weight loss and supplements

I wish everyone a very safe, healthy and happy New Years eve...

First, thank you Martac for taking the time to comment!

Yesterday a 6 year study was released demonstrating that the popular supplement sold for memory enhancement, Ginko Biloba, has absolutely no benefit. There was no doubt about the results: very clearly, this supplement does nothing to help people with memory problems or helps prevent memory issues from developing.

This supplement has sold hundreds of millions if not billions of dollars over the past 10 years, How can a supplement of no value be sold to so many people? The answer: marketing hype. Pure and simple scam marketing hype.

So what does this have to do with weight loss? The answer is that starting now, with so many people's New Years Resolution being weight loss, many supplement companies launch their miracle weight loss pills. You will see infomercials, commercials, print ads, radio spots and other advertising venues hawking these products. Many people see the "weight loss is simple...take this pill" ads and they take out their credit cards.

Do not be one of the victims of scam. Weight loss is NEVER a simple matter of taking a pill. Not the supplements you see being hyped, not our serotonin product, not any product. Weight loss requires the work of managing caloric intake, planning your meals and lowering your carb and fruit intake. This is work...work that can save your life.

To quote PT Barnum: "There is a sucker born every minute". Do NOT be one of them!

Help Us Write the Best Weight Loss Book EVER!

CALL FOR HELP!!!!!!!!!!!!!

As I mentioned in a previous entry, we are in the process of writing a book about weight loss. Unlike books in this genre which focus on some catchy or fad subject matter that garners Today Show appearances (Skinny Bitch Diet???, Really???) our book will be reality based and will cover such subjects as the chemical nature of carbohydrate addictions, the basis of stress eating and how to overcome this, childhood obesity, stories of remarkable achievemnet and how they did it, and a number of other topics that are extremely pertinent to achieveing and maintaining weight loss.

One of our chapters is being written by YOU!!! (Sorry if you didn't know this!). One of our chapters is called "SEROTININ PEARLS" This chapter will be bullet-point (actually butterfly point) helpful hints that our patients find help their efforts. Such common-sense things such as "Dont go shopping when you are hungry" to "Keep a picture of yourself at a heavier weight AND a lighter weight on your refrigerator" to "Don't keep high-caloric food sources in your house".

We are asking that YOU send us your helpful hints that have worked well for you. Sharing this with our other readers will helo their efforts and reading theirs will help your.

For those of you submitting 5 or more hints, you get a FREE book at our major book signing event in June AND our many many thanks. In advance , thank you for your help!

weight loss and support

One of the elements that helps a person's weight loss efforts is support. The support of family, friends, co-workers, etc. When the person trying to lose weight is being sabotaged by people around them, the results are not as aggressive. Whether it be the well-intentioned relative who says " Oh, just a little bit of this cake cant hurt you!"..to the other relatives or "friends" who say..."You are losing too much weight....you dont need to lose anymore"...people around us will be influencing our weight loss efforts.

Try to recruit others to join your efforts and try to hang out with them...perhaps friends, co-workers, family members who need/want to lose weight. Team up with them on this effort. By surrounding yourself with people who SUPPORT your efforts (as you are supporting theirs) you will have a much better chance of success. Do not be afraid to put an invitation out to people you know who would benefit from weight loss to join you...whether it be exchanging recipes to having a workout partner...having support will help lots.

weight loss and sacrifice

First, Thanks MM for the comment and I look forwaerd to discussing the goal weight when we see you. Congrats on the great weight loss!!! What a change in dress size!!!! Amazing!!!

This morning I want to bring up the concept of sacrifice and deprivation. When we begin a weight loss process most often we sigh and say to ourselves that we are about ready to "diet" and that is not fun. The reason why it is not fun is that we equate "dieting" (remember...we are lifestyle changing, NOT dieting) to sacrifice and deprivation. We are giving up fun food sources and fun drinking activities...i.e. we are sacrificing fun.

I do not want to bring up negative thoughts, but lets pretend that something happened medically that was serious. Serious enough to deprive you of more years with your family, children, grandchildren....serious enough to deprive you of working in your profession...serious enough to deprive you of enjoying the recreational activities you may love, like golfing, going out for drives, shopping with friends etc. Those all would be much mre serious deprivations than not eating a piece of cake.

Evaluate the things in your life that you would be deprived of if God forbid a serious medical problem developed for you. This would be horrible but yet if you are overweight, you are increasing your chances of this happening. Do not deprive yourself of a great qulaity of life. That is true deprivation ans sacrifice.

weight loss and age

First of all, before we start, just a bit of a football update...Giants need to win out by beating the Panthers and the Vikings and then they need Green Bay or Dallas to lose one of their games over the next 2 weeks. Dallas plays the Skins tonight. GO REDSKINS HAIL TO THE REDSKINS I AM ROOTING FOR DAN SYNDER TO SMILE TONIGHT

Okay, back to business....last week I had several patients enter the program with their initial goal being unrealistic..they wanted to get back to their college weight.

Setting a realistic weight goal is important but it must be remembered that our bodies' change as we age and metabolism slows down. Heck, I went off to college 155 pounds..if I weighed tha now my patients would think I had a malignancy.

Do not look at the charts...the ideal weight for you will take into account lots of factors and we are available to help you determine what an ideal (and realistic) weight shoudl be for you.

Do not set your goal too difficult to maintain...getting there is one thing..maintenance is an entirely different picture.

Aim for a weight that keeps you healthy, off some medications that were there only because of the weight and a weight that makes you feel attractive to yourself . Ask our opinion as to what that weight is for you.

weight loss and self esteem

I certainly hope that all of you enjoyed your Christmas day. I know it was challenging to def;ect some of thos high-caloric food and drink sources that were a part of everyone's dinner table. Hopefully, you all did a great job of concentrating on the fact that the love for your family members and friends is conpletely separated from the need to ingest lots of calories.

One of the major positive effects we see for patients as their weight loss programs progress is the marked increase in self-esteem that accompanies the weight loss. The ability to fir into clothes that are perceived more fashionable and form fitting, not have to hide from social events that may include picture taking and feeling more attractive both to yourself and others all add up to a much heightened level of self-esteem. We see this in people of all ages, but especially in our teenagers. It is quite amazing to see the transition of self-esteem in a relatively short period of time.

Certainly, our prime focus on weight loss is to become healthier, rid ourselves of medications, lessen our risk of serious medical sequelae, but the added benefit of feeling so mcuh better about ourselves is wonderful.

Stress and Eating

I want to wish each and everyone of you a very happy and healthy holiday. I hope Santa brought you a wonderful gift that warms your heart and does NOT contain any calories. Enjoy your friends and families and as you are feeling the warmth of the gatherings,, this will help you remember all the reasons why it is si important to you to stay as healthy as possible in order to be at many more of these loving events.

Yesterday's entry about serotonin and stress eating prompted several comments of interest. One of the issues brought up was about the chronic nature of the business stress environment. There are clearly some jobs (NOT dermatology...laughing) where the stress levels will be always very high because of the nature of that position. On the physician side a surgeon who specializes in high-risk cases will feel more stress than the radiologist. Perhaps on the legal side, an attorney who practices family law involving tough issues like child custody may feel more stress than the government attorney who reviews contracts. An educator teaching in a very difficult school may feel stressed than a music teacher at a ritzy private school.

In any event, the more stress the more propensity to turning for immediate gratification sources such as food and alcohol. These of course will lead to weight problems.

Certianly, if you struggle from weight issues and have the chance to chnage stress environments, this is a great solution. However, for many people under stress, they cannot. These people then have to learn how to approach stress in ways other than derailing eating and drinking behaviors.

Exercise is a stress reliever for many including me. NOt only does exercise prevent stress eating, it also burns off calories. Meditation, yoga, self hypnosis and other methods may be employed.

Find ways of not turning your stress into a feeding frenzy. Eating the food sources helps nothing long term other than making you unhealthy and unhappy.

weight loss, key lime pie, serotonin and stress eating

Good Christmas Eve morning..First and foremost I want to wish every one of you an incredibly safe journey if you are traveling. For those of you staying around town, I hope the night brings you great warmth and happiness. I have been writing the chapter in our upcoming book about serotonin and its effect on eating behaviors and then I heard a story yesterday clearly points out the rle of neurotransmitter imbalance on eating behaviors.

Yesterday I had a very prominent attorney tell me that when she feels under stress at times, she will indulge by eating an entire key lime pie. She was not talking about a piece of it....we are talking the entire pie. She actually explained that she does separate out and discards the whipped cream, but the tart part and crust is then consumed.

This attorney has a very stressful position and especially for females, the brain chemical serotonin becomes depleted during times of stress. The brain manufactures serotonin from the building block amino acid tryptophan. This amino acid is found in large amounts in carbohydrates and sweet food sources. When the brain becomes deplete of serotonin, the person is compelled biochemically to seek the food sources that have the building block. Unfortunately that amino acid is found in high-caloric foods.

I had three answers for my very stressed out attorney: 1- Recognize the behavior sequence and do not allow herself to be in the position of having the availability of that key lime pie..i.e. do not have it in the house and do not go to a restaurant that offers this 2- Take the serotonin supplement three times a day 3- Go back to school and become a dermatologist!!! (no weekends, nights, emergencies, etc!)

weight loss and weekend eating

As mentioned previously, I am often asked whether it hurts weight loss efforts to "take the weekend off" as this relates to following a prudent dietary strategy....My answer has always been "no", and now a study comes out to confirm this: http://www.msnbc.msn.com/id/34482022/ns/health-diet_and_nutrition/from/ET


Vigilance is very important every day when you are trying to become healthier and happier. Alcohol and other weekend derailign sources will hinder those efforts. Remember: there is no food or drink that will taste as good as your weight loss will feel,

To my comment person re: not rubbing in the Giants win over the Skins. You are welcome. My heart goes out for the fans and the coach of the team. Zorn seems like a really great guy and he has been castrated by the owner. Zorn doesnt deserve this treatment and I am soooo rooting for them to beat the Cowboys Sunday nite....as a matter of fact, can I borrow a Campbell Jersey for that night???

weight loss and "what they say"

I often hear patients tell me: "but THEY say that a glass of red wine a day is good for you" but THEY say that nuts are good for you" "but THEY say that one day a week you can eat what you want one day a week and still lose weight".

