HCG DIET and Lifestyle Changes
Robert L. True, MD, FACOG, FACSDiplomate of American Acad. Anti‐Aging
5203 Heritage Ave.Colleyville, TX 76034www.truemd.com
TRUE AESTHETICS CENTER
Disclosures
• Medical Director for True Aesthetics CenterColleyville, TX 76034
• Co‐owner of a marketing and information website: www.HCGTrueDiet.com
• Author of Book on HCG: Break the Cycle
Overview• Obesity Epidemic• Medical Problems with obesity• Weight loss is Anti‐Aging• Why Diets fail• HCG Diet: Lifestyle changes• What is the Best concept for losing weight
We Have a Problem
OBESITY
Prevalence
• Worldwide Epidemic• Surgeon General called being overweight is the biggest health concern in the USA
Incidence
• Over 64% US adults are overweight
• Over 34% US adults are obese
• Increased 119% over last 25 years
• Directly linked to increase in morbidity and mortality
BMI and Overweight/ObesityOverweight incidence (BMI > 25) is around 64% overall (3 fold increase over 20 yr)
Obesity incidence (BMI >30) is around 34% overall (3 fold increase over 12‐20 years)
McTigue KM, Harris R, Hemphilll B, et al. Screening and interventions for obesity in adults:summary of the evidence for the US Preventive Services Task Force. Ann Intern Med. 2003;139: 933‐966.
48.2%
Problem is:
• Most Americans don’t eat right• Most Americans don’t exercise enough• Most Americans don’t know wellness
Worldwide Obesity Prevalence
• Developing countries– >40% men and women
• Over 250 million people around the world – ~7% of current world population
• Europe– 22% of women– 15% of men
If Michelangelo came to America
Before After
Obesity is Bad for Your Health
• American Cancer Society • 1/3rd cancer deaths in the United States each year are due to:
• poor nutrition• physical inactivity• obesity• or other lifestyle factors• and thus could also be prevented.
Complications Increase
• Diabetes• Obstructive sleep apnea• Depression• Hypertension• Steatohepatitis• Polycystic ovary syndrome• Dyslipedemia• Musculoskeletal problems
Ebbeling CB, Pawlak DB, Ludwig DS. Childhood obesity: public‐health crisis, common sense cure. Lancet. 2002;360:473‐482.
Increased Risk of Co‐Morbidities
Disease BMI<25 25-30 30-35 BMI >35
Arthritis 1.00 1.56 1.87 2.39
Heart Ds 1.00 1.39 1.86 1.97
DM 2 1.00 2.42 3.35 6.16
Gallstns 1.00 1.97 3.30 5.48
HTN 1.00 1.92 2.82 3.77
Stroke 1.00 1.53 1.59 1.75
BMI=Body Mass IndexHeight and Weight
•Normal weight •BMI: < 25
•Overweight •BMI: 25-30
•Morbidly Obese •BMI: >40
•Moderately •Obese •BMI: 35-40
•Obese •BMI: 30-35
Keeping off the pounds isn't just good for your figure, it can help fight cancer, too.
http://www.nydailynews.com/lifestyle/health/2009/09/24/2009Obesity_is_now_the_leading_cause_of_cancer_beating_out_smoking
Obesity & Cancer
• Today, Obesity is the leading cause of cancer• About 1 in 12 new cases of cancer are due to excess weight (USA)
– The Associated Press, 2009, From Mtg: European Society for Medical Oncology and Eruopean Cancer Organization
Breast Cancer Risk Increases with Increase in Overweight
• Women who gain more than 20 pounds from age 18 to midlife double their risk of breast cancer, compared to women whose weight remained stable.
• Nurses’ Health Study
Risks of Dying From Breast CANCER
• Around 11,000 to 18,000 deaths from breast cancer can be avoided per year if maintain a normal BMI < 25 (primaily in women over age 50)
• Recommendation: Maintain BMI <25 throughout a woman’s adult life
Petrelli JM, Calle EE, Rodriguez C, Thun MJ. Body mass index, height, andpostmenopausal breast cancer mortality in a prospective cohort of U.S. women. Cancer Causes and Control 2002; 13(4):325–332.
Economic Impact
Disability Decreased productionAbsenteeismHealth Care
* Texas Comptroller of Public Accounts (Susan Combs) March, 2006 report
Annual Cost of Obesity
• Managing obesity costs in the U.S. alone is $100 billion
• $52 billion are direct costs of healthcare.• These are 5.7% of all US health expenditure• Cost of lost productivity due to obesity is around $3.9 billion a year
• $33 billion spent for weight‐loss!!!
