Happy New Year,,,One Last Nag

I wish all of you a very happy, healthy and safe New Year...Let's look forward to 2009 being a MUCH better year. Remember at all times: If you have your health, you truly are fortunate no matter what the stock market has done, no matter what horrible world news is in the newspaper, no matter who the latest politician is that has been caught doing something bad. It takes one serious medical illness to put all of this into perspective. Do everything possible to keep you and your loved ones in as best health as possible.

I look forward to being a part of your quest to make 2009 a healthy and happy year! All the best!

losing weight over the holidays

One of the patients I saw yesterday had a very successful weight loss week despite the holiday festivities. I asked her the "secret to success". Her answer: Take only small tastes of the high-caloric foods and not large portions. Also, pick the few items that are most desirable to you and have small portions of those, but leave the other high-caloric foods/desserts that are not as appealing to you completely untouched. Also, she recommended that because there are fewer hours at work during holiday weeks, she scheduled more exercise time. The patient also expressed lots of happiness that she decided to embark on weight loss before the holidays as opposed to packing on the pounds and doing the New Year's Resolution thing.

Alcohol is a major barrier to effective weight loss and if, on New Years Eve you have a choice of doing booze or doing a good dessert...opt for the dessert.

weight loss and patterns of behavior

Please take some time this week and write down all the behavior patterns you can think about that derail your weight loss efforts. Do you skip breakfast? Do you not plan your meals in advance? Are you a nighttime snack person?? Do you have a glass of wine every nite??? Write down everything and anything you can think about that may play a role in hindering your weight loss efforts and make a conscious decision to start intervening with these issues. Your list may have 20 items, 10 items or 100...if you can see exactly what the issues are, then perhaps you will be better positioned to permanently do something about them.

Okay: Posner movie reviews: Clint Eastwood's Gran Torino: EXCELLENT Merly Streep in Doubt: Excellent


Football weekend: Giants positioned to go all the way again...if the Giants win the Superbowl anyone reading this blog that e-mails me at: serotab@aol.com and sned the mesage "Go-Gmen" will get taken out to lunch by me and Linda.

weight loss and supplements

The FDA issued warnings covering over 20 Over-the-counter supplements that are being sold for weight loss. Some of these supplements (made out of the United States) actually contained the same chemical as the anti-seizure medication Dilantin.

You cannot turn on your computer without being inundated with ads for "magic pills" that purport to cause massive weight loss with little effort on your part. Buyer beware! Not only what you are buying with probably not help, but you are putting yourself in harm's way.

Anything that sounds "too good to be true" usually is, and certainly, as this relates to weight loss, it ALWAYS is. We developed and sell a supplement, but you will never hear us say: "take this pill....do nothing...and weight will come off". Long-term weight loss always has to include a dietary and exercise component, and supplements may be adjuncts to this effort. However, check out the supplement and its ingredients carefully and make sure there is some sort of safety track record associated with its usage.

Balmy weather...weird... this makes people get sick...we always see in my medical practice a spike of respiratory infections when the weather turns warm over the winter....time for a run at the park and then on to NFL Sunday....have a great one!

Post Holiday Left Overs

First, thanks Suzanne for imparting further strategies for planning out holiday meals so as to have healthy choices available. Lots of candy and cookies around the house from gifts...PLEASE be very careful to NOT mindlessly ingest these items over the next week. It is so easy to just pick up one or two snacks and think it will not harm your weight loss efforts but, cumulatively, these high-caloric food sources will be deleterious. If you are off today, make some time for exercise. Personally, since I got Tanner The Dog, I feel guilty about exercising indoors so I have felt compelled to take him outside for runs. As I am getting older, I find myself hating the cold. I went out this week and bought some heavy duty hats, sweatshirts, gloves, etc to protect me from the cold. If you do not have inside equipment or belong to a gym, then your exercise will need to be outside. If you did not get holiday gifts that were related to exercise, consider exchanging something for outside exercise garb. Have a great day !

Happy Holiday

I wish all of you the very best of health and happiness.