Okay...my question is: who are THEY??? Probably the same people who told my parents not to let me go swimming after eating cause I would get cramps and die.

I really believe that "THEY" are really things people read on the internet, things people hear around the water cooler and other arenas where lots of misinfotmation exists.

Beware of the internet and some of the information we read, as often it is erroneous.

Have a question, check with us, not "THEY"!!!

weight loss and medications

Last week I saw several patients who were able to drop several prescription medications because of the weight loss they experienced in our program. One patient was able to discontinue a blood pressure pill and a diabetic medication and another patient did not require a diabetic and acid reflux med.

Take stock of what medical problems you are experiencing as a comorbidity of weight control issues and realize that it is possible that some of these medications may be able to be discontinued as the medical problems resolve due to the weight loss.

Sleep apnea, arthritis, restless leg syndrome, cancer of the breast, colon, pancreas, stomach are some of the other life-threatening issues related to being overweight. Aside from the discontinuation of cigarette smoking, weight reduction is the most effective intervention you have control over to prolong your life and live happier and healthier.

weight loss and the post snow day

Well, lots of snow on the ground with most of us being home bound for now going on almsot 40 hours.

If there has been some boredom-related eating, get to that basement gym equipment and put some extra time on those machines.

If you are planning meals at home today hget creative to make some high-protein and vegetable dishes that will challenge your culinary prowess yet not challenge your waistline.

Out door activities to burn off calories? lots of it! shoveling, wlaking thru the snow (try a slight jog with boots on!)

Turn the weather adversity into a positive weight management expereince. Be creative and stay away from those Dove chocolate minis!

weight loss and santa

Wow..lots of snow...I think this is the third time in 21 years we actually closed the office.....

Reminder: NO baking cookies and doing the snow eating stuff I wrote about yesterday,....if you have gym equipment at home, work out!!!

Read an story about a British journal article attacking Santa for being a poor role model for kids because of the childhood obesity epidemic. Seems the author took offense of the "fat and jolly" role model, meaning thaqt kids list Santa as their favorite character, and the author contends this promotes kids to want to eat lots and be overweight like Santa.....

Attacking Santa would be akin to insulting one's grandmother....you just do NOT do this....

Helping our children learn healthier eating patterns is incumbent upon parents, and blame cannot be pointed at Santa.....

By the way...second favorite character that children pick? Yep, Ronald McDonald.....

weight loss and snow

Okay....first big storm approaching and we will all be housebound for a day or so....for any of you heading to Giant or Safeway this morning my strong advice is NOT to buy the cake making materials, popcorn and any of the other food sources that we tend to turn to when we get snowed in.

There is a certain "nesting" instinct that takes over when we sense being cut off from food/protection....hence the reason why there is a run on toilet paper and milk at the stores despite us all knowing the reality that we will be able to shop the next day or so after the snows that hit our area...we are never "cut off" of food and almost all of us have provisions for days and days.

Being home and feeling housebound produces a boredom factor that results in trips to the kitchen...also,..cooking activities pass the time.

Be sure to not succumb to the boredom eating behaviors that accompany snow days.....we will all be challenged enough in the next several weeks!

weight and job promotions

As unfair as this sounds, a study was released from Yale that actually showed that females in better physical shape had higher levels of raises and job promotions than women who were overweight. Men were not included in this study.

Should job performance be judged on someone's weight? Should professional progression be affected by weight? Of course not. But this is an unfortunate reality...we are often judged by others on our external appearance.

Losing weight should be an individual decision based on one's desire to be healthier. live longer , etc. However, clearly, others judge as as well professionally based on our appearance and losing weight can only be helpful. Having said this, does being "too attractive" hurt a woman's professional advances if that is intimidating to other women? A very complicated subject and one that I am very interested in your thoughts. Please feel free to comment.

weight loss and pressure

Yesterday I entered a new patient who was somewhat tearful as she related that the major reason for her beginning our program was her husband's unhappiness with her weight situation.

We all would like to think that the reason(s) why we want to lose weight our our own...not outside pressure from a spouse, parent or other family member. However, it is a very sensitive situation when a spouse, boyfriend/girlfriend/significant other seems dissatisfied with the physical status of the affected, overweight person. In the case of the female overweight person, usually the male partner is a Type "A", avid exercising person who never struggles with weight control. Often, not being a medical person, the male is very insensitive to the weight struggles that the female incurs. Its not as if the female is eating Bon-bons every nite...metabolism slows and the weight control issues spiral.

I am not certain what the "answer" is to this very complicated issue. Feeling attractive is often influenced by what others think about our look, and in the case of a spouse or lover, this is even more blatant.

I do not believe that losing weight saves marriages, because if a weight control issue was the make or break of a relationship, then the relationship is probably not worth keeping. However, losing weight for one's self makes you happier, healthier, better self-confidence, and yes, others will find you more attractive. Is that important to you? You need to answer that question for yourself. Tough issue this morning, but one that does require soul searching for each of us.

weight loss and resolve

Intellectually, we know all the reasons why we want to lose weight....the improved health, lessening the risks of serious medical problems, ridding ourselves of medications that would no longer be needed, looking younger, having a higher self-esteem, etc. Our intelligence part of the brain tells us these reasons daiky. Then why is it so difficult to follow through on this plan? Clearly there is another part of our brain that is instinctually driven that almost compells us to eat the high-calorie food sources.

To lose weight requires constant thinking and planning. To gain weight requires no thougjt at all...do what is fun and do what feels good.

Try to think of ways to allow the intellectual part of your brain to tise above the instinctual part. As soon as we stop thinking about it, we are almost guaranteed to go vback to old behaviors and that will result in weight gain.

weight loss and associations

Good morning....GREAT comment yesterday...helpful to all and I encourage you to take a look at the comment left by "Anonymous" to yesterday's entry.

Associations: Macaroni and ____________ peanut butter and ____________ hamburger and ___________ steak and ______________

filling in the blanks....cheese, jelly., fries and mashed potatoes.

We are all used to combining food sources in these association-type of ways. But it doesnt have to be that way....perhaps a hamburger and a side caesar salad....steak and steamed vegetables, movie theatre and NO popcorn...

Take time to think of the associative eating patterns that you do and try to eliminate these "automatic" combinations that will derail your desire to be happier and healthier.

weigtht loss and airports

No, I am not writing this entry at 1am..rather, I am in the Vegas airport ready to hop the redeye back to DC.

Tonight when I got close to my gate I saw a huge line in front of one of those pretel and cinammon bun places. Talking about calories! this cream topping is supplied for only a small amount of money extra, and people were going to town on those sticks and the topping. It is 10PM here.....I would imagine that most people ready to leave Vegast 11PM had earlier in the evening found their way into a famous Vegas buffet or other high-caloric dinner venue. So why then this sabotaging dessert choice? Boredome waiting for their plane? Concern that hunger will occur during the flight so a preemptive intake? Other reason.

Bottom line: if someone is in mode to lose weight, eating airport snacks.,.,,ice cream, pretzels, Cinnamon sticks etc will derail your efforts. Plan your meals to avoid having to choose food sources in airports.

Now to my flight....see you Monday!

weight loss and alcohol

First, I want to thank very much our very fine staff members who are at the office seeing patients and taking care of your medical and weight loss needs allowing the rest of the staff to be here for our Holiday party in Vegas. We had a staff dinner last nite and what stories I was hearing about the exploits of Jessica, Jennifer(s), Julia, Shayna, Nathan, Nicole, Jean and Donna. I cannot believe what I was hearing! But alas, what happens in Vegas stays in Vegas so I cannot share any of this on the blog. But, rumors do exist that a new movie entitled "The Hangover, Part 2" is being contemplated based on the adventures of the Serotonin-Plus crew.

What a place to talk about a subject that has profound impact on weight loss efforts...alcohol.

Alcohol usage is incredibly damaging to weight loss efforts and I often hear the refrain: "A few glasses of red wine daily is good for you." Let me dispel that...alcohol in any form hinders weight loss efforts. There is a adverse metabolic effect of alcohol that is damaging beyond the calories you see listed on the side of the bottle.

This time of year is especially challenging as it seems that almost every social/holiday function is based on lots of alcohol availability.

Make your choices wisely...if your goal is to lose weight, then keep alcohol out of your life.

Weight loss and corporate America

Good Friday Morning....

I read an article in the paper that a cereal manufacturer company is lowering the sugar content of their flagship cereals such as TRIX, Lucky Charms and Cocoa Puffs. (Isn't it amazing that these cereals were present even when old guys like me were kids!) This is a responsible act. Fast food companies targeting their ads to minorities with a high obesity rates is IRRESPONSIBLE.

I saw a cartoon months ago that was poignant. It showed Osama Bin Laden holding in his hand a food plate with a huge burger on it with fries and the caption was: "We don't have to do anything to them..they are doing it to themselves."

Corporate America, whether it be soda companies, fast food restaurants, candies etc are doing nothing illegal, and quite frankly nothing unethical, but it is always wonderful to see some acts of responsible behavior on their part. Obesity is killing America: Lets total this up: Swine flu which hits the front page weekly has killed 100 people. Obesity related diseases kill hundreds of thousands of Americans yearly. Many companies are selling us foods that are contributing to this killing epidemic. We need to turn them off.

Viva Las Vegas

Goiod Thursday Morning....Yes, as the title implies, your good, non -blackjack playing, non-buffet eating, non-alcohol drinking doctor (okay, truth be known...he does play some blackjack, does go to one buffet but does not drink!) and most of the staff are celebrating their holiday in Las Vegas for a quick getaway....we oc course do have staff back home so your medical and weight managment needs are covered till I return Saturday....I am VERY proud of our wonderful staff...they really do care soooo much about you, your family and your medical/weight management needs and the Vegas quick-trip is for me to say thanks to them for helping us be (sorry for the boasting here) the most attentive and caring medical practice in the area.

