First of all, stop dieting. So you are not your ideal weight. This is not necessarily your fault. Most of us are scurrying with frightening rapidity as we navigate our lives. And not only is the medical information confusing, eating for ideal weight is difficult in this country. As a physician I may say this, we physicians have dropped the ball again. Most physicians have no training in medical weight loss. And our school systems do not teach nutrition.

We all know America has a societal issue of being overweight, and we even have an epidemic of childhood obesity. Being our ideal weight is the essence of whether or not your physician medically dances with the pharmaceutical companies, prescribes multiple medications to eradicate multitudinous symptoms which would probably go away if we were taught how to be our ideal weight. We are dancing around the issue of the real problem by prescribing cholesterol, blood pressure, and blood sugar lower drugs….You get the idea. Please know medication is occasionally required, and I do prescribe judiciously. However, extensive laboratory studies, ECGs and Echocardiograms may be necessary.

The typical scenario is that you have been a chronic dieter and some have even employed the services of a commercial weight loss center. Statistics, and real life, repeatedly show that even more weight is regained over 99 percent of the time. Mostly, this is because you lost muscle which requires calories to stay alive, and water. You did not lose much fat, but the number on the scale went down, because muscle weighs twice as much as fat. You may be happy with the new number, but…..

You also did not learn when, what, where, and how to eat. A six cookie a day diet, with one meal, or a commercial weight loss center diet is about l200 calories, only 300 calories more than the Holocaust diet. So you lose muscle and water. Muscle is 75-80 percent water.

Now we have a great big problem. With less muscle, you burn less calories, something in medicine called inefficient metabolism. And, your body thinks it is starving, goes into starvation mode, and burns even less calories. This is obviously not the way to achieve and maintain your ideal body weight. Losing muscle and gaining weight as we graciously age is a medical disorder, which makes me think physicians should help their patients.

Out of sheer frustration hearing my patients obsess over gaining weight and not being able to lose it and/or keep it off, I catapulted myself into the incredibly brilliant scientific research and literature regarding weight gain. I even went to Paris to learn Mesotherapy and decode the French Paradox.

So how does a physician learn medical weight loss without being a self propelled Einsteinian med head study geek. On my journey I discovered The American Society of Bariatric Physicians, which began having bi-yearly medical conferences for physicians in the l970s. Bariatrics is simply the doctor word for medical weight loss. And yes, in the old days, appetite suppressants were prescribed. As of this moment, I do not feel the need.

We sat for nine hours a day for five days sequestered in lecture hall listening to brilliant presentations by physicians, surgeons, Ph.D. in biochemistry and nutrition. Very impressive knowledge regarding fluid status, biochemistry, adequate gastrointestinal absorption, hormonal deficiencies and imbalances with aging, food sensitivities, genetics, pharmacology, molecular cell biology, exercise physiology, up regulating basal metabolism, behavior modification — just to name a few lectures. Commercial weight loss centers do not have this level of knowledge and they sell you crappy synthetic food with soy, which makes the thyroid work poorly.

Medical weight loss involves an in depth history and physical. After I know more about you than your spouse did when s/he married you, you get on “the scale.” You stand fully clothed on the electrical impedance scale (a physics thing – does not hurt.) The scale gives the following vitally important information:



    1. Your weight in pounds


    1. Pounds of body fat


    1. Pounds of muscle


    1. Pounds of water (most of us are dehydrated)


    1. BMI (Body Mass Index)


    1. BMR (Basal Metabolic Rate, or the rate at which YOU burn calories)


    1. BEE (Basal Energy Expenditure, or calories YOU require to remain alive)


    1. YOUR ten pound target range


    1. Another calculation telling you how many calories required if you move



Hopefully you now understand that a regular scale telling you how much you weigh is not the true story. A one hundred pound anorexic can be over fifty pounds of fat, and may require only 500 calories to stay alive, because their body is in starvation mode.

Just a few suggestions for embarking on your journey to take control of your health via achieving your ideal weight include:



    1. Congratulations, you have read this, so you already started


    1. Read Why French Women Don’t Get Fat


    1. Read my book What Your Doctor Won’t Tell You About Weight Loss (Mesotherapy and More)


    1. Measure your waist every morning in your birthday suit


    1. Do not wear clothes with an elastic waistband


    1. Drink two quarts of water a day


    1. Eat thirty grams of protein three times a day


    1. Have extensive laboratory studies done by a physician trained in bariatrics


    1. Learn to test your blood sugar


    1. Be brave, get on “the scale”


    1. No diets, ever


  1. Seek a trained physician, visit the American Board of Bariatric Physicians website or the American Society of Bariatric Physicians