate success more so than a number on the scale. Set small, achievable, measurable goals and celebrate when you reach them.

We see successful change when people recognize and challenge all-or-nothing thinking. A common self-defeating thought is, “I blew it by eating that cookie! I may as well have whatever I want now and start over on Monday.” Learning to put things in perspective can prevent a binge. Having a cookie does not mean you are lost in the woods, you are only one step off the path and it is easy to get back on!

The buddy system is another way to maintain motivation.  At Three Health, we offer a monthly support group along with weekly therapy groups. Making major lifestyle changes can be more difficult when we try to go it alone. Getting feedback from others can help us gain personal insights and healthy strategies to get through life’s tougher moments.

Small, non-food rewards such as a new book, a manicure, or a round of golf can be a new way of acknowledging successes and gives one the incentive to continue to practice healthy habits.

It is important to recognize that a healthy lifestyle—which involves nutrition, exercise, assertiveness, and boundaries—is a life-long goal and not a one-time deal.  Remember, you are worth the time and energy it takes to make healthy changes and Three Health is here to help!

By Marlene Sexton, LMFT

This is often the first question a patient will ask when seeking out medical care. And we know why. We all spend a lot of our own money on health insurance. We want you to be able to use your health insurance to reduce any of your possible medical expenses. As State of Washington, Department of Health licensed professionals, we are one of the few weight loss practices where you can use your health insurance benefits. 

Year after year we all pay higher monthly premiums, higher co-pays, and are seeing high deductibles—commonly $2,000+. Many of us can’t afford to go to the doctor. The whole system feels, well, broken.

If one does get sick and has to visit the doctor, usually for a prescription, the process starts with fewer choices for care. And there will be a co-pay. And then another bill from your doctor for the balance that the insurance company didn’t pay. And to make it even worse, If we haven’t met our deductible the bill will be for the entire amount. Ouch. 

Here’s how we, the medical providers, feel about insurance: 

We often wait up to six months to get paid a small percentage of what we submitted for payment months earlier. In the meantime, we must pay staff, rent, taxes, insurances, and utilities. We actually hire extra staff whose sole purpose is to try to get paid so that we can keep our doors open. Guess who ends up paying for all this? As with any businesses, one way or the other, it’s you. The consumer. 

A consumer? Yes. A consumer of healthcare. But, in the traditional insurance model, the consumer has little or no way to participate in choices or to understand what they’re really paying for.

We would like to change that.  

“So, can I use my Insurance?”   

With Three Health you can. Just a little differently than you’ve done in the past. We use a cash pay model. Which simply means you pay for our services when rendered. But in this model, you file the claim with your insurance company, and you get reimbursed directly. 

We provide you with a ‘super bill’ with the very same CPT coding that we would submit to your insurance company. We assist you in submitting the super bill to your insurance company for reimbursement.

Here is how you will come out ahead with the cash pay model.

Credit. As a fully accredited healthcare provider, claims can be applied to your out-of-network deductibles.

Tax Savings. You can use your HSA account to access tax-free funds dedicated to general healthcare services. 

Lower Costs. By eliminating extra costs to our practice we can package our services to you for less money. 

No co-pays. You will not be asked for a co-pay every time you you have an appointment with us. Remember, co-pays do not apply to your deductibles with the health insurance company. They are cash out of your pocket.

Telemedicine. This is a big one. We have the secure technology in place to provide you with expert care via the internet. This saves time. A lot of time. Time you’d normally spend getting here. Time in our waiting area. Time with the provider. And time to get back home.  

Time. We can give you, the patient, more face-to-face time. For the health insurance model to be financially viable, one medical provider needs to see 30 patients a day on average. That’s about four to six minutes per patient. That’s not good for anyone. Your provider should take the time to listen to you, answer questions, and make you feel like a person. Not a commodity.

Discounts. We offer our on-going cash-pay patients discounts for our services, biometric testing, and products. We can do this when we don’t have to wait month after month for single visits billed to the insurance company to be reimbursed. 

