Hey there.
I know that we haven't been blogging a lot to inform you of what is new in the world of Chicago Weight Loss, but it isn't because we haven't been busy!
Dr. Bartfield and I have been working hard with Loyola University Medical Center. We are working to create a truly comprehensive weight loss center that will be combining the best of medical weight loss and bariatric surgery.
The plan is to have surgical cases done at Loyola but use a space that is being adapted at Gottlieb Hospital for everything else. We will offer people both surgical and non-surgical options for losing weight. We will have a full support team including the Gottlieb Health and Fitness Center, psychologist, dieticians, and more.
Loyola and Gottlieb Hospital are very committed to this project. Loyola and Gottlieb merged a few years ago and Loyola has now recently merged with Trinity Health Network. This has led to an infusion of resources and enthusiasm.
We have been interviewing bariatric surgeons from around the country; several are enthusiastic about developing a program in Chicago for weight loss that offers people both surgical and non-surgical alternatives.
One criticism I have of many surgical programs is that they don't offer their patients a real alternative to surgery. Loyola has emphasized that they are not interested in "Drive By Surgery". They have emphasized that medical baratricians such as Dr. Bartfield and myself will be very much involved in the care of the patients.
We'll be posting additional updates as they occur. In the meantime we are still seeing patients in our offices and helping people with their weight issues.
Dr. R. Finegold.
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Thursday, September 8, 2011
Monday, April 27, 2009
Wii Follow Up
Hello again! Your faithful receptionist Jill reporting for Chicago Weight Control once more!
Dr. Finegold is a big fan of the Wii, especially the Wii Fit. There are also actual games for the Wii that will help you to stay active outside of Wii Fit as well. My friends and I are video game enthusiasts and have experimented with the Wii for some time now. There are games on there that require a lot of physical activity that might be passing over. Also, these games can be a little more engrossing.
Any of the sports games for the Wii will often involve a lot of movement. Tennis, baseball, bowling, what-have-you will try to mimic the sport as closely as possible which means that you will be swinging, running, etc. Just make sure the Wiimote strap is over your wrist or you will have it go flying at your television/window/someone's head.
A real gem that can be easily overlooked is Rayman's Raving Rabbids with good reason. It's a game that was developed by one of my personal favorite developers (Ubisoft), but in spite of that it's still a game I would've overlooked just because it is weird. It involves cartoon "rabbids" (rabbits) that kidnap the main character and make him entertain them. They are screaming, babbling idiots. However, the game is loaded with humor and activity. There are dance-offs with the Wiimote, races with the Wiimote (you run in place and shake your hands while holding the Wiimote), water gun races, lasso tests, etc. Loaded with fun music, crazy humor, and blazing colors, Rayman's Raving Rabbids is ideal for those who want to further enjoy their Wii. The first game is available for $16.99 and there is a sequel that also involves you playing with your butt.
Another great game is WarioWare: Smooth Moves, another crazy game that involves a lot of Wii movement. This is a game that is all minigames that involve a lot of movement in a short amount of time. This one is not exactly intended for older audiences, but probably more up until mid-30's. The visual style might be difficult for those older than 37 to understand, but maybe not. It's fun, crazy, and can hurt your eyes at times, so be careful. I would suggest this for the younger Wii owners. ^_^
These games are all approved for young children in the house as well, should there be any. :)
Dr. Finegold is a big fan of the Wii, especially the Wii Fit. There are also actual games for the Wii that will help you to stay active outside of Wii Fit as well. My friends and I are video game enthusiasts and have experimented with the Wii for some time now. There are games on there that require a lot of physical activity that might be passing over. Also, these games can be a little more engrossing.
Any of the sports games for the Wii will often involve a lot of movement. Tennis, baseball, bowling, what-have-you will try to mimic the sport as closely as possible which means that you will be swinging, running, etc. Just make sure the Wiimote strap is over your wrist or you will have it go flying at your television/window/someone's head.
A real gem that can be easily overlooked is Rayman's Raving Rabbids with good reason. It's a game that was developed by one of my personal favorite developers (Ubisoft), but in spite of that it's still a game I would've overlooked just because it is weird. It involves cartoon "rabbids" (rabbits) that kidnap the main character and make him entertain them. They are screaming, babbling idiots. However, the game is loaded with humor and activity. There are dance-offs with the Wiimote, races with the Wiimote (you run in place and shake your hands while holding the Wiimote), water gun races, lasso tests, etc. Loaded with fun music, crazy humor, and blazing colors, Rayman's Raving Rabbids is ideal for those who want to further enjoy their Wii. The first game is available for $16.99 and there is a sequel that also involves you playing with your butt.
