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Why did you gain weight? Why can’t you lose it?

In 2013, the American Medical Association declared that obesity is a disease. As a disease, it requires a medical specialist to effectively manage and reverse when possible.

Weight gain is not simply about calories in versus calories out, or eating less and exercising more. Hormones (insulin and others) play a critical role because they regulate hunger, energy usage, energy storage, cravings, and other complex interactions. Carbohydrates from food induce a rise in insulin levels, which in turn can lead to increased fat deposits. All patients differ in the amount of carbohydrate they can safely tolerate, so we individualize their carbohydrate intake. Our initial blood testing identifies a significant number of patients with insulin resistance (30-40%) and Type II diabetes.

Our job would be so easy if we could simply tell all patients to avoid carbohydrates. But executing a successful customized plan for an individual’s makeup is far more complex. We must focus not only on dietary interventions, but also on behavioral changes, self-awareness, and education. Our Registered Dietitians’ training in motivational interviewing is highly successful at eliciting necessary behavior changes. This technique helps identify each patient’s individual obstacles and overcome them. Some patients are deeply influenced by friends or family and these patients need extra support and coaching.

The food industry makes carbohydrates ubiquitous and difficult to avoid, so we must jointly strategize for success. As patients learn nutritional fundamentals, they move from being unaware of their previously poor eating habits to conscious of proper nutrition. We then guide them in experimenting with what health foods work for them throughout our consultations with them, we focus on education, achievement of goals, and implementing changes. Our shared goal is that these changes become a lifelong lifestyle and not another transitory “diet program”.