Note: To get more updates on this particular weight loss journey, pictures of the food I eat, and my entire catalogue of weight loss information, articles, mindset advice, experience, strategies, and tips/tricks that I have gathered and published over the years click here. I have gained and lost hundreds of pounds. Twice previously, I have lost approximately 80 pounds. Both times it took me about 1 year to lose that amount of weight. I have also lost 20-30 pounds on several occasions. I lost most of this weight using the keto diet in conjunction with intermittent fasting. Unfortunately, like most people, I eventually got off the keto diet, began binging on carbs, and gained the weight back. My main struggles with overeating were at night after work and weekends. About 3 months ago, I introduced a new weight loss medication option, which I also determined to test on myself so I could better advise patients and lose weight again myself. This medicine is semaglutide also known by the brand names Ozempic and Wegovy. For more information on this medicine read my previous article. After starting the semaglutide injection at the 0.5 mg dosage I noticed that it suppressed my appetite, decreased hunger, altered food preferences, and made me feel fuller quicker. I experienced side effects of tiredness, mild nausea, stomach cramps, occasional acid reflux, diarrhea, and constipation. These symptoms are also the most common ones I have seen experienced by patients. For me the worst symptom by far was constipation and I had to take medications like Miralax and Magnesium to help somewhat relieve it. I took the semaglutide 0.5 mg injection for 7 weeks and have done the last 5 weeks without it, as I wanted to test how things would change after stopping the injections. I was also determined that I would try to continue forward on my own. I also missed weighing myself on week 7. My starting weight was 270 pounds. Here are my subsequent weights. Weight (lbs): Week 0: 270.0 Week 1: 260.6 Week 2: 252.8 Week 3: 246.2 Week 4: 240.0 Week 5: 237.2 Week 6: 233.0 Week 7: missed weigh-in and last injection given Week 8: 227.8 Week 9: 224.6 Week 10: 220.4 Week 11: 217.2 Week 12: 215.0 Total weight loss after 12 weeks: 55 pounds Those are pretty impressive results but they are not entirely a result of the medicine. I would say the medicine got me half way there but I had to put in the other half. I have invested a lot of effort into following a consistent diet and trying to increase exercise as my body would permit.
It was definitely easier to eat fewer calories while on the injection but I have still maintained a lower amount of calories after the injection. I estimate my caloric intake while on the injection to be about 750-1000 calories/day. Off the injection my caloric intake has increased to about 850-1300 calories/day. I eat twice daily and have tried to eliminate most snacking. I have cut out soda entirely. I already don't drink alcohol. Overall, I am eating relatively lower carbs but not extremely so. I have been in ketosis for about 1 week total out of the 12 weeks but not purposely so. I have not entirely eliminated any food group. I have tried to remove junk food, chips, crackers (non-real food) as much as possible. I have also tried to severely curtail very energy dense food such as nuts and cheese and have been eating a generally higher protein percentage. I drink water with electrolytes with a slight addition of salt and I frequently supplement with otc magnesium pills. I drink a significant amount of electrolytes/water before eating a meal which has helped with satiation. On days that I am more sedentary I have tried to eat no more than 500 calories per meal. This was especially true during the first 4-6 weeks as I was still not really exercising much. During very active days I have permitted myself to eat up to 750 calories in a single meal. I have been eating my first meal from about 1130am-1 pm and then my second meal from 5-6 pm. I have not been eating in the morning mostly because I am not hungry anyway. The initial 4-5 weeks I didn't exercise much mainly because of pre-existing physical limitations, lack of energy, lack of motivation, pain, etc. As I have lost weight I have had increased energy, physical capacity, and motivation to do exercise. Subsequently, I have increased exercise from 0-2 times/week (mostly zero) to 5-7 times/week. The amount and intensity of exercise has also greatly increased. My weekly exercise regimen now consists of one 2 hour session of tennis, 4-5 bike rides lasting 45 minutes, and 1-2 low impact high intensity 10-15 minute aerobic workouts. I also stretch 10-15 minutes/day 3-4 times per week. The above regimen is what I have followed and it has worked. However, I am not prescribing this strategy as something you should follow. I simply wanted to give everyone a detailed look about what I have been doing. Obviously, follow your own doctor's advice before following any diet or exercise regimen. To get more updates on this particular weight loss journey, pictures of the food I eat, and my entire catalogue of weight loss information, articles, mindset advice, experience, strategies, and tips/tricks that I have gathered and published over the years click here.
