Dr. Charlie Seltzer, Philadelphia, PA (2025)

Board Certified in Obesity Medicine by the American Board of Obesity Medicine
Certified by the National Strength and Conditioning Association as a CSCS
Board Certified in Internal Medicine
Only physician in the country to hold all three certifications.

03/04/2025

I want to say a big thank you to for interviewing me for “How I Went From An Obese Teenager To A Fit Medical Doctor.” Details of my weight loss & fitness journey all here plus my current macro, supplement, and lifting plan.

03/04/2025

Non-alcoholic fatty liver disease (NAFLD)
Non-alcoholic fatty liver disease (NAFLD) is the term for a range of conditions caused by a build-up of fat in the liver. It's usually seen in people who are overweight or obese.
Early-stage NAFLD does not usually cause any harm, but it can lead to serious liver damage, including cirrhosis, if it gets worse.
Having high levels of fat in your liver is also associated with an increased risk of serious health problems, such as diabetes, high blood pressure and kidney disease.
If you already have diabetes, NAFLD increases your chance of developing heart problems.
If detected and managed at an early stage, it's possible to stop NAFLD getting worse and reduce the amount of fat in your liver.
Stages of non-alcoholic fatty liver disease (NAFLD)
NAFLD develops in 4 main stages.
Most people will only ever develop the first stage, usually without realising it.
In a small number of cases, it can progress and eventually lead to liver damage if not detected and managed.
The main stages of NAFLD are:
simple fatty liver (steatosis) – a largely harmless build-up of fat in the liver cells that may only be diagnosed during tests carried out for another reason
non-alcoholic steatohepatitis (NASH) – a more serious form of NAFLD, where the liver has become inflamed
fibrosis – where persistent inflammation causes scar tissue around the liver and nearby blood vessels, but the liver is still able to function normally
cirrhosis – the most severe stage, occurring after years of inflammation, where the liver shrinks and becomes scarred and lumpy; this damage is permanent and can lead to liver failure (where your liver stops working properly) and liver cancer
It can take years for fibrosis or cirrhosis to develop. It's important to make lifestyle changes to prevent the condition getting worse.
Am I at risk of non-alcoholic fatty liver disease (NAFLD)?
You're at an increased risk of NAFLD if you:
are obese or overweight – particularly if you have a lot of fat around your waist (an "apple-like" body shape)
have type 2 diabetes
have a condition that affects how your body uses insulin (insulin resistance), such as polycystic o***y syndrome
have an underactive thyroid
have high blood pressure
have high cholesterol
have metabolic syndrome (a combination of diabetes, high blood pressure and obesity)
are over the age of 50
smoke
But NAFLD has been diagnosed in people without any of these risk factors, including young children.
Although it's very similar to alcohol-related liver disease (ARLD), NAFLD is not caused by drinking too much alcohol.
Symptoms of non-alcoholic fatty liver disease (NAFLD)
There are not usually any symptoms of NAFLD in the early stages. You probably will not know you have it unless it's diagnosed during tests carried out for another reason.
Occasionally, people with NASH or fibrosis (more advanced stages of NAFLD) may experience:
a dull or aching pain in the top right of the tummy (over the lower right side of the ribs)
extreme tiredness
unexplained weight loss
weakness