So, in addition to great care, we’ve created a model based on many years of experience and innovative thinking where you, the consumer, actually come out ahead for a change.

Questions? Just ask. Truly, we are in this together. 

Call us at 425-606-0022 for more information.

By Bradley Butterfield, LMHCA

The Team at Three Health

Summer is a great time of year for all sorts of casual and formal events, most of which can be stressful for individuals who are trying to lose weight.  It seems there is an endless smorgasbord of food at almost any social function.  Unlike the winter holidays, where food choices are fairly predictable, summer lends itself to the opportunity for more surprises and more exotic food options.

Like any social occasion, whether it be vacation, wedding, graduation or back yard pool party or barbecue, the strategies for maintaining weight or losing weight are the same.

First , it is important to look at the event and realistically evaluate your goal.   Many people feel that they have earned a vacation and it is something they should enjoy.  When it comes to food, it is one of the things that they may be looking forward to enjoying.  So if you are going on a 2 week cruise of the Mexican Riviera, you may want your goal to be to not gain weight during that time away.  If you have a wedding one day that you have to travel to, your goal may be to stick to your plan and continue to lose.

For weight maintenance, I usually recommend that you employ many of the same principles of your everyday weight loss plan with the exception of allowing yourself 1 extra indulgence, be it wine or dessert.  Typically, if you stay on your protein plan for breakfast and lunch, you will not gain if you allow yourself to have something extra in the evening only.  This is usually effective for 1-2 days, many more than that and you’ll find yourself gaining, or struggling with cravings.

When going to a social event where there is a potluck or if you are invited to someone’s house, you can be sure they will not mind if you bring a dish to share, just make sure it is something you can enjoy and that it fits into your nutrition plan.  Examples include:

Meat and or cheese Tray

Fresh Vegetable Tray

Low carb dessert (sugar free jello, berries with whipping cream)

High protein hors devours: shrimp cocktail, chicken breast cut into cubes, steak bites, chicken wings

Veggie salad with meat or cheese (Caesar salad)

Pickles, olives, green beans, asparagus and pickled veggie tray

The most important principles still apply:

Don’t let yourself get too hungry, eat before you go to the event.

Bring something that fits into your eating plan, that way you will have all the resources you need.

Finally, if you go off track remember, you have the opportunity to go back on track at your next meal. Don’t talk yourself into the defeatist attitude “well I already screwed up so…”  Instead say to yourself, “well I went off track, but I am supposed to eat again in a few hours and I will get back to my protein then.”

Brandy W.

It was cool and overcast at this year’s conference for clinicians specializing in the treatment of obesity.

But even without sun, the Obesity Medicine Association’s recent gathering in San Diego was just what the doctor ordered.

On April 4th and 5th Brad Butterfield and I attended the OMA conference. And in some ways, it was good to have, meh, weather. There were no distractions from our purpose: to reignite our passions and get excited about the important work we do!

After all, it has been months since we have seen our patients. And it can be easy to lose sight of our mission when our focus – for weeks – has been leases, contracts, phones, websites, internet and, well, starting a business.

So it was a salve for the soul to be surrounded by the same ilk of medical professionals that takes obesity medicine very seriously.

Some major takeaways for us were:

Focusing on the causes of obesity. We know it is NOT a self-inflicted disorder. There are too many factors, many of which are out of one’s control, to have an individual take full responsibility for this disease. Classifying it as a disease means there are treatments.

Our team has many years of collective experience. We have spent countless hours with patients, helping them come up with solutions to the problems they encounter during the process of losing weight. We see success as a series of incremental victories – every day!

I personally consider myself a reservoir of sorts, collecting patients’ struggles and also as an assistant, someone who helps people find solutions to their struggles.

Time and time again, I have conversations with people about the medications used in weight loss. There is still a stigma that surrounds this area of treatment. There is no other disease of the magnitude of obesity (a pandemic) that does not have an established set of protocol that includes medication. We need to advocate to the public, other providers and our patients that there are safe and effective medications.

