Here are our answers to some of the most Frequently Asked Questions regarding weight loss and our program.

What is obesity?
According to the American Society of Bariatric Physicians, obesity results from a complex interaction of genetic, behavioral and environmental factors causing an imbalance between energy intake and energy expenditure. According to the National Institutes of Health, an increase in body weight of 20 percent or more above desirable weight is the point at which excess weight becomes an established health hazard. Lower levels of excess weight can also constitute a health risk, particularly in the presence of other disorders like diabetes, hypertension and heart disease.

What is the difference between obesity and overweight?
Often the Body Mass Index Table (BMI) is used to differentiate between these two. Body Mass Index (BMI) is a measure of an adult’s weight in relation to his or her height. According to the CDC, a person is said to be overweight if their BMI is between 25 & 29.9, and obesity is having a very high amount of body fat in relation to lean body mass, or Body Mass Index (BMI) of 30 or higher. We will calculate this for you during each visit, along with your Body Composition and chart it for you to show your progress.

What are the health hazards of obesity?
It's been calculated that if we could cure cancer, we could add 2 years to the life of the average American. If we could cure obesity, we could probably add 6 to 8 years to the life of the average American. Statistics show that obese people die at increased rates from every disease imaginable except suicide and tuberculosis. Obesity can cause:

• Hypertension (high blood pressure)
• Osteoarthritis (a degeneration of cartilage and its underlying bone within a joint)
• Dyslipidemia (for example, high total cholesterol or high levels of triglycerides)
• Type 2 diabetes
• Coronary heart disease
• Stroke
• Gallbladder disease
• Sleep apnea and respiratory problems
• Some cancers (endometrial, breast, and colon)
• Physical Disabilities

Because of the increased pressure and strain on the joints, they are more prone to injury. Obesity is also quickly becoming our number one public health problem in this country.

Does obesity strain the heart and vessels?
Yes. Atherosclerosis, high blood pressure, and diabetes are side-effects of obesity that make a person more susceptible to heart attack.

Can obesity be controlled?
Yes! The best way to do this is to make sure that the energy you take in as food calories doesn't exceed the energy you expend in daily activities and exercise. To lose weight, you have to consume less energy than you use. You can do this by choosing your foods carefully and according to their health benefits, portion control with the help of our weight loss medications, and a daily exercise routine that you enjoy, that you will stick with and helps you see results.

How many calories are burned by various exercises?
The number of calories expended during exercise varies depending on the type, intensity and duration of the exercise, as well as the body weight and fitness of the individual who is exercising. An obese person will burn more calories performing the same task than will a physically fit person. Most people don’t sustain an exercise program long term simply because they start too intensely and expect too much ("crash exercising" is as bad as "crash dieting"). A safe, effective exercise program begins with a medical examination, supervision from a trained fitness or health professional, and progresses from balance and low intensity strength training & walking (or other preferred low impact aerobic exercise) to higher intensity strength training and higher impact, higher intensity aerobic activities. As a reference, we have listed a few common activities below to give you an idea of how many calories one might burn at different levels of fitness.

Does "spot reduction" work?
Surgery is the only way to instantly reduce the fat in specific areas of the body. Unfortunately, we do not get to choose the areas that we would like to reduce. Fortunately, a lifestyle of good nutrition and consistent aerobic exercise and strength training will reduce the fat ALL OVER your body, not just the areas that trouble you the most. When you exercise a muscle, the signals go out to the fat depots all over the body to release fat to provide energy for exercise. The fat is converted to energy and carried to the exercising muscle. Depending on age and gender, body type and a few other factors, fat may tend to leave a certain body area before it leaves other areas, but that is not something that is controlled by the type of exercise you perform. The key is to expend more energy than you consume in a day and provide the body with the nutrients it needs to build muscle and be healthy.

What foods are best during dieting?
The American Heart Association guidelines urge adults who are trying to lose weight and keep it off to eat no more than 35 percent of total daily calories from fat and less than 7 percent of total daily calories from saturated fat and less than 1 percent of total daily calories from trans fat. These diets can cause a quick drop in weight because eliminating carbohydrates causes a loss of body fluids. Lowering carbohydrate intake also prevents the body from completely burning fat.

A healthy diet that includes a variety of foods and is rich in fresh fruits and vegetables along with regular physical activity can help most people manage and maintain weight loss for both cardiovascular health and appearance. The American Heart Association urges people to take a safe and proven route to losing and maintaining weight. By paying attention to portion size and calories and following our guidelines, you can enjoy healthy, nutritionally balanced weight loss for a lifetime of good health.

Our online journal is an excellent way of keeping track of both calorie intake and expenditure as well as the sources of the calories.

But isn't protein the best food for dieting?
The American Heart Association doesn't recommend high-protein diets for weight loss. Some of these diets restrict healthful foods that provide essential nutrients and don't provide the variety of foods needed to adequately meet nutritional needs. People who stay on these diets very long may not get enough vitamins and minerals and face other potential health risks.

