GynoFiles

Daily and weekly weigh ins, particularly if incorporated into a weight loss program can help a dieter lose weight. In fact a study of the new weight loss medication Contrave said, it's a huge component. In their controlled study those that got their special scale (with the pep talks and the beeping to make you do it, so no, it wasn't just any scale) lost 7% of their weight over a year. So it does help to do daily weights and we will discuss weighing in often, journaling, and tracking. Gynos especially like their patients to come weigh in with them. Although daily weights were one simple step to help you lose weight, there are other ways to monitor successful body shaping and health through a weight loss regimen. to checking weight, it's not always the amount of weight on the scales, as everyone knows. And it's not just whether you fit into your jeans. It's exactly how fat you are. We've written a lot about fat distribution, and we've written about g...

Smoothies, and very low calorie days are often healthy in the context of having a stable healthy diet. The goal is to be heart healthy. Have a reasonable body fat and a reasonable amount of muscle within your body type. Actually doing a very low calorie day for long stretches, is essentially dieting by starvation. Starvation or near starvation have been studied for over a century. The classic dietary experiments of Folin and Denis in 1915 were among the early advocates of such plans for very obese individuals. Later regimens championed by Strang-Evans had 660 calories per day and did little to significantly reduce the weight of the super obese weighing between 300 and 700 pounds. In these cases severe hormone abnormalities prohibit weight loss even with this low intake. Low calorie and very low calorie diets have been championed as a path to rapid weight loss, and for some who are merely overweight and modestly obese may benefit from such plans as a way to briefly get weight off. The...

Body composition has a very complex relationship between fat, hydration, muscle, and bone mass. The regulatory hormones that control each are integrally linked and seem to control how we gain or lose weight, how the weight is distributed, how fit we are, how much muscle we can build as we get older and many other aspects of our health. To help understand this complex relationships how fit you are is more accurately measured by body composition readings than BMI. Specifically knowing your relative skeletal muscle mass can determine if you have an appropriate amount of strength for your gender and age. Knowing your body fat, and the differential between your visceral fat and your overall fat percentage can help determine your overall leanness. It is important to be lean for thermoregulation.  Once it was thought that heavier women would have fewer hot flashes because of overall higher estrogen levels. Then the prevalent theories were that body fat functions as a natural 'sweater l...

Longevity and living well is determined by having the healthiest tissues possible. Being leaner, even if not lean specifically is healthy. We have focused a lot on body height per weight, and as a general measure. The newest concept is to look at your fat percentage. Some experts set these percentages by age, others set it as a single number. Research shows  that greater than 42% body fat is obese for women and greater than 34% for men is obese. These numbers are not set arbitrarily, but above these ranges women begin to get hormonal disruption, dysfunctional fat, and ectopic fat. Secondarily there is loss of muscle medically which is termed scarcopenia. We see this more commonly in vegetarians, especially vegans and carb addicted individuals. The healthiest way to lose weight is to do it slowly, in a controlled way. Weight loss varies over the course of a diet, and not just due to calorie count and exercise. What happens is that as you begin on a diet, if we follow your body com...

This is a picture of the Goat's Rue plant, which is the original source of the insulin sensitizing medicine metformin. It is also known as French lilac, not known to Hippocrates, but it has been used since the middle ages to reduce thirst and frequent urination, before these symptoms were known to be due to diabetes specifically. Once only used as a treatment for diabetes, metformin today is one of the most widely prescribed medications used in PCOS, infertility, weight loss, and to preserve cardiovascular health in those with metabolic syndrome.Studies prove that it can reduce a pre-diabetic's chance of becoming a diabetic. It is critical to realize that radical lifestyle and diet changes might do even better in early treatment of many of these conditions including diabetes and PCOS. Its chemical mechanism of action is quite complicated, but it has an effect on skeletal muscle to enhance it's uptake of glucose (sugar). Overall it leads to fat burning, decreased new produc...