The following pair of statements made at the conference really struck me:

• If people believe they can change, then they can. We believe our patients can change. We know they can change.
• Eating and exercise are behaviors. Think about that. Really let it sink in. We need to change our behaviors.

Change is not a particularly simple or easy task. These statements reaffirmed what we have known all along. Behavior change has to be at the core of successful weight loss. It cannot be “doing a diet” until a goal is reached, then going back to eating “normally.” What is normal anyway? Eating a lot of quick and easy processed food with no thought or intention or focus on nutritional value? That’s not going to work, ever, in the long run.

So hooray for the OMA! They have done it again! We are fired up and so close to opening our new clinic. Stay tuned for more information on that front – and expect an email to be coming your way shortly. 

Thanks for reading, 

Brandy W.

Dr. Robert Lustig, a whole foods advocate, put together the below graphic to show why your occasional (seemingly harmless) junk-food fix is really so addictive.

That little piece of cake? Well, it basically plays out like crack on the brain. Junk food sparks neurotransmitters, which influence our mood and behavior. And processed foods are designed to give us pleasure and fuel the reward system, which makes them highly addictive. And highly palatable! These foods trigger Dopamine. No wonder it is so hard to resist the sweet stuff.

In real life, this is how Dopamine plays out.

Try eating one M&M, or chip or cracker. (Goldfish crackers – they might as well have crack in them!) It feels impossible to not want more after having just one. Even if you weren’t particularly craving that food when you ate the first one – now, we’ll, you are all about it.

On second thought, suggesting that you eat junk is terrible advice! That is exactly what these pseudo food conglomerates want you to do: Just try it. You’ll be hooked. So don’t try it! Just take my word for it – you’ll want more right away.

Instead, change your “diet” by cutting out these processed foods. This will help you lose weight. Why? It decreases the voice of the drug addict in your head saying: “Just try a bite” or “One won’t hurt you.”

You know you can’t have just one chip. They have teams of scientists making sure this fake food is irresistible to your brain. And the really bad part is that once you realize you can’t have just one chip – that is what upsets people. They start grieving the loss of these so-called “foods” and, well, that’s why we need to address the behavioral aspect of this process.

Here’s us how Lustig spells it out:

In short, we need something to help us feel better.

Enter Exercise.

Most people will get a burst of serotonin from moving their body, dancing, walking, yoga, running. You get the idea.

That is why being active is so important when trying to manage body weight. Moving our bodies makes us feel good – and then we rely less on Dopamine for our “happiness.”

By the way, this doesn’t have to mean killing yourself on the elliptical or lifting weights. But it does have to include doing something that you enjoy and moves the body. Most people that I have worked with who lost a significant amount of weight – and have kept it off – have done it though walking. Imagine that. Walking. So simple and free.

Yes this does mean “Diet and Exercise.” But it does not have to mean a severe caloric restriction, and cutting out all foods that actually taste good (hint that’s the fat). After all, being hungry is never going to work long term. A diet that fuels muscles and allows access to stored energy is what works. By now you know that I am biased toward a high fat/low-carb diet because it works better to control hunger and appetite. Like I said before, low fat diets can work. But they don’t when they cause more hunger and include a lot of fake a** food.

Brandy Wiltermuth

Eating tons of sugar is bad! And we know it! So what to do next?

Sugar is in everything and it makes us happy—for a moment. Then it’s gone and we want more, which is why it is so bad. It’s addictive and that’s a fact.

One weight management doctor I worked with poignantly said, “All white powders are addictive to humans.” I think he is right.

The article’s author gives some reasonable suggestions about how to cut down on sugar consumption. I agree with many of these suggestions, but with caveats for those trying to lose weight.

