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Avoiding Holiday Weight Gain

Posted on December 02, 2019 by CFWLS

You don’t want to be standing on the scale after the holidays and wondering what happened. We want to avoid that problem. Holiday weight gain: everyone thinks about and everyone fears it. Is it inevitable? What can you do to avoid it? How do YOU make the best choices?

Here are a few statistics. It’s often stated that the average person gains 3-5 pounds during the holidays. But, this is not true. The average American does gain about 1.1 lbs. during an entire year. So, it doesn’t take that many years to start getting into some problems. About 10% of the population gains greater than 5 pounds in a year. This is typically the population that I see. One of the problems is that it’s not just the entire year. About 80% of the weight occurs during the 6 weeks between Thanksgiving and New Year’s. A significant proportion of people (my patient population) will gain a significant amount of weight during a year. And, most of this occurs over the holidays.

There are a lot of factors that lead to overeating during the holidays. There are a lot of social gatherings. We get together for social functions over the holidays with friends and family and it usually revolves around food. The holidays tend to bring about more stress (family, gift buying, decorating). The stress can lead to exhaustion and we make poor food choices. There’s a lot more emotional eating during the holidays. We can be sad, depressed, or stressed. Cold weather causes us to desire comfort food. One of the issues is the food around the holidays tastes good! It’s very palatable and it’s everywhere! Cookies everywhere! Plenty of temptation. Often there are treats that only come out during the holidays.

How do you avoid that holiday weight gain? I like to look at what I call the 3 basic pillars of weight management. The three pillars are: eating (home and at parties), exercise, and behavior modification. We’re going to look at these three things and how we can use them to help us.

Eating is the biggest one. Don’t skip breakfast. A couple of good studies have shown when people don’t eat breakfast they tend to eat more by the end of the day then what they normally would. The exception is if your breakfast is going to be a high carbohydrate meal. You’re better off skipping breakfast. If you start off with a carbohydrate breakfast, you’re going to end up eating more during the day. If you have a good protein start to your day you’ll actually eat less during the day. Recruit family and friends to help you. Let them know you’re trying to lose weight and you need their support. Typically they will be supportive if they know about it. Hopefully they want try and sabotage you. You might need to avoid them for a period of time. At home you might need to have an “off limits” area for yourself. If you have treats in the house for other family members that could tempt you, place them in an “off limits” area. Make it a rule that you won’t go into that off limits area. If you don’t make that rule, it makes it harder to avoid temptation. Don’t purchase or make the things that tempt you the most. If you need to make holiday cookies for your child to take to school, make ones you don’t typically like. Use the “catch and release” program. If someone brings you cookies, try one, and they immediately give it away. Get it out of the house.

A different scenario is eating at parties/functions. They’re occurring all the time during that 6 week period over the holidays. Here are some things to do to help protect you. Don’t go hungry. The last thing you want to do is show up at a holiday party starving because then you’re going to eat everything. Eat something healthy before you go. Bring a healthy choice with you so you know you’re going to have something you can eat. Increase the water. Water loading makes us feel full. It doesn’t last very long but it can prevent over eating. Use small plates and small utensils. If you use smaller plates and smaller utensils you will eat less. This has been shown in multiple studies for multiple years. Watch the alcohol for numerous reasons. It has a lot of calories in it. Also watch the high calorie drinks like egg nog. We tend to get that “drinking amnesia” where we forget that we had drinks and don’t consider all the calories involved. Alcohol releases inhibitions and we tend to eat more. Do the “walkabout” first. Look around at all the food and figure out what you’re going to have. Choose the good protein sources and colorful veggies. Choose your poison carefully. You can choose some things you don’t get to eat often. Complete deprivation doesn’t work well. I’m not a big fan of deprivation diets. If you tell yourself you can never eat something, you’re going to fall off the wagon at some point and go crazy. Have the mindset that you can be happy with just a small portion of the food. Don’t stay in the room that has the food in it. Get your food and leave the room. Eat in another room. Keep your hands full (not food related). You’re less likely to eat if your hands are full. Hold your drink in your dominant hand. Most people don’t eat very well with their non-dominant hand. These little tricks can be very helpful in avoiding the dietary disasters of the holidays.