Obesity Decreases One’s Lifespan
• A 20 year old male with BMI > 45 can expect to live 13 years less than normal counterpart
• A 20 year old female with BMI > 45 can expect to live 8 years less than normal counterpart
Fontaine KR, Redden DT, Wang C, et al. Years of life lost due to obesity. JAMA. 2003;289:187‐193.
Life Expectancy
• Current trend, overall, had been an increase in life expectancy
• If current trend of increase obesity continues, life expectancy may decrease by up to 5 years sometime during this century
Olshansky SJ, Passaro DJ, Hershow RC, et al. A potential decline in life expectancy in the United States in the 21st century. N Engl J Med. 2005;352: 1138‐1145.
Problem: Most Physicians Don’t Treat Overweight
• Only 40 percent of obese patients were advised by their Physician to lose weight
• Only 25% of physicians feel competent to treat the overweight patient
• Most physicians have very little exposure to obesity treatment
We Can Help!
• Anti‐Aging concepts:• Prevention• Wellness• Staying Fit• Looking Younger• Better Quality of Life
Anti‐Aging?
• I plan on living forever. So far, so good.
Anti‐Aging: Definition
• Decrease degenerative processes that cause the appearance of older age
• As we get older, our bodies go through wear and tear; i.e. the “aging” process
• Anti‐Aging concepts help slow, or even reverse this process
What Can You Do?
* Want a program that works to lose weight
* Want a program that motivates people
* Want to change the Metabolism* Want to change the Lifestyle
Treatment Outcomes
• Reality check!• 85% of dieters regain lost pounds within a year
• 95% cannot maintain a 5% weight loss for 5 years.
Dansinger ML, Gleason JA, Griffith JL, et al. Comparison of the Atkins, Ornish, Weight Watchers, and Zone diets for weight loss and heart disease risk reduction: a randomized trial. JAMA. 2005;293:43‐53.
Short Term Diets
• Most Dieters tend to regain much of weight by 1 year
• There is no significant difference among the different short term diet types
• Includes traditional VLCD and Low Carb DietsDansinger ML, Gleason JA, Griffith JL, et al. Comparison of the Atkins, Ornish, Weight Watchers, and Zone diets for weight loss and heart disease risk reduction: a randomized trial. JAMA.2005;293:43‐53.Pirozzo S, Summerbell C, Cameron C, et al. Advice on low‐fat diets for obesity. Cochrane Database Syst Rev. 2002;(2):CD003640.Hong K, Li Z, Wang HJ, et al. Analysis of weight loss outcomes using VLCD in black and white overweight and obese women with metabolic syndrome. Int J Obes (Lond). 2005;29:436‐442.Foster GD, Wyatt HR, Hill JO, et al. A randomized trial of low‐carbohydrate diet for obesity. N Engl J Med. 2003;348:2082‐2090.
So What are You Going to Do?
• To help decrease the Obesity Epidemic
• To decrease Medical Problems with obesity
• To instill Anti‐Aging and Preventive concepts into the lifestyles of your patients
For Sure
If you keep doin’ what you’ve been doin’, you’re gonna keep gettin’ what
you’ve been gettin’.
CHANGE: Behavior Modification
• The most effective nonpharmacologic and nonsurgical obesity treatments includes behavior modification
• To instill into the patient’s daily life the proper diet and adequate exercise
Knowler WC, Barrett‐Conner E, Fowler SE, et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med.2002;346:393‐403
The Best Behavior Modification
• High‐intensity interventions, defined as more than 1 person‐to‐person visit per month during the first 3 months of a weight‐loss program, are more effective than low‐ and moderate‐intensity treatment
McTigue KM, Harris R, Hemphilll B, et al. Screening and interventions for obesityin adults: summary of the evidence for the US Preventive Services Task Force. Ann Intern Med. 2003;139: 933‐966.
Importance of Compliance
• Patients who are compliant: best results• Lose more weight than less compliant pts• Better able to maintain weight loss over time• Patients must make a commitment!
Dansinger ML, Gleason JA, Griffith JL, et al. Comparison of the Atkins, Ornish, Weight Watchers, and Zone diets for weight loss and heart disease risk reduction: a randomized trial. JAMA. 2005;293:43‐53
What is Needed?
• MOTIVATION !• Quick weight loss is one of the best motivating actions known.
Once weight is off
• Instill lifestyle changes to keep it off
• Best is to create new habits
• Do a program that incorporates all
HCG Diet
• Based on the studies of Dr. ATW Simeons
• Clinic in Rome, Italy• Over 50 years of experience in weight loss success
• Great for MOTIVATION!• Lacks in incorporating new concepts of lifestyle changes
HCG Changes the Metabolism
• Use HCG plus eat 500 calories/day
• Body goes into “preserve the species” mode
• Body burn the abnormal fat reserves
• Wants to “feed the baby”
It Works!