First, I support the idea of keeping sugar intake to less than 50 grams a day. It’s a good goal and I think it is appropriate—if weight loss is not the goal. If weight loss is the goal, however, than most people will see slower weight loss at 50 grams. I usually recommend no more than 20 grams of your total carbohydrate intake coming from sugar.

Next, I personally find it helpful to avoid sugar first thing in the morning. I have better energy all day and fewer cravings in the afternoon and evening if I eat savory foods like eggs and bacon for breakfast instead. And I am not the only one. Many of my patients also report noticing the same thing.

Finally, I also like to taper my overall calorie intake throughout the day, but that is a post for another day.

Brandy Wiltermuth, ARNP

Judith Kee, a mother from Lynnwood, Washington, is one of Brandy’s patients.

Kee already has lost 70 pounds eating a low-carb diet. She not only has taken off significant weight, but has gained more confidence than she’s felt in years.

Below are excepts of a Q&A about her journey.

Q. What brought you to Brandy?

A. I had a friend who had seen Brandy previously. She had been very successful and I was tired of trying and failing on my own. Honestly, I was tired of being fat.

Q. What caused the weight gain?

A. I used to be super active, and life got in the way. I had a series of events occur, which made me depressed and I stopped working on myself.

Q. How did the weight affect your life?

A. I was embarrassed. All of the people my boyfriend and I hung out with had super skinny wives or girlfriends. I was always the large one and I felt ashamed. My kids would tell me I was fat, which made me sad. I didn’t want to be out and about because I felt judged. I missed who I used to be. It affected my relationship with my partner Bruce, because I didn’t feel attractive anymore and questioned why he loved me.

Q. How was your transition to a low-carb diet? (i.e. hard, sustainable, easy?)

A. Fairly easy and very able to follow. I was nervous at first, then realized how simple it was.

Q. Do you enjoy what your eating and has it become a lifestyle for you?

A. I love what I eat. I think it will become a lifestyle. I still get nervous that I will revert back. But Brandy’s support helps me believe in myself.

Q. Do you ever feel deprived?

A. Never!

Q. How do you feel since you have lost weight? How has it affected your life? (i.e. different relationships, self-esteem?)

A. OMG! I feel amazing, I look amazing! My life is great, my family and friends, they all support and love the new me. I feel so much energy and desire to continue!

Q. How much weight have you lost?

A. 70lbs

Q. What continues to motivate you?

A. Brandy’s guidance, my family and friends, and my desire to continue feeling this great.

Q. Would you recommend Brandy to friends and family and, if so, what would you tell them about her?

A. I already have and will continue to do so. One friend sees Brandy and another is going to schedule to see her.

Q. Do you have any before photos? 

A: Hard to believe the one photo is from my work Christmas party and the other was a dinner we went to yesterday! Thank you so much for making my life better!

Q. How has the psychologist helped you change your relationship with food? Has this service helped you with any other aspects in your life?

A. It certainly helps to have additional support. I had worked with a therapist prior to seeing Brandy, which is one reason I finally took the step to see her.

This post covers the most basic skills you will need to succeed in a weight management program.

The first thing you need to know is that most diet plans go through a slow metamorphosis. That often means they begin to work to some degree, but they cannot sustain permanent weight loss. It is essential to review the “ground rules” periodically, just to ensure you do not stray too far off the path.

Take A Drink

First, drink at least two quarts of water daily.  Some people never feel thirsty. Instead, they feel hungry, but it’s a vague hunger and difficult or impossible to satisfy. Your body needs water to burn fat, so try to have at least one cup of water every time you eat something after you wake up and before bed.

On The Record

Next, record what you are eating. This doesn’t have to be fancy or meticulous. You just have to know what you are putting into your body. We generally recommend that you know how many grams of protein and carbs you are getting. But try not to focus on calories alone; rather, look for patterns and don’t dwell on specific foods.