Exercise to avoid weight gain. In encourage people to schedule their workouts. This is the time to go more intense. You’ll boost your metabolism somewhat. You might get a little more leeway with your eating. Make sure you’re doing the weight training. After you’re done eating go for a brisk walk. Get out of the chair and move as opposed to just moving to the couch to watch TV. You could buy yourself an early Christmas present and purchase some personal training sessions. It will keep you accountable. It can help you into the New Year getting your exercise on track.

There are behavior aspects to avoid weight gain over the holidays. Plan! It’s especially important if you’re going to travel and visit family. Once we get out of our usual environment and have less control, it’s important to plan ahead. A lot of these social things revolve around eating. It’s good to revise your recipes. Nowadays this is relatively easy to find online. You can find many recipes with lower carbohydrates. Remember why you are celebrating the holiday and what the main focus is. Focus on the socializing with friends and family. Keep healthy snacks close at hand. If you know you’re going to struggle, have the better choices readily available. Keep unhealthy things out of sight. Handling stress effectively is easier said than done. You can take a brisk walk, practice deep breathing, warm bath, or whatever positive thing you can do to keep that stress under control. Finally, get your rest. If you get quality rest, you’re going to handle these situations better. If you do overindulge, get back on track immediately. Don’t let a few bad choices turn into days or weeks. You don’t want to lose the momentum. You have to be very careful. 98% of our patients are sensitive to carbohydrates. If they drift, they struggle. It doesn’t take a whole lot of drift to have a big struggle. It’s like a drug. If you have a little bit, you’re going to want more.

Holiday weight gain is NOT inevitable! You need to plan, socialize with family and friends, watch the alcohol, and bump up your exercise. When you indulge, get right back on track. Yes, it is that important.

If you need help, let us know! Check out our non-surgical options or Back on Track After Weight Loss Surgery.

What You Need to Know About a Gastric Bypass

Posted on November 11, 2019 by CFWLS

Let’s start with a few facts about the gastric bypass. It’s been around the longest period of time. If you know anyone who’s had gastric bypass, they lose weight fairly quickly. People are often very concerned about the speed of the weight loss. Speed of weight loss doesn’t matter. It’s all tied to body composition.. If you’re losing weight quickly and it’s all fatty tissue, than the faster the better. On the other hand, if you’re losing weight quickly but it’s lean body mass, that’s not so great. You’re going to get more and more tired and weaker and weaker. You’re slowing your metabolism down which will make it much harder to lose weight and easier to gain weight. No matter what, if you have gastric bypass, you’re going to lose weight fast. We refer to gastric bypass as being restrictive and malabsorptive. Restrictive means we’re making your stomach smaller. If we make you a smaller stomach, you can’t eat very much. You’re going to lose weight. The concept is simple. We make your stomach about the size of an egg. People often wonder if their stomach is going to stretch out. The answer is yes. We know it’s going to stretch out and we want it too. We don’t want your stomach the size of an egg. What we’re shooting for long term with all these operations is meal size, that being a small plate. That’s where we want to go. But, we’re working with stretchy material just like your skin is stretchy. If we make your stomach meal size small plate it would stretch way out. A normal size stomach can hold about 2-3 liters. We have to make your stomach tiny to begin with knowing that it’s going to stretch out.