If cirrhosis (the most advanced stage) develops, you can get more severe symptoms, such as yellowing of the skin and the whites of the eyes (jaundice), itchy skin, and swelling in the legs, ankles, feet or tummy (oedema).
See a GP urgently or call 111 if you have any of these symptoms and have a liver condition.
How non-alcoholic fatty liver disease (NAFLD) is diagnosed
NAFLD is often diagnosed after a blood test called a liver function test produces an abnormal result and other liver conditions, such as hepatitis, are ruled out.
But blood tests do not always pick up NAFLD.
The condition may also be spotted during an ultrasound scan of your tummy.
This is a type of scan where sound waves are used to create an image of the inside of your body.
If you're diagnosed with NAFLD, further tests may be needed to determine which stage you have. This may involve a special blood test or having another type of ultrasound scan (Fibroscan).
Some people may also need a biopsy, where a small sample of liver tissue is taken using a needle so it can be analysed in a laboratory.
Children and young people with an increased risk of NAFLD (those with type 2 diabetes or metabolic syndrome) should have an ultrasound scan of their liver every 3 years.
Other tests you may have include a CT scan or MRI scan.
Treatment for non-alcoholic fatty liver disease (NAFLD)
Most people with NAFLD will not develop any serious problems, but if you're diagnosed with the condition it's a good idea to take steps to stop it getting any worse.
There's currently no specific medication for NAFLD, but making healthy lifestyle choices can help.
Treatment also may be recommended for associated conditions (high blood pressure, diabetes and cholesterol) or complications.
You may be advised to have regular appointments with your doctor to check your liver function and look for signs of any new problems.
Medicines
There's not currently any medicine that can treat NAFLD, but various medicines can be useful in managing the problems associated with the condition.
For example, your doctor may recommend medicine to treat high blood pressure, treat high cholesterol, treat type 2 diabetes and treat obesity.
Liver transplant
If you develop severe cirrhosis and your liver stops working properly, you may need to be put on the waiting list for a liver transplant.
Or it may be possible to have a transplant using a section of liver removed from a living donor.
As the liver can regenerate itself, both the transplanted section and the remaining section of the donor's liver are able to regrow to a normal size.
Things you can do if you have non-alcoholic fatty liver disease (NAFLD)
Adopting a healthy lifestyle is the main way of managing NAFLD.
For example, it can help to:
lose weight – you should aim for a BMI of 18.5 to 24.9 (use the BMI calculator to work out your BMI); losing more than 10% of your weight can remove some fat from the liver and improve NASH if you have it
eat a healthy diet – try to have a balanced diet high in fruits, vegetables, protein and carbohydrates, but low in fat, sugar and salt; eating smaller portions of food can help, too
have water instead of sweet drinks
exercise regularly – aim to do at least 150 minutes of moderate-intensity activity, such as walking or cycling, a week; all types of exercise can help improve NAFLD, even if you do not lose weight
stop smoking – if you smoke, stopping can help reduce your risk of problems such as heart attacks and strokes
NAFLD is not caused by alcohol, but drinking may make it worse. It's therefore advisable to cut down or stop drinking alcohol.