On The Move

Walking is the most common exercise for weight loss and maintenance. Start with five to 10 minutes per day, and increase your walking time by one minute each week. Also, instead of trying to carve out 30 minutes of exercise three times a week, set weekly goals. For example, if your goal is 70 minutes per week, aim for 10 minutes each day, which is often more manageable than planning for 30-plus minutes of exercise three times a week.

In reality, you might only get 30 minutes done once a week. In short, 10 minutes each day is better than zero minutes.

Just Eat

Rather than stumbling into mindless eating and picking at food, make a rule to eat only when you are sitting down. Those random, incidental bites will seem much more obvious if you employ this rule.

Also, do not eat when you watch TV or use a screen of any kind. Lots of calories are consumed when you aren’t paying attention, and you won’t feel full or satisfied when eating in front of a screen.

You Must Eat

Your mother was right—do not skip meals!  No matter how many times people are reassured they need to eat to lose weight, this old thought process sneaks back in.

It’s time to change your mantra from, “I’m trying to lose weight, so I just won’t eat,” to “I have to eat to lose weight.”

People who don’t eat breakfast tend to overeat in the evening. So plan out healthy meals in advance.

Protein: Your Weapon

Finally, protein, protein, protein! Try to get the recommended amount of protein I have suggested for your individual diet plan. Protein drives metabolism and is far more satiating than carbohydrates.

If you have difficulty eating enough animal protein, you can always use a variety of supplemental food products, which are available everywhere. Just remember to keep an eye on the carbohydrate component in protein powders and shakes. And don’t add any carbs (e.g., milk, fruit) unless you are counting those as part of your total carb intake.


Many people suffer from insulin resistance, but few understand how it relates to obesity.

Insulin resistance is at the core of most metabolic disease processes. And many Americans have an insulin problem thanks to our sugar and carb-rich diets.

Lesson Number 1 about insulin resistance: what it is and why it is important.

Sadly, the disease of obesity remains stigmatized and over-simplified, so have some of its recommended treatments. Thankfully, good online resources help educate people about the science behind diet and effective weight loss.

Dr. Sarah Hallberg, a bariatric medical weight management specialist, is trained specifically to help people lose weight. She has made a mark on the bariatrics field by dispelling a lot of misconceptions about obesity and diet.

In this Ted Talk video, Dr. Hallberg spells out the all-too common problem that many Americans face with regard to insulin and their diets, including why we feel hungry shortly after binging on “American Chinese food.”

Type 2 Diabetes, formerly known as “sugar diabetes,” is a big part of her focus. So is exploring the link between diet and the disease. One question I like to raise with patients is, “If Americans eat too much sugar, and it is the cause of Type 2 Diabetes, why then has the American Diabetes Association recommended people with this disease consume at least 45 grams of carbohydrates at each meal?”

Another question is, “Why are some health professionals still arguing that consuming fewer than 130 grams of carbohydrates in a day could result in death?” I am calling B.S. on that one! After all, where did this idea of a per diem carb threshold come from?

Here is one stab at an explanation (albeit a bit long), which I found to be very helpful.

Still have questions? Let’s talk about them.

Brandy Wiltermuth, ARNP

How she changed my life

How many times has someone truly inspired you or changed how you feel about yourself? Not too often. Or maybe you meet people everyday that lead you down the path to enlightenment. For me, Brandy was the key that opened several doors in my life that I didn’t believe were options.

It started in September of 2015. I met Brandy in a cute boutique office that specialized in medical weight loss. My weight had been creeping up due to stress and unhappiness in a vicious cycle of emotional eating that felt like it would never end. I hated how I felt, how I looked and lost hope in myself. Brandy had hired me to help her help others, while silently I fought my own battle with my weight. I worked up some courage and sought out help from Brandy as I watched my weight continue to spiral out of control.
During my consult, we went over the multiple reasons my weight became such a burden and Brandy assured me that it wasn’t my fault: obesity is a disease and should be treated as such. She was patient with me when detailing how food is processed within my body and how important macronutrients were when trying to lose weight. She used real science, not hocus pocus or some point system that didn’t make sense. Describing the real problem, she explained that sugar and carbs are the real culprit, making weight loss extremely difficult. I will never forget when she said “fat does not make you fat, sugar makes you fat.”