Another great game is WarioWare: Smooth Moves, another crazy game that involves a lot of Wii movement. This is a game that is all minigames that involve a lot of movement in a short amount of time. This one is not exactly intended for older audiences, but probably more up until mid-30's. The visual style might be difficult for those older than 37 to understand, but maybe not. It's fun, crazy, and can hurt your eyes at times, so be careful. I would suggest this for the younger Wii owners. ^_^
These games are all approved for young children in the house as well, should there be any. :)
Friday, April 24, 2009
WIN Products
I’ve always been very wary of the claims of the supplement industry.
“Lose 80 pounds in 5 minutes while scratching your nose!” Or, “Our magic ingredient from sea shells makes you lose weight, have more energy, and jump higher than Michael Jordan!” Then there is, “Our pill makes your sex drive increase more than Bill Clinton!”
The rules regulating the supplement industry are much more forgiving than the rules that the prescription drug manufacturers have to play by. The prescription drug people have to produce something called a product insert (PI), which is then carried in the publication called the Physician’s Drug Registry (PDR). The PI is supposed to list,among other things, the research supporting the drugs claims, as well what exactly the drug can be used for. Unless there is solid research to back every claim, the manufacturer can’t make claims about what their drug can be used for. Companies that violate this policy due so at their peril, as Eli Lilly discovered recently when they had to pay a fine over 1 billion dollars for making unsubstantiated claims about their drug Zyprexa.
The supplement industry, by comparison, gets a pretty free ride. As long as they aren’t killing anyone, they can pretty much make any claim that they want about their product, without being required to produce proof to back up their claims. Thus you see the wild claims that many supplement manufacturers have made over time without a shred of supportive proof.
So with this in mind, I was pretty skeptical when some of my colleagues, whom I respect, approached me about a supplement company that they deal with, called WIN
(Wellness International Network).
WIN makes a variety of supplements for weight loss and energy, among other things.
When I first looked at their product line I was skeptical--it just looked like a classier supplement line, but still a supplement line, making unsubstantiated claims.
When I looked further, however, I was pleasantly surprised by some things that I discovered, such as the fact that WIN has several products listed in the non-prescription version of the PDR. There are a million supplement companies out there, but only a few get this privilege. In order to be in the PDR, a supplement has to meet minimum manufacturing and product quality control standards.
For example, consider their Omega 3 pill. Omega 3s are a supplement that I have supported for years. There is great epidemiological data supporting that they decrease the risk of sudden death and heart disease, as well as being useful and safer for arthritis.
Omega 3s are high in poly unsaturated fatty acids. Some supplement manufacturers have been caught putting up to 30% saturated fats in their pills. As a consumer, that is akin to putting your mouth directly on the french fryer vat and your local burger chain.
There is a prescription version of Omega 3, called LoVaza. It meets FDA standards for purity. It is marketed by Glaxo, the world’s biggest pharmaceutical company. However, Glaxo doesn’t manufacture the fish oil. It turns out an independent company makes it. They send half of their output to Glaxo and the other half to WIN. The WIN omega 3 sells for about half of the prescription version and is identical to it, literally coming off the same assembly line as Lovaza.
We have been trying many of the WIN weight loss and metabolism products and
much to my surprise--they work! People lose weight, have no side effects, and have more energy. They are a great alternative for our patients that don’t want or have maxed out on the benefit or prescription drugs. So the first time WIN makes a product that looks to good to be true, I’ll be the first one to jump on it. However, as for now, we have become a WIN distributor, able to offer their products to our patients at a steep discount, and I’m excited.
“Lose 80 pounds in 5 minutes while scratching your nose!” Or, “Our magic ingredient from sea shells makes you lose weight, have more energy, and jump higher than Michael Jordan!” Then there is, “Our pill makes your sex drive increase more than Bill Clinton!”