The second part is the malabsorptive part. That’s where the bypass comes in. We’re going to bypass the part of the stomach called the excluded portion. We go to the very beginning of the small intestine and divide it and pull it up and hook it into that tiny stomach so that we bypass the rest of the stomach. Whenever we bypass any portion of the intestinal tract, you’re not going to absorb things perfectly. You don’t absorb all the calories that you eat. But, you also don’t absorb some of the vitamins, minerals, and micronutrients quite as well either, which can be problematic. The surgery itself doesn’t take that long. It’s about 1 hour and 40 minutes. It can be done laparoscopically now. What we do is use long instruments and cameras and make little incisions on you. Recovery is pretty quick. Hospital stay is pretty quick. Recovery can take a while because this is a big operation. Whenever we start rearranging your anatomy, that’s a big operation. Recovery can take a good 4-6 weeks. Sometimes it can take up to 8 weeks to feel back to normal.

There are risks with every operation in the world. This is a bigger operation so the risks are bigger. When I talk about risk, I divide it into two time-frames. This is not something I made up. This is a medical standard which is basically right around surgery (peri-operative). By medical definition this means the first 30 days. The second time-frame is long-term which, by medical definition, means longer than 30 days. What’s the worst thing that could happen in that first 30 days? Could you die? The answer is yes it could happen. The risk of death is real when we start dividing your intestinal tract. It wouldn’t matter if I was talking about taking your appendix out or taking your colon out. When you look at national statistics, the risk is about 1: 200. What we see is about 1:500. Bottom line is that it may be rare, but not impossible. The things we worry about the most are infections. Some things are easy to treat such as urinary tract infections. Other infections aren’t so easy to treat such as pneumonia. They occur about 2% of the time after any surgery where you have to go to sleep for. You have to go to sleep for all these surgeries. It’s somewhat related to how long did the surgery take? The biggest fear as far as infections go is a leak on the inside. What if the pieces we took apart during surgery and put back together leaked? There are literally trillions of bacteria that live in the intestinal tract. When we start dividing the intestinal tract some of those bacteria could potentially get out. If they set up a rip-roaring infection, potentially you’d have to have another surgery to fix that. Wound infection means on the skin. They’re more of a nuisance than dangerous. They have to be treated with antibiotics. DVT is a deep venous thrombosis. PE is a pulmonary embolism. These are blood clots. You can get a blood clot without having surgery. You can get it from being dehydrated. One of the most common ways to get a blood clot is traveling on a long plane ride. You can also get it from having a general anesthetic. Again, it’s somewhat related to how long the surgery takes. The longer the surgery takes, the higher the risk is. We do all kinds of things to prevent that during surgery. The blood clot risk is 1-2%. If you got a blood clot you have to be on a blood thinner to dissolve that blood clot. The first thing that happens to that tiny stomach is the tissue swells up. Just like if you sprained your ankle. Your ankle would swell up. Stuff just trickles through the stomach initially. If you’re not able to stay hydrated you have to come back to the hospital to get IV fluids. You have to rest for a few days.

Long-term means 30 days until forever. The most common long term physical problem is peptic ulcer. You can get an ulcer without having gastric bypass. But when you have the anatomy of gastric bypass, the risk of getting an ulcer goes up. The people who tend to get ulcers are smokers and people who take anti-inflammatory meds. Ulcers just need to be treated. Something that could require another surgery is a bowel obstruction. Adhesion means scar tissue. If you’ve had any surgery on your abdomen you’re going to have scar tissue, not only on the outside, but also on the inside. That scar tissue can potentially kink the intestine. Just like a kind in a hose, nothing is going through there. You then have to go back to the operating room. Hernias are another risk. You can get them without having surgery. Any place we make an incision there is potentially a weaker spot. Stenosis means narrowing. What we’re talking about is right where we take the stomach and hook the small intestine to it. A scar could potentially form and cause a narrowing. If this happened, stuff wouldn’t go through very well. We would send you to a gastroenterologist. They would take a look down there and can stretch it out. Typically it doesn’t need any surgery but it does need to be evaluated and treated. Vitamin and nutrient malnutrition is relatively common. You won’t be able to absorb things perfectly. You’re going to have to take some things long term in addition to taking a battery of tests every 6-12 months to make sure those things are staying where they should. That’s a forever thing. That doesn’t go away.