What does a Jewish doctor do on Christmas morning? 1-Look for Christmas movies on television 2- Take Tanner the dog out to Burke Lake Park for a run 3-see a movie at the theatre 4-just had to attend to a patient with a bad sore throat 5-try very hard not to write anything about losing weight on a holiday that is meant for everyone to enjoy the love of their families and not worry about calories for one day....

i will get back being a pain tomorrow!!! laughing...have a great one!

Happy Holiday

We have all been hit with horrible financial news over the past number of months. Yes, all of our "paper" wealth has taken a major hit and the newspapers daily deliver us worse news about the financial future...the values of our houses, the deteriorating job market, etc.

As you spend time this holiday season, enjoying your family and loved ones, focus on the "real" wealth that we all (hopefully) have and that is the love that exists in our circle of family and friends. Furthermore, health is truly our major resource, because no matter the value of our house or our stock market portfolio, if we do not have good health, these other things matter little.

Have a great Christmas eve and I wish all of you the very best of health and happiness

Staying Healthy

As you are enjoying the company of your friends, family and loved ones, give special thanks, if you have relatively good health, for the fact that you are there in a pretty good state to enjoy your family time. In my internal medicine practice, I see many cases of people who have the sudden onset of signficant medcial problems that have a good chance of shortening that unfortunate person's lifespan. There will be less Christmas dinners for that person to enjoy their families. It is sad.

What shortens a person's lifespan? Heart disease, diabetes, cancers.

What contributes to the development of heart disease, diabetes, breast cancer, pancreatic cancer, colon cancer? Obesity

Losing the weight is certainly going to help you aesthetically, but for living life to the fullest and being there to see you children and grandchildren grow and florish, there is no better thing you can do for yourself. Life often is a series of choices. Choosing to be there with your loved ones over impersonal high-caloric food sources or alcohol is, in my opinion, a better choice.

Big Push.....

Okay: 10 more days till the New Year.....try very hard to NOT let the next 10 days really turn your scale in the wrong way. Make a conscious effort to enjoy the love and festivities of the holiday season and not start going back to old habits. If you are receiving gifts of calories for the holidays (cookies, fudge, brownies, Godiva, etc) and you are trying to lose weight, turn around and give them to someone who does not have a weight issue. These food sources are NOT comfort and are NOT your friend. Anything that makes you less healthy and less happy is NOT a "treat".

As you are planning your Christmas day or Eve meal, make certain to have lots of healthy choices for those around you who are also trying to lose weight.

You will be VERY happy January 1 if you see that the scale has not given you bad news because you are paying attention now!

GREAT game last nite!!!!! Giants looked like a Superbowl team again. Congrats to you Skins fans....they played an excellent game....really bottled up Donovan.

choosing wisely at meals

At restaurants there are lots of "accompanying" things that make for a much higher calorie count...the bread that comes out with butter, the before dinner alcohol-containing drink, the side dishes and the dessert tray that is then presented.

Picking and choosing the "right" parts of the restaurant meal can go a long way in helping your dietary efforts...give up the cocktail....leave the bread alone....and....order that really good steak or lobster....but have a vegetable as opposed to mashed potatoes...and....the dessert tray??? it is not worth it and react to your senation of satiety...there is no way you are still hungry at that point!

Finding partners...

As January approaches and most people have as their New Year's Resolution weight loss, it would be great to find others who may want to join forces on a quest for significant and sustainable weight loss. Do not be afraid to approach family or friends who also have a weight problem and offer up some type of "partnership" on the effort. Perhaps exercising together, planning meals and strategy, some healthy "bet" or competition...something that will make your weight loss efforts seem easier and perhaps more fun.

Okay...I have an idea: for anyone of you reading out there that has an interest, write me an e-mail: serotab@aol.com and I will start keeping a list of people interested in "teaming up" and I will pass on contact numbers...or...post a note on this blog with your contact e-mail.

Having "company" during your weight loss efforts can boost the results for everyone!

Winter Weather Advisory and Weight

It has been very nasty outside..dark, cloudy, rainy....it seems many many months ago that the birds were singing, sunrise was bringing warmth and the flowers looked beuatiful. Those morning, it was a great chance to take a walk or jog outside. Now? forget about that! dismal, dark and cold. We feel like rolling over in bed and staying asleep.

Exercise levels are prone to drop off and if we do not adjust our eating, weight will start going up instead of our desired loss.