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Note: To get access to my entire catalogue of weight loss information, articles, mindset advice, experience, strategies, and tips/tricks that I have gathered and published over the years click here.
Semaglutide is a relatively new medicine that was initially used for diabetes but it is now receiving increasing attention for use for weight loss. In fact, many patients who have used this medication for diabetes have experienced significant weight loss. Consequently, further studies have been performed to address the weight loss potential of this medication. In recent trial data released just last year, this medicine was associated with significantly reduced body weight compared to placebo (-15.2% versus -2.6%) that was maintained over 1 year when used in conjunction with diet and exercise. The weight loss potential of this medication has also been demonstrated in my own clinic with many patients losing significant weight since starting it. Most patients have had minimal to mild side effects. In regards to weight loss, semaglutide appears to act to reduce appetite and food intake by acting on the nervous system. It also works to delay gastric emptying which aids the feeling of satiety. The majority of weight loss is due to decreased caloric intake. Some common side effects of the medication include nausea and vomiting, constipation, diarrhea, and stomach discomfort. These side effects are not thought to be a significant cause of weight loss with this medication. What are some other benefits of semaglutide? In some patients like those with diabetes and a high risk of heart disease, semaglutide was associated with decreased rate of cardiovascular death, non-fatal heart attack, and non-fatal stroke. Some potential concerns with the medication include an increased chance of pancreatitis, possible thyroid cancer, gallstones, and retinal changes. It should not be given in patients with a family or personal history of multiple endocrine neoplasia type 2, impaired renal function, or medullary thyroid cancer. The injection is a once weekly mildly painful subcutaneous injection often given in the abdominal area. In order to ensure tolerability and efficacy the dosage starts at 0.25 mg and can increase to 2.4 mg which was the most effect dose. Even lower dosages were found to be effective but the higher dosages were associated with more weight loss. The goal with each patient is to use lowest effective dosage for the shortest duration of time and to focus on creating good eating and exercise habits which can be continued after the medication has been stopped. If you have questions about this medication or are interesting in trying it please give us a call. See below for further resources: 1. Wegovy (semaglutide): a new weight loss drug for chronic weight management To get access to my entire catalogue of weight loss information, articles, mindset advice, experience, strategies, and tips/tricks that I have gathered and published over the years click here. Note: This information is only up to date as of December 2020 and is subject to change.
It goes without saying that this year has been a challenging one in many ways. The Covid-19 (SARS-CoV-2) virus has now spread widely within our population and penetrated deeply into our collective psyche. There has been tragic loss of life especially for those who are more susceptible. This has included the elderly and those who have comorbid chronic medical conditions or who are immunosuppressed. Despite this fact, for much of the population the risk of serious morbidity or mortality from Covid-19 is quite low. Now after nearly a year since the virus emerged, the FDA has recently approved 2 vaccines to combat the virus. Consequently, I have been getting a lot of questions from patients about my opinion about the vaccines. I hope to give you some general information from the published trial for one of the vaccines (Pfizer) so that you can make an informed decision for yourself. If you would like to review the published article yourself from the New England Journal of Medicine click here. To summarize, the trial published for the Pfizer Vaccine appears to show the following:
Since the trial results was published and the general public have begun receiving the vaccine it appears that some serious anaphylactic allergic reactions have occurred according to some news reports that I have seen. This was not reported in the published study from what I could ascertain. In addition, you should also be aware that vaccine recipients will be tracked and possibly have their information shared with state and federal regulatory agencies. Finally, I am not here to promote a particular treatment or a vaccine. Due to highly varying risk factors between individuals it is up to each person to determine if a particular treatment is right for them after they have considered the risks, benefits, and alternatives based on accurate information. The fear, uncertainty, and physical suffering caused by this virus should not preclude or supersede the right of each person to determine what medical treatment is right for them. Covid-19 treatment and testing is offered at my office. Feel free to call for more information. Like everyone I have been carefully watching the Coronavirus outbreak that started in Wuhan China and has now spread to other countries including the United States.
