Weight Loss Clinic

For the first time in history, obesity and overweight are now more of a worldwide epidemic and public health concern than malnourishment. It is estimated that 50% of Americans are overweight or obese. Obesity is now where smoking was 30 years ago. It will soon take over smoking as the leading preventable contributor of premature death. Childhood obesity has soared 300% over the last 15 years. It is common to blame video games and lack of activity for this increase, but one cannot underestimate the role of poor food habits and the fast food society that we now live in. Diabetes, alone, costs the Canadian economy 15 billion dollars a year in direct and indirect costs. It is estimated that 70% of that (or 10 Billion dollars) can be eliminated by diet and exercise. That’s just diabetes!!! Add to that the cost of heart disease, cancer (30% of cancer is diet related), arthritis, high blood pressure, gallbladder disease…the list goes on. It is easy to see how obesity/overweight and poor nutrition are now a major public health concern.

People often think that good nutrition and being skinny are the same thing. In fact they are not always related. One can be a relatively healthy overweight person. One can also be a very unhealthy skinny person. The volume of food determines your weight, while the quality of food determines your health. At our clinic, we address both aspects, weight and health.

After your initial consultation with me, we will determine your risk factors, and arrange appropriate blood tests to assess any medical conditions and develop a baseline. The program then starts with a one hour intake session with our nurse in which she will review the principles of the program, healthy choices and a general meal plan to achieve a 1.5-2lb per week weight loss. Attendance is then weekly with our nurse – over a period of 6 to 12 weeks (depending on your needs). At the beginning, the time is spent on customizing the meal plan to your personal preferences and food likes/dislikes. There is a period of “negotiation” to make it realistic and enjoyable. If you do not like the food choices, then you will not stick to the plan, so we try to find the best options for you based on your likes and lifestyle issues. Once you understand good choices, bad choices, good volumes and bad volumes, then we start the education. We will cover many topics including: what is the relationship between food and blood pressure, food and diabetes, food and heart disease. What about cholesterol. What about my risk of cancer? How do we reduce my risk of sudden cardiac death by 50%?

Every time you come in, you learn more about how nutrition impacts your health. We believe in what we call cognitive behavioural therapy. The more you understand, the more likely you will make good choices. As we say to patients, “why don’t you go across the road against a red light?”, because you’ll be hit by a car and die. Same thing with nutrition, the more you understand the less likely you will WANT to make poor choices. We say it often to parents, “why don’t you give your child a cigarette?”. It sounds ridiculous, but when you understand that food is medicine, you will understand the impact that poor choices will have on children. Society has now accepted that second hand smoke is completely unacceptable and most of us would be outraged by someone smoking around kids. For some reason, we seem to think it’s okay to feed our children volumes of junk food and allow them to reach weights of adulthood by the time they’re ten. It is thought that this will be the first generation that doesn’t outlive their parents.

Follow-up continues once a week until you have reached your personal goal. Maintaining that goal is best achieved by long term attendance of once a month. Studies have shown that patients that continue attending as little as once a month (a three hour commitment for the whole year) have an 80% success rate in keeping the weight off over the next 5 years. On the other hand, patients that stop attending only have a 10% success rate. In other words, even if you lose weight successfully, long term follow up is required to prevent you from going back to old habits, which occurs 90% of the time.

Conditions

We use nutritional education to manage obesity, type-2 diabetes, high blood pressure, high cholesterol, infertility (due to irregular periods/PCO) and many other conditions related to (or caused by) being overweight.

It is important that people come for the right reasons; this has a lot to do with “issues of control”. If you come to please somebody else, whether a family member or your doctor, you are not in a position of control. However, when you come for yourself, you're assuming full control.

How to take Control

Our goal is to put control back into your hands: with education and permission.

We provide you with knowledge and understanding. We will dispel any rumors or myths and will provide you with scientifically proven facts. In addition to that, we will give you "permission".

When you understand the science behind obesity, weight loss, high blood pressure, diabetes and many other medical disorders, it becomes far easier to manage.

It often surprises patients when they ask, "Can I have some chocolate?" and we respond, "Sure". If we were to say no, then they would "rebel" and have two - just to spite us and exhibit their control. Does this sound like you? Well it is very common behaviour in overweight and obese patients. We then follow our permission by saying, "As long as you understand that a chocolate bar is 250 calories. It would require you to exercise for one hour just to burn it off".

Control is in your hands; permission has been granted. Once you are allowed to have that chocolate, it's no longer as desirable and it will sit on your counter for days before you even have a bite.

How to keep the weight off

It is well known that 90% of weight-loss programs fail. Why? Two important reasons; first, people are not seen often enough to receive support. Second, patients often don't appreciate the importance of long term follow up and support.

Losing weight is half the battle - equally important is maintaining the weight loss. Obesity is now considered a chronic medical disease, not just an appearance issue. It is associated with an increased risk of heart disease, diabetes, high blood pressure, cancer, arthritis, gall bladder disease, high cholesterol...just to name a few. As a medical disease, obesity has to be respected with the same long term follow up you would engage in for any of the above conditions.

Since there is a strong behavioural component to eating and obesity, long-term follow-up and support is vital. Contrary to popular belief, special occasions and events do not cause people to gain weight; it's the regular routine that causes problems. This is why health organizations recommend long-term follow-up.

What happens without follow-up?
Typically, people are proud of their achievement and reward themselves with a piece of cake. If they don't gain any weight then that behaviour is repeated. Within a couple of months, they gain back 5 pounds and promise themselves that they will lose it in "a few weeks". Unfortunately, they never do - and instead start to regain even more weight. Gradually, clothes become tighter and therefore they get out their old "fat" pants. Eventually, they regain all of the weight they lost, and then some.

This will always happen if you go back to your original habits. What you learn from us is a way to change your habits over the long term without being hungry. Does this mean you can never have junk food or chips again? Of course not, but instead of poor choices being 80-100% of your calorie intake, you eat well 70-80% of the time and still have room for "junk".