09/23/2024

Diabetes
Diabetes mellitus refers to a group of diseases that affect how the body uses blood sugar (glucose). Glucose is an important source of energy for the cells that make up the muscles and tissues. It's also the brain's main source of fuel.
The main cause of diabetes varies by type. But no matter what type of diabetes you have, it can lead to excess sugar in the blood. Too much sugar in the blood can lead to serious health problems.
Chronic diabetes conditions include type 1 diabetes and type 2 diabetes. Potentially reversible diabetes conditions include prediabetes and gestational diabetes. Prediabetes happens when blood sugar levels are higher than normal. But the blood sugar levels aren't high enough to be called diabetes. And prediabetes can lead to diabetes unless steps are taken to prevent it. Gestational diabetes happens during pregnancy. But it may go away after the baby is born.
Symptoms
Diabetes symptoms depend on how high your blood sugar is. Some people, especially if they have prediabetes, gestational diabetes or type 2 diabetes, may not have symptoms. In type 1 diabetes, symptoms tend to come on quickly and be more severe.
Some of the symptoms of type 1 diabetes and type 2 diabetes are:
Feeling more thirsty than usual.
Urinating often.
Losing weight without trying.
Presence of ketones in the urine. Ketones are a byproduct of the breakdown of muscle and fat that happens when there's not enough available insulin.
Feeling tired and weak.
Feeling irritable or having other mood changes.
Having blurry vision.
Having slow-healing sores.
Getting a lot of infections, such as gum, skin and vaginal infections.
Type 1 diabetes can start at any age. But it often starts during childhood or teen years. Type 2 diabetes, the more common type, can develop at any age. Type 2 diabetes is more common in people older than 40. But type 2 diabetes in children is increasing.
Causes
To understand diabetes, it's important to understand how the body normally uses glucose.
How insulin works
Insulin is a hormone that comes from a gland behind and below the stomach (pancreas).
The pancreas releases insulin into the bloodstream.
The insulin circulates, letting sugar enter the cells.
Insulin lowers the amount of sugar in the bloodstream.
As the blood sugar level drops, so does the secretion of insulin from the pancreas.
The role of glucose
Glucose — a sugar — is a source of energy for the cells that make up muscles and other tissues.
Glucose comes from two major sources: food and the liver.
Sugar is absorbed into the bloodstream, where it enters cells with the help of insulin.
The liver stores and makes glucose.
When glucose levels are low, such as when you haven't eaten in a while, the liver breaks down stored glycogen into glucose. This keeps your glucose level within a typical range.
The exact cause of most types of diabetes is unknown. In all cases, sugar builds up in the bloodstream. This is because the pancreas doesn't produce enough insulin. Both type 1 and type 2 diabetes may be caused by a combination of genetic or environmental factors. It is unclear what those factors may be.
Risk factors
Risk factors for diabetes depend on the type of diabetes. Family history may play a part in all types. Environmental factors and geography can add to the risk of type 1 diabetes.
Sometimes family members of people with type 1 diabetes are tested for the presence of diabetes immune system cells (autoantibodies). If you have these autoantibodies, you have an increased risk of developing type 1 diabetes. But not everyone who has these autoantibodies develops diabetes.
Race or ethnicity also may raise your risk of developing type 2 diabetes. Although it's unclear why, certain people — including Black, Hispanic, American Indian and Asian American people — are at higher risk.
Prediabetes, type 2 diabetes and gestational diabetes are more common in people who are overweight or obese.
Complications
Long-term complications of diabetes develop gradually. The longer you have diabetes — and the less controlled your blood sugar — the higher the risk of complications. Eventually, diabetes complications may be disabling or even life-threatening. In fact, prediabetes can lead to type 2 diabetes. Possible complications include:
Heart and blood vessel (cardiovascular) disease. Diabetes majorly increases the risk of many heart problems. These can include coronary artery disease with chest pain (angina), heart attack, stroke and narrowing of arteries (atherosclerosis). If you have diabetes, you're more likely to have heart disease or stroke.
Nerve damage from diabetes (diabetic neuropathy). Too much sugar can injure the walls of the tiny blood vessels (capillaries) that nourish the nerves, especially in the legs. This can cause tingling, numbness, burning or pain that usually begins at the tips of the toes or fingers and gradually spreads upward.
Damage to the nerves related to digestion can cause problems with nausea, vomiting, diarrhea or constipation. For men, it may lead to erectile dysfunction.
Kidney damage from diabetes (diabetic nephropathy). The kidneys hold millions of tiny blood vessel clusters (glomeruli) that filter waste from the blood. Diabetes can damage this delicate filtering system.
Eye damage from diabetes (diabetic retinopathy). Diabetes can damage the blood vessels of the eye. This could lead to blindness.
Foot damage. Nerve damage in the feet or poor blood flow to the feet increases the risk of many foot complications.
Skin and mouth conditions. Diabetes may leave you more prone to skin problems, including bacterial and fungal infections.
Hearing impairment. Hearing problems are more common in people with diabetes.
Alzheimer's disease. Type 2 diabetes may increase the risk of dementia, such as Alzheimer's disease.
Depression related to diabetes. Depression symptoms are common in people with type 1 and type 2 diabetes.
Complications of gestational diabetes
Most women who have gestational diabetes deliver healthy babies. However, untreated or uncontrolled blood sugar levels can cause problems for you and your baby.
Complications in your baby can be caused by gestational diabetes, including:
Excess growth. Extra glucose can cross the placenta. Extra glucose triggers the baby's pancreas to make extra insulin. This can cause your baby to grow too large. It can lead to a difficult birth and sometimes the need for a C-section.
Low blood sugar. Sometimes babies of mothers with gestational diabetes develop low blood sugar (hypoglycemia) shortly after birth. This is because their own insulin production is high.
Type 2 diabetes later in life. Babies of mothers who have gestational diabetes have a higher risk of developing obesity and type 2 diabetes later in life.
Death. Untreated gestational diabetes can lead to a baby's death either before or shortly after birth.
Complications in the mother also can be caused by gestational diabetes, including:
Preeclampsia. Symptoms of this condition include high blood pressure, too much protein in the urine, and swelling in the legs and feet.
Gestational diabetes. If you had gestational diabetes in one pregnancy, you're more likely to have it again with the next pregnancy.