The rules regulating the supplement industry are much more forgiving than the rules that the prescription drug manufacturers have to play by. The prescription drug people have to produce something called a product insert (PI), which is then carried in the publication called the Physician’s Drug Registry (PDR). The PI is supposed to list,among other things, the research supporting the drugs claims, as well what exactly the drug can be used for. Unless there is solid research to back every claim, the manufacturer can’t make claims about what their drug can be used for. Companies that violate this policy due so at their peril, as Eli Lilly discovered recently when they had to pay a fine over 1 billion dollars for making unsubstantiated claims about their drug Zyprexa.
The supplement industry, by comparison, gets a pretty free ride. As long as they aren’t killing anyone, they can pretty much make any claim that they want about their product, without being required to produce proof to back up their claims. Thus you see the wild claims that many supplement manufacturers have made over time without a shred of supportive proof.
So with this in mind, I was pretty skeptical when some of my colleagues, whom I respect, approached me about a supplement company that they deal with, called WIN
(Wellness International Network).
WIN makes a variety of supplements for weight loss and energy, among other things.
When I first looked at their product line I was skeptical--it just looked like a classier supplement line, but still a supplement line, making unsubstantiated claims.
When I looked further, however, I was pleasantly surprised by some things that I discovered, such as the fact that WIN has several products listed in the non-prescription version of the PDR. There are a million supplement companies out there, but only a few get this privilege. In order to be in the PDR, a supplement has to meet minimum manufacturing and product quality control standards.
For example, consider their Omega 3 pill. Omega 3s are a supplement that I have supported for years. There is great epidemiological data supporting that they decrease the risk of sudden death and heart disease, as well as being useful and safer for arthritis.
Omega 3s are high in poly unsaturated fatty acids. Some supplement manufacturers have been caught putting up to 30% saturated fats in their pills. As a consumer, that is akin to putting your mouth directly on the french fryer vat and your local burger chain.
There is a prescription version of Omega 3, called LoVaza. It meets FDA standards for purity. It is marketed by Glaxo, the world’s biggest pharmaceutical company. However, Glaxo doesn’t manufacture the fish oil. It turns out an independent company makes it. They send half of their output to Glaxo and the other half to WIN. The WIN omega 3 sells for about half of the prescription version and is identical to it, literally coming off the same assembly line as Lovaza.
We have been trying many of the WIN weight loss and metabolism products and
much to my surprise--they work! People lose weight, have no side effects, and have more energy. They are a great alternative for our patients that don’t want or have maxed out on the benefit or prescription drugs. So the first time WIN makes a product that looks to good to be true, I’ll be the first one to jump on it. However, as for now, we have become a WIN distributor, able to offer their products to our patients at a steep discount, and I’m excited.
Nintendo Wii Fit
OK, I guess that I need to put this disclaimer out front and center: I am not a paid spokesperson for Nintendo. I haven’t gotten one lousy nickel to tout their product, but here I go.
I have to start by saying that I am as allergic to video games as one can be. Besides their other objectionable qualities, their contribution to our Pediatric Obesity problem cannot be minimized. As I have written elsewhere in this blog, as much as 1/5 of our kids aged 11-19 are now obese, about a 4 four fold increase from two decades ago. Video games can’t be blamed for all of this, but it is no secret that as these games have become increasingly popular, more kids (and now adults) sit on their rear ends and exercise only their thumbs.
For a while, I have been hearing people talk about the Nintendo Wii. I had heard that it was more interactive than the competitors (namely Sony Playstation and Microsoft XBox). What really made me notice was a radio segment that I heard on NPR about how popular the Wii and Wii Fit have gotten with seniors, particularly in assisted living type arrangements. Shortly after hearing this story, this point was graphically reinforced in my practice.
I have a senior citizen in my general internal medicine practice, an 85-year-old gentleman who has congestive heart failure and COPD (Emphysema) living in an assisted living facility. This patient has to use oxygen continiously but remains quite active despite all of these limitations.
One day I received a call from the head nurse at the facility. It seems that my patient had gotten into an argument with another resident in their activities area. Apparently there was a dispute over whose turn it was to use the bowling console on the Wii, and my patient reinforced his claim by punching the other resident in the kisser. According to the rules of the facility, we had to have the patient sent for an evaluation at the Geriatric Behaviorial Unit at Gottlieb Hospital (a Pysch Unit), where the psychiatrist in charge of the unit concluded he wasn’t crazy, just angry that someone was stealing his turn.
I then became aware that several of my weight loss patients were resisting my entreaties to join a formal exercise program and stating that the Wii Fit was their only form of exercise. I had to resist sniggering at these patients and told them that they needed a formal program.
