• Tony-Boggess

    Dr. Boggess (Medical Director)

    Dr. Tony Boggess is a Physical Medicine and Rehabilitation (PM&R) physician, speaker, and writer who specializes in Nutritional and... read more

Medical Weight Loss

Being overweight exhausts energy reserves and places undue stress on our physical and physiological systems. Even if you eat correctly and exercise according to standard recommendations there are many rate-limiting factors that may be inhibiting your ability to loose the pounds you desire.

These factors include:

  • Slowing of metabolism
  • Hormonal imbalances
  • Possible prediabetic, insulin resistant state
  • Poor liver function
  • Lack of understanding of proper diet and exercise.

(Hint: Not what the ‘food triangle’ or rouges at the gym tell you to eat…)

What follows are recommendations that I and most other natural health physicians recommend as basic strategies for weight loss. Only after these have failed, are the more novel approaches such as Beta HCG, or other medical weight loss programs warranted.

These steps (medically supervised) include:

  1. Diagnose and treat any thyroid, adrenal, or hormonal imbalances
  2. Increase metabolism at the cellular level
  3. Protect cells and tissues from the effects of glycation (sugar damage)
  4. Improve the body’s response to insulin
  5. Improve liver function and detoxification pathways
  6. Manage stress, eat right, and exercise ‘smart.’

Improve metabolism at the cellular level

•Coenzyme Q10 (CoQ10). I often go to higher than standard doses with my patients especially if they suffer from fatigue. *Higher doses need to be taken only under physician supervision because CoQ10 is a mild blood thinner. So it’s important to consult with your physician prior to taking if you are on blood-thinning medications.

•L-Carnitine. *Can cause gastrointestinal upset. In such case, take with food or decrease dose to more tolerable level.

•Resveratrol. Has been shown to have antioxidant properties, anti-inflammatory properties, improve cellular metabolism, and activate ‘anti-aging’ genes (a concept that is being heavily researched by many drug companies currently). *Can cause gastrointestinal upset. In such case, take with food or decrease dose to more tolerable level.

•D-ribose. D-ribose the actual sugar fuel your cells use to produce energy, so over time it can help burn up calories and assist in weight loss. *Can cause one to feel lightheaded, if this happens can be taken with food or reduce dose until tolerated.

•Healthy Fats/Oils. Simply put, if you want your body to burn fat, you have to train your system to utilize fatty acids as its primary fuel by consuming healthy, natural, fats and fatty acids, and shunning the unhealthy ones. Learn more

Check for hormone imbalance

Requires diagnostic testing ordered by a physician

Special note: Although lab values may be normal, subclinical low levels can indicate an imbalance (or pre-disease state) and warrants attention, especially if symptoms are present. Often, holistic physicians will know how to treat with natural agents, whereas, conventional physicians do not have this option… Just something to keep in mind.

Conditions/hormones to evaluate

Thyroid function (including T3 and Reverse T3)

Food Tip: to balance thyroid, eat foods rich in iodine such as sea kelp or cruciferous vegetables (broccoli, cabbage, Brussels sprouts, cauliflower and kale) daily.

Estrogen Dominance
(a commonly undiagnosed cause for midsection/abdominal weight gain),
Food Tip: to balance estrogen, eat two to three servings of cruciferous vegetables (broccoli, cabbage, Brussels sprouts, cauliflower and kale) daily

Subclinical Adrenal Imbalance/elevated cortisol levels/depressed DHEA-S
Hint: to balance cortisol, undergo light aerobic exercise and avoid post workout crashes. For example a few minutes daily of swimming, jogging, bicycling or walking, strength training with professional guidance, stress reduction and relaxation techniques, yoga, and gentle breathing exercises.

There are any number of supplement protocols to support adrenal function (after testing is completed) tailored to each individual patient’s need.

Growth Hormone
(especially an important consideration for aging adults)

Undiagnosed Diabetes, Prediabetes, or Insulin Resistance

Special note: with sugar/insulin tests it is important to look for subclinical normal results and interpret them appropriately. The following values are standard accepted interpretations from the functional medicine community at large. Please compare these to your own physician’s interpretations (which may be grossly mistaken as normal).

Fasting glucose test.
Standard normal = 65 – 99 milligrams per deciliter (mg/dL) is far to generalized

Functional Medicine Interpretation

Optimal: 76-81 mg/dL
Normal: 82-85 mg/dL
At risk: 86-99 mg/dL
Prediabetes: 100-125 mg/dL
DiabetesL: 126 mg/dL and above

Blood Insulin
Not commonly looked at by most conventional physicians, but can provide useful additional information

Standard normal = 6-35 microunits per milliliter (mcU/mL) is far too generalized

Functional Medicine Interpretation:
Optimal—6 mcU/mL or less
At risk—8-10 mcU/mL
Prediabetic—11-25 mcU/mL
Dangerous—above 25 mcU/mL

2-hour oral glucose tolerance test – Looks at the body’s dynamic insulin response to glycemic/sugar stress.

Interpretation
Normal: less than 140 mg/dL
Prediabetic: 140-159 mg/dL, or an increase in glucose of 50 mg/ dL or more within Dangerous: 160 mg/dL

Hemoglobin A1c (HbA1c) –Quantifies glycation (sugar damage) to red blood cell proteins and provides indication of blood sugar levels over the last 3 months.

Interpretation
Normal: 4.5% – 4.9%
At risk: 5.0% to 5.6%
Prediabetic: 5.7% to 6.9%
Diabetic: 7.0% or higher

Other Basic Information

Eat Smart A Mediterranean style diet is a good start. This eating style is low in animal fat and refined carbohydrates, and rich in lightly cooked vegetables, raw fruit, legumes, fish, spices, olive oil and some lean poultry. A good general diet for fat reduction has approximately 40 to 50 percent carbohydrates, 30 percent fat (mainly “good fats” such as omega-3s), and 20 to 30 percent protein. Don’t be a calorie counter. Eat as close to natural as possible. Go back to the original diets of “hunting and gathering,” avoid processed foods, make sure you include a good protein, a complex carbohydrate and a good fiber source with each meal

Metabolic Typing may be suggested under special circumstances to devise an ideal diet for and individual, but this is rarely needed.

Limit un-buffered sugar intake (i.e. the white crystalline substance or syrup concentrate isolated from sugar cane, beets, and corn which acts on the body like a drug…) Understand that sweet substances, namely High Fructose Corn Syrup, Sugar, and Chemical sweeteners are being added to food only because we crave them like the dickens. Which is precisely the first clue that we should minimize intake. learn more.

Avoid Soft Drinks & Chemical Sweeteners like Nutrasweet and Splenda (which actually contribute to weight gain) learn more

Drink healthy, clean, chemical-free water learn more

Identify food sensitivities that cause water retention and impair metabolism. Requires diagnostic testing ordered by a physician

Lastly, consider novel techniques, such as a hCG weight loss program

For patients who are struggling with weight loss despite trying all of the above and having undergone a full medical work up, I recommend a protocol using the hormone human chorionic gonadotropin (hCG) together with a calorie-restricted diet. Many patients have had great success with this, but it is a medically prescribed and supervised program so requires an in office consultation. (Please contact our office for more information)