We see great results with gastric bypass. You’ll lose about 70% of what you were overweight. If you were 100 pounds overweight you’ll lose 70 pounds. If you’re 200 pounds overweight, you’ll lose about 140 pounds. That’s the average. Some people lose more, some people lose less. About 40% of people with gastric bypass regain most of their weight back. Overall the long term anatomical and nutritional problems, with relatively poor weight maintenance, make it difficult for me to recommend gastric bypass for most people.

What should you do? You need to decide what’s best for your unique situation. There is no right or wrong here. What I encourage you to do is give us a call and set up a 1:1 consultation to discuss the options. Let’s you and I sit down and go over your situation. Everybody’s situation is different. Give us a call at (757) 873-1880 or email us at success@cfwls.com.

I have some final thoughts for you. Weight loss is the most important step you can make to improve your health!! There are so many medical problems that are directly related to weight loss. If we can control weight, we can control medical problems. If we can control all these medical problems it gives you the best chance of living a long, healthy life.

Watch the online seminar and give us a call (757-873-1880) and set up your 1:1 appointment. If weight is contributing to your health problems let us help you. I hope to see you very shortly here in the office.

Weight Regain and Getting Back on Track

Posted on April 29, 2019 by CFWLS

You’ve regained some weight. It happens. What are you going to do about it?

First, lets talk about the reasons for re-gaining weight and recognizing some of this back-sliding. Take charge of your thinking. We’ll talk a little about self-management skills and some tips to get you back on track and lead you to success. picked up a very good book recently. It’s written by a psychologist who’s very attuned to this problem. She’s written previous books. She wrote The Beck Diet Solution. Her name is Judith Beck. I would encourage anyone who is struggling with weight to read it. It’s not a diet book but how you actually change your behavior towards eating. She and her daughter took it one step further. They put together the next step in all this called The Diet Trap Solution. It looks at different behavior traps and mindsets that we fall into and what do you do about it. Very good book. I haven’t quite completed it yet. I might take some of those ideas and put them into a talk like this.

What are the typical reasons for regaining weight? The biggest reasons are shifting your calories to more carbohydrates and not exercising. I hear so often that a patient is doing so well and then they drift off on the exercise. I preach on this over and over again. Keep that carbohydrate ratcheted down. Everyone has a carbohydrate tipping point. When you get above that tipping point you will struggle. For those people who have a really high tipping point, they’re probably not struggling. For those of us who have a low tipping point, we shift and we struggle. Count your carbohydrates!

There are other things that tend to affect this. Lack of sleep increases stress which leads to eating more comfort foods. Lots of things occur when we don’t get good quality sleep. Sleep is the way we recover. We get worn out during a day. We need to recover. If we don’t get good quality sleep we never actually recover. Stress hormones don’t go down. Increased stress causes an increase in cortisol. You become leptin resistant. It’s a hormone made by your fatty tissue. It makes you feel satisfied when you eat something. Therefore, we increase comfort foods again which causes increased fat storage. Certain medications can cause weight gain. The biggest culprits are the psych meds like anti-depressants. The only exception I’m aware of is Wellbutrin. It has a chemical appearance similar to some of the appetite suppressants. For some people, Wellbutrin helps them lose weight. A lot of the blood pressure meds and most diabetic meds cause weight gain. Depo Provera causes weight gain. I don’t think I’ve ever seen anyone not gain weight. I would encourage you to use a different birth control. Medical conditions such as thyroid problems can cause weight gain. The thyroid regulates your overall metabolism. Menopause obviously affects half the population. Aging is also a culprit. As we age, some of the hormone levels go down, specifically testosterone. Estradiol levels go down with menopause. Estradiol and testosterone both help you preserve lean body mass which keeps metabolism higher. As estradiol levels go down during menopause, estrone levels go up and cause fat storage. It gets easier to gain weight as you go through menopause. There are things we can do to combat that.