Okay: hints to avoid weight gain on a Vegas trip: 1-keep alcohol to a bare minimum 2-when you hit the Mirage buffet, stick with protein, protein and more protein and do NOT go to that dessert bar...there is no way you feel anything close to hunger 3-work out daily..bring those gym clothes..the fitness facilities and spas are great 4- snack foods such as nuts that are in that server bar...stay away!

Okay,...back to the tables..oops...i mean the gym....(yeah, right....)

weight loss and sex

Good Wednesday Morning....Please be careful driving out there today....

Today I bring up a topic that was brought up by a patient in the program yesterday...a topic that is uneasy for most people to discuss and an issue that probably does affect most people with weight issues...sex.

The patient told me that since she lost over 40 pounds, one of the best outcomes of this has been a marked improvement in her relations with her husband. She said that not only does she feel much more attractive, but physically, everything seems to work much better. She told me that her husband seems much more interested in passionate moments and keeps commenting about how much younger he feels and how much younger she looks.

I have had several men tell me that after their significant weight loss, erectile dysfunction improved.

Clearly, there are many other reasons why losing weight improves the quality of life, but there are certain "byproducts" of significant weight loss...improved relations is one of them.

weight and psychological issues

Good Tuesday Morning...

Yesterday I had an interesting discussion with a patient in our program which allowed me to obtain some additional insight into some of the damaging psychological aspects involved with people having weight control issues.

People who do not have weight issues do no think/angst for a second about such mundane things as getting on an airplane and thinking whether the seatbelt will go around them, thinking about whether an event will require a certain type of clothes that may not fit or worrying whether an event will include picture taking of the people attending.

My patient told me that before she lost a significant amount of weight, issues such as these and more would preoccupy her thought processes in a very negative fashion. Even so far as to choose (and pay more) for an airline that she knew had a larger seat/seatbelts that would fit around her.


Losing weight helps reduce medical risks such as diabetes, heart disease, cancers etc. However, the psychological improvement that accompanies weight loss is incredible.

weight loss and vacation choices

Good Monday Morning.....

I was up in Atlantic City for an overnight on Saturday and one of the things I noticed very prominently at the Taj Mahal Hotel was that the number of overweight/obese people at the casino was amazingly high. We all know that the percentage of Americans overweight is 67% but my estimate was that the number was closer to 85% at the hotel.

I went to the gym upon arrival and I was the only person in the gym right smack in the middle of the day.

Activities at the hotel? gambling and eating and drinking.....clearly, if someone is in a mode to lose weight, this would NOT be a good choice of vacation venues.

As you are pondering your winter getaways AND if you are in a weight losing mode, try to avoid "All -Inclusive" resorts, cruise ships, Las Vegas or any other place which focuses on "all you can eat" and lots of drinking...Perhaps vacations that inolve lots of hiking/touring/walking Perhaps food venues that focus on quality..not quantity...

Set yourself up for success in your weight loss efforts and choose your vacation venues wisely.

weight loss and liquid diets

Good Sunday Morning....

I read in the NY Post this morning that Slimfast had a recall of their products because of possible bacterial contamination.

I have mentioned this before and will do so again: Long term weight loss strategies MUST be based on eating "real food" as opposed to meal replacements. Learning how to eat the proper admixture of proteins, fruits, carbs etc in the correct portions is what will sustain your weight loss.

The Post labeled the story "The Diarrhea Diet".....pretty funny, huh?

GO GIANTS!!!!!!

weight loss and maintenance

First, I want to thank the people who posted some very nice comments and also the patients and staff who were a part of our event last nite. We missed our patients who could not make it and do wish to thank you again for being our patients.

This past week we had a number of patients return to our practice who were with us awhile ago and unfortunately put on a significant amount of weight that they had lost. I emphasized to these patients (and to those of you who may have done this and have not come back in) that we understand this completely and there is nothing to be embarrassed about. Many of these patients told me that they hesitated to pick up the phone and call us because of the embarrassment factor.

As much as we tell ourselves that there is no "finish line", when we exit the formal visits of a program psychologically we tend to perceive a finish line and start returning to old behavior patterns. As this relates to eating behaviors this will result in weight gain.

I implore every one reading this to write your weight down once a week next to your scale at home and if that weight goes up 5 pounds from when you exit our program, CALL US. This becomes a one time visit...not a multiple week, thousand dollar program. We will refocus you, provide you with a medical jumpstart again and you will lose those 5 pounds quickly. Unfortunately if 30 pounds or more goes back on it is a full program again.

This is hard...nothing easy about losing weight and maintaining. We are here to help you.

Our 21st ANNIVERSARY

Good Friday Morning

Tonight represents the 21st anniversary of our medical practice and this is a very nostalgic and poignant night for me. We celebrate this by throwing a Patient Appreciation Nite. The staff and I provide low caloric and caloric foods and drinks and would love for you to stop by and join us.

For 21 years I have had the honor and priviledge of providing medical care (21 years) and weight loss help (7.2 years) for thousands and thousands of really great people in the Northern VA/DC/Maryland area. 15 years ago I made the bold and risky move of removing myself from insurance lists and so many patients continued to use our practice. I want to thank you so very much for allowing me to practice medicine without having some mid level insurance employee telling me how to treat you. Your loyalty to my practice is met with my loyalty to you: Anyone who has called me on a holiday/Sunday etc know what I am talking about...I am available to you and your family at all times and many of you have seen me in a sweaty baseball hat on a Sunday morning or had me placing an IV into you on Superbowl Sunday to have you avoid an ER visit.

Medicine is changing rapidly...from electronic health records where doctors walk around with PCs typing into it as they are talking to their patients never looking into their eyes to large practices where your call under duress is met with a recorded phone menu frustrating you because all you want is a human voice asking : "How can we help you?" Yes, I am old school but somehow I think that old school is good when it comes to helping people medically.

I want to thank Ellen, Brian and Kym for always supporting my efforts to establish and build the practice and also understanding when Dad had to run off to the office to see a patient after hours.

I want to thank all of my workers both past and especially present for allowing me to boast the "best practice in the area" and the fact that so many of you wonderful people still come to us despite the insurance issue tells me that that staff and I are doing a pretty good job.

For those of you expecting this retrospective nostalgic note to end with "I am announcing my retirement".....SORRY!!!!! I am more energized than ever!!! We have so many ideas as to how to help your medical and weight loss needs better and better. Our staff is young and full of enthusiasm and committed to bringing us to higher and higher levels of patient satisfaction.

I will end this with one more "thank you" for being our patient. Please join us tonight , 5-7 pm for our event. If you cannot make it, please know that your presence is missed and I cannot tell you how much I appreciate you calling me "your doctor".

Onto the next 21 years!

weight loss and scam supplements

Good Thursday Morning...REMINDER!!!!!!! PATIENT APPRECIATION NITE TOMORROW, FRIDAY 5-7 WE WANT TO SHOW YOU HOW MUCH WE APPRCIATE YOUR CHOOSING OUR PRACTICE TO PROVIDE YOUR MEDICAL AND WEIGHT LOSS NEEDS

Yes, it is that time of year when the scam Direct Response industry (you know, the infomerical folks) start coming out with their miracle weight loss pills. You have seen the commericals...the people holding their pants that are 10 sizes too large now and cry into the camera telling everyone how this miracle pill changed their lives. The DR industry knows too well that as we head towards January, many people have their New Year's Resolution to lose weight. People are susceptible to the message that there exists some easy, "short-cut" to lose weight.

I have mentioned this before and will emphatically state this again: There is no such thing as a pill that allows you to lose weight and jkeep it off without the aggressive caloric restriction and exercise necessary. The commercials make it seem that taking the pill makes it easy.

You will never hear your good Doctor tell you that the Serotonin pill is a "miracle" tablet for weight loss. It is not. We use it as part of an overall program that includes a high protein dietary planm, exercise and also a prescription medication.

Buyer beware....as it relates to weight loss, anything that sounds too good to be true, i.e. making weight loss sound easy, must be scrutinized very carefully. Weight loss long term requires behavior modification.

weight loss and the internet

http://www.msnbc.msn.com/id/32862449/ns/health-fitness/from/ET

Good Tuesday morning....The above link details a study out of Australia that proves what I suppose we all suspect: Those people who are affixed to the internet have a much greater risk of weight problems than those who do not use computers DESPITE exercising.

Those people who spend greater than 3 hours a day on the internet have a 2.5 times greater chance of developing obesity compared to people who spend no computer time at all.

Is it the snacks that are consummed while on the computer? Is it just the sedentary nature? The study actually showed that people who exercised regularly still had weight issues more frequently.

If your occupation requires lots of internet time, make certain NOT to snack while doing your work....eat your meals and healthy snacks on a schedule.....

If your occupation does NOT require lots of internet time, then convert lots of your internet time to activity!

REMINDER!!!!!! Patient Appreciation Nite THIS FRIDAY!!!!! 5-7PM PLEASE COME VISIT US FOR A GREAT TIME AND ALLOW US TO THANK YOU FOR BEING OUR PATIENT

weight loss and gifts of Health

Good Tuesday Morning....A reminder...Patient Appreciation Nite this Friday...5-7pm...Come out and see your Doctor croon Frank Sinatra songs on the Karioke....Please join my staff and me for a very fun time....as you know we have many young people working in the office and the energy they bring to these events is incredible. We look forward to seeing you.

A subject we have discussed before but one that is important to bring up again: As you are purchasing gifts for friends and family members for the holiday please be very sensitive to the medical issues that the person may have and how that gift may adversely affect that person.

Obviously, as this relates to weight, try very hard to NOT give gifts of calories. The overweight person does NOT need brownies or cookies. You will derail their efforts to be healthier and happier. That nice bottle of wine will also perform the same sabotaging efforts.