We have talked, in women's health, a lot about the HPO: the endocrine system that communicates between the H: the hypothalamus, the P: the pituitary gland, and the O: the ovary. Generally speaking when we talk about 'hormone imbalance' the gynecologic endocrinologist means there is something off with this cycle of how the ovary talks to the brain. Now it has been realized that other endocrine systems have just such a channel of communication and how that works between the brain and the adipose tissue has  now been called the "brain-fat axis" and this is an important control of how your body uses energy, or decides to amass fat stores. It is now well-known that appetite-regulating peptides that were studied as neurotransmitters in the central nervous system can act both on the hypothalamus to regulate feeding behavior and also on the adipose tissue to modulate the storage of energy. Energy balance is thus partly controlled by factors that can alter both energ...

Intake of food is the key to survival, and it is no wonder we have a vast array of physiological checks and balances to control how food is consumed, stored, and used in our body. What is a wonder is how the science of this system is both in it's infancy, and not well understood by many scientists nor taught much in medical curriculum yet. Most physicians, even those who treat weight disturbances have therefore never heard of, and do not know how to use knowledge of the molecules that regulate our weight. The list above is just a few of these, here is a quick guide to some of these factors: 1.  Leptin regulates food intake 2. The pituitary gland is controlled by the hypothalamus and this gland has a molecule, PMOC which works through nerve types called Hypothalamic pro-opiomelanocortin (POMC) neurons which regulate energy and glucose metabolism. Leptin appears to work in part through stimulating these as well. 3.  α-melanocyte stimulating hormone (α-MSH) is another h...

Is your waist healthy? Do you need to improve? You are picking out that old favorite team gear and now you noticed that you are unable to button your pants as easily? The first clue to your nutritional health is not necessarily your weight. Your weight may not even have fluctuated much, but there it is, the dreaded thicker waist. Just doing a bit less? Having too much wheat based carbs? Eating sugar and forgoing the right fats? Trying the turkey and chicken instead of burgers and steaks?Weight gain in the middle is not good.  As your waist to hip ratio rises, your get thicker in the middle and even if you can button your pants, it's that you are getting that muffin top look. Whether or not you have a good or even relatively healthy 'overweight' BMI, if you have too thick of a waist it is called central obesity,  as measured by waist circumference (men – greater than 40 inches [102 cm]; women – greater than 35 inches [89 cm]). Your BMI is a measurement of your w...

As we help women achieve and maintain a healthy BMI, we see too many people in the middle of a successful diet, suddenly struggling to maintain the pace of weight loss. Knowing the cause can help guide us to a solution. Hormones pay a role in the regulation of weight and food consumption. These are hormones that most of us do not discuss with our providers. But understanding these hormones will help explain why so many of us hit a roadblock when tying to lose weight. When you begin a diet you find that you lose weight, but as you go on watching your calories you find that weight loss slows, and in some cases that weight gain resumes. When we eat food, normally when we are not trying to gain or lose weight as we at the leptin hormone from our fat decreases, the ghrelin from the stomach increases, the hormones glucagon-like peptide-1, cholecystokinin, and peptide YY from our intestine, and insulin and amylin from the pancreases all decrease. Those effects help regulate the signal to r...

There are 5 FDA approved weight loss medications: orlistat , lorcaserin , naltrexone-buproprion , phnterimine-topiramate and liraglutide . There are not many research trials comparing these medications. In the June 2016 JAMA issue the medications were compared. The research trials are difficult to do because close to 40% of patients drop out, and thus it's very difficult to apply the groups to an individual patient. At Women's Health Practice we have many patients who have lost in the 30-80 pound range, and some have accomplished their weight loss in 6 months. Although individual patients can lose significant amounts of weight more than what is reported in these studies, as a group most research trials show that these medications help women, average age of 45, lose about 5% of weight over 52 weeks of weight management plan. The process is a slow and laborious, as many individuals need to lose significantly more than that to achieve a heart healthy weight.. However, this pace...

 Medical science now has begun to recommend limited fasting. We used to call days of higher calories 'cheating days' and days of lower calories the days we 'stick on our diet.' Even normal weight women have been heard to echo this sentiment. Some diet advice cautions that these higher calorie days might lead to more and more meals of unhealthy foods and even binge eating. But Krista Varady, a nutritionist for University of Illinois-Chicago, found that with the process of varying caloric intake, the very low calorie diet days help overall reduce calories. Long term health studies seem to indicate that fasting bouts can slow aging, reduce the risk of cancers, and reduce the risk of diabetes .You should work with your gyno on what your consumption should be. Although it would be safe to not eat at all on fast days, everyone should  keep up water consumption, and eating about 600-700 calories on those days would trigger the physiologic effects you are looking for. Feast...

The doctors Stein and Leventhatal in 1935 discovered why some women had big cysts on their ovaries, extra hair growth and troubles getting pregnant. And though we recognize their work as the beginning, their name long left the condition of Polycystic Ovaries. After it was called Stein and Leventhal's disease this has been called a disease, a condition and now a syndrome, PCOS or Polycystic Ovarian Syndrome . It begins in teen years, at which time it may mean some acne and  occasional irregular cycles. most likely it resolves with menopause and the quieting of the ovarian hormones. Obesity is an integral component of the condition for many women and it's thought to be the result of insulin resistance due to PCOS but modifiable by therapy. The most common issue with getting pregnant is chronic anovulation which leads to patients not getting pregnant. Now it has been shown in a publication by Doherty in the journal of OBSTETRICS AND GYNECOLOGY that women with PCOS have inc...

The benefits of breastfeeding for baby has never been in doubt. The health benefits of breastfeeding for mom were mostly for many years focused on faster post partum weight loss, and then the focus blurred with not only on benefits, but physical negatives for mom from breastfeeding. The saying 'you loose a tooth for each child' meaning the loss of bone calcium in pregnancy exaggerated by calcium loss during breastfeeding. Nutrition, exercise, and avoiding smoking has pretty much eliminated that concern! But interestingly as we have begun to scientifically explore the wide ranging benefits for mom from breastfeeding beyond weight loss: less diabetes, less breast cancer, less hypertension, fewer myocardial infarctions, and now it has been shown to help prevent cardiovascular disease due to less atherosclerosis, in a study on lactation from the CARDIA group.  Breastfeeding to reduce the physical risks of gestational diabetes is becoming more and more important as gestational di...

Just because you anti-age, you may not necessarily be assuring longer life. It does seem like a reasonable assumption though, so most of us want to know a plan to live longer and live well. No one sure fire longevity plan exists, but here are some basics to consider. The longevity gurus are seeking to live to, at least 150 years young, the rest of us scare if you tell us we’re living much beyond 90, making that much assumed leap that living longer at that age, will not be living well.And then there are financial considerations we can't even imagine. The current theoretical limit of old age for humans is about 120 years old, that’s about the oldest we’ve ever established anyone can live, barring the occasional raised brow as to the actual birth date of some of these older individuals. At the turn of the century before last we lived to about 50, now about 80, 80.8 for women as of the latest statistics. But that reflects more people living from diseases that killed th...

Since a new CDC repor t looked at whether US pregnant women's weight gain and found too many women are not hitting recommended amounts, the question remains what should you do about it? The answer lies in a combination of recommendations. You need to start with your provider and get in mind the normal weight recommendations. The CDC article reviews them:Gain 28-40 if you are underweight, and 25-35 if normal weight, 15-25 if you are overweight and 11-20 if you begin pregnancy with a diagnosis of obesity. This is based on pre-pregnancy BMI. Then discuss with your provider: what is your metabolism really like: do you gain easily, have you recently been on a diet, are pregnancy nutrition requirements going to be difficult for you to eat as they are so different from your normal way of eating. Have you ever been a calorie counter? Did you have to recently give up smoking? Be realistic and discuss a plan with your birth provider so that you can tackle these issues together. For some it ...

It's tough to know how exercise is going to translate into health for all your body parts, and ultimately