Weight Management

Weight Management

FitBodyRx is a medically supervised weight loss program designed to help patients struggling with the growing epidemic of obesity. According to the National Institute of Health more than 2 in 3 adults are overweight or have obesity.

Being overweight or obese is defined as an abnormal or excessive fat accumulation that presents a risk to one’s health. A common way to classify weight is by using the Body Mass Index (BMI), which is the weight in kg divided by the height in meters squared (kg/m2).

BMI Classification

Underweight

<18.5

Normal Weight

18.5 – 24.9

Overweight

25.0 – 29.9

Obese

30

Obesity may be the result of multiple factors such as behavioral, environmental, genetic, metabolic, physiological, or psychological. Obesity increases your risk of multiple medical  diseases or conditions such as diabetes, dyslipidemia, hypertension, coronary heart disease, stoke, sleep apnea, cancer, poor mental health, body pain, and/or poor physical functioning.

The management of weight is dependent on BMI and weight related co-morbidities. Lifestyle modifications such as diet and exercise are recommended for those with a BMI of 25 (overweight). Pharmacotherapy (weight management medication) is recommend for those with a BMI of 27  and weight related co-morbidities or those with a BMI of 30. Surgery is recommended for those with a BMI of 35 with co-morbidities or those with a BMI of 40. To qualify for surgery individuals should have attempted other means of weight loss with inadequate success and have no contraindications for surgery.

It is important to note that obesity is a complex, multi-factorial disease and individuals may be recommended multiple followups with different specialists. It is important to have a good understanding of the different treatment options, have realistic expectations, set a reasonable goal, and have the motivation to succeed. Our goal is help you along the way so that you have the confidence and support you need to reach your goals.

In order to select the right the plan for you we recommend a consultation with our team. This way we get a better understanding of your health and can make the proper recommendations.

HCG Diet Plan

This is a comprehensive plan based on the administration of Human Chorionic Gonadotropin (HCG). HCG is a hormone produced during pregnancy by the placenta. It is FDA approved for treating certain problems of the male reproductive system and in stimulating ovulation in women who have had difficulty becoming pregnant. There has been no evidence to substantiate claims for HCG for weight loss, therefore, you will be unlikely to see any benefits if taken alone without a adherence to strict diet.

This diet was first described by Dr. Simeons dating back to the 1954. He discovered that this hormone could accelerate fat mobilization from certain areas of the body if combined with a Very Low Calorie Diet (VLCD). Dr. Simeons describes three types of fat (structural fat, normal fat reserve, and abnormal fat reserve). Our structural fat is the fat necessary to maintain our body structure (i.e. it is the fat found between various organs, fat that keeps the skin taut, and the fat that provides the hard fat that provides the springy cushion under the bones of the feet). Our normal fat reserve is the the fat we use for energy when needed or on a daily basis. The abnormal fat reserve is the fat that gets deposited in areas of our body when the body attempts to save fat after being exposed to excessive quantities of fat. This stored fat is not readily available to be used for energy. Due to our metabolism, our bodies attempt to utilize energy from normal fat reserves or extract protein from our muscles before accessing the abnormal fat reserves. Here is where HCG helps. HCG alters your metabolism so that the energy from the abnormal fat reserves is used thus preventing the drastic muscle loss noted in diets with low calorie intake. This is crucial to maintaining a stable metabolism, maintaining weight loss, and not regaining weight at the conclusion of the diet. Since muscle is important for metabolism, losing muscle makes it harder to maintain a lower weight, may result in quick regain of the lost weight, and may potentially result in the gaining of more weight. This is unfortunately common with many diets. Frustrated individuals work hard to lose weight only to regain more weight compared to when they started. These individuals with attempt multiple times to loose the weight with out success and potentially making subsequent weight loss attempt less likely to succeed. This may result in excessive weight gain and frustration. With the help of HCG this diet focuses on correcting low metabolism, excessive hunger, emotional eating, and cravings. The idea is to reset your metabolism to a new normal level so that once your plan has finished, you can eat normally without gaining weight. In other words, this diet helps to lower your body’s set point allowing you to have fluctuations in weight but ultimately maintaining the lower body weight.

The HCG diet plan varies in length with the first phase lasting from 26 and 43 days. This phase consists of the administration of HCG with a strict diet. The first two days consist of calorie loading and daily HCG injections. This is followed by a 500-calories/day diet starting on day 3 which is continued till the end of the phase. HCG is calculated to end 3 days prior to end of the phase to allow continuation of the 500-calories/day diet until HCG is completely eliminated from the body. The next phase consist of 3 weeks of eating a regular diet with the exception of no sugars or starches. This is followed by the third phase which consist of 3 weeks of slowing adding sugars and starches. Following strict guidelines you can expect to lose 0.5 – 0.75 pounds/day for women or 0.65 – 1 pound/day for men.