During these months, it will be very helpful to have in a warm, well-lit basement, exercise equipment which will allow you to get that exercise in. Yes, belonging to a gym is great, but if you know your personality is such that you will have trouble getting up, dressed and to the gym before work, then home equipment is your answer. Putting this equipment in front of a tv set to provide entertainment will make the exercise time go by easier.

weight loss and happiness

Over the past several weeks I have seen a number of patients who have demonstrated, almost in a linear correlation, a marked improvement in their happiness that has paralleled their weight loss. When these patients first started our program, their mood was bordering on the clinical depression side. After signficant weight loss, the mood problem reversed completely, with an almost elated sensation occurring.

The improved physical appearance, higher level of confidence, more energy, positive feedback from friends and relatives, etc....all of these contribute to a person being happier when they lose weight. Coming off of medications for diabetes, hypertension, hypercholesterolemia and other medical entities associate with weight problems is yet another reason for improved happiness.

Yes, on an immediate basis, the ingestion of a dessert can make us happy...for a bit. BUT, weight loss will make a person happy for much longer.

An Idea to Help With These Next Two Weeks...

Everywhere you turn for the next several weeks there will be high-0caloric food and drink choices staring you in the face. You will have people all around you ingesting alcohol, cookies, chocolate and other food and drink choices that will derail your plans to lose weight.

Here is a suggestion: Take the time to sit down with a piece of paper and write out a list of those food and drink sources during this holiday time that will sabotage your efforts to lose weight. These items may include egg nog, Godiva chocolate, Cookies, etc. If you generate a list of 15 or 20 items, then strike out 50-75% of them and put them as "completely off limits". Allow small portions of the remainder. In this way, you will reduce the amount of calories you will take in but at the same time allow yourself some of the holiday food and drink sources that will allow you to not feel totally deprived.

Chart that Weight!!!

I know I have recommended this previously but I REALLY REALLY everyone should do this and if you have not done so, DO IT TODAY!!! Keep a chart on a clipboard next to your scale at home and record your weight weekly on that chart. If that weight ever goes up by 10 pounds more than when you left our program, please pick up the phone and call us. We can bring you back into the program for 1 or 2 weeks and help you refocus.

If you do this, there is NO WAY you can gain back 20, 30, 40 or more pounds.

PLEASE do not be embarrassed if you have gained weight back. It is incredibly difficult to maintain weight loss, and it is common to need help. W e are here for you.

TV Commercials and Weight

While watching football yesterday (dismal day for the G-Men and Skins) I was amazed to see the plethora of commercials touting huge portions of food for a relatively inexpensive price. From the "5 Dollar Foot Long" Subway commercials to the "Panormous" Pizza Hut commercials to the "555" Dominos commercials...it seems as if you can get lots of calories for a relatively small amount of money.

Corporate America is great at showing us tasty looking foods on commercials (do you notice though that in real life, the food never looks as good as in the commercials???) and then hitting us with an "Offer we can't refuse".

Do we really need a foot long sandwich as opposed to a 6 inch one??? It is that important to get three Dominos pizzas (with one topping each) as opposed to a less-caloric meal?

If you are in a weight losing mode (and if you are reading this then my guess is that you are) then please think carefully before picking up that phone and dialing your local pizza delivery place....the deal sounds good, but your scale will not like it!

Helping other's weight loss efforts

There is no question that you have friends and/or family members who are trying to lose weight. Having support in your efforts and providing support for others will go a long way in helping everyone. Such things as having "healthy" choices available when you throw a party, not giving (as a show of love and caring) baked goods or candies as holiday presents and perhaps organizing a weekly walk, discussion or other type of support function to help everyone stay focused will help everyone lose weight. You want your friends, family and loved ones to be as healthy and live as long as possible. Why, if they are overweight, would you provide high-caloric gifts? You will be hurting them. Many other alternatives for presents are available...gift coupons for movies, massages, etc.

Posner's Picks for today include: Tampa over Atlanta, Cincy over the Skins (sorry Skins fans for that one), Jets over Buffalo and Carolina over Denver.