As it turned out, they are the ones entitled to snicker. I now have had several patients lose up to 30 pounds each with the Wii as their only form of exercise. They are all woman in their 40s with families. They can’t find time in their lives to join a fitness center but their kids have helped them use the Wii and the Wii Fit. They enjoy it, wind up spending more time with their families, and are losing weight. What the heck can I complain about?
I became curious enough to buy a Wii and a Wii Fit. Actually I wasn’t able to at first, because the stores were completely sold out, and had to wait a few months until stocks were replenished.
At the time of the purchase I had a 23-year-old son living with me while he was recuperating from surgery for a workman compensation injury. He is a very active young adult, always into hiking, mountain climbing, and other activities. After his surgery it was a struggle for him to walk across the room, which was depressing him and us greatly.
Pretty soon my wife and I were fighting him for access to the Wii. I came home one day and found him running in place while the screen showed an image of him jogging through a park. There was a female image (or, in Wiispeak, a “Mii”) running ahead of him. Periodically she turns and beckons him on, and damned if he didn’t start running faster every time.
My wife loves the hoola hoop and the ski program. I love sitting on the couch behind her and watching her shake her bootie while she does these, but that is probably more information than I should be letting out.
My wife in general does not like to exercise, but with the Wii she has passed many an hour, highly entertained the whole while, and while I am not allowed to know the results on the scale, she is clearly having a good outcome. I am a home theater buff and an audiophile, and I wasn’t a bit surprised to read in one my magazines recently that Nintendo has kicked both Sony and Microsoft’s corporate butts with their sales. If I had younger kids I would definitely get the Wii instead of letting them play Grand Theft Auto for hours. And as my stories relate, it isn’t just for kids.
I have to start by saying that I am as allergic to video games as one can be. Besides their other objectionable qualities, their contribution to our Pediatric Obesity problem cannot be minimized. As I have written elsewhere in this blog, as much as 1/5 of our kids aged 11-19 are now obese, about a 4 four fold increase from two decades ago. Video games can’t be blamed for all of this, but it is no secret that as these games have become increasingly popular, more kids (and now adults) sit on their rear ends and exercise only their thumbs.
For a while, I have been hearing people talk about the Nintendo Wii. I had heard that it was more interactive than the competitors (namely Sony Playstation and Microsoft XBox). What really made me notice was a radio segment that I heard on NPR about how popular the Wii and Wii Fit have gotten with seniors, particularly in assisted living type arrangements. Shortly after hearing this story, this point was graphically reinforced in my practice.
I have a senior citizen in my general internal medicine practice, an 85-year-old gentleman who has congestive heart failure and COPD (Emphysema) living in an assisted living facility. This patient has to use oxygen continiously but remains quite active despite all of these limitations.
One day I received a call from the head nurse at the facility. It seems that my patient had gotten into an argument with another resident in their activities area. Apparently there was a dispute over whose turn it was to use the bowling console on the Wii, and my patient reinforced his claim by punching the other resident in the kisser. According to the rules of the facility, we had to have the patient sent for an evaluation at the Geriatric Behaviorial Unit at Gottlieb Hospital (a Pysch Unit), where the psychiatrist in charge of the unit concluded he wasn’t crazy, just angry that someone was stealing his turn.
I then became aware that several of my weight loss patients were resisting my entreaties to join a formal exercise program and stating that the Wii Fit was their only form of exercise. I had to resist sniggering at these patients and told them that they needed a formal program.
As it turned out, they are the ones entitled to snicker. I now have had several patients lose up to 30 pounds each with the Wii as their only form of exercise. They are all woman in their 40s with families. They can’t find time in their lives to join a fitness center but their kids have helped them use the Wii and the Wii Fit. They enjoy it, wind up spending more time with their families, and are losing weight. What the heck can I complain about?
I became curious enough to buy a Wii and a Wii Fit. Actually I wasn’t able to at first, because the stores were completely sold out, and had to wait a few months until stocks were replenished.
At the time of the purchase I had a 23-year-old son living with me while he was recuperating from surgery for a workman compensation injury. He is a very active young adult, always into hiking, mountain climbing, and other activities. After his surgery it was a struggle for him to walk across the room, which was depressing him and us greatly.