Key Points

  • No exceptions, additions, or substitutions to the diet
  • Can not exceed 500 calories per day
  • Medications or supplements may reduce the effectiveness of plan
  • Drink 64 ounces of water daily
  • Discuss any medical conditions with your physician
  • Weekly weigh-ins
  • No massages as this can move the fat around and reduce your weight loss
  • Cosmetics such as oils, creams, and ointments may be absorbed by the skin making HCG less effective (only lipstick, eyebrow pencil, or powder should be used).
  • Vitamins: MIC+B12 and B-Complex vitamins help with elimination of fat during metabolism and provide energy.

Plan Details

Step 1

The first step involves a medical consultation and becoming educated on the diet. You will be given information regarding the diet and may even watch a video demonstration. Next your health history will be reviewed and a focused physical exam performed. Your body measurements as well as before photos are taken to serve as a baseline. Blood analysis test may then be order to assess your overall health, potential cause for being overweight, as well as to evaluate the risks of being on a weight loss diet. Once the necessary studies have been obtained the physician will make recommendations or approve you to start the HCG diet with medical supervision.

  • Blood Analysis
    • Complete Metabolic Panel
    • Lipid Panel
    • Complete Blood Count
    • DHEA-S
    • Free and Total Testosterone
    • Estradiol (E2)
    • Progesterone
    • Cortisol
    • Thyroid Stimulating Hormone (TSH) Free T3
    • Insulin
    • Hemoglobin A1C (HbA1C)

Step 2

Make a commitment to be on the weight management plan. Choose the day that works for you. Clear temptations before your start date. Remove all non-HCG items from your vision. Having them around and visible is a temptation that may result in unsuccessful weight loss. Make sure that you will not be tempted by any event such as a holiday,    gathering, or party. If you are an emotional eater make sure you have a plan in place to deal with stress (i.e. taking a walk, talking on the phone, spending time with your pet, etc.). Make a commitment to yourself that you will not cheat even once, you are doing this for your health and it is proven to work when following strict guidelines. Minimal deviations can negatively affect the ultimate goal of achieving long term results.

Step 3

Administer HCG (daily for 23 – 40 days) and start “loading days” (2 Days). The first two days are considered “loading days”. The purpose of this is to allow HCG enough time to take effect, replete normal fat reserves, and to avoid hunger at the start of the 500-calories/day diet. Examples of food to eat include bacon, burgers, candy, chocolate, eggs, ice cream, fried foods, mayonnaise, pasta, pastries, pizza, etc. You may experience some weight gain during the loading but this is an important step to fill your normal fat reserves. On day 3 start the 500-calories/day diet which will last between 24 – 41 days depending on your weight loss needs. The duration of this diet is calculated to continue for 3 days after the last administration of HCG to allow all the HCG to be eliminated from the body (i.e. if you are prescribed 40 days of HCG you will conclude the 500-calories/day diet after 43 days). The 500-calories/day diet consists of a daily consumption of 2 servings of protein, 2 serving of vegetable, 2 servings of bread, and 2 servings of fruit as well as 64 ounces of water. Note: headaches have been reported during the first week of this phase and an Aspirin may be taken considering no contraindications to Asprin.

Approved Beverages: May be consumed in any reasonable quantity so use your good judgement to avoid excess consumptions. May use Stevia as a sweeter and may only use only 1 tbsp (0.5 fl oz) of skimmed milk daily.

Item

Amount

Calories

Tea

1 cup (8 fl oz)

2

Coffee

1 cup (8 fl oz)

1

Approved Proteins: Measure out 100 grams (3.5 ounces) of raw protein two times a day. Alternate protein choice to consume two different proteins in any given day. All visible fat must be removed and then weighted raw. Boil, broil, grill food or stir-fry but no frying or adding oils. Not allowed to consume salmon, eel, tuna, herring, dried or pickled fish.

Item

Amount

Calories

Veal

100 grams (3.5 ounces)

105

Beef (Extra Lean)

100 grams (3.5 ounces)

119

Chicken breast (Skinless)

100 grams (3.5 ounces)

109

Fish (Fresh White)

100 grams (3.5 ounces)

133

Lobser

100 grams (3.5 ounces)

89

Crab

100 grams (3.5 ounces)

83

Shrimp

100 grams (3.5 ounces)

85

Approved Vegetables: Add 1 cup of vegetables two times a day. May increase amount of vegetables by 1/2 cup if calories permit. Only one vegetable choice per meal but alternate vegetable choice to consume two different vegetables in any given day.