Movie coupons, gift certificates for clothes stores...these types of gifts do not at all sabotage weight loss efforts. Please be sensitive to the things that would harm someone and hopefully your loved ones are giving similar thought.

weight loss and aesthetics

Good Monday morning....

DH44: Thanks for the info about the chat space problem...we will get right on it...

Last week we were given a piece in the Washington Business Journal about a company that takes a picture of you and then through computer work, shows you what you would look like 10 pounds lighter, 20 pounds, 30 etc....The business is based out of Lorton....

I think this is a GREAT idea and we actually contacted the company to see if somehow we could include this during our first visit....provide our patients with a crystal ball as to what they will look like when the weight is dropped...what a great motivational tool!

Losing weight makes us healthier...no doubt...diabetes risk, heart disease, cancers, Alzheimers disease...the list goes on and on about how we can live a longer healthier life when we lose weight. But, one of the "payoffs" of weight loss is looking younger and feeling more attractive. There is nothing wrong with wanting to look our best...confidence and self esteem become heightened.

I will keep you informed as to whether we can bring this service into our program....It would be so much fun to see, before the weight loss journey begins, what you have to look forward to from an aesthetic standpoint.

weight loss and challenging yourself

Good Sunday morning..beautiful weather today will allow you to perhaps get some outdoor exercise!

We often are challenged by people and things around us. Whether if be a teenage child whose behavior is less than optimal to a co-worker or employee whose performance is not up to par to financial issues that come up...we are constantly being challenged.

The thoughts of challenging ourselves is often not a good one, as there is already too much challenge out there already. As this relates to weight, it is critically important that yo do challnege yourself to live the lifestyle necessary to bring you to a healthy weight. Challenge yourself to be around those holiday alcohol drinks and high caloric food sources and NOT give in to the immediate gratification behaviors. This is a good personal challenge to take and one that could keep you alive longer in a better state of health.

weight loss and friends

Good Saturday morning.....so, was getting up at 5 am and getting in line yesterday to shope worth it???

We have come up with a fun idea to expand our weight loss program to more people and help our current patients earn free visits. If you are interested, please contact Jennifer Johns in our office to find out more about our "Serotonon-Plus Party". Basically, if you have 3-10 friends who may be interested in a weight loss effort, then you host a gathering at your house some evening. Serotonin-Plus will provide healthy snacks and either moi (I think that is French for "me"), Donna or Jessica and Jennifer. We will explain our program to your guests and answer any questions. If anyone actually begins our program, then you earn a free visit (100 dollar value) for every person who starts the program. 10 people sign up? You have earned 1000 dollars worth of visits! We will also offer a 5% discount that night to any of your friends who commit that night to the program.

Sounds like a Tupperware party? Well, perhaps, but Tupperware cannot save a life..weight loss can. It is difficult to bring up wright issues to your friends for fear of insulting them or hurting their feelings but trying to help people important in your life.

I am reminded of the line from a commercial that says : "Friends who are friends will not let you drive drunk". Perhaps a variation of this could be : 'Friends who are friends will not let you increase your risk of dying". Contact us to find out more about our Serotonin Plus Party program that will begin after the first of the year.

weight loss and leftovers

Good Black Friday morning...For those of you lining up outside some store on this very chilly morning, I have one word for you: INTERNET....shop the internet for your great deals!!!. Oops..this is a weight control blog, not a shopping advice column so lets get back to business...

Leftovers....lots of them in the refrigerator and on the kitchen counter. Try very hard NOT to get into the "picking" mode where you start taking small amounts of the remaining food sources from yesterday's feast. What you may perceive as small, inconsequential amounts of that apple pie, spoonful of left over stuffing or anything else high-caloric that you may have saved, will , in fact be detrimental to you.

We certainly have learned well not to "waste" food, so I am not suggesting that any food be thrown out. Rather, perhaps the high-caloric food sources can be given away to people with no weight controi issues. Keep the protein sources and perhaps discard the high-caloric carbs.

Have a great day shopping, resting, or working (sorry staff of Serotonin-Plus, we HAD to open...just call me Scrooge!)

weight loss and Thanksgiving

Happy Holiday Morning...

No food/eating nagging from me on anything today.....enjoy your families, feel the warmth and if things are not going exactly how you want them to go now, remember this will only be for now....whether it be a weight struggle, a financial issue or a personal problem(s) things WILL get better and if you focus on your health to keep that optimal, everything else will fall into place....Have a great Holiday and mark your calenders for Friday December 4 5pm for our Patient Appreciation Nite....see Donna sing....see Posner croon Sinatra.....free VIP admission for all of our patients!

Weight Loss and the Holiday

Happy Thanksgiving eve.....I wish everyone safe travels....


If you are a guest at somone's house and bringing a gift please think of innovative low-caloric food gifts or non-food gifts to say "thanks" to your hosts....

If you are hosting the holiday gathering, please ensure you have healthy, low-caloric offerings available to your guests so they do not feel forced to "break" their improving eating habits....

Feel the warmth of your gathering and realize that the pumpkin pie, stuffing and wine are not as important as the people there who you would love to see for many many years. If we all stay healthy, a much better chance of sharing the experience together!

weight loss and Thanlksgiving

Good Tuesday Morning....First, I want to thank the people who comment on the entries....very insightful and helpful to me and everyone who reads them...

For those of you who are preparing the Thanksgiving celebration, there is no question that you can still have many choices available to you annd your guests that will NOT derail weight loss efforts. The protein choices of turkey, roasts, hams etc are very compatible with your efforts. Side dishes can also include vegetables...not just mashed potatoes , sweet potatoes etc.

Also, consider portion controlling the desserts...perhaps rather than just putting out the cakes and putting out a cake cutting knife in a tradtiional manner allowing a large piece to be cut off, prepare a very small "sampler" where you place a very small amount as a "tasting" plate with a touch of each of your dessert offerings. And ice cream??? Does anyone at the table actually need ice cream on top of their cake/pie?

Try to separate the enjoyment and love of the people you are with from the need to ingest lots of calories. You are choosing to live longer and healthier so you can be there for many more Thanksgiving celebrations.

weight loss and darkness

Good Monday morning....First, I want to remind everyone to put Friday, December 4th on your calenders for patient appreciation nite...5-7...we would LOVE to see you there...we are bringing in Karioke and if you would like to see Frank Sinatra come alive, then yours truly will croon Mew York New York,

As I am writing this entry, I am seeing how dark it is out there...during the summer I would be seeing a beautiful, warm sunrise and after writing this, go outside, put the IPOD on and run outside. Now, I have to go to the gym and get on a treadmill...not as much fun and the exercise is more boring.

If you have previously counted on walking or jogging outside for your exercise either before or after work, but now cannot do this due to darkness, an alternative is required. For long term weight loss, consistent exercise is usually required, and you should focus on an activity that you do not despise. Many people enjoy exercise classes at a gym,.step or aerobic. For me, tennis is much more stimulating than the treadmill. Plan and make exercise a scheduled activity at least 3-4 times a week.

weight issues and children

Early morning flight tomorrow out of Buffalo so you get these wonderful insights a bit earlier...kind of like the old days when my parents would get the Sunday Daily News in New York on Saturday nite.,..the bagel places in new york were churning out hot NY bagels on Saturday nite....My dad would take me out for a saturday nite ride for those great smelling bagels and get that paper early....but alas, if my Dad only knew then that his son would be railing against bagels as being too high in carb calories and they should not be eaten!

I read a very disturbing report in the USA Today earlier in the week that almost 1/4 of the children in the nation have had times in which food was scarce in the household. 1/4 of the children in America have suffered from hunger? This is the United States...not some third world country...I was shocked.

Clearly, if households are experiencing financial issues that are difficult the response will be parents trying to purchase as many food sources they can at as low a cost as possible...this will lead to the purchase of fast foods, pasta etc. The result unfortunately will be an increased tendency towards obesity in the children. The affected parents are trying their very best to feed their children and not have them feel "hungry" but the outcome will not be long-term health.

Solutions? Perhaps having government monies directed to food support programs for familys in need.....funding this? Not an answer this doctor can come up with but everytime I read about waste, fraud and abuse involving billions of our tax dollars on ridiculous BS, one has to wonder how much healthy food that could buy for children who need our help.

weight loss and the movies

Good Saturday morning...Writing this entry from north of the border in Toronto...Cold up here!!!! I love the way the people say "about" here....sounds like "abooooooot" Actually, they are probably laughing at me for doing my Nuuuu Yooork thing of putting "r's at the end of so many words....And rather than saying "yes" as a question after making a point, they say "ay"...Okay enough about Canadian accents.....back to weight issues....

Anyone going to the movies this weekend??? News reports this week detailed an investigation of the caloric content of the "snack" foods that the different major movie theatre chains provide and the information is mind-boggling. At one of the chains, the large sized popcorn and soda (a sugar containing one) had over 1600 calories...the equivalent of 6 eggs, 4 strips of bacon and 4 sausage links. The caloric content of the candies was appallingly high.

When you enter the movie theatre, the smell of the popcorn can be mesmerizing. To avoid succumbing to standing on that food/popcorn line, make sure to eat dinner or lunch before you to the movies. Also, keep fresh in your mind just how hard you have worked the entire week to shed those pounds, and if you give in to the snacks, you may reverse your entire week of great work. Remember: you are choosing to be healthier and happier...that is a GREAT choice and a much better than the immediate taste of popcorn. So no popcorn or nachos, ay???

weight issues and taxes

Good Friday morning....hope the weekend has some fun for you....

Controversial subject time....Yesterday I had a patient express concern about potential "penalties" enacted for overweight people. We have heard previously of having to buy another seat on an airline if above a certain weight and having certain highcaloric food sources taxed extra, like sodas. This patient heard that proposals are in place of having overweight people pay an extra "tax" (perhaps higher insurance premium?) based on being overweight.

Let's provide an analogy: The cigarette smoker. The smoker has higher rates of COPD, cancer, heart disease, etc and there is no question that the smoker will spend more money on physician visits, medications, hospitalizations etc. Should non-smokers pay more health insurance premiums to offset the additional costs to the system that the smoker incurs? Should the smoker pay more money into the system because of being a smoker?