Pretty soon my wife and I were fighting him for access to the Wii. I came home one day and found him running in place while the screen showed an image of him jogging through a park. There was a female image (or, in Wiispeak, a “Mii”) running ahead of him. Periodically she turns and beckons him on, and damned if he didn’t start running faster every time.
My wife loves the hoola hoop and the ski program. I love sitting on the couch behind her and watching her shake her bootie while she does these, but that is probably more information than I should be letting out.
My wife in general does not like to exercise, but with the Wii she has passed many an hour, highly entertained the whole while, and while I am not allowed to know the results on the scale, she is clearly having a good outcome. I am a home theater buff and an audiophile, and I wasn’t a bit surprised to read in one my magazines recently that Nintendo has kicked both Sony and Microsoft’s corporate butts with their sales. If I had younger kids I would definitely get the Wii instead of letting them play Grand Theft Auto for hours. And as my stories relate, it isn’t just for kids.
Willingness to Change
Before my wife and I were married the clergyman performing the ceremony gave us personality inventory surveys. This is a survey where you are asked many questions and are given a range of answers to choose from. One example would be as follows:
Q: When driving to work every day you choose to:
A) Take the same, known route every day.
B) Try different routes to see if you can find one that is best, and then settle on that one.
C) Take different routes all the time for the sake of variety.
D) Point the car in any old direction and let it do its thing.
My wife turned out to be a person who likes to be cautious and do the safe and predictable. I, on the other hand, fit the profile of the "Commandant". I had to be in charge, telling everyone else how to do things.
I wasn't surprised at my outcome. I do tend to think that I am the Tsar of the World and that all other people are laboring on this planet for the sake of my amusement. My wife keeps reminding me that the world doesn't revolve around me, and I'm always stunned to realize that she's right.
I was kind of surprised at her results. I know that no one would ever characterize her as wild and crazy, but she can be pretty adventurous. For example, she she is always willing to try all ethnic cuisines: Thai, Indian, Ethiopian, West African, Caribbean, etc. On the other hand, there are some limits there. Whenever we have Indian food, she tends to like to order the same two or three dishes: chicken tikki masala, saag paneer, lamb pasanda. She tends to shy from branching out to new items if it means not being able to get her favorites. And while she likes using our meal replacement bars to help curb her appetite, she eats the same bar every time (Peanut Butter Crunch bar).
My wife is a very reasonable person, one capable of self reflection, who can recognize when something she's doing isn't working for her and needs to be changed in order to reach a desired result.
It's too bad that more weight loss patients can't come to the same conclusions. It is surprising how many people are displeased with their weight, but not willing to examine what habits they have in their lives that led to them becoming that weight and what they would have to do to change it.
For example, when it comes to eating the weight loss plans that work the best emphasize taking small, frequent meals. This includes eating breakfast. There are many reasons why these plans are more effective at helping people lose weight, but I will list the most important reasons:
Q: When driving to work every day you choose to:
A) Take the same, known route every day.
B) Try different routes to see if you can find one that is best, and then settle on that one.
C) Take different routes all the time for the sake of variety.
D) Point the car in any old direction and let it do its thing.
My wife turned out to be a person who likes to be cautious and do the safe and predictable. I, on the other hand, fit the profile of the "Commandant". I had to be in charge, telling everyone else how to do things.
I wasn't surprised at my outcome. I do tend to think that I am the Tsar of the World and that all other people are laboring on this planet for the sake of my amusement. My wife keeps reminding me that the world doesn't revolve around me, and I'm always stunned to realize that she's right.
I was kind of surprised at her results. I know that no one would ever characterize her as wild and crazy, but she can be pretty adventurous. For example, she she is always willing to try all ethnic cuisines: Thai, Indian, Ethiopian, West African, Caribbean, etc. On the other hand, there are some limits there. Whenever we have Indian food, she tends to like to order the same two or three dishes: chicken tikki masala, saag paneer, lamb pasanda. She tends to shy from branching out to new items if it means not being able to get her favorites. And while she likes using our meal replacement bars to help curb her appetite, she eats the same bar every time (Peanut Butter Crunch bar).
My wife is a very reasonable person, one capable of self reflection, who can recognize when something she's doing isn't working for her and needs to be changed in order to reach a desired result.
It's too bad that more weight loss patients can't come to the same conclusions. It is surprising how many people are displeased with their weight, but not willing to examine what habits they have in their lives that led to them becoming that weight and what they would have to do to change it.