A Great Theme...Making a Choice

This morning I had a patient tell me that she went to a function that had a great buffet line and she was able to not damage her weight loss efforts by repeating this line over and over to herself:

"The food will not taste as good as my weight loss will feel"
"The food will not taste as good as my weight loss will feel"

I did love that line because this, in fact, sums up the choice that we make when we decide to lose weight: We know the high-caloric food sources taste really good, but we also know that when we lose weight, we feel more confident, have higher energy levels and overall feel much better. So, if we cant "have it all", which route should we choose? We can either continue to do lots of the high-caloric foods that provide temporary happiness or lose weight, whiuch will help us live longer, feel better and look younger. A great choice is the latter!

Antiaging and Weight Loss

Hi once again from Las Vegas...one more day at the antiaging convention than home tonight....

I delivered a speech yesterday morning about the use of oral serotonin supplementation in a medically supervised weight loss program. I was surprised to learn that most physicians who have "Anti-aging" practices do not have formal weight loss prgrams in their offices.

Once again, the concept of "internal aging" vs. "external aging". Being overweight, and developing a number of the associated medical syndromes....hypertension, diabetes mellitus, arthritis, atherosclerotic heart disease, etc causes a markedly increase in "aging" of the internal organs. As the "outside" can be getting aestheic help, such as botox, surgical procedures etc to make us physically look younger, if the inside is aging rapidly, big problems wwill occur.

Aside from the "anti-aging" that our organs will go through as we lose weight, at the same time, our external appearance becomes more youthful as well.

Back in NOVA tomorrow!

food choices, weight loss and being out of town

Good morning from Sin City...In case you ever arein doubt about splitting 8's when the dealer has a "10"....my advice: DON'T DO IT.

Okay...now to business....I have noticed a dramatic difference in the size of the people in Las Vegas who choose to eat at sit-down restaurants as opposed to the buffets or food courts at the hotels. It seems that there are many more overweight people choosing the buffets or the "fasr food" choices at the food courts. When I have been at the sit-down restautrants, the % of people with weight problems drops off.

I have discussed this before in the blog but will bring this up again: A long term strategy for weight loss will include NOT putting yourself in situations that will create problems in controlling your caloric intake, and most definitiely, buffets and food courts will test the strength of our resolve. Especially the buffets...they are all advertised as "ALL YOU CAN EAT". Try to pick good places to sit down, take your time and enjoy a meal that offers a number of high protein and vegetable choices. And no doubt, unlike a buffet where we all tend to make multiple trips to the food bar, at a sit-down restaurant we will be served one plate.

I am talking at an antiaging convention this morning and perhaps I may come back looking 10 years younger. (Or perhaps not)

Aging and weight loss

I am off to Las Vegas today to talk at an antiaging conference about obesity and aging. The "outside" of us, i.e. the aesthetic appearance is dramatically altered by weight loss. Our patients who lose significant amounts of weight look up to a decade, if not more, younger. It is amazing to see the physical change and how much more youthful someone appears after weight loss.

"inside"...i.e. the internal organs are also considerably helped by weight loss. The heart, joints, lungs etc are incredibly improved by losing weight. These organs and joints will allow us to live longer in a healthier state.

There are many reasons to lose weight and certainly from an "aging" perspective, it is incredibly helpful to shed those pounds.

Will write you from Vegas!!!

Weight Loss and Dogs

Tanner, my new yellow lab, is a really, really sweet dog. Very obedient, attentive and not too hyper...and...has not done anything bad in the house yet! He loves to run outside...I had him out for a number of walks and runs over the weekend. I run daily on a treadmill when cold, but in addition to the treadmill workouts, I found myself doing lots more exercise BECAUSE of the dog. So my point is this: IF you are an dog lover/liker, and do not have one now, aside from the companionship and love you will get back, getting a dog will FORCE you into more exercise. Having to walk the dog, getting up a bit more early to do this, or even running with your dog will have you burning off more calories. If you cannot have a dog for any reason, then PRETEND you do...teasing of course, but what I mean is set that alarm earlier, get up and walk yourself (no leash required) or go on that treadmill or elliptical machine. Exercise is a vitally important component of any sustainable weight loss initiative.