The overweight person: Higher rates of diabetes, heart disease, cancers etc....more money spent on medical issues. Should the non-overweight person be expected to incur costs involved in treating overweight people for the co-morbidities?

I think most people think that it comes down to "choice". The person born with cystic fibrosis has no choice in this disease. Therefore, monies spent on medical treatment are not due to the "fault" of the affected person. I believe few, if any, of the general population would expect the person with CF to "pay more" into the system or be "taxed" extra. Is cigarette smoking a choice? Is being overweight a "choice"? If it is deemed that these medically affecting situations are under the control of the affected person, is it therefore "fair" for that person to be taxed or otherwise pay extra into the system?


Your thoughts? Mine opinion is the following: We need to focus not on finger pointing and affixing "blame" and trying to monetarily hit people but rather do something about this devastating problem immediately and aggressively. Not everyone can afford the BEST weight loss program ever (OURS!!!) so the government should fund weight loss clinics that are affordable or free for the poor...more education at the schools...perhaps POSITIVE incentives for people to be at a healthy weight,...taxing the hell out of the fast food chains, soda companies and every other entity that are contributing to this deteriorating situation...and other measures that proactively address the obesity epidemic.

weight loss and the future

Good Thursday morning...One week to Thanksgiving...is time flying or what???

A study released by the United Health Foundation predicts based on data analysis that the obesity rate in the U.S. will be 43% by 2018 and Americans will be spending 343 BILLION dollars on obesity related health issues by that year. The obesity rate has risen 129% in the past 20 years.

Whenever we see these type of numbers, we feel alarmed but I am not quite certain if we all understand just how devastating this trend will mean. concerning consequences to our society. If we think that there is a healthcare crisis now, wait until 1/3 of the population has diabetes with all of the comorbidities associated with this disease. Rationing of healthcare? Bet on it....there will be no way the generation under the babyboomers will be able to pay the taxes necessary to support Medicare and other government programs that will provide healthcare. Healthcare expenditures will rise exponentially and people will be going without medications and there will be many who will not be able to see a doctor. Throw on top of this the critical shortage of primary care physicians in America and this is all setting up a frightening situation.

The above sounds like the little kid screaming "The sky is falling" but the data is real and this is what the future holds if we cannot, as a society, put a brake on this situation.

weight loss and vigilance

Good Wednesday morning....

Yesterday I was speaking with a new patient who informed me that she didn't have ascale at home. I believe most people have scales at home but I also think that many people experiencing weight control issues do not use those scales. They know their weight is not a healthy one, but do not want to face the real number. Clothes do not fit, the mirror shows changes but psychologically the overweight person does not want to see the stark reality on the scale.

I know it is difficult to stare at a number you are not happy with, but vigilance and monitoring of your weight is extremely important for long term success. Obviously when you are coming to your visits here, we monitor the weight, record that weight etc. However, when you leave your formal visits, the accountability becomes your alone again and if you are not monitring your weight and recording it, I would almost guarantee that your weight will return to pre-program levels.

Opening up your 401K statements when the market was crashing was painful. Getting on a scale when you know your weight is not optimal is also painful. But this vigilanc is crtically important in your long-term weight control.

weight loss and the government

Good Tuesday Morning....

All over the news this morning is the US Government's taskforce changing mammogram recommendations for women. Major changes, with the new recommendation being that a low-risk woman should not be screeened until after 50 (was age 40) and then every other year, not once a year. This will create quite the controversy as obviously, if a woman developed a small lesion at age 43, how would she eve know before it was way too late? Oh, well, think about how much money is being saved by NOT screening women over 40 and for those who develop cancer before age 50 (I would bet that everyone reading this blog has heard/known someone who developed breast cancer before age 50) too bad! Lets total up how much money the insurance companies will make by NOT having to pay for these mammograms. Tens of millions for sure.

Under the "governments" watch, obesity is killing Americans in numbers far exceeding swine flu and other medical issues making front page news. Aside from making insurance company executives millions more in bonuses, how about "the government" do a better job of monitoring the nation's largest health concern (obesity) and doing something about it in a more proactive way. Government weight loss centers? Better education programs in schools? Allowing tax subsidies for obese people doing weight loss programs which cost is bourne by taxing companies such as McDonalds extra for doing this to us?

Once again, these type of "guidelines" will set up a "haves" and "have-nots" system in which women with more money will buy their mammogram every yeat and those with less will be forced into screening every two years....and run the higher risk of cancer. Your thoughts?

weight loss and monitoring calories/exercise

Good Monday Morning...

First, I want to thank the people who are commenting....I would recommend that you all read these comments..some VERY helpful insights.....really good stuff....THANK YOU for posting comments!!!!

As I have mentioned many times, the gaining of weight requires no thought process at all...the losing of weight requires CONSTANT vigilance.

Look at the caloric content of every food source you ingest and compare it to the amount of exercise needed to burn those calories off. We have on the website a list of aerobic activities and how many calories you burn doing those activities for specified times. I run 5 miles, takes me 46 minutes (okay.,..stop laughing..the old guy is slow) and burn off 640 calories. Okay...how long does it take Posner to eat a piece of chocolate cake that has 1100 calories? Hmmmmm...about 5 minutes. The point here is that we can consume calories so much quicker than we can burn it off. So, when you are considering eating a food source that you know will derail your weight loss efforts think about the amount of time necessary to burn that off. Is it really worth that immediate gratification food source? You will then have 2 choices: either gain the weight or take lots of time to exercise it off. Do you really want to spend an extra 45 minutes at the gym in exchange for that piece of cake, those 2 glasses of wine or the cookies? Keep vigilance of this..and make the smart choice.

weight loss and self-confidence

Good Sunday Morning...I know I will have a great day cause the Giants cannot break my heart today...they are on a bye and do not play!

First, I want to thank the several people who offered up suggestions for our book content. These ideas really help.

Yesterday I saw a young woman who entered our program about 12 weeks ago and has lost about 20 pounds. On the first visit she was very shy and almost withdrawn. Eye contact was even difficult.

12 weeks later..a completely new young woman...smiling...dressed to show her new look, an energy aura beyond belief...in essence, a total transformation...not just physically...but the entire persona.

Losing weight makes us healthier and helps reduce the medical co-morbidities associated. However, the benefits to self-esteem and self-confidence is amazing as well.

Weight Loss....Our book....

Good Saturday morning...

I am asking for your help. Donna, Julia and I will be co-authoring a book about weight loss. We are having a number of chapters already included including stress eating, childhood obesity, post menopasual weight gain, and lots of others.

However, we wanted to get some ideas from you, our patient, as to what subjects may be of great interest to you in a book written about weight issues.

So many weight loss books are "hype" books designed to make weight loss sound easy...Catchy titles, cartoon pictures, simplistic explanations, etc. We would like our book to be much more serious and address the "real" issues involved.


Sooo.....Help!!! please send us some ideas for content that would make this book very special.

We will plan a really nice book signing event in the spring and we will make sure you get an invitation!

weight loss and genetics

Good Friday morning....

I saw a study published that described a permanent change in DNA in children that occurs in children who are exposed to much stress, resulting in an increased risk of depression because of neurochemical factors. Basically, when a child is exposed to much stress, some changes occur in a gene that results in the over production of certain neurochemicals that result in higher liklihood of depressive disease as an adult.

The question occurs then as to whether this type of stress exposure in childhood also may result in other neurochemical changes involved in eating behaviors resulting in a higher liklihood of obesity as that child becomes an adult.

Brain chemicals play a large role in mood disorders and also eating patterns. There are so many things we do not know about this entire neurochemical pathway and hopefully further research will result in therapies to address these imbalances.

weight loss and children

Over the past several weeks we have placed a number of adolescents into our program. First, I would like to applaud the parents for addressing the weight issues of their children by taking a very proactive role in helping their children achieve better health and happiness.

Many of us may not remember the very senstive issues involved in the interactions of teenagers, but there is no question that the "cheerleader" clique is probably the most "popular" group. Getting the best prom dates, receiving lots of attention, etc. will almost always be reserved for those teens who look the best. For those struggling with weight issues, the hit to the self-esteem can be immense. As much as we may tell our children how beautiful they are even if weight or other physical issues arfe present, the child is often ostracized to some extent in their peer groups. As we may all remember, sometimes teens can be brutal to each other.

I absolutely LOVE helping every one of our patients lose weight so they can be healthier and happier. Helping an adolescent lose weight is even more especially rewarding because the self-esteem and self-image issues are so prominent at that age that a positive change can create a hige difference. If you have a teen struggling with weight issues, set up a free consultation. We would love the opportunity to help.

weight loss and the need for help

First, I want to thank "anonymous" for reminding me to brag about Donna's performance in the 1/2 marathon this weekend. Donna trained very aggressively for this race and performed exemplary. As all of you know who have met her, Donna is the very best Physicians Assistant in the area. I mean this...I have been working in the area for 21 years, have had several PAs who have worked for me previously. interacted with PAs from other practices, and there is no doubt in my mind that Donna is A-Number-One the very best PA in the area. We are very very fortunate to have her as part of our team. After delivery of her baby, Donna put great effort to shed the weight she gained, and as all of you know who have seen her, she is in tip-yop shape and a great role model for anyone who has given birth and strives to get back to the pre-pregnancy weight.

I have written about this issue before, but recently we have had a number of people present for consultations about our program and they are embarrased about needing help in their efforts. I tyr very hard to make people understand that there is no need to feel "weak" or "embarrassed " about needing help. If weight loss was easy, 67% of America would not be overweight. Getting a jumpstart in your efforts and getting help being put "into the zone" is often required. We are here to help you and understand these issues.

weight loss and restaurant choices

Good morningl...I know you Steelers fans are happy.

Over the weekend, I went to an Italian buffet restaurant at the Gaylord Hotel at the National Harbor. A bountifull display of cheeses, breads, pasta, salad, carved meats, brick oven pizzas and lots of other high-caloric foods. And, of course, there was a dessert bar with canolis, ice cream pastries and cakes. The price of this was 32 bucks.