For example, when it comes to eating the weight loss plans that work the best emphasize taking small, frequent meals. This includes eating breakfast. There are many reasons why these plans are more effective at helping people lose weight, but I will list the most important reasons:
- Frequent meals keep us from getting too hungry and therefore over-eating at a later time.
- Our bodies can only process a limited amount of calories at any given time. Once one exceeds the 400-600 calorie limit, the body immediately stores extra calories as fat.
The second part of that is critical for I've seen patients who eat 1500 calories a day gain weight simply because they eat two big meals throughout the day rather than others who spread it over six smaller meals.
When we discuss meal plans with our patients many of the react by saying: "I can't do that! I don't eat breakfast!" or "I can't stop eating fast food three times a day!" or "I can't wake up half an hour earlier just to exercise, because I don't do that now!"
There is a study in the current issue of the Journal of Obesity. It looked at patients who were having Lap Band surgery. It required that these patients undergo the same psychological profile testing that my wife and I took before their insurance companies would pay for the surgery. The main point of the test is to assess the patients' willingness to make lifestyle changes. Presumably if a patient isn't willing to change any of their habits then they won't succeed in losing weight after the surgery.
This study found just the opposite. Readiness to change in no way correlated with how well people did after the surgery. The authors concluded the profile assessment for patients was a waste of time.
Should we be surprised? Think about patient who want surgery. In general, they want a quick fix with the knife. Change the way they eat? Exercise? Either they can't envisage doing it or they have made some attempts and discovered that they can't. They would rather have a surgeon alter their God-given anatomy and lose some pounds, and any changes that they make are enforced on them by the nature of the surgery.
It is interesting that this study only followed the Lap Band patients for two years. I have seen many patients who had surgery, didn't change anything in their lifestyle, and have regained the weight. Ultimately the body can readjust to the effects of the surgery and if nothing else has changed, well...funny how that problem reoccurs.
Change. It isn't just a political slogan. If you have habits that have led you to develop a problem such as excess weight, you need to look within yourself to find out what you are doing wrong. Ask yourself what you have to do to change it. We can help, but without that willingness to examine oneself there is only so much that we can do.
Wednesday, February 18, 2009
Free Consult vs. Actual Visit: Where the Line is Drawn
Hello out there! Once again, this is your faithful receptionist Jill here to report on tidbits that may or may not be helpful. Your choice!
I get an awful lot of questions about this one, so I think I should clarify now in writing.
When new patients see the free consult we offer, they get really excited (as well they should). An experienced doctor of internal and bariatric medicine giving a free visit? Is this too good to be true? Doctors normally charge out the wazoo for things, how can this be?
The answer is simple: until any testing is done, the visit remains free. We will ask you ahead of time to fill out the necessary papers from our website (especially the nutrition evaluation--very important if you don't want to do anything beyond the "free" part of the visit) and make up a chart for you in the office. You can ask all the questions you want to the doctors, and they use everything you filled out for them (the medical history and nutrition evaluation) to try and tailor their advice as specifically to you as possible. They'll answer any questions on past medical events in your life, why it seems that you can't lose weight now, what habits you've formed and why, and advise you as much as they can.
When the visit stops being a free one is when the Indirect Calorimetry machine gets pulled out. This nifty machine is a ten minute breathing test that measures your Resting Metabolic Rate (RMR). What this means is it tests how many calories you'd burn if you just sat around all day. This is an $80.00 test. BCBS HMO patients, your plan doesn't cover the test and you will have to pay upfront. The rest of you it is dependent on your personal plan whether or not you're covered. If you're a self-pay you also have to pay up front. This is an important test because it helps the doctors to realize how fast your metabolism is and how to work with it for effective weight loss. It also determines how many calories the doctors would like you to eat per day, and the minimal amount of exercise you would need to do to start losing weight.
After patients take the IC (and those who are serious about healthy weight loss do so right away) the free consult turns into an actual visit. So yes, we do charge for the visit at that point. We try to let you know all this ahead of time or during the visit, but some patients are still suprised when they hear that they were charged.
Don't blame me, though. The doctor is the one who determines who gets charged. Don't complain to them either--they're just doing their job.
So now you know. And if you ask me on the phone, you'll hear this same spiel. I will let you in on a little secret: those who "skip" the free consult and go ahead with the IC test lose at least three pounds in the first week. After that it's up to ten pounds the next time we see them. It continues from there. So while the first visit may not always be free, you do get your money's worth. ^_^
I get an awful lot of questions about this one, so I think I should clarify now in writing.