Many times we gain weight back because we start going back to old behaviors. Almost all relapses occur within 90 days. It occurs fairly early. Sometimes during that 6-9 month period we really see people starting to struggle again because the old behaviors start sneaking back in. New behaviors have to become a habit. Backsliding occurs when you overeat any food after a lapse. This is often triggered by an event or situation (stressful relationship, social influences, etc.). Once we start doing this we drift back to our old behavior. You need to use coping responses to combat the relapses. The following helps: positive self-talk, exercise, meditation, deep breathing, and discussions with supporters. You want to have these coping mechanisms in place because these backsliding situations will always develop. It can be a positive situation or negative that causes the backsliding. Sometimes this happens when we start categorizing food. I’m not a big fan of diet depravation. The exception is that if there is truly a trigger food that sets off your eating (you can’t eat just one potato chip-you eat the whole bag) then you need to stay away from it. That’s something you have to figure out yourself. But for most foods I don’t like to categorize them as “bad.” If we treat things as truly bad, it creates tension which leads to obsession. It’s really working on portion control. If others are telling you that you can’t have certain foods, it often leads to rebelling.

You want to take charge of your thinking. Typically errors in thinking almost always accompany ineffective coping skills. We want to change the strategy to help take control of your thinking. Avoid the trap of perfectionism and unrealistic things. An unrealistic goal would be to be the same size you were at age 18. Use positive self-talk. Listen to yourself. What are you saying? Are you making excuses?
Are you making rationalizations? You want to challenge yourself, but you also want to be reasonable with yourself. Challenge yourself to commit to your goals. Learn to make better decisions. Don’t let your emotions cloud those decisions. We are emotional animals. We let emotions take control and that never works.

Develop self-management skills. Learn how to identify and change behavior patterns. Self-management tools include learning to: communicate effectively (be open and honest), problem solving (assess, plan, take action), self-monitor (track coping skills), mange conflict (handle relationships effectively(, cope with emotions (recognize healthy/unhealthy feelings), avoid thinking traps (challenge irrational beliefs), manage stress effectively (meditation, exercise), and mange time (“to do “ list, et priorities, follow a plan). There’s never enough time so we have to prioritize things.

Tips to help get you back on track. First, don’t beat yourself up. We all backslide. Try to figure out what event triggered a relapse and learn from it. Second, be patient. Creating new habits takes time. It’s something we have to work on over and over. Third, think outside the box. If you’re doing something that’s not working for you, it’s time to change what you’re doing. By doing the same things you’ve always done, you’ll get the same result. Those are one of the definitions of insanity-doing the same thing over and over again and think we’re going to get a different result. Take a different approach. If you’re struggling and have questions, talk to one of the counselors here at The Center for Weight Loss Success. We have multiple programs here. I’m not a counselor. I’ll tell you what you need to do. A big part of it is how you make that happen in your life. Sometimes sitting down with one of the counselors and figuring out what you’re struggling with and what the solutions are can be a big help. How can I change this? Change is hard!

Tips to re-start! Try one of the “Jump Start/Quick Start” 2 week programs at CFWLS. It simplifies things using some of the shakes. It’s a simple thing to do. You have to translate that eventually into long-term. If you’re struggling and you’re going to do just one thing: count your carbs! You’re getting the most bang for your buck right there. Even when we think we’re doing well, we drift. If you’re going to do two things: count your protein! It’s easy to count. You want to make sure you haven’t drifted on that too. If you’re going to do three things: count your exercise! Write it down! If you don’t how we are going to know what was really wrong? We may think we’re doing everything right. But if you don’t write it down, we’ll never really know that. Typically writing it down will change your behavior. So simple things but not necessarily easy.

Tips for success! Arm yourself with knowledge. Use the info through the programs and staff at CFWLS to help you recognize backsliding and take the steps to stop it in its tracks. Go back and review the information. Acknowledge and celebrate when you take control of that first slip. Realize that we’re not going to be perfect. Keep supportive people around you. Recruit people to help you. The staff at CFWLS is always ready to help.