Needless to say, the overwhelming majority of the people there were morbidly obese. I saw plates heaped with foods and the dessert bar was packed. Yes, your Doctor went up 3 times for food.


This issue here is that if you have a weight control problem the very LASST restaurant choice should be an "ALL YOU CAN EAT" buffet especially when it is fairly pricey. This tests the very limits of human nature...if we are paying lots for this we will make every effort to "get our money's worth".

Choose restaurants that you are ordering off o a menu and the more you eat, the more you are going to pay for this.

weight loss and diet pills

On Friday I received a telephone call from a company that wanted to pick my brain a bit about my experience in treating patients for weight loss, as their client is a pharmaceutical company coming out soon with a new weight loss pill. I am thinking about how many times I have seen articles in the newspaper about some "miracle" weight loss pill that is about ready to hit the market.

Inevitably, these things always seem to wash out...either side effects that require the company to pull the pill off the market or the efficacy is questionable.

We, as a country, are always hopeful that the "magic" pill will come out, allowing us simply to take a pilll and lose weight and keep that weight off. It is very important to understand and accept that no pill exists now, nor do I feel such a pill will be invented that makes weight loss that simple.

Losing weight requires work...watching caloric intake, planning meals, exercising etc. Anthing, whether it be a surgery, a program or "pill" that makes long term weight loss sound easy has to be viewed with lots of skepticism.

weight loss and the Healthcare reform bill

Good morning.....okay Redskin fans..i have a prediction...I think they are going to upset the Falcons today!!!

I saw this morning that the House passed the Healthcare reform bill....I have not read in depth much of what it contains...what I do know is that 1- It does not include anything about tort reform, so have a nice Sunday brunch Trial Lawyers of America...you can still go after Doctors, hospitals etc cart blanche without any worries about having to pay the defendants legal bills in the event you lose. Americans should feel safe knowing that their physicians and ERs will continue to order every test known to mankind to ensure their charts are "buffed" in the event one of these lawyers comes after them. Lets add billions of dollars of costs because of this issue that is not even an afterthought in the Healthcare "Reform" act. 2- Hey, if America's largest health concern is obesity and the co-morbidities asssociated with it, then how about the governmnet establish weight loss centers thruout the United States? How much money would be saved by people NOT developing diabetes, multiple cancers, heart disease etc? We continue as a nation to focus on the treatment of disease states and not the prevention. 3- Not sure anything was addressed about the hemmorhaging of primary care physicians because of the horrendous discrepancy of compensation between specialists and their revenue. What happens when there are far too few doctors available to treat the frontline problems?


Anyway, you, my patients, should know that Posner will still be around for a pretty long time to address your weight loss and/or medical needs. Regardless of what the politicians and their lobbying comrades come up with!

weight loss and cancer

A report came out yesterday attributing 100,000 cancer diagnoses per year directly attributable to obesity. It is well known that colon, breast, pancreatic and esophogeal cancers have been linked to weight issues but also endometrial cancer is associated with obesity.

Every day we are reading reports about Swine flu...a disease which has killed about 100 people. The report about the 100,000 cancer diagnoses was on page 20 in a small article.

Obesity and weight contol issues are killing Americans at a rate far greater than any virus or terrorist attacks. The major threat to America is coming from within....and that is our inability to make significant headway into the obesity epidemic.

On an individual and family basis, we all need to do our part to make this catastrophic problem go away. Please think about this lots....and decide which is more important....being healthy to enjoy your family and the fruits of your hatd work or some food source that temporarily makes you feel good, but yet is leading to future medical catastrophy.

Sorry for the bummer of an entry this morning but seeing this report buried deep into a newspaper angers me...this is front page stuff.

weight loss and surgery

Yesterday we entered into our program a very nice woman who actually lives in Texas but works and travels to d.c. often enough that she is able to do our program. Her weight loss goal was to lose about 60 pounds. The patient was a bit frustrated that her primary care physician in Texas recommended to her that she consider a gastric bypass procedure as her remedy for the obesity.

Surgery? I absolutely agree that for some patients, surgery is the only option. However, if a person has not tried a medical program (no less the very BEST medical wight loss program in the country...modest, aren't I??? laughing) why would a physician recommend surgery right off the bat?

We have placed many patients in our weight loss program who already had bariatric surgery and they gained tremendous amounts of weight back. People who have the procedure still eat the same damagng food sources after surgery in many cases, but they learn how to separate out the portions so as not to do lots of eating at one time.

Learning how to eat the correct admixture of the different food groups, incorporating new behavioral strategies and "mentating" through difficult stress issues as opposed to eating are the steps necessary for lon term success in weight control. Surgery is the last option.

weight loss and the younger generation

Good morning....First..I BLEW the date of our 21st Annual Patient Appreciation Night.....It is Friday DECEMBER 4!!!!!!!! PLEASE mark this on your calenders...The staff and I would LOVE to see you that night.....

Okay, some political observations.....In New Jersey the incumbent Governor lost, and as per one of my previous blogs, during the race, the incumbent apparently made disparaging comments about his opponent's weight. Well, now the thin guy is out of office and the overweight gentleman who was disparaged won. Regardless of whether you are a Democrat or a Republican, you gotta love the fact that perhaps one of the reasons the incumbent lost was because of insenstive remarks about someones weight. With America being 67% overweight, I guess the majority of voters had a BMI greater than 25 and made their voices heard. KUDOS to the New Jersians. Weight has NOTHING to do wth the ability to lead a state, teach a child, work on a government contract, etc.

Second: Lead article in some papers about the US Army having problems clearing recruits to join as 75%, let me repeat, 75% of the eligible young men could not fit the physical criteria, most of which were weight control issues. Obesity is killing Americans and the childhood/adolescent rate is dangerously high. These overweight yiung people will turn into even more overweight adults and trhe subsequent co-morbidity dieseases such as diabetes], heart disease, etc. will skyrocket even more resulting in disaster. The threat to America comes from many external forces, but internally, we are doing more harm to ourselves. Your oile in this? As a parent, grandparent, uncle/aunt etc., do NOT feed into this problem by not intervening with this issue oif you have young family members experiencing weight issues. Get proactive!

weight loss and holiday functions

First, I want to cordially invite all of you to our annual Patient Appreciation Nite scheduled for Friday, December 5, 2009 from 5-730PM. We do this every year and this is now our 21st year in practice. Please stop by and say "hi" and allow us to thank you personally for being our patient. There is not a day that goes by when I do not realize that I am the luckiest Doctor in the world to have such a great patient population of intelligent, fun, stimulating and wonderful people who allow me the honor of taking care of their medical and/or weight loss needs. YOU have allowed me to focus on medicine and not get bogged down with a depressing insurance based practice. YOU have allowed us to grow into the largest medically supervised weight loss program in the D.C. area. We never forget your importance to us and want to thank you for being our patient. Karioke again this year!!!! A great hit!!!

As we are preparing for this event, we always ensure that we have "healtheir" food and drink choices for those of us who are trying to control our weight. Obviously, with us running a weight loss center, it would be kind of ridiculous for us to only have cake, sandwiches, beers, etc. There will be lots of healthy choices. However, as you plan your holiday events, always remember that there will be many people at your function who will similarly be in a weight losing mode. Please ensure that you too have "healthy" choices available. Sometimes when we go into a weight losing mode, we take a bit of pleasure in "feeding " others. Have choices available!

weight loss and work satisfaction

After speaking and treating thousands of patients for weight control problems. it becomes apparent to me that work satisfaction issues correlate with the degree of "stress eating" that occurs when a patient comes home.

Personally, I have great job satisfaction...every day I get the chance to help people...whether it be a sick medical patient or a person with weight control issues, I am rewarded every day by seeing a patient get on that scale and see a huge smile....I watch patients whose self-esteem rises exponentially week after week, have a worried medical patient become calmer after I provide them with an explanation as to why their condition is benign, etc. When I come home from work, I do not feel hard pressed to grab a few drinks, eat snack foods etc.

However, people whose professions are less satisfactory...whether a person in the government who does the same beaurocratic job day after day with no tangible effect of "changing the world", a lawyer who sucks legal fees from their clients for doing nothing more than generating their own billable hours as opposed to really helping a person, and other professions where it is difficult to see the direct effect of "helping others", these people come home not happy and will often seek refuge in the wine and food sources that provide immediate gratification.

If you find yourself coming home not happy, try to find things that wil change this...obviously not easy to change jobs immediateyl, but perhaps outsode activites that allow you to feel "purpose"...volunterring? becoming active in philanthropic causes? Do something that makes you feel you are heloping others. When you come home feeling that you make a difference, you will find yourself happier.

weight loss and relationships

Good morning.....yes, I am over the Giants horrendous performance yesterday.

First: answer to the comment yesterday: our third phase maintenance polan is bout 1300 caloies per day.

Last week I had several patients lament that one of the major issues adversely affecting their personal relationships with their spouse/boyfriend was the obesity. Intimacy was much less frequent than originally and the quality of that intimacy was not up to expectation. From a physical aspect, weight control problems may limit the male's capacity for sustaining excitement, libido may be adversely affected and "performance" may be limited. Weight issues involving either or both partners can also affect positions possible.

Reality: Losing weight makes many things better. In many cases, the intimacy aspects of a realtionhsip are helped as well.

weight loss and calories

Good morning...hope all of your Halloween events were fun and safe...

In our weight loss program, we do not have patients count calories, but rather, portions of the different food groups. This strategy results in aggressive weight loss when followed. However, this morning I want to focus on calorie counts.

3500 calories equals a pound. When you burn off this amount of calories, you will lose a pound. Everyday life activities such as walking, breathing , etc burns off calories.

However, aggressive exercise will burn off more...and just think about this...burn off 100 more calories a day (this takes about 20 minutes on a treadmill at 4.0 MPH) and this is 36500 calories a year (10 pounds) and if you ate 100 less calories a day (this is avoiding very little) this simlarly would result in 10 pounds of weight loss per year. These are MINIMAL interventions that in aggregare, would result in lots of weight loss.

