5 Steps to prevent Heart Disease

Thursday, January 14, 2016

Treatment for Obesity is here but country doesn't want to pay for it

There is a treatment for the Disease of Chronic Obesity

But:

The 4 diet medicines are very expensive

People don't want to take diet medicine lifelong. 

Family doctors don't know these medications are indicated for life.

It is not understood that the most benefit of these medications is to maintain weight loss. 

Except for Bariatric surgery, there is no profit in Obesity clinics, thus hospitals have not yet developed obesity clinics nation wide as they do not know the above. 

Letter of Lament by a Obesity Specialist looking for a job 

 

Dear Friend,
To my surprise in all my study for the ABOM boards, nutritional ketosis as the reason for Atkins success was never discussed.

I did a short experiment with one hour/day exercise at YMCA weight gym and LCHF in documented blood ketosis.  I gained 4 pounds.
I then went on Qsymia, walked one mile a day 5 days a week and was very sedentary as I studied for obesity boards.
I clearly began eating less ad libitum.  I did eat less.  I lost 5% body weight even after a cruise.  (Nutritional ketosis and exercise did not cause weight loss)

Despite being on Qsymia, Victoza, Invokana, walking a mile a day, eating less ad libitum on LCHF I think I have hit a plateau.
 Perhaps if I stopped all ETOH I would lose again?  I urinate calories in form of glucose and ketones yet no change in weight? (Setback at plateau?)

Obesity is an amazing subject.

The guidelines would suggest increase exercise to one hour a day.  That might help in short term but in long term, I think the physiology catches up on down days.  You can't out run your fork as people who actually work in obesity clinics say.

I am happy to continue my medications just to maintain my weight loss.  I was 280 lbs.
 I achieved and maintain my weight of 216 lbs today ad libitum Atkins, walking my dog one mile 5 days a week and drinking 4 oz ETOH a day. I call it the Bon Vivant diet but mostly it is due to the diet medications. 

All diets are restrictive but LCHF allows ad libitum. It will still fail in most reduced obese as seen in this graph.
That is when one of the new diet medications should be added to prevent weight regain.

I had my annual physical yesterday with my family practice physician.  To my surprise he has been doing obesity work for 3 years.  He did not know there are obesity boards.  He mostly uses phentermine because the other drugs are too expensive.  He also said Contrave did not cause enough weight loss to be worthwhile for his patients.  I tried to tell him about waterfall effect of trials and need to use multiple drugs to individualize therapy.  Too much to talk about in 5 minutes.
 In my search for a job I notice hospitals don't realize they need obesity specialist and bariatric surgeons don't want to share the money even though they need a ABOM specialist to prevent recidivism in their patients with diet medicines. 

I think I have arrived on the scene a little early.  Just as my message about treating early with statins with positive CAC was early in 2009. 2016 MESA analysis of CAC data

In closing, This article about nutrition science shows the need to individualize diet and monitor how healthy that diet is for the individual with LDLp, CAC and CIMT. 

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