09/23/2024

Lymphatic blockage is a common health issue that leads to the accumulation of toxins in the body, triggering a series of adverse reactions. One of these is the occurrence of fat and swelling in the body. When lymphatic flow is obstructed, toxins cannot be efficiently eliminated and instead remain in the tissues, resulting in impaired cellular function and slowed metabolism, increasing the risk of weight gain and swelling. Additionally, when lymphatic blockage occurs, it can affect the digestive and immune systems, leading to issues such as constipation. The accumulation of fluid can increase abdominal pressure, thereby compressing the digestive system, slowing intestinal motility, and triggering or exacerbating inflammatory responses in the digestive tract, thereby impairing intestinal function.

09/23/2024

Hypertension (High blood pressure)
High blood pressure is a common condition that affects the body's arteries. It's also called hypertension. If you have high blood pressure, the force of the blood pushing against the artery walls is consistently too high. The heart has to work harder to pump blood.
Blood pressure is measured in millimeters of mercury (mm Hg). In general, hypertension is a blood pressure reading of 130/80 millimeters of mercury (mm Hg) or higher.
The American College of Cardiology and the American Heart Association divide blood pressure into four general categories. Ideal blood pressure is categorized as normal.
Normal blood pressure. Blood pressure is lower than 120/80 mm Hg.
Elevated blood pressure. The top number ranges from 120 to 129 mm Hg and the bottom number is below, not above, 80 mm Hg.
Stage 1 hypertension. The top number ranges from 130 to 139 mm Hg or the bottom number is between 80 and 89 mm Hg.
Stage 2 hypertension. The top number is 140 mm Hg or higher or the bottom number is 90 mm Hg or higher.
Blood pressure higher than 180/120 mm Hg is considered a hypertensive emergency or crisis. Seek emergency medical help for anyone with these blood pressure numbers.
Untreated, high blood pressure increases the risk of heart attack, stroke and other serious health problems. It's important to have your blood pressure checked at least every two years starting at age 18. Some people need more-frequent checks.
Healthy lifestyle habits —such as not smoking, exercising and eating well — can help prevent and treat high blood pressure. Some people need medicine to treat high blood pressure.
Symptoms
Most people with high blood pressure have no symptoms, even if blood pressure readings reach dangerously high levels. You can have high blood pressure for years without any symptoms.
A few people with high blood pressure may have:
Headaches
Shortness of breath
Nosebleeds
However, these symptoms aren't specific. They usually don't occur until high blood pressure has reached a severe or life-threatening stage.
Causes
Blood pressure is determined by two things: the amount of blood the heart pumps and how hard it is for the blood to move through the arteries. The more blood the heart pumps and the narrower the arteries, the higher the blood pressure.
There are two main types of high blood pressure.
Primary hypertension, also called essential hypertension
For most adults, there's no identifiable cause of high blood pressure. This type of high blood pressure is called primary hypertension or essential hypertension. It tends to develop gradually over many years. Plaque buildup in the arteries, called atherosclerosis, increases the risk of high blood pressure.
Secondary hypertension
This type of high blood pressure is caused by an underlying condition. It tends to appear suddenly and cause higher blood pressure than does primary hypertension. Conditions and medicines that can lead to secondary hypertension include:
Adrenal gland tumors
Blood vessel problems present at birth, also called congenital heart defects
Cough and cold medicines, some pain relievers, birth control pills, and other prescription drugs
Illegal drugs, such as co***ne and amphetamines
Kidney disease
Obstructive sleep apnea
Thyroid problems
Sometimes just getting a health checkup causes blood pressure to increase. This is called white coat hypertension.
Risk factors
High blood pressure has many risk factors, including:
