Weight gain

There are basically 4 reasons/associations for why patients gain weight (fat gain) which are diagnose-able by a physician. 

3. Severe thyroid disease: hypothyroidism or hyperthyroidism
4. Medication induced: (steroids of any type, antihistamines, beta blockers, SSRI/mood medications)

Our physicians can help you evaluate for these 4 concepts. Beyond these causes, there are numerous genetic causes for weight gain for which there are usually not tests available, nor are there any specific treatments for those gene disorders. We cannot test for genetic causes in our clinic and nor can we treat for those. Even if you have all 4 above issues you can still maintain a normal weight with or without medications. Out Out of our scope are other causes of weight gain that are related to fluid fluctuations (unrelated to fat gain). 


There are essentially 4 ways you can try to lose weight (with the assistance of your physician) but three of which don't work well

1. Calorie restriction. Restricting when and how much is the best and most proven way to lose weight if a person sticks with the dietary changes for life. Basically eat less. Remember that the common denominator for all "diets" is calories. It really should not matter what you are eating as long as there is a reasonable calorie deficit, which your physician can help you decide upon for  your individual case based on your history and body muscle mass and your basal metabolic rate.  In general don't drink your calories  (just drink water if you are thirsty) and eat lots of plants. Eating healthy is recommended and a good source of information is the book and movie "In Defense of Food: An Eater's Manifesto" by Michael Pollan. 
2. Exercise - there are two types. muscle building and aerobic. It takes A LOT of exercise to lose weight and many studies show that exercise is  generally NOT effective for weight loss so there is controversy. There are many other benefits to physical activity however including cardiac and cancer benefits
3. Weight loss medications- generally these are NOT a long term solution to weight loss and have MANY side effects. Our clinic generally does not prescribe these medications. Best case scenario in the published studies for these medication is 5-15 pound weight loss after 1 year of use. 
4. Gastric surgery- in some cases this may be indicated a patient has obesity co-morbidities and your physician can help your decide if this is worthwhile.


Dr. Jogi has some specific recommendations for weight loss for his patients. Consult your doctor for what is right for you:

There are 5 steps that Dr. Jogi can suggest. Try "baby-steps" by doing one step at a time. Please set your expectations first: if you were to follow all the steps, a good amount of weight loss would be 1-2 pounds every 1-3 months, with intermittent intervals of no weight gain or loss for several months. Anything more suggests you are doing something to lose weight that is not sustainable. Exercise is fine to do for mental, cardiac, and bone health. But you should have no expectation that exercise alone will lead to sustained weight loss, usually studies have show it can lead to weight gain.
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1. Compress the time that you eat any food into an 8 hour period. For example 12pm to 8pm or 10am to 6pm. Stay consistent. Then the subsequent 16 hours you may only drink non-sugary liquids (Best is water). For more details you can google search "Dr. Fung diet" and his books called Obesity Code and Diabetes Code. Or you can simply watch his free youtube videos
2. Reduce the carbohydrates and processed foods you are eating to less than half of your current intake. No or less grains, no potatoes, no added sugar.
3. Make your entire diet mostly plant-based. (80%+ vegetables). If this seems daunting or difficult please review the reading list below. A good way to start is to consider getting meals from www.VeginOut.com which is a vegan ready-made food service delivery.
4. Don't eat food from outside of your home: more than twice a month is too much.
5. Calorie tracking can be frustrating but worth trying. Download myfitnesspal app to track your calorie intake for a week, note the average calories per day. Then plan to eat 150 less calories less per day from that day forward. Alternatively you can try Weight Watchers online system and follow their point system. Physically going to Weight Watcher meetings is very useful.
6. If you feel you need to lose weight much fasting than 4-7 pounds a year, then you should consider a meal-replacement program such as the Methodist Medical Weight loss program 832.667.5673 in which you meet weekly and interact with dietitians, nutritionists, psychologists, and internist. They frequently have free information session. Remember that it is best to stick with these types of programs for at least 3-5 years to maintain the lowered weight.
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------Steps to becoming a vegan--------------
Following a vegan dietary regimen is not necessary, but many patients ask how to begin such a diet. Below are suggestions and reading material
1. This is a long process and so get informed. Watch the following films:
What the Health
Supersize Me
Food, Inc
King Corn
Fast Food Nation
Forks Over Knives
Planeat
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Read the following books:
How Not to Die. by Dr. Michael Greger
The Original Fast Foods by James and Colleen Simmons
The China Study by T. Colin Campbell
Fit For Life by Harvey and Marilyn Diamond
Eat More, Weigh Less: Dr. Dean Ornish's Life Choice Program for Losing Weight Safely While Eating Abundantly by Dr. Dean Ornish
Consider visiting the following websites for RECIPES. Vegan DOES NOT MEAN EATING SALADS EVERY DAY:
http://www.veganpeace.com/animal_cruelty/animal_cruelty.htm
http://www.tcolincampbell.org
http://www.vegfamily.com/vegan-pregnancy/index.htm
http://www.vegansociety.com
Get excellent home food delivery of vegan food to reduce your chopping time. Prep time is 2-3 minutes on your stove for ready-made food. www.VeginOut.com and consider writting "Referred by Medhavi Jogi" in the comments box when you order the first time.
2. Ditch dieting and start permanent changes
You don't have to be vegan. But you should pick one type of diet and stick with it
3. Baby Steps
Dr. Jogi recommends a gradual approach to improving you diet. It takes years to build a habit, so don't change it overnight. Make these very gradual changes:
a. Take into account all of the junk food in your home. This includes anything with sugar, refined flour, and has been processed. Make a list of it and post it on the fridge.
b. On a weekly basis, target one junk food that you have decided you are not going to buy anymore and replace it with a healthier food that you like. For example, if you cook with white flour start buying whole wheat flour. If you buy potato chips and cheese dip every week, start buying corn chips and salsa instead. If you eat raisinets every day, start buying plain raisins or grapes instead.
4. Shop the perimeters of a grocery store
5. Skip the Eggs
6. Avoid dairy and meat
7. If you really are not taking any meat, eggs, or dairy, then Dr. Jogi strongly recommends vitamin B12, 1000 units daily.
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