• Patients lose weight rapidly• Feel fine while they lose the weight
• Get motivated to lose more and/or maintain the weight
• Develop proper weight management habits
• If done correctly
Must be Medically Supervised
• Program is for 12 weeks:• First 6 weeks: HCG + Diet• Initial visit evaluation• Visits regularly during first 6 weeks: encourage lifestyle changes
• Make sure no problems occur (e.g. electrolyte disturbances)
Must be Medically Supervised
• Second 6 weeks: Transition• Maintain Lifestyle changes• Guidelines, final visit at 12 weeks
• May repeat program, or do permanent lifestyle changes
• Creating Good Habits
Create Lifelong Habits
• Do six weeks on HCG and six weeks off
• Repeat if necessary• If do behaviors for 12 wks, 24 wks or 36 wks, perhaps these could be ingrained behaviors like habits that they can continue to do for life.
Good Habit: Portion Size
• Learn to eat smaller or correct portion size
• 3.5 oz of protein food• Appropriate amount of fruit
• Large amount of vegetables
We tend to “supersize”
Good Habit: Food Journal
• Must do a food journal• Easy to write about 3 food groups twice a day
• Learn food calories
Keeping a food journal has been proven to help people lose weight
and keep it off.
References for the benefits of doing a food journal:
• Monitoring weight daily blocks the freshman weight gain: a model for combating the epidemic of obesity. Int J Obes (Lond). 2006 Jun;30(6):1003-10 • Charting of daily weight pattern reinforces maintenance of weight reduction in moderately obese patients. Fujimoto, K, 1992, Am J Med Sci, 303(3), 145-150. Kyushi University, Fukuoka, Japan• Irregular patterns in the daily weight chart at night predict body weight regain. Tanaka M et al, Exp Biol Med, 2004, 229(9) 940-945• Self weighing in weight gain prevention and weight loss trials, Linde, J, Ann Behav Med, 2005 30(3), 210-216, University of Minnesota• A descriptive study of individuals successful at long-term maintenance of substantial weight loss, Klem, M et al, Am J Clin Nutr1997, 66: 239-246, University of Pittsburgh School of Medicine (National Weight Control Registry -NWCR)
Good Habit: Right Food Choices
• Forced to eat the right food groups
• Avoid processed foods
• Encourage fresh fruits and vegetables
• Lean meats
Good Habit: Weigh Daily
• Weigh yourself• Teaches Accountability
• Main principle of any diet that works
• A MUST
Good Habit: Exercise Regularly
• Best success: Do exercise• Exercise is recommended during my diet program
• Discuss options and interval training
• Best to start during 2ndweek
Exercise is Key
• Successful weight loss studies show a common denominator:
• Continued and ongoing physical activity
Pavlou KN, Krey S, Steffee WP. Exercise as an adjunct to weight loss and maintenance in moderately obese subjects. Am J Clin Nutr. 1989;49:1115‐1123.
Klem ML, Wing RR, McGuire MT, et al. A descriptive study of individuals successful at long‐term maintenance of substantial weight loss. Am J Clin Nutr. 1997;66:239‐246
Creating Good Habits
• Lose weight quickly: get Motivated
• If you can see good Weight‐loss, easier to be and stay motivated
Behavior Modifications (Good Habits) include:
• Food Journal• Knowing Portion Size• Knowing Calorie Content of Foods• Proper Food Choices• Accountability• Daily Weighing • Regular Exercise
HCG Diet Consequences• Most lose an average of 20 – 30 pounds over 12 wks• Helps patients get off that weight‐loss plateau• Creates a change in metabolism• Forces your body to pull nutrients from abnormal fat to shrink the fat
• Problem: Potential nutrient and electrolyte disturbances
• Must be medically supervised• Forces patients to get the 1 on 1 interaction needed for success (best Behavior Modification)
Opportunity is Out There
• There’s a huge opportunity to do a weight loss program
• Pick the program that works for you and for your patient
• Pick one that motivates, works to lose weight rather rapidly, incorporates long term weight loss actions for permanent healthy weight management
Summary
• Obesity epidemic is rising: health problems• Weight loss is an Anti‐Aging action • Do what successful people do• HCG Diet changes metabolism: Motivates• Lifestyle changes incorporated within the program create habits for long term weight loss maintenance.
THANK YOU
• ROBERT L. TRUE, MD, FACOG, FACS
• True Aesthetics Center• Colleyville, TX 76034• website: www.HCGTrueDiet.com
• Author of Book: Break the Cycle
For more information, go to Booth #
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