When new patients see the free consult we offer, they get really excited (as well they should). An experienced doctor of internal and bariatric medicine giving a free visit? Is this too good to be true? Doctors normally charge out the wazoo for things, how can this be?
The answer is simple: until any testing is done, the visit remains free. We will ask you ahead of time to fill out the necessary papers from our website (especially the nutrition evaluation--very important if you don't want to do anything beyond the "free" part of the visit) and make up a chart for you in the office. You can ask all the questions you want to the doctors, and they use everything you filled out for them (the medical history and nutrition evaluation) to try and tailor their advice as specifically to you as possible. They'll answer any questions on past medical events in your life, why it seems that you can't lose weight now, what habits you've formed and why, and advise you as much as they can.
When the visit stops being a free one is when the Indirect Calorimetry machine gets pulled out. This nifty machine is a ten minute breathing test that measures your Resting Metabolic Rate (RMR). What this means is it tests how many calories you'd burn if you just sat around all day. This is an $80.00 test. BCBS HMO patients, your plan doesn't cover the test and you will have to pay upfront. The rest of you it is dependent on your personal plan whether or not you're covered. If you're a self-pay you also have to pay up front. This is an important test because it helps the doctors to realize how fast your metabolism is and how to work with it for effective weight loss. It also determines how many calories the doctors would like you to eat per day, and the minimal amount of exercise you would need to do to start losing weight.
After patients take the IC (and those who are serious about healthy weight loss do so right away) the free consult turns into an actual visit. So yes, we do charge for the visit at that point. We try to let you know all this ahead of time or during the visit, but some patients are still suprised when they hear that they were charged.
Don't blame me, though. The doctor is the one who determines who gets charged. Don't complain to them either--they're just doing their job.
So now you know. And if you ask me on the phone, you'll hear this same spiel. I will let you in on a little secret: those who "skip" the free consult and go ahead with the IC test lose at least three pounds in the first week. After that it's up to ten pounds the next time we see them. It continues from there. So while the first visit may not always be free, you do get your money's worth. ^_^
Wednesday, February 11, 2009
Excercising and Prairie Stone
I looked at the nice lady in front of me and sighed. “I’m sorry, ma’am, I just don’t have a pill that is called exercise.”
The patient was a very nice lady of about 70. She had lost about 16 pounds but nothing for the past several months. She was at the Dieters dreaded plateau. She was adamant about not wanting to exercise. She had arthritis of the hip, exercise bored her, she didn’t like the way that she looked in workout clothes, she didn’t have the time and every other excuse in the book she could think of.
The problem is that there is no weight loss program that has any chance of long term success without incorporating exercise. It is possible to lose a few pounds without exercising, but what we lose will be a mixture of fat and protein (from our muscles and our internal organs). If we regain that weight, which almost always happens, it comes back as fat. Exercise combined with weight loss makes our body preferentially dump extra pounds as fat, not as protein. And studies show that the people who manage not to regain weight overtime average an hour of exercise a day.
Most weight loss programs will succeed temporarily but ultimately fail because they are lacking one component or another. Last week I saw two patients that had regained tremendous amounts of weight after having gastric bypass surgery. Neither of these patients had ever changed their lifestyles to incorporate exercise. They wanted the quick fix of surgery because someone else did all the work for them. They still had their couch potato lifestyles and despite the fact that they couldn’t eat like they formerly had because the effects of the surgery would make them throw up if they did, they still managed to regain most of the weight they had lost over time. When I pointed this out to them, and suggested that they should finally begin adopting regular exercise, they turned away, uninterested. Just give me a pill, doc. Another quick fix for my problems. Don’t make me do any work or make any changes.
All of this is an introduction for something that I am excited to announce. Our practice, Chicago Weight Control, is about to expand our comprehensive Medical Weight Loss Program to a new location. We are starting an affiliation with Prairie Stone Health and Fitness Center (hereafter referred to as PS). PS is actually a Hoffman Estates Park District facility, but I’ve never seen a park district facility that looks anything like it. It is a truly state of the art health facility. The fact that it is a park district facility makes it feel less like a money hungry health club and reminds me much more of other partner in comprehensive programming, the Gottlieb Memorial Hospital Health and Fitness Center. Both facilities have a genuine interest in improving the wellbeing and fitness of their members. While they both have facilities that compare nicely to the glitziest commercial health clubs, they are the kind of places where normal, out of shape people who don’t have perfect physiques to begin with won’t feel out of place in.