Keep track of the amount of calories you are consumming (after the program visits are finished) as well as the amount you are burning off and work diligently on both ends of the equation!

Giants will prevail today!!!! GO G-MEN!!!

Weight Loss and Helpful Hints

Good Morning...In 2 hours, Elvis comes alive, and if you are near the Burke office stop in and see the King...he will be seeing patients but in between, there could be a few bars of Love Me Tender and Viva Las Vegas...Also, on a more social note, every year the staff and I have a Holiday Open House that we call "Patient Appreciation Nite" We provide snacks, (lots of them "healthy") wine and last year we had karioke which was hilarious. We have been doing this for 21 years and the reason: WE NEVER FORGET HOW HAPPY WE ARE THAT YOU CHOOSE TO COME TO OUR PRACTICE. We have the most incredible patient population of wonderful people and we are honored that you have decided to allow us to take care of your medical and/or weight loss needs. Friday, December 5th is the date...5PM-730 PM. PLEASE stop by

Please read the comment posted yesterday....lots of helpful hints that came from a Weight Watchers Newsletter. You NEVER read any bashing things about Weight Watchers written in this blog. Their program is based on behavioral modification and life style changes. It is NOT an exploitative business trying to sell you shakes, bars and other items that provide a rtemporary fix to the weight problem. Losing weight and keeping that weight of is NOT a "diet"...it MUSTbe a behavioral modification strategy. For long term success, I would ask that each and everyone of you eliminate the concept of "dieting" and focus on "life style changing".

weight loss and Halloween

Good morning...for those of you who would love a good laugh....staff and I are dressed for Halloween today and tomorrow....our costumes???? you gotta stop by to find out (hine for Posner garb: The King comes alove tomorrow)


Okay, now comes the most treacherous period of time for weight control....Halloween through New Years.....average weight gain in America during this time period: 7.4 pounds. From the Halloween candy to the Thanksgiving dinner to the Christmas and New Years celebrations, we eat lots of food and consume lots of calories. Then comes the lament on December 31 "My New Year's resolution is to lose weight".

START NOW!!! Do not give in to the "left over" Halloween candy. Start your efforts now! If you have gained weight since you were last here, come in for a "tune up" few weeks. Build lots of "wiggle room" over the next 4 weeks before Thanksgiving. Get to that gym more often. Do NOT let yourself be one of the millions who have to do that tiresome, old new years resolution about having to lose weight. Start now!

weight loss and inches

Good morning....

The new INBODY body analyzer we have in the office provides much more information than the scale alone. Often, people come in for their appointments and become disappointed when the number of the scale fails to drop significantly in a given week, yet the person feels that the clothes are fitting much differently. Fluid retention, especially in women, often explains why the numeric weight on the scale does not drop lots that week. The INBODY allows us to monitor this. Moreover, as people turn to weight training as an adjunct to their weight loss efforts, the INBODY allows us to measure lean muscle mass.

If you have not been in recently, we woild be happy to provide you with a complimentary body scan to see all of these parameters, not just your weight in pounds.

For those of you currently in the program, we will continue to scan you every 4 weeks or so providing you with all of this info.

weight loss and weather

Another soggy, dark miserable day...for those of you who exercise outside, it probably ain't happening today...for those of you are at housebound today because of the wetaher, you will be challenged NOT to start reaching for snack foods...

As the weather gets colder and it remains darker it is much more challenging to maintain the exercise levels and the more prudent eating activities that we can during the summer months.

Home gym equipment would address the dark/cold/rain issues and NOT having those snack foods around the house that would challenge you would address the snacking issue.


Do not let the seasonal changes derail your efforts to become healthier and thereby happier...

weight loss and sleep

Good morning.,....everyone be careful driving out there today.

A number of patients tell me that one of their "downfalls" is nighttime eating. This seems to be very prevalent in those patients who have difficulty sleeping. They find themselves hitting the kitchen and snacking lots.

A few thoughts on this: 1- If you are having sleep problems, see your doctor becasue there are things we can do to help you. Lack of sleep, aside from the nighttime eating issue, leads to daytime soumlence, lack of energy, fatigue, irritability etc 2- do NOT have those "snack" foods...nuts, pretzels, popcorn and other things in the house that will challenge your efforts. Believe me, if you have those high-caloric foods in your cubboards, they will call out to you by your first name. DON'T BUY THEM!!!

Off to the gym...have a great day

weight loss and nurturing

Good morning...I am completely bummed out this morning as thr Giants lost last night....People in the office stay away from me for the first part of Monday morning when the Giants lose on a sunday...why do lots of men allow their team's loss affect them the next day??? It is a "Y" chromosome thing....

Lets talk about a "X" chromosome thing...nurturing. Whether it be a chemical/hormonal thing or a learned response, women tend to be more nurturing than men. Whether if be making an apple pie on a sunday, bringing cookies into coworkers or providing a high-caloric "treat" for our children, women tend to nurture others with food. Very difficult patients in our program are nurses and teachers as both geroups tendto always be challenged by high-caloric food sources brought in my their colleagues. Common to both professions is female predominance.

It is important that we, as a country, must be better about not "nurturing" others around us just with high-caloric food sources. Especially if or colleagues and/or family members are overweight we are HURTING them by challenging their food control by bringing them high calorie foods.

Tonight Posner is rooting for the Skins....doesnt happen often but it is that way tonight.... Eagles need to go down...its enough we have to put upo with the World Series thing again...UGH (man am i bitter today from the Giants loss...I will be better after lunch...promise!)

weight loss and individual differences

Genetics/inheritance of DNA plays a large role in our body morphology. Obviously, there is almost no one who enters our program who professes to have a "very fast metabolism". Almost everyone feels their metabolism is slow. However, there clearly are differences between people on how they assimilate/burn off calories.

I have has several patients tell me that "they heard it was okay to take one day a week and eat what you want." Many, many people who have weight control issues CANNOT do this. If they take one day (or more of course) and eat high-caloric foods, weight will NOT go down even if the first 6 days of the week were well planned and conducive to their efforts.

Some people can "get away with" eating lots of food and not gain weight (hello many males) but for most women, especially over 30 years old, this is not the case.

weight loss and the government

Good morning...Once again the news stories contain articles discussing government intervention into the obesity issue by such things as taxing sugar-containing sodas and perhaps other food sources that are contributing to the growing epidemic of obesity in the United States.

The government (by the way, we all seem to use the word "they" when it comes to affixing blame to a situation..."THEY" really do not care about the small investor... "THEY" are responsible for the mess in this country.."THEY" don't know how to drive in the snow... Okay...who are "THEY"??????????) is paying lots of money for healthcare in the Unites States, and with that being the case, does the government have the right to take steps to lower the obesity rate by such things as "taxing" poor food and drink choices? I think that most of us agree (especially us non-smokers) that we could care less what the government levels on cigarette sales. Most of Americans could care less if there was A 20 dollar surcharge on a pack of cigarettes...only people who would care are smokers, tobacco companies and operations that profit from selling the cigarettes. How about people who have no weight problems who feel their insurance premiums are high and/or their federal tax dollars afre being spent on healthcare for people who have co-morbidities seondary to obesity? Does the non-obese person who does not drink regular Pepsi care if there was a 20 dollar surcharge on a can of Pepsi?

Fundamental to this discussion are the "rights" of Americans to consume the sugar drinks, be at a weight that is not healthy and not be "penalized" for this via paying higher health premiums, taxes on foods/drinks that perpetuate the weight problems etc.

My thoughts? This is a capitalistic society and I love the freedom of America for businesses to sell their products in a competeive manner. However, if there are definite food/drink sources....tobacco, alcohol, high fructose drinks etc that are hurting Americans, then the government should, in fact, act on the people's behalf to lessen the chances of poor food/drink choices being made. Your thoughts?

weight loss and dining out

Last night I wandered into a restaurant near where I am staying in Florida and the place was interesting in that they change the menus seasonally and EVERY entree is 450 calories or less. Steak, pork seafood dishes, salads etc...all less than 500 calories. The dessert tray was brought over with all these great looking desserts but they were in really small portions...all desserts under 300 calories. No bread was brought to the table.

Sure, if alcohol was consummed, a dessert bought etc, the meal would have been not greatly conducive to a weight loss effort. BUT..think of other restaurants where they bring that hot bread to the table...portions are huge...desserts are very large...: much more chance of derailing your weight loss efforts.

When dining out, seek out choices that will be compatible with your plans to be healthier and happier.

weight loss and investment

Good morning....I am writing this entry from Florida....yes, your doctor does take an occasional few days off...thank you to Donna and the staff for providing the great care in my absence.

Me Marsha posted a comment yesterday that was positively commenting on the "worth" of our program, basically saying that if she totaled up all the monies she has spent on "fad" diets, this would have exceeded what her investment is in our program, and although expensive, she feels better "worth for her money" being in a medically supervised program.

Money is precious as we all work so hard to earn it. Taking a grand and investing this in a weight loss program is a big chunk of money. However, lets look at the flip side: What happens if we develop a serious disease such as a heart attack, diabetes, breast cancer or pancreatic cancer? How much lost wages will be realized because of time away from work? How many doctor/hospital bills will not be fully covered by insurance? How much money will be spent on medications?

The answer is that preventing the comorbidities of being overweight will SAVE you tens of thousands or perhaps hundreds of thousands of dollars in the big picture. Your investment into your own health is the very BEST investment you can make. I am not just talking about paying for our program...such things as hiring a personal trainer, getting workout equipment for your house , etc...all of these "investments" will save you LOTS of money over time. The added bonus: you will feel happier, look younger, improved self-confidence.

You cannot invest in the stock market , real estate or anything else nearly as high a return on your investment as investing in YOUSELF.

weight loss and fad diets

http://www.aolhealth.com/diet/basics/diet-trends-cookie-diet?icid=mainmaindl3link3http%3A%2F%2Fwww.aolhealth.com%2Fdiet%2Fbasics%2Fdiet-trends-cookie-diet

Thanks Ellen for the above link....