There were some initial brave Chinese medical personnel who tried to raise the alarm about the virus. One such health worker, an ophthalmologist named Li Wenliang who later died from the virus, reported on his social media his concern for a flu-like virus that had emerged in the hospital where he worked. According to the Guardian he may have been targeted by Chinese police for spreading false rumors about a mysterious illness that later turned out to be the "Coronavirus." Now the virus has continued to spread and has caused terrific loss of life and hardship across Asia, parts of Europe, and now the U.S. While there is still a chance that the American people can for the most part remain untouched by the virus the future is uncertain and now is the time to prepare. While information about the virus is still sketchy I will attempt to sum up some information that is out there so you can get prepared. My first piece of advice is to remain calm and don't panic. Getting into panic mode will only decrease your ability to think rationally and paralyze you when action is needed to be taken. Secondly, the virus has tended to cause a much higher mortality rate among elderly individuals that are in nursing homes or are immunosuppressed. While this is not good news for those individuals who fit that description it does mean that mortality rates are not as high for most people. I have seen estimates of mortality of about 2% when patients have access to advanced medical care in first-world countries. Hopefully, this will mean that there will be a lot less loss of life then originally feared. If the virus does reach pandemic proportions and becomes widespread it is important to know what to look for. The virus seems to present with symptoms slightly different than many respiratory viruses. The most common symptoms may include fever, cough, and shortness of breath with significant involvement of the lower respiratory system (ie. the lungs). The lungs of infected individuals can sometimes be so significantly damaged by the virus or by the immune system response to the virus that individuals can develop viral pneumonia or even acute respiratory distress syndrome which is even more ominous. These diagnoses can be detected with a CT scan. The virus appears to be spread both through direct contact and respiratory droplets and the incubation period may be as long as 15 days. That means that a person could be a carrier of the virus for sometime before symptoms develop. The virus spreads easily and has proven to be very difficult to stop once it gains a foothold. The most common strategies recommended for preventing the spread of this virus include using proper hygiene, proper hand washing, and limiting exposure to respiratory droplets through use of masks. One strategy that doesn't get a lot of attention but is very important is to simply not touch your eyes, mouth, or nose. The virus can only cause an illness if it can get inside you. Unfortunately, the treatment for Coronavirus is mostly supportive at this juncture and no medication has been proven to be effective although many different antiviral agents are being tried. A vaccine is reportedly being targeted for development although vaccine development is typically not a short process. Despite the lack of specific proven treatments it probably makes sense to make sure your physical health and diet are the best they can be. Since the virus appears to affect people that are immune compromised the most, making sure that your immune system is in good working order is critical. This includes making sure you are getting all the vitamins and nutrients you need and that you have low inflammation in your body in general. Some of the biggest contributors to inflammation include high stress, poor sleep, obesity, and poor diet. Decreasing your blood sugar and increasing your insulin sensitivity is very important as diabetics are far more susceptible to illness. Finally, it stands to reason that everyone should be prepared with basic medical supplies and access to food and water should shortages develop. This is a time for Americans to come together to help each other instead of becoming more divided. The virus is no respecter of persons. It doesn't care who you are and neither should we care. Cold and flu season has finally arrived and is in full force. I don't like to see patients getting sick; I would rather them be healthy. I would also prefer to help patients strengthen their physical resistance to illness and develop an increased capacity to rapidly dismiss sickness when it occurs.
During this time of year, some patients seem to get sick more frequently than others. Many of these patients blame their propensity for illness on bad genes, an inherent immune system deficiency, or just plain bad luck. Unfortunately, it is not usually one of the aforementioned factors that is the root cause of the susceptibility to disease. The truth is that the ability to resist illness and to maintain optimal health is not a given. Optimal health is created, not inherited. Achieving real health necessitates following a daily health routine that is purposeful. The purpose of this routine is to develop strength, increase energy, and enhance resilience. This routine can and should become just as automatic as setting an alarm clock. It should become a habit, or even better, a health reflex. One of benefits of optimizing your health is an increased capacity to stay healthy. I am often asked by patients why I don't seem to get ill even when I am constantly exposed to sick people. While I do still get sick, I have developed some strategies that seem to have helped me stay healthier. Here are some of my top recommendations for staying free of colds and flu that don't include taking supplements or prescriptions.
I hope you enjoyed some of my top personal tips for staying free of colds and the flu. This list is by no means exhaustive. My vision for every person is that they avoid useless suffering and have more joy and happiness in their lives. If you find that you are getting ill on a regular basis try some of the steps above and see if they help. If you are following all these steps and are still getting regularly ill then check with your doctor. Last of all, BE the BEST YOU! |
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June 2022
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