• Mar3

    Medicare Pays for Obesity: A Webinar and Cheat Sheet

    Posted in: Media, Obesity and Weight Loss, Wellness and Health

    Lots of things are starting to move. The economy is getting a little better. The bees in the avocado orchard are buzzing. My patients seem to be firing on all cylinders.

    And Medicare is starting to pay doctors to counsel patients about obesity…and to help them lose weight. (I’ve been lobbying for this for decades). Right now, it’s aimed at guys in John Goodman’s age bracket. But not for long!

    This is remarkable, life-changing and powerful. Doctors are like other workers: they do more of what they are paid well to do. And the right word from your physician can make the difference between losing the fat, or not.

    Of course, Medicare does not pay docs well to do this: I estimate (from the RVUs) $34 to counsel patients on what is arguably the most complex and difficult to treat endocrine disorder.

    But Medicare does offer 22 visits (if you lose 6.6# by visit 16, in month 6).  And tells doctors, nurse practitioners and physician assistants what they need to do to help patients.

    I think this is so important I am doing a live 90 minute webinar for clinicians and managers later this month. I’ll publish a step-by-step downloadable log, and a separate, detailed white paper here for those who want to get the documentation just right.

    I’ve been interviewing coders and clinicians all over the country! Medicare and risk management are so hard to understand! But essential! Because I’m on a mission to help people who want to get really healthy do so! Whether it’s 20, 40 or 100#, you can do it!

    Another encouraging note: PBS stations in Colorado, Idaho, Illinois, Iowa, Kansas, Kentucky, Louisiana, Oklahoma, Texas, Utah, Vermont and Wisconsin are re-broadcasting my “Eat and Cook Healthy” this month…and more every day!

    It’s 90 minutes (+5 DVDs and a CD) jam-packed with everything I could squeeze in about culinary medicine–and what to eat for diabetes, cholesterol, back pain, heart disease and more. It’s a donation to PBS, one of the best things I know.  TV is a blast to do: you can see a sneak preview on YouTube, and follow me on Twitter for broadcast times.

     
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  • Feb6

    Overweight but Malnourished: How? What to Do?

    Posted in: Common Conditions, Obesity and Weight Loss, Wellness and Health

    TOTAL CALORIES: 24,375 TOTAL GRAMS OF FAT: 1,285 TOTAL COST: $86.47

    My patients eat a lot of calories, but are actually malnourished.

    Your brain doesn’t count calories–it counts nutrients. But there are few (worth absorbing), and it’s hungry for more.

    Your stomach is empty and growling but you just ate.  Too many calories, too few nutrients. Brain poop. (Conversely, a low starch, higher healthy fat Mediterranean diet seems to fight brain damage).

    Belly fat is toxic, and sugar and starch cause its accumulation, not fat.

    Belly fat lies adjacent to the liver, mainlines fat there and you end up with foie gras as a liver.  Which is still illegal in my sweet home Chicago, a true paradox.

    The kidneys get squeezed, and you get high blood pressure. The number one hormonal organ in your body, if you’re overweight, may well be your belly fat.

    80 million Americans are diabetic, or pre-diabetic. That epidemic is going to destroy our health as a country.

    Doctors treat with medicine, because those are the weapons that we were trained to offer.  But they’re only band-aids, and as effective as French Fries on a heart patient’s hospital menu.

    Diabetes medicines often cause more weight gain. So do some common high blood pressure medicine–beta blockers, for example, slow down your pulse and with that, y0ur metabolism.

    But there is hope.  Nearly 90 percent of type II diabetes are reversible.  Having high cholesterol is often reversible, without statins. Controlling high blood pressure with your lifestyle and healthy self is within your reach.

    The environment takes decades to change.  But you can change your own habits tomorrow.  One small step at a time.

     
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  • Jan17

    100 Years Ago, JAMA Thought that a Liter of Water at Meals Was Too Much

    Posted in: Aging and Costs of Aging, Common Conditions, Obesity and Weight Loss, Vitamins and Supplements, Wellness and Health

    JAMA has a section called “100 years ago” in which the Journal of the American Medical Association (JAMA) quotes a column from its archives, verbatim.

    Last week, it was

    January 13, 1912

    WATER-DRINKING WITH MEALS

     ”…While the ingestion of moderate quantities of water with meals may be harmless in persons with good gastric motility, since the excess of water is rapidly expelled into the intestine, it is likely to be harmful in persons whose motor power is below par: and it is probable that there are many such who do not consider themselves ill enough to consult a physician.

    Furthermore, nothing that has been said is intended to lend any support in the American custom of drinking water that is ice-cold…”

    I do think we’ve made progress since them. There’s Vitamin Water, Noah’s Spring Water (pH 8.4, sparkling and delicious), cold water to help you use lose weight, and water to hydrate athletes.

    But it just goes to show: doctors, in all our wisdom, come to conclusions slowly. And that’s what most of us get paid for: slow conclusions and caution.

    I get paid for something different: trusting patients own experiences with medication, supplements, food and beverage; and their own observations of what works (and doesn’t work) for them.

    Informed by the best modern science, and that’s what it is, people can actually lower cholesterol, triglycerides, blood pressure, blood sugar, weight, obesity, overweight; eat an optimally anti-aging diet and the best foods, beverages and dietary supplements and minimize interactions between them;  and wipe out back pain, allergies and much more.

     
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  • Jan11

    Top Pedometers and GPS Watches: Consumer Reports 2012

    Posted in: Aging and Costs of Aging, Obesity and Weight Loss, Uncategorized, Wellness and Health

    Treadmills and elliptical trainers are some of the best aerobic exercisers available for weight loss 2012, and Consumer Reports picked its top models this month (reviews to come).

    But if you already have a treadmill or an elliptical, or want to start more simply, select a pedometer (around $30) or a GPS watch (around $200) or both.

    Consumer Reports rates equipment as follows:

    Top 3 pedometers: Mio Trace Acc-Tek, the new Omron GOsmart Pocket HJ-112 (or get the tried and true Omron HJ-112) and the Yamax Digi-Walker CW-701.

    (I especially like both Omrons)

    Top 3 GPS watches: Nike+ SportWatch GPS, the Garmin Forerunner 210 and the Timex Ironman Global Trainer GPS Speed + Distance T5K267F5.

    (I especially like the Garmin)

    These are less expensive than a treadmill: I tell my patients to get 3 pedometers, because inevitably one is lost, and one is always somewhere you meant to put it on, but forgot. They’re invaluable, especially when you’re trying to get to 10,000 steps!

     
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  • Jan2

    Women and Men: What Helps Guys Diet?

    Posted in: Obesity and Weight Loss, Wellness and Health

     
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