Item

Amount

Calories

Spinach

1 cup

7

Chard

1 cup

7

Chicory

1 cup

7

Beet-greens

1 cup

8

Green Salad

1 cup

5

Tomatoes

1 cup

32

Celery

1 cup

16

Fennel

1 cup

27

Onions

1 cup

46

Radishes

1 cup

18

Cucumbers

1 cup

16

Asparagus

1 cup

27

Cabbage

1 cup

22

Approved Fruits: Add two fruits per day.

Item

Amount

Calories

Apple

1 medium

95

Orange

1 large

87

Strawberries

1 cup

47

Grapefruit

1/2

52

Approved Carbohydrates: Consume a total of two items per day.

Item

Amount

Calories

Grissini Breadstick

1 breadstick

20

Melba Toast

1 toast

20

Approved Spices: May be consumed as desired, however, caution should be taken with salt as it may result in weight gain due to water retention.

Item

Amount

Calories

Salt

1 teaspoon

0

Black Peper

1 teaspoon

5

Onion Powder

1 tablespoon

24

Garlic Powder

1 tablespoon

32

Chili Powder

1 tablespoon

24

Paprika

1 tablespoon

20

Marjoram

1 tablespoon

5

Parsley

1 tablespoon

1

Basil

1 tablespoon

0.5

Oregano

1 tablespoon

10

Approved Vinegar: Only apple cider vinegar is approved.

Item

Amount

Calories

Apple Cider Vinegar

1 tablespoon

3

Vegetarians: Since milk and curds may be the only animal proteins consumed by vegetarians, the weight loss may be affected. In order to consume sufficient animal protein, up to 500 mL of skimmed milk per day is required depending on curd consumption. 100 mg of skimmed cottage cheese may occasionally be used instead of meat. Vegetarians lose on average only half of what non-vegetarians lose.

Key Points:

  • Visible fat must be removed from protein
  • Weigh protein raw
  • Boil, broil, grill, or stir fry in non-stick pan, no added oils
  • Consume two different proteins each day (i.e. chicken and fish)
  • Fruits and carbohydrates can be eaten between meals
  • Stick to the diet protocol, no substitutions (i.e. can not replace an apple with a breadstick)
  • If calorie count is less than 500 may consume an additional 1/2 cup of vegetables if count does not exceed 500
  • Limit beef to no more than 2 times per week
  • Do not mix vegetables (i.e. only one type of vegetable per meal)
  • Drink 64 oz of water daily
  • Drink 8 oz of water before each meal
  • May consume the juice of one lemon daily
  • Apple cider vinegar is only vinegar approved
  • Avoid excess salt consumption as this can increase your weight due to water retention
  • No chewing gum or mints as these may contain unapproved sugars
  • Weight yourself every morning without cloths and after emptying your bladder
  • Cosmetics such as oils, creams, and ointments may be absorbed by the skin making HCG less effective (only lipstick, eyebrow pencil, or powder should be used).
  • Vitamins: MIC+B12 and B-Complex vitamins help with elimination of fat during metabolism and provide energy.

Sample Menu:

Meal

Items

Breakfast

1-2 cups of coffee or tea

1 carbohydrate item

Snack

1 fruit

Lunch

1 protein item

1 vegetable item

Snack

1 carbohydrate item

Dinner

1 protein item

1 vegetable item

Snack

1 fruit

Plateau: This is normal and consist of 4-6 days of no weight loss which typically occurs near the end of a 40 day course. Consider an “apple day” for psychological comfort. The “apple day” starts at lunch with any size apple and the patient may consume up to 6 apples by lunch time the next day. Besides apples only water is allowed in quantities to quench thirst.

Step 4

After the completion of the 500-calories/day diet for the next 3 weeks you may consume normal foods except for starch and sugar. It is important that the normal foods contain sufficient amount of protein. You also must stay within 2 pounds of weight from last HCG administration day. If more than 2 pounds of weight is gained then the recommendation is to skip breakfast, maintain adequate hydration, and then eat a large steak with only an apple or raw tomato in the evening. If this is not done on the same day of weight gain then it may take 1 to 2 weeks to lose the weight.

Step 5

In the following 3 weeks gradually add starch in small quantities controlled by morning weights. You also must stay within 2 pounds of weight from last HCG administration day. If more than 2 pounds of weight is gained then the recommendation is to skip breakfast, maintain adequate hydration, and then eat a large steak with only an apple or raw tomato in the evening. If this is not done on the same day of weight gain then it may take 1 to 2 weeks to lose the weight.