Age. The risk of high blood pressure increases with age. Until about age 64, high blood pressure is more common in men. Women are more likely to develop high blood pressure after age 65.
Race. High blood pressure is particularly common among Black people. It develops at an earlier age in Black people than it does in white people.
Family history. You're more likely to develop high blood pressure if you have a parent or sibling with the condition.
Obesity or being overweight. Excess weight causes changes in the blood vessels, the kidneys and other parts of the body. These changes often increase blood pressure. Being overweight or having obesity also raises the risk of heart disease and its risk factors, such as high cholesterol.
Lack of exercise. Not exercising can cause weight gain. Increased weight raises the risk of high blood pressure. People who are inactive also tend to have higher heart rates.
To***co use or va**ng. Smoking, chewing to***co or va**ng immediately raises blood pressure for a short while. To***co smoking injures blood vessel walls and speeds up the process of hardening of the arteries. If you smoke, ask your care provider for strategies to help you quit.
Too much salt. A lot of salt — also called sodium — in the body can cause the body to retain fluid. This increases blood pressure.
Low potassium levels. Potassium helps balance the amount of salt in the body's cells. A proper balance of potassium is important for good heart health. Low potassium levels may be due to a lack of potassium in the diet or certain health conditions, including dehydration.
Drinking too much alcohol. Alcohol use has been linked with increased blood pressure, particularly in men.
Stress. High levels of stress can lead to a temporary increase in blood pressure. Stress-related habits such as eating more, using to***co or drinking alcohol can lead to further increases in blood pressure.
Certain chronic conditions. Kidney disease, diabetes and sleep apnea are some of the conditions that can lead to high blood pressure.
Pregnancy. Sometimes pregnancy causes high blood pressure.
High blood pressure is most common in adults. But kids can have high blood pressure too. High blood pressure in children may be caused by problems with the kidneys or heart. But for a growing number of kids, high blood pressure is due to lifestyle habits such as an unhealthy diet and lack of exercise.
Complications
The excessive pressure on the artery walls caused by high blood pressure can damage blood vessels and body organs. The higher the blood pressure and the longer it goes uncontrolled, the greater the damage.
Uncontrolled high blood pressure can lead to complications including:
Heart attack or stroke. Hardening and thickening of the arteries due to high blood pressure or other factors can lead to a heart attack, stroke or other complications.
Aneurysm. Increased blood pressure can cause a blood vessel to weaken and bulge, forming an aneurysm. If an aneurysm ruptures, it can be life-threatening.
Heart failure. When you have high blood pressure, the heart has to work harder to pump blood. The strain causes the walls of the heart's pumping chamber to thicken. This condition is called left ventricular hypertrophy. Eventually, the heart can't pump enough blood to meet the body's needs, causing heart failure.
Kidney problems. High blood pressure can cause the blood vessels in the kidneys to become narrow or weak. This can lead to kidney damage.
Eye problems. Increased blood pressure can cause thickened, narrowed or torn blood vessels in the eyes. This can result in vision loss.
Metabolic syndrome. This syndrome is a group of disorders of the body's metabolism. It involves the irregular breakdown of sugar, also called glucose. The syndrome includes increased waist size, high triglycerides, decreased high-density lipoprotein (HDL or "good") cholesterol, high blood pressure and high blood sugar levels. These conditions make you more likely to develop diabetes, heart disease and stroke.
Changes with memory or understanding. Uncontrolled high blood pressure may affect the ability to think, remember and learn.
Dementia. Narrowed or blocked arteries can limit blood flow to the brain. This can cause a certain type of dementia called vascular dementia. A stroke that interrupts blood flow to the brain also can cause vascular dementia.

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