I mentioned we have the “Back on Track After Weight Loss Surgery.” We also have the whole digital program as well. You do it yourself. There are PDF’s you can download and print. There are a lot of things that go along with it.

If there are questions give us a yell here at CFWLS. You can email us at success@cfwls.com

The phone number is 757-873-1880. Stop by and get your body composition analysis done. You should be receiving the recipes and weekly weight loss tips. Tune in to Losing Weight USA each Tuesday at 6:00pm for the next webinar. Remember it’s your life. Make it a healthy one!

Phentermine – Could it Help You Lose Weight?

Posted on February 21, 2019 by CFWLS

I’d like to talk to you about Phentermine. Phentermine is an appetite suppressant. It’s been around for a long time. Appetite suppressants are really carefully regulated by the FDA, so there are some hoops to jump through for those people utilizing them, but it’s very doable. Potentially it can be helpful from a weight perspective, but also from a hunger/craving perspective. It works very well for cravings.

A lot of appetite suppressants have come and gone. There have been a number of them over the last 20 years or so. They got approved by the FDA, were around for a few years, and then gone. One of the reasons is because the drugs were causing other problems. There are a couple of newer ones in the last few years. None of them really work any better than phentermine. The new ones can be really expensive. Phentermine has been around for about 60 years now. It can be very helpful. And it’s very safe. We’ll talk about the risks, which are something we do have to keep an eye on. It can help with any medical weight loss plan. You have to be doing the right things. Phentermine will not make up for a bad eating and exercise plan. It’s very closely monitored by the FDA. Part of that is because back in the 90’s they had phen-phen. It was a combination medication of phentermine and also phenfluramine. They put two medications together and it worked wonderfully. Unfortunately, the phenfluramine ended up causing heart problems. It was taken off the market. Because phentermine was associated with it, it’s very closely regulated. Overall, it’s a very safe medication. It has stood the test of time. It can actually be used long-term but it needs to be monitored. There can be some potential side effects. You do have to watch blood pressure. It’s rare but not impossible.

The clinical indications for using phentermine are a BMI over 30 or BMI over 28 with medicals problems. It’s similar to having weight loss surgery. Generally what they’re talking about mostly are sleep apnea and diabetes. Chemically, phentermine looks like amphetamine. Because amphetamine can cause all kinds of problems, and can be addicting, it was thought that phentermine was in the same class as amphetamine, and therefore just as dangerous. It was more regulated by the FDA. A lot of those theoretical problems really never panned out.

I’ve been utilizing phentermine in the patient population for about 15 years now. Just like surgery, it’s a good tool. It’s just another tool in the toolbox. There’s nothing magic about it. It can be a good additive tool along with the surgery. All it really does is takes the edge off hunger. It really takes the edge off cravings. It won’t prevent you from eating. It can also help with carbohydrate withdrawal. Most of our patients are very sensitive to carbohydrates. If they fall off the wagon and start eating too many carbs and then try to cut them back again they’ll go through withdrawal. Carbohydrates are like a drug. The phentermine can help with the carbohydrate withdrawal symptoms. We have found that phentermine can give you 8-12 pounds of extra weight loss. It’s the same with our surgical patients. If they feel like they’ve stalled out, the phentermine can give them some more weight loss.

If you are keeping your carbohydrates down while utilizing phentermine, you can lose a tremendous amount of weight. The weight loss from phentermine will vary from person-to-person depending on age, genetics, sex, and other health problems.