In a time when fat-free and low-fat are all the rage, I can see how confused one can become. So many methods of weight loss are plastered on our TV screens and in our social media. “Eat this, not that,” “eat less, exercise more,” “fat-blocker capsules,” and so on, and so on. We all know these methods because we’ve tried them. I know I have. It wasn’t until Brandy taught me what food really is and supported her argument with proven science that I was able to see real results. Brandy’s calculated diet, based on my own biometrics, worked for me and breathed new life into the person I am today.

By no means am I perfect, because just like anyone else, I have days when I go overboard on the cheesecake. But with what I know now, I know it’s not the end of the world. Diet always sounds like a dirty word, but if you think about it, it’s just what you eat, although the general connotation is that it’s a restriction. Sure I don’t spend an entire evening eating cookies, candy and pasta anymore. But I don’t put foods in a box and forget them either. Brandy has showed me how to enjoy foods I love in a way that continues to allow me to lose weight, and I have never felt deprived.

If it were up to me I would clone Brandy and make sure that everyone who has battled with their weight gets a chance to meet her. She has truly changed my life in more ways than I could ever explain. I have lost 60lbs and I have the tools now to live a healthier life.

I am a healthcare provider, not an entertainer. But I do want to talk about another loaded “F word” – FAT!

I am starting this blog after working more than a decade in medical and surgical weight management. And I hope it will become a resource for patients looking for good, reliable information on low carb and ketogenic diets, which, yes, include fat.

Honestly, I am more than a little annoyed with the standard, low-fat diet recommendations mindlessly tossed around for the last 40 or so years. Such guidance often has been given by well-meaning health care professionals (doctors, nurses and dietitians). But too little time has been spent thinking about what the rationale (and science) for dispensing such advice. Why? In part, we can thank US Senators in the 1970s for stoking fears and typecasting fat as the “villain.”  But we also all drank the Kool-Aid! The low-fat campaign has been so effective that when prospective patients come to my office, nearly all say: “I know what I need to do. Eat less, exercise more.”

But nearly all of my patients already have TRIED VERY HARD to eat less and exercise more. For the vast majority, this over-simplified doctrine has failed. And most of my patients previously have attempted an average of 10 diet/exercise plans. Many did lose weight – sometimes a lot of weight. But they were not able to keep it off. Why? Why didn’t they maintain the weight? The reasons are usually multiple…

• Major life stress: changes in a job or work location, a divorce, illness, injury…
• Hunger
• Sticking with diet was too much work or too time consuming
• Lost motivation
• Progress plateaued
• Got off track and couldn’t get back

What is less common to hear is that the diet didn’t work. Diets do work, eating plans work, self-monitoring what we eat works, being mindful works, measuring and weighing food works, meal replacement plans work, pre-packaged food works, low-fat can work, low-carb can work and whole foods can work.

There, I said it, low-fat diets can work! BUT they also can leave people feeling hungry and unsatisfied, because fat (after all) is what transfers the taste of food and is satiating.

So if diets work, why don’t people read a book, follow the plan, lose weight and keep it off forever? Because they have not changed their relationship with food. Most weight loss plans, whether based on diet or exercise, are quick fixes and are meant to be temporary. Why? Because telling someone “this is what you have to do for the rest of your life” is daunting.

Changing one’s relationship with food is a difficult, non-linear process. It starts with education and getting accurate information to patients so they can make better, healthier choices. We have to redefine “healthy choices” to include butter, eggs and cheese! We also need strategies for the real world.

In the coming weeks I plan to lay out a series of posts (teach-ins) about how the body’s natural chemistry reacts to the food we eat. They might at first appear technical, but don’t be daunted. After all, we only get one body in this life! And yours will thank you for taking the time to understand how it – and it’s relationship to fat – actually works.