If you click on this link, it will discuss a story on Good Morning America concerning a woman who went from a size 24 to a size 6 on the "Miracle" Cookie Diet. Have you seen those annoying commercials where people are singing: "Who has their hand in the cookie jar...?"

Once again, corporate America scamming the public...yes, the same public that spends 55 BILLION dollars a year on weight loss efforts. This latest fad involves eating "high-protein" cookies for breakfast and dinner and then a 500 calorie dinner. So the company runs these annoying commercials all the time, their PR person gets a gig on Good Morning America profiling some woman who was probably paid by the company to chronicle her "Miracle" success story and then the viewers of GMA will pick up the phone and order this Cookie Diet thing.

Ladies and Gentleman, let me make this clear once again: LOSING WEIGHT REQUIRES BEHAVIOR MODIFICATION AND LIFE=STYLE CHANGES. ANY PROGRAM BASED ON ARTIFICIAL FOOD SOURCES WILL FAIL IN THE LONG TERM.

So, if Dr. Posner was sitting on the couch of GMA and asked what he thought of the "Cookie Diet" he would pull the New York thing of feigning a sneeze and saying "BULLSHIT".

Seriously, do not be scammed by any supplement company or commercial weight loss organization that makes losing weight sound "easy". As we all know, losing weight requires lots of work on behavior modification and there are no real shortcuts. So, do NOT put your hands in the cookie jar...plan how you can eat "real" food, but in the correct proportions.

weight loss and being there for others

Good morning,...First, Suzanne, I wish your mother a speedy and excellent recovery....it is VERY hard to see our parents deteriorate physically...it is a physical and mental challenge being able to start taking on the "parenting" role to our own parents.

Suzannes comment actually prompted my blog topic this morning. We are looked upon by many people to be a support system. Whether it be our spouses who need our support, to our aging parents to our children (whose generation seems to need this support for lots more years than the boomers needed/got from our parents)...we, the baby boomers (and if you were not born between 1948-1964 then stoill read this cause in about a decade or so, this will apply to you as well) find ourselves with our own health issues but yet, we still are the primary source of support for so many people.

However, if our own health suffers, we will be in no position to help those around us who are reliant on our support. Losing weight will put you in a healthier situation, ward off chronic diseases, and will allow you to live longer in a healthier state. Obviously, if is great to be healthier so YOU can enjoy retirement and the fruits of your labors, but also, you will be bteer positioned to help those family members who need you. With people living longer because of the excellent derugs and surgeries available, and our childrens generation being the "boomerang" generation (they do come back after college) we all need to be healthier. Losing weight is a huge step in getting back that health.

weight loss and "ME" time

First, good morning..second, yes, i am stll VERY upset about the Giants getting their butts kicked in New Orleans....their defense looked AWFUL. I think I could have put cleats on and looked better than their linebackers.....oh well, things could be worse, I could be a Skins fan (oops...just p---ed off lots of readers..sorry!)

Second...some VERY insightful comments yesterday and I would encourage you to read these....they help me learn more about how to help people. and I think they may help you as well.

As I was driving to work this morning listening to the traffic reports about this delay here and that dealy there, I started thinking about all the people who sit in traffic and have to wasted hours a day....then at work for hours..long commute home..prepare dinner, attend a soccer practice, help with homework, then bedtime and the next day begins. When do people get "ME" time? I am referring to the ability to take the time to think about thermselves...exercise, plan meals, snacks, relax with a good book or watch a movie.....when does this time happen? If it doesnt happen at all, it is so easy to see how the quickest and easiest "me" time is eating a fun food source.

Finding "me" time is a very important element to long term health. Sometimes it seems impossible, but perhaps if you think things through, there may be an ability to shift some things around to create some "me" time. This is not selfish....it is imperative for long term good health

weight loss: the sprint vs. the marathon

Good Sunday Morning....What horrible weather!!! I believe one more day of this bad stuff then back to the sun!

Yesterday I was seeing a patient whose weight loss has been steady and we were discussing the pace of her weight loss. She brought up this statement which I LOVED: "Losing weight should be looked at like a marathon, not a sprint." Whay is meant by that is weight loss AND the maintenance of that healthy weight is a LIFE-LONG effort (marathon) as opposed to whipping as much weight off as quickly as possible and then "ending" the effort. That is why we use "real" food in our program as opposed to the Optifast/Medifast model of liquid diets. Our aim is to NOT rush weight of you only to have that weight come back. Learning new eating behaviors and approach to your eating behaviors and exercise patterns are what this is all about. Yes, we do incorporate a prescription anorectic to "jumpstart" your efforts, but this is only meant to help you psychologically get "into it" more by seeing an obvious result in the firts 2 weeks.

"Dieting: is not what losing weight is about..."life-stylechanging/behavior modification" IS what losing weight is all about...and this is in fact a marathon, not a sprint.

weigth loss and sabotage

First, I want to thank Donna for writing the entry this morning....Donna has been with us now over 8 months and has done an INCREDIBLE job here....

I had a patient today who discussed with me the concept of "self-sabotage" referring to eating food sources that will derail weight loss efforts...stress eating of high caloric foods and snacks....we also discussed the "external" sabotage that our friends and famiuly will often do to us. Despite seeing an obvious weight problem, people around us will offer up desserts, "treats" and other sources that will hurt our efforts to become healthier and happier.

We must learn to NOT self-sabotage and certainly, not allow us to be sabotaged by well-intentioned friends and family.

My weight loss story

Good Morning! Hope everyone is doing well despite this crummy weather. In case you were wondering.... no, this is not Dr. Posner. I think the bad weather got the best of him and he asked me, his trusty physician assistant, to write today's blog. A task that I gladly accepted.

I wanted to use this opportunity to tell you a little bit about my weight loss journey. As some of you already know, I had my daughter Elana 10 months ago. Before I got pregnant I weighed 130lbs, which was about 5lb more than I liked to be for my 5'2" stature. During the first trimester of my pregnancy I made the huge mistake of eating a lot of carbohydrate-laden foods... Eggos and marshmallows were my favorite.... to counteract the fatigue and nausea associated with early pregnancy. By the end of the first 12 weeks I had gained 15 lbs. During my second trimester I wised up and started doing a little research on nutrition during pregnancy and discovered that while my body craved carbs, what I needed was more protein. In conjunction with the nutritional counseling I received through my natural birthing classes, I managed to gain very little weight my second trimester. However, my appetite picked up again at the end of the pregnancy and along with the tremendous amount of edema associated with my pre-eclampsia I weighed 185 1bs on the day of Elana's delivery.

So there I was after my delivery with a beautiful baby, who only weighed 5 lb and 9.5 oz to my dismay, and a very swollen and not so beautiful me. I was very happy when I saw the first 15 lbs come off within 2 weeks, though most of it was water. Then I got serious about eating healthy, not only for me but for my baby since I was breast-feeding. I went back to the pregnancy diet that I was given at the birthing classes, which was a high-protein regimen with lots of green leafy vegetables and fruits. I quickly began to feel more energized and I started losing weight steadily. I returned for my 6-week follow-up and was cleared for exercise... yeah! I had already been walking for a few weeks, but started doing more intensive aerobic activity with light weight/resistance training. Things were going well! Elana was doing great, breast-feeding was a breeze, and I was getting into the groove of being an active new mother. By my 30th birthday in February I was down to 150 lbs... having lost 35 lbs in 2 1/2 months.

Then it was time to think about going back to work in early March. I was set to return to my old job, but some things had changed in my absence that were going to make juggling motherhood and my career very stressful and difficult. So I started looking for a new position, and saw Dr. Posner's ad for a PA, which I promptly responded to.... and one week later had a new job at an exciting internal medicine/weight loss practice. I was so grateful to have the opportunity to help my patients with their own weight loss efforts, while I continued with my own. Once I started working at the practice, I had all the information I needed at my fingertips. I was on the right track before, but the nutritional counseling provided through Serotonin Plus was just what I needed. Since I was still breast-feeding, I had to stick with my own version of Phase 2 1/2 and had to forego medications.... but it worked. By Easter I was down to 140 lbs, and my sister-in-law told me that she hated me for have such a "sweet baby girl that doesn't cry" and losing my "baby fat". I was pleased!

Eventually... like we all do.. I hit a plateau at about 135lb. I knew that meant I had to step it up a notch. Elana was 6-months old and done with breast-feeding, so I started Phase I and running. Let me give you some history.... I avoided running when I played lacrosse in college by volunteering to be the goalie... meaning I hated it so much I let people hurl hard rubber balls at me! However, something changed after a friend gave me a running stroller for my long walks with Elana.... and I started running. I found that I enjoyed running a lot and it was a great way to get rid of stress. In addition, each time I went for a run with Elana, it got easier and easier and the weight loss was very encouraging. I decided I was going to run a race ... a 4-miler in Ashburn at the end of June.. and I did! At the end of the race I was exhausted, but felt great! I did it, and my family including Elana was there to cheer me on!

I have continued to run with and without the stroller... having completed a 10K and 5K since. I actually placed third for my age group in the 5K... which is big accomplishment for a "beer-drinking" girl from Pittsburgh that was 185 lbs nine months prior. I am set to run a 1/2 marathon on November 8th and just signed up for a full marathon in March! I still can't believe I'm going to do that! My current weight is 121 lbs, which is a little more than what I weighed when I graduated high school in 1997. However, I am in the best shape of my life... thanks to the Serotonin Plus program and the support of my family.

So my journey coutinues.... I continue to see patients lose weight and enjoy helping them with their journeys. I continue to be constantly energized by the success stories I see "day in and day out" with our program. Working with all of you has made it very easy for me to maintain focus, despite everyday challenges. Thank You for sharing your stories with me at your weekly visits, and allowing me the opportunity to share my story with you!

Sincerely,

Donna L. Eckenrode, PA-C