04/23/2024
MWHC Medical Minute(s) (Fine, fine, yes, I’m long winded. I’m funny, too, though, right? You’re smiling?): Nutrition & Weight loss
Weight loss is a running theme through many conversations the past months.
Am I more aware of it because I’m struggling with menopausal weight gain? -oh yes, it’s personal! (It’s been 4 months, and I *think* I’ve lost 3 pounds overall)
Am I interested because of how semaglutide (Ozempic/Wegovy) and terzepatide (Mounjaro/Zepbound) have created national conversations and even conflict? - oh yes, who can resist drama?
Am I entering the conversation because these new medicines are very powerful (dramatic weight loss) and could have potentially powerful adverse effects if we use them carelessly - bowel obstruction, severe depression, muscle wasting and frailty, and illegal business practices of people trying to make money at the cost of patient care? - oh yes, I’m your physician! I’m here to make sure we start off with “DO NO HARM!”
In a world of “either/or”, a holistic perspective includes “both/and” (and even more “and” oftentimes).
We know that weight loss has to be personalized. No one diet fits all. The “best” weight loss diet is the one that you can sustain.
And what motivates one person to stay with a change in dietary patterns is different pending your level of activity, your gender, your age, your medical conditions, your stresses, your work-life balance, your financial circumstances, where and how you buy your food, even what season of the year it is.
I’m like, “heck, yea, I can do a vegan, whole foods, plant based diet!” (If someone will grow my food and prepare it for me. Alternatively,, I was totally vegan at a vegan conference and could have done it the rest of my life if I lived at a vegan conference the rest of my life).
Or, “for sure, I’m going to do the ProLon Fasting Mimicking diet” for 5 days a quarter to cleanse my system (If I didn’t have to be around people, telling me to please eat because I’m in a terrible mood and terribly off).
Or, “yes, let me do that weight watchers app” so I can only track the foods that are processed and eat all the unprocessed foods for 0 points without tracking it (Well, that app is currently my weight tracking app, because I’m not tracking any foods at all)
Or, “Let’s go keto!” (Except then I can’t go (so constipated!!) at all).
So many of us try, and fail, and get discouraged when we talk about, or work towards, weight loss. Because holidays happen, eating out happens, stress happens, and… as much as I want to be a family physician/fitness model/doctor to the Seal teams like Dr. Gabrielle Lyon on podcasts with Jocko Willink who can say, “this is how you do it!”… I’m just Arlene McCain, a menopausal, boundary-struggling, Lucy- loving (she’s destroyed my 3 hour morning practice), Utz Sweet Heat BBQ chips eating (when available. Thank goodness it’s not always!), exercise-routine challenged (I was SOOOO consistent for 6 months last year), family doc that loves to sit for an hour talking about life and love, then goes home and connects with my 16 year old by making small dents into the 1000+ episode anime series “One Piece,” where I usually fall asleep by the 3rd or 4th episode and wake up to Lucy’s potential wet/dry surprises around the house before going to sleep for real (for 4 or 5 hours).
So, for me, when I think about, “what works” for weight loss, I sincerely say, “whatever works for you.” I think it’s important to take all the things you’ve tried over different times of your life, during different seasons of the years and be clear about what works for you without feeling bad about what does or doesn’t (it’s true, a bunch of my special chips barely moves the needle on my sugar, while a sandwich with 647 bread and a mandarin make my sugar jump high and take a long time to settle back down). How do foods affect you? Don’t be shy. Own it! (See here? I’m telling myself this, too).
The one thing I can say with 99% certainty is that we CANNOT be rigid. We are humans - made for diversity, made to experience lots of different aspects of life. Our bodies will not allow us to eat the same thing all day, every day because we are not supposed to be doing the same thing all day every day. So we have to be in tune with ourselves enough to know what we really need to nourish our bodies at certain times, and to honor our bodies and give it what it needs to do what we ask it to do. We can go out of our way to do things for others, right? Go out of your way to do things for your body.
You’re not here to live other people’s lives.
You’re here to live your life AND to offer your gifts and talents to others.
When we feed the billions of bacteria in our gut just a few things, that eventually means that we’re selecting certain bacteria to dominate, which shifts our natural gut diversity, and starts to limit our natural resilience.
That’s my initial big picture thoughts on food and weight loss. Take from it what you need to (ie, what resonates with you inside so loudly, you’re like, “Amen,sister!)
Now, the lovely thing about having community is that we have lots of people trying different things with different results. We have resources in one another. So, let me share a few resources that have come up regarding nutrition/weight loss recently. (And if you’ve got more, add them in, with your own sassy (or serious) comments. We are all Editors on this Google doc)
1. https://www.nobsweightloss.com
“She is really fantastic and is really about empowering women in all areas of their lives. Her approach to weight loss is about controlling the mental aspect of it which for women is probably 95%. Her free podcast is Losing 100 Pounds With Corinne Crabtree.
She is truly motivating. She has lost 100 lbs and kept it off!!”
2. Renew Food Planhttps://irp.cdn-website.com/6bc68388/files/uploaded/ReNew-Food-Plan-Comprehensive-Guide_v2.pdf
“The ReNew Food Plan prescribed by a Functional Medicine practitioner is a therapeutic, short-term approach followed for a specific amount of time, often used as a first step in: Ridding the body of the most common foods that cause inflammation
Identifying food allergies, sensitivities, intolerances, and triggers
Eliminating foods with potentially addictive and harmful components
Providing nutritional support for the body’s detoxification systems”
3. https://youtu.be/HBuXIBm55fM?si=DEwGvfmlbLvlnRcT
(focus on getting enough protein)
Jocko Podcast 428: Lift Heavy Things, Move, and Get Enough Protein. With Dr. Gabrielle Lyon
4. https://open.spotify.com/episode/2N3jMu1oTl7Am4kOc7761z?si=EF5rSRpSQKCXKjEhbHhtZA
DPC Rocks! Q&A: Semaglutide
On this episode, physician Arlene McCain (McCain Whole Health Care) & pharmacist Jathan Payne (Medicap Pharmacy) discuss semaglutide. What is it? What do patients need to know? What are (hidden) costs? What do we need to know about compounding? What are other options for weight loss? (Note: it starts 16 seconds in... still working on editing skills)
https://docs.google.com/document/d/18-9GIEosepH2EtxMft-k4njqRRfiIo1SsWh-dd5oCa4/edit?usp=sharing