The program that we have had with Gottlieb has been in place for a few years and has been a great success. We have had over a hundred patients go through it and the average 12 week weight loss is 28 pounds. We have seen people who continue in the program lose over two hundred pounds over time and learn to keep it off.
The Gottlieb program was created as a “dream weight loss program.” Patients see a physician trained in weight loss (myself or Dr. Elhag); they have their metabolism and laboratories checked; they meet with a dietician to craft a diet specific for their needs;
they have monthly group meetings to review behavioral issues in weight loss; and most importantly they meet with a trainer once a week and are required to visit the health club at least three times a week. At the end of the program, most have found the exercise to not only be beneficial but fun, and join the facility.
I am sure that we will be able to duplicate the program at PS and look forward to its initiation.
We have informational meetings scheduled at Gottlieb on Wednesday 2/11/09 and at PS on 02/25/09. Call us at (708) 452 5809 for information about registering for either meeting.
The patient was a very nice lady of about 70. She had lost about 16 pounds but nothing for the past several months. She was at the Dieters dreaded plateau. She was adamant about not wanting to exercise. She had arthritis of the hip, exercise bored her, she didn’t like the way that she looked in workout clothes, she didn’t have the time and every other excuse in the book she could think of.
The problem is that there is no weight loss program that has any chance of long term success without incorporating exercise. It is possible to lose a few pounds without exercising, but what we lose will be a mixture of fat and protein (from our muscles and our internal organs). If we regain that weight, which almost always happens, it comes back as fat. Exercise combined with weight loss makes our body preferentially dump extra pounds as fat, not as protein. And studies show that the people who manage not to regain weight overtime average an hour of exercise a day.
Most weight loss programs will succeed temporarily but ultimately fail because they are lacking one component or another. Last week I saw two patients that had regained tremendous amounts of weight after having gastric bypass surgery. Neither of these patients had ever changed their lifestyles to incorporate exercise. They wanted the quick fix of surgery because someone else did all the work for them. They still had their couch potato lifestyles and despite the fact that they couldn’t eat like they formerly had because the effects of the surgery would make them throw up if they did, they still managed to regain most of the weight they had lost over time. When I pointed this out to them, and suggested that they should finally begin adopting regular exercise, they turned away, uninterested. Just give me a pill, doc. Another quick fix for my problems. Don’t make me do any work or make any changes.
All of this is an introduction for something that I am excited to announce. Our practice, Chicago Weight Control, is about to expand our comprehensive Medical Weight Loss Program to a new location. We are starting an affiliation with Prairie Stone Health and Fitness Center (hereafter referred to as PS). PS is actually a Hoffman Estates Park District facility, but I’ve never seen a park district facility that looks anything like it. It is a truly state of the art health facility. The fact that it is a park district facility makes it feel less like a money hungry health club and reminds me much more of other partner in comprehensive programming, the Gottlieb Memorial Hospital Health and Fitness Center. Both facilities have a genuine interest in improving the wellbeing and fitness of their members. While they both have facilities that compare nicely to the glitziest commercial health clubs, they are the kind of places where normal, out of shape people who don’t have perfect physiques to begin with won’t feel out of place in.
The program that we have had with Gottlieb has been in place for a few years and has been a great success. We have had over a hundred patients go through it and the average 12 week weight loss is 28 pounds. We have seen people who continue in the program lose over two hundred pounds over time and learn to keep it off.
The Gottlieb program was created as a “dream weight loss program.” Patients see a physician trained in weight loss (myself or Dr. Elhag); they have their metabolism and laboratories checked; they meet with a dietician to craft a diet specific for their needs;
they have monthly group meetings to review behavioral issues in weight loss; and most importantly they meet with a trainer once a week and are required to visit the health club at least three times a week. At the end of the program, most have found the exercise to not only be beneficial but fun, and join the facility.
I am sure that we will be able to duplicate the program at PS and look forward to its initiation.
We have informational meetings scheduled at Gottlieb on Wednesday 2/11/09 and at PS on 02/25/09. Call us at (708) 452 5809 for information about registering for either meeting.
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