Restaurants and weight loss

Last night at dinner my son, who is trying to lose some weight, offered this advice:

Toward the end of dinner, when he is feeling not hungry anymore, he purposefully puts his napkin on the plate to signal the waiter/waitress to remove the plate. There may be some potatoes or other food sourses still left, but Brian told me that if the plate remains there, he will find himself still picking at the remnanst almost absentmindedly. If the plate is removed, he cannot do this.

The other issue certainly is the "dessert tray". Who truly feels any "hunger" at the end of a restaurant meal to then have a high-caloric dessert???

By removing the pre-dinner alcohol drink, the bread that is brought to the table, a high-caloric side dish and the dessert, you can save a thousand calories and still have a great time!

On a non-weight loss note: New do for your doctor!!!a 2-year old yellow lab....Tanner....VERY sweet and athletic....

Thanks!

Our 20th Anniversary party was so much fun last night !!!

For those patients and friends that showed up, I want to thank yoo very much for taking time from your busy schedules to help us celebrate.

For those patients who could not make it: I want to thank you very much for allowing me to take care of you and your family's medical needs.

For my staff of uniquely intelligent and caring people: Thank you so very much for setting this function up and cleaning the office when it was finished.

For my family: I want to thank you for so much support during these 20 years.

Today is my first day of the next 20 years! A little older (alright, lots older) but still lots of energy and enthusiasm!!! I promise...back to weight loss issues tomorrow....

20th Anniversary...some reflection

Okay, if today you are tuning in for some advice about weight loss, sorry....your doctor is in a very reflective mood and today's entry will not be about weight loss.

Twenty years ago I opened my doors to start an internal medicine practice. My family and I moved to Northern Virginia in the summer, 1988, and I had just ended my U.S. Navy obligation as an internal medicine physician in Jacksonville Florida. I joined an internist in Mt. Vernon, and after three months, realized I did not want to continue in his practice. It was a very typical-for-that-time type of solo practice where the doctor would round at the hosipital before hours, see patients in the office from 9-4, and then round again. Quickly, I saw this was not for me: patients waiting hours past their scheduled appointment time, hospitals and nursing homes constantly paging you, admitting patients through the emergency room who had no physicians...all of this was not what I envisioned when I left the Navy to become a private practice doctor. I decided to open my own practice, and at that time, I had two small children, Ellen worked as an assistant county attorney and we had moved into a house that was way more expensive than our house in Florida.

On December, 5th, 1988 I opened my office in Burke and had three patients (all from the old practice) my first day and none the second. I had a total of 7 patients my first week. I was moonlighting at a military outpatient clinic called 'PRIMUS" in Burke, and every patient I would see I would hand them a card telling them about my new practice. I would give lectures at libraries at night to try to meet new patients as well. With great support from my family, I have now had the great fortune of completing 20 years of providing medical care to the wonderful communities of Burke, Springfield, Fairfax, Fairfax Station and the surrounding areas. Over the 20 years I have had hospitals open up pracitce right near my office with lots of marketing bucks behind them, but we still maintained a wonderful, viable practice.

I remember seeing old clips of Lou Gehrig giving his speech to Yankee Stadium, one of his lines was 'Today, I consider myself the luckiest man in the world...." The guy was dying at the time.
Today, I do consider myself one of the luckiest men in the world. The great thing for me is that I am not dying and I get a chance to keep doing the things that make me feel so lucky. I want to thank each and every one of my patients who chose/and keep choosing me to help them with their medical needs...both past and present patients. I know that sometimes when patients come into my office, they ssee weight loss signs, bottles of pills, and other signs that suggest that Dr. Posner is moving in other directions. Let me assure you that at no time during any of these other efforts have I ever not answered your weekend calls, concerns, etc. as this relates to my internal medicine practice. The best way of showing my gratitude is to continue to be the type of doctor you can count on 24/7, 365 days a week to be available to you either in person or by phone. Thank you for a great 20 years!!!!

How To Navigate Around The Holidays...

Several patients came in yesterday who had great success during Thanksgiving week in their weight loss efforts. In common, this was their plan of action: they decided not to deprive themselves of any particular food source (excpt alcohol) that was around the table, but they took only "tasting" portions of the different foods. From the mashed potatoes to the stuffing to the sweet potatoe casserole, small spoon-sized portions were tasted. This action seemed to result in not feeling completely "deprived", which is a terrbibly frustrating sensation.

