Table of Contents
- Introduction
- 1: Different Nutrition Plans
- Low Carb/High Fat Diets
- Whole-Foods, Plant-Based Diets
- Intermittent Fasting Diet
- Volumetrics Diet
- 2: Medications
Introduction
Our philosophy at Big Tree Medical of El Paso is to be your home for everything medical, which means caring for all medical conditions that a primary care team can safely treat. We strongly believe that this should include anti-obesity treatment, but unfortunately this is not done at most primary care offices. We include management of obesity as a routine part of your Big Tree membership; there is no additional charge. Not only are we here to treat your diabetes, high cholesterol, sinus infections, and joint pains, but we are here to treat you holistically. We do this through our team-based approach, using our different health care providers to target different aspects of your anti-obesity treatment. We have had multiple years of experience with our weight loss program and are excited on what we have to offer for people struggling with their weight in 2021. Many of our own staff have participated in our weight loss program and would really enjoy helping you on your journey that they themselves are on. Please review this weight loss packet to help determine which options best fit your lifestyle and goals of becoming a better you.
Low Carb/High Fat Diets: Keto, Atkins, South Beach, Paleo
Description
- Very low-carbohydrate diet: 21-70 g per day of carbohydrates.
- Consuming minimal carbohydrates places your body in a state of ketosis to produce both blood sugar control (due to less sugar going into the blood) and weight loss. What is Ketosis? Ketosis occurs when your body burns stored fat for energy and produces ketone bodies as a byproduct.
- You have to eat less than 50g of carbohydrates a day to put your body into ketosis. Some programs recommend keeping this between 20-30g of carbohydrates per day. This resulting ketosis causes an appetite suppression, thus leading to decreased caloric intake.
Pros
- Simple and straightforward to follow.
- No counting calories.
- Limited feelings of hunger.
- Enjoyable for meat eaters.
- Allows high fat foods such as meat, cheese, and butter.
- Often results in quick weight loss.
- Eliminates carbohydrate rich foods that provide fiber and phytonutrients and antioxidants.
- Requires strict monitoring of carbohydrate intake.
- Keto Flu during introduction period of diet.
- Difficult to sustain for the vast majority of people.
Health Concerns
- Do not follow this diet if you have preexisting renal, cardiovascular disease, or heart problems.
- Increased intakes of Protein and Fat usually increases saturated fat intake which is linked to increased risk of cardiovascular heart disease.
- Increased risk for developing kidney stones and gout.
Whole-Food, Plant-Based Diet (Vegetarian or Vegan Diets)
Description
- Diet made up of fruits, vegetables, whole grains, legumes, nuts and seeds with limited intake of meat and animal products.
- Vegetarian diets usually include milk and eggs (lacto/ovo vegetarians) whereas vegan diets avoid all animal products.
- This diet can support gradual weight loss because most plant foods are naturally low in calories. Servings of higher fat options such as nuts, seeds, coconut, and oil may need to be monitored more closely to support weight loss.
- Vegetarian and vegan diets are associated with a lower BMI and lower incidence of diabetes and heart disease compared to most other diets.
Pros
- Simple to follow.
- Limited counting and measuring typically needed.
- Increased intakes of antioxidants and phytonutrients which improve detoxification in your body.
- Allows carbohydrate rich foods.
Cons
- May require more meal planning initially.
- Diet is lower in Vitamin B12 so daily supplementation with 250mcg of B12 is encouraged.
- Eliminates meat consumption which may be difficult for some.
- May need to monitor protein and calcium intake for adequacy.
Health Concerns
- When eliminating animal products, you are at risk for developing Vitamin B12 deficiency.
- If you have diabetes and are on medication for this, medication adjustments may be needed to help reduce risk of low blood sugars.
Intermittent Fasting Diet
Description
- This diet involves fasting for 16-36 hours. This can be supplemented with caffeine to help with appetite suppression and homeostasis of blood sugar levels.
- When you fast, this results in a reset of your appetite thermostat which may cause a lower threshold of food that is required to make you feel FULL. Because of this, you typically won’t eat as much as you think you would on your non-fasting days.
- Your non-fasting days do not have any caloric counting involved. You typically can eat whatever you want.
Pros
- Simple and straightforward to follow.
- No counting calories during non-fasting days.
- Can provide steady, long-term weight loss and maintenance.
- Frees up time to accomplish daily task on fasting days: no cooking, washing dishes, meal planning.
- Affordable-no special foods or supplements you need to buy.
- Guilt free eating on weddings, parties, and other special occasions.
- Flexible fasting days through the week.
- Big mental hurdle when starting out.
- Harder to do with people who eat out of boredom or to suppress anxiety/depression.
- Requires steady liquid intake to prevent dehydration/headaches during fasting days.
Health Concerns
- If you have diabetes and are on medication for this, fasting is typically not a good weight loss option.
- If you have a current or past medical history of an eating disorder, such as anorexia or bulimia, this is not a good diet option for you.
Volumetrics Diet (Calorie Density Approach to Weight loss)
Description
The goal of calorie density is to learn about calorie concentrated foods and calorie dilute foods and how to manage them to manage your weight.
Calorie Density=how many calories is stored in a unit of space or given weight of food.
- Zucchini stores approximately 100 calories in a pound.
- Sweet potato stores approximately 400 calories in a pound.
- Peanut butter stores approximately 2700 calories in a pound.
By eating mostly calorie dilute foods and carefully managing foods that are calorie dense you can lose weight while feeling full and satisfied and not eliminating food groups.
One easy way to tell if a food is high or low in calorie density is to look at the nutrition label and compare the serving size listed in grams with the number of calories. If the serving size number is larger than the number of calories this is a low-calorie dense food, and you may eat this food in abundance.
If the serving size in grams is less than the number of calories, then you must closely monitor your serving size.
Easy Ways to implement Volumetrics Diet
- Add fresh vegetables to pasta dishes such as chopped zucchini or spaghetti squash with pasta.
- Add steamed cauliflower to mashed potatoes.
- Add chopped mushrooms to ground beef or turkey.
- Add cauliflower to rice.
- Eat a salad with low fat dressing before your meal.
For maximum weight loss fill ½ the plate full of non-starchy vegetables, ¼ the plate with potato, rice or pasta (minimal fat added) and ¼ the plate with lean protein(meat, beans, or lentils). The more vegetables and beans you eat the more weight you will lose.
Pros
- Feel full, never go hungry.
- No food groups are eliminated.
- Eliminates need for calorie counting once awareness is gained.
- Emphasizes fruits and vegetables rich in antioxidants and phytonutrients.
- Shows you how to fit your favorite foods into your diet.
Cons
- Requires learning up front to become aware of which foods to eat.
- Limits calorie dense foods such as butter, oil, nut butters.
- May require more planning and preparation to consume more vegetables.
Health Concerns
- If you are diabetic, you may need to closely monitor blood sugars while transitioning to this style of eating. You may end up eating less or more carbohydrates and need to monitor and adjust medications depending on your blood sugar response.
Anti-Obesity Medication Options
General Considerations before starting an Anti-Obesity Medication.
- Weight loss medications are approved for patients with a BMI greater than 30 kg/m2 or a BMI 27- 29.9 kg/m2 with weight-related comorbidities (diabetes, high blood pressure, high cholesterol).
- If medication is used in your weight loss program, it MUST be done in conjunction with healthy eating and physical activity. Medications used alone without the other two changes will set you up for failure.
- Most people respond better to a single ingredient medication vs. two ingredient medication secondary to side effects.
- If you respond well to your weight loss program, you can expect to lose at least 5% of your body weight in a 3-12 month period. If medication is used to assist with your weight loss and it is discontinued, weight gain may reoccur. Given this, it is reasonable to consider using anti-obesity medications long-term to help maintain your weight loss once it is achieved (at least >5% weight loss).
- If you don’t lose >3% of your body weight in a 12-week period on the maximum dose of a specific medication you likely will not respond to that medication.
General Monitoring Parameters with Anti-Obesity Medications
- You will need to check your weight, blood pressure, and heart rate at least once a month while on your medication.
- If you have underlying Type 2 diabetes, you may need adjustments to your diabetes medication when starting your weight loss program to reduce your risk of developing low blood sugars. For example, if your A1C is less than 7.5 you may need to decrease your dose of diabetes medication by 20-50% if it is one associated with hypoglycemia. These medications include insulin and sulfonylureas (glyburide, glipizide, glimepiride). We recommend checking your blood sugar daily during the first several months in your weight loss journey if you are on a diabetes medication.