There are potential side effects. You absolutely need to have an EKG done prior to starting phentermine. You want to document that your heart is fine. It’s not going to cause a heart problem. But if you’ve already got a heart problem, it can worsen the problem. Almost everyone starting phentermine gets a dry mouth. Make sure you’re drinking a lot of water. It can make you feel slightly jittery. It’s kind of like having a few cups of coffee. They typically fade away in about 7-14 days. It’s a side effect. It’s not how the medication works. I tell people that if it makes you jittery and it bothers you, then quit taking it. The medication will be out of your system within 12 hours. One of the uncommon side effects of phentermine is insomnia. If you take it too late in the day you might have a hard time going to sleep. But that typically over time goes away. Other uncommon side effects are tremors, dizziness, and high blood pressure. It’s really rare for blood pressure to go up, but that’s one of the reasons why we have to monitor it. Theoretical potential problems (which are related back to the phen-phen) are heart problems and addiction/withdrawal. You can get used to the medication, but that’s not necessarily addiction. You can build up a tolerance to the medication where it stops working as well. But you can’t go through withdrawals. You don’t have to wean off the medication. You can just stop taking it.

There are some real reasons to avoid phentermine. If you have an allergic reaction to it, obviously you shouldn’t take it. If you have a history of heart problems (no matter what it is), I would discourage you from taking it. You shouldn’t take it if you have high blood pressure that’s poorly controlled. You can take it if your blood pressure is well controlled. Theoretically you should avoid phentermine if you’re taking antidepressants. Because of the chemical make up of phentermine, there was a thought that there would be a cross over, and some antidepressants would make this exacerbate heart problems. It would make antidepressants not work as well or the antidepressant would make it exacerbate heart problems. But it’s absolutely fine to take it with antidepressants. There is actually some antidepressant affect with phentermine.

Legally I have to have a discussion about the” art” of taking phentermine to a patient if they’re going to be taking it. I have to talk about the potential side effects as well as the” art” of using the medication. It tends to last for 10-12 hours. So, since most people don’t wake up starving, don’t take it first thing in the morning. There’s no sense in taking it then. Take it mid to late morning. Play with the timing. If you find you’re having a hard time getting to sleep, then take it earlier. If you have a lot of hunger and cravings right before bed then you need to take it later. It’s one of those medications that work if you take it. It doesn’t work if you don’t take it. You don’t have to build up to it or wean off of it. Therefore you can use it intermittently. It’s fine to use it certain days of the week. We typically write it as a daily dose but there’s no reason you need to take it every day. Take it as you need it. It can be used long term. It originally was written in the PDR to be used for only 8-10 weeks. They originally said that because the original studies were only done for 8-10 weeks. It was then approved by the FDA but never approved for long term use. It has been used for long term use for many years the PDR has never been changed. So most physicians only prescribe it for a few months. It’s kind of silly to think we can fix something in a couple months. I’ve had people on phentermine for 10-12 years. It just has to be monitored. We’re making sure there aren’t any blood pressure problems, ensuring it’s still helping, and make sure there are not side effects bothering you. If it’s not helping, you shouldn’t be taking it anymore. There is evidence that if a person is taking it long term that if they stop it every few months for 7-10 days, and then it tends to work better.

There are some cautions about phentermine. Sometimes it may work so well that you don’t eat. We’ve talked about intermittent fasting and how that works. The problem with skipping meals and intermittent fasting are two different things. If you’re just skipping means, then it was unintentional. Fasting is intentional. You don’t want to be skipping meals all the time. If you’re doing intermittent fasting for a day or two, you can take phentermine. It’s another tool in the tool box. Starvation has never been a good weight loss plan. Phentermine won’t stop you from eating. If you’re eating for many reasons (not hunger), then it’s not going to help you. You need to take a good look at the behavior side of things. Why are you actually eating? Work on solving those problems. Without a good nutritional and exercise plan, any weight loss with the phentermine will likely be temporary.

In summary, phentermine has been around for a long time. It has stood the test of time. It can be very safe. It can be very helpful, especially for cravings. But it still needs to be used with a good diet and exercise plan. It doesn’t work to fix a poor life plan. You need to have a normal EKG. We have to monitor your blood pressure as well as side effects.

Come in and get your body composition done. Make sure your losing body fat and not lean body mass. Remember it’s your life! Make it a healthy one! Take care everyone.

Thanks to Dr. Clark...