Both patients did'nt lose lots of weight this week...about 1.5 pounds, BUT the important point is that they had a great Thanksgiving holiday, were able to partake of the variou food sources and did not feel deprived.

As the Christmas parties start abounding, consider that strategy to help your weight loss efforts.

Treating 5 pounds like 50....

Yesterday I had two patients return to us who had previously done great in our program. Both lost around 50 pounds about a year ago. One person that came back gained back all 50. The other gained 5.

Both were somewhat embarrassed about coming back, but I reassured them that we understand completely how hard it is to maintain weight loss, as we are so naturally built to be a weight gaining organism. As much as we stress that there is no "finish line" when it comes to weight loss efforts, psychologically, we are always looking for that finish line so we can start going back to some of the old, more fun, eating behaviors.

Anyway, for the patient that gained 5 pounds, perhaps 1 or 2 visits to refocus, give some pills, and the person is right back to where he wanted to be. In the case of the 50 pound weight gain, this will take months (again).

Point here is treat the 5 pounds as urgently as you would treat the 50: If you do not allow more than 5-10 pounds to go back on before you make an aggressive move (calling us, on your own, doing phase 1, etc) then there is no way you can allow yourself to put back on 20, 30 40 or more pounds back on.

Serotonin, sunlite, seasonal affective disorder,weight

Another dark, cold morning...also, getting darker so much earlier at nite. Do you notice that sometimes your mood tends to be less "up" during the winter months? ("Seasonal Affective Disorder") Also, do you find yourself eating more carbs during the winter?

Here is, in part, a chemical explanation of this: Serotonin is made inside the brain from the amino acid tryptophan. When sunlite hits the retina, this makes the brain make more serotonin. During the winter months, when there is less sunlite, the brain is making less serotonin. The person is then compelled to eat more tryptophan to try to help the brain have more substrate to make more serotonin. Unfortunately, the tryptophan is present not just in chicken and turkey, but large amounts are found in sweets and carbs. These sweets and carbs carry with them lots of calories resulting in weight gain.

How do you break the cycle??? Some people use special lighting (very popular in Alaska) in their households. For a number of our patients, the oral serotonin supplementation helps dramatically with Seasonal Affective Disorder. There are also a number of people in my medical practice who require "SSRIs" (selective serotonin reuptake inhibitors) such as Prozac and Zoloft during the winter months. The problem with the antidepressants though is that they only raise serotonin at the mood (Serotonin-1-A) receptors and not the serotonin receptors involved with appetite and cravings.

Enough biochemistry this morning! Have a great day and.....countdown is 4 more days till our 20th Anniversary Patient Appreciation Nite....December 5th, 5-730 Pm!!! PLease join us!!!

Keeping track...

This past week we put several patients back into our program who had previously lost well over 40 pounds during their initial program but unfortunately over a number of months, put every pound back on. Embarrassment delayed them from picking up the telephone and calling us, but eventually they decided they needed our help again.

First, nothing to be embarrassed about being a normal human being.. As I tell each and every patient entering our program, we, as humans, are built to be a weight gaining species. Lest you doubt that, ask yourself whether when you "crave" food, are you craving high-caloric foods such as ices cream or chocolate, or are you craving broccoli? Is a "reward" for a long day at work a glass of wine or a glass of water? When we gather with friends, is it at a gym to exercise or is it at a restaurant or someone's home to eat and drink? The answers herre are obvious, and explain why, in part, we have such difficulty maintaining our weight loss. The botton line is that for most people, there is nothing fun about giving up food and drink sources that we love. We will do it for short periods of time (dieting) but not for long periods (life style change).

Keep that chart next to your scale and weekly, WRITE DOWN the weight and the date. If that weight ever goes more than 10 pounds from when you left our program, CALL US!!! If you follow this recommendation, there is no way can someone go out there and put back on 30, 40, 50, etc. pounds. We will catch it at 10, and only a few weeks of refocusing will be required to help you get that weight back down and we can help you figure out how the 10 pounds happened and what you can do to perhaps avoid this.

Different subject: Sorry Skins fans...I think Portis being hurt, even though he played, damaged the Skins efforts. They are still in the playoff hunt!