Recommendations:

  • Do not eat with the intent to feel full, eat with the intent to feel satisfied
  • Measure out the food you will eat and if you feel that you are still hungry wait 15 minutes before serving another smaller portion of food
  • Minimize temptation, avoid being exposed to unhealthy foods
  • Restaurant portions are frequently enough for two meals, divide out a portion for another next meal
  • Limit your alcohol consumption
  • Beware of snacks, if you are going to have some snacks set your limit and do not pass it
  • If you feel hungry shortly after a meal have a cup of water and take a walk
  • It is better to eat multiple times a day than eating large meals
  • Choose baked, boiled, broiled, grilled over fried foods
  • Avoid sugar-sweetened and diet carbonated beverages
  • Exercise: When not on the 500-calories/day diet exercise the recommendation is to exercise (1 hour of moderate intensity cardio at least 5 days a week and resistance  training at least 3 days a week). Do not do resistance training of the same muscles every day but rather every other day to allow your muscles to recover

Dealing with emotions:

  • Control your stress: Attempt stress management like yoga or meditation.
  • Check your hunger: Is your hunger emotional or physical? If you have recently eaten consider this as emotional.
  • Food diary: Record what you eat and your mood to help identify causes of overeating.
  • Get support: Consider a support group.
  • Boredom: If you are eating from boredom consider taking a walk, playing with a pet, watching a movie, call someone, or be productive.
  • Do not deprive yourself: Do not eat the same thing all the time, variation is good and an occasional treat can prevent excessive cravings.
  • Snack healthy: If you are feeling the urge to eat choose a low-fat, low-calorie snack such as fresh fruit, vegetables, or unbuttered popcorn.
  • Sleep: If you are snacking to keep up just take a nap.
  • Seek therapy: If you are unable to control your emotional eating seek professional help.
  • Forgive yourself: If you have an episode of emotional eating forgive yourself and learn from it.

Key Points:

  • Completion of HCG effect: If normal weight has been achieved and ravenously hungry with continued administration of HCG the abnormal fat stores have been eliminated and diet calorie count should be increased to 800-1000 calories until the end of the HCG administration phase if less than 23 days.
  • Menstrual Interruption: Pause in weight loss may occur a few days before and during a menstrual cycle or day of ovulation. This may due to hormones and water retention.
  • Interruption of Treatment: If more than four days of interruption is necessary then must increase calories to 800.
  • Massages: Not allowed as this disturbs the process of fat elimination.
  • Fibroids: Very large fibroids should be operated on before treatment.
  • Gallstones: Patients with gallstones may have more frequent attacks of biliary colic so may consider giving Ursodiol 300 mg BID.
  • Gout: May be precipitated with HCG consider giving Zyloric (2 tablets daily)
  • Additional weight loss: A 2nd course of HCG may be started after 6 weeks, 3rd course after 8 weeks, 4th course after 12 weeks, 5th course after 20 weeks, and a 6th course after 6 months.

Plateau Questionnaire:

  • Was a non-approved spices added to diet?
  • Was portion sizes correct?
  • Was enough water consumed?
  • Was proteins or vegetables mixed in a meal?
  • Was a non-approved cosmetic used?
  • Was salt intake increased?
  • Was beef consumed more than 2 times per week?
  • Was food eaten from outside source like a restaurant?
  • Did a menstrual cycle occur?
  • Are bowel movements irregular? Consider Smooth move Tea
  • Was chewing gum, mints, vitamins, supplements, lozenges consumed?
  • Is timing near the end of the 40 days HCG administration?

Exercise: Start by light walking 20 minutes daily. Do not do any cardio or strength training during the 500-calorie/day diet phase. Work your way up to the recommended 1 hour daily exercise with 2 days of strength training after the 500-calorie/day diet portion of the program.

Protocol

  • Choose duration HCG administration 23 or 40
  • 125 – 150 iu of HCG for injection or 400 iu for sublingual or nasal administration (except during menstruation)
  • 1 mL of B complex given at first appointment
  • “Loading” for 2 days
  • Start 500-calorie/day diet and continue 3 days after stopping HCG administration
  • Every 7 days during the HCG administration phase
    • Check BP and Measurements
    • Give patient 7 syringes pre-loaded with HCG
  • Every 14 days during the HCG administration phase
    • Give 1 mL of lipotropic injection (MIC + B12)
      • Helps with the elimination of fat during metabolism. As HCG releases fat into the body, these lipotropic injections help move fat out of the liver
    • Give 1 mL of B-Complex injection
      • B-complex vitamins assist the body’s metabolism and provide energy

Disclaimer: Individual results may vary