According to the American Heart Association and the National Institutes of Health, as little as 50-60 grams of protein is enough for most adults. This breaks down to about 10-12% of total calories. Your body only needs 0.36 grams of protein per pound of body weight. To calculate the exact amount you need, multiply your ideal weight by 0.36. This will give you your optimum daily protein requirement in grams. Since the amount of protein needed depends on the amount of lean body mass and not fat, ideal weight is used instead of actual weight.

Common sources of high-quality proteins include: tuna canned in water, roasted chicken breast, roasted turkey breast, baked salmon, peanut butter, and yogurt. Those who are vegetarian may look to tofu, nuts, seeds, lentils, and soy foods to meet adequate daily protein intake.

Are vitamins necessary during dieting?
The American Heart Association recommends that healthy people get adequate nutrients by eating a variety of foods in moderation, rather than by taking supplements. An exception for omega-3 fatty acid supplements is explained below. The Dietary Recommended Intakes (DRIs) published by the Institute of Medicine are the best available estimates of safe and adequate dietary intakes. Vitamin or mineral supplements aren’t a substitute for a balanced, nutritious diet that limits excess calories, saturated fat, trans fat, sodium and dietary cholesterol.

Fish intake has been associated with decreased risk of heart disease. On the basis of available data, the American Heart Association recommends that patients without documented heart disease eat a variety of fish – preferably omega-3-containing fish – at least twice a week. Examples of these types of fish include salmon, herring and trout. Patients with documented heart disease are advised to consume about 1 gram of EPA + DHA (types of omega-3 fatty acids), preferably from fish, although EPA+DHA supplements could be considered, but consult with a physician first.

Why not a crash diet?
“Crash diets” place the all of the emphasis on short-term rather than long-term weight loss. The goal is a lifetime change in thought processes, exercise and eating habits and the establishment of dietary patterns that you can stick with indefinitely. Do not undermine yourself and the progress you’ve made by setting unrealistic goals, drastically changing everything about yourself all at once or depriving yourself of everything that you enjoy. The key is to enjoy your life and your new lifestyle while being encouraged when you real goal after goal. Crash dieting might help you achieve a different number on the scale, but the damage done to your health, nutritionally and emotionally, is not worth it.

How many calories must be cut from the diet to lose a pound a day?
To lose a pound of fat a day would mean a cut of 3500 calories a day from your diet. This is impossible unless you normally eat this amount, which is well above the average dietary content. Think of each pound of fat as representing 3500 calories of stored energy. To lose this amount of fat, you have to deprive yourself of this amount of energy. It stands to reason, then, that a diet that causes you to lose a pound or more a day is not working primarily through loss of fat. A low-carbohydrate diet may give you an immediate loss in excess of a pound a day, but the weight won't be lost as fat. It will be lost as fluid. As soon as you go off the diet, the water is quickly regained.

But isn't fast weight loss desirable?
Most of the fad diets these days will entice you with the promise of fast weight loss, but marketing schemes and quick fixes are not the answer to health and self esteem. The individual who gradually changes his or her lifestyle and dietary habits is most likely to succeed. The goal is slow, progressive, continuous weight loss at a rate of a pound every week or two. We don't care what you weigh 2 days from now, we care what you weigh 2 years, 5 years, and 10 years from now and that you are healthy and happy. So there is no reason to lose weight quickly.

Are medications effective in helping you lose weight?
According to the American Society of Bariatric Physicians (www.asbp.org), risks and side effects are associated with anti-obesity medications, however these side effects are minimal and of short duration for most people. With over 40 years of experience in this area, our Bariatricians, Nurse Practitioners and staff are extensively and properly trained in prescribing these drugs and monitoring our patients’ use. When used as part of a comprehensive program including diet and nutrition changes, exercise, and lifestyle modification, prescription anti-obesity medications can be a useful adjunct to a medical weight loss program. Medication alone will not lead to successful weight loss and maintenance. Many of the appetite suppressants and other medications available today have a long history of safe and successful use. New medications are being researched and become available after clinical testing and Food and Drug Administration approval.

What about diet drinks and diet products?
At PWC, we have a variety of bars, shakes and dietary supplements to help you achieve your goals. We have an online store as well as stores in our office locations. We have tasted and tested each of our products to ensure that you do not feel like you are eating “diet foods”. Meal replacements can help you eat more frequently to keep your metabolism up without adding large amounts of calories. They are also well-balanced nutritionally to make sure you get the vitamins and minerals essential for proper nutrition.

• New Patient Forms

• Established Patient Forms

 Recommendations

• Journal Every Day

• Calculate Your BMI

Helpful Guides

• 10 Reasons to Exercise

• Calories Still Count

• Obesity Facts

• Start Exercising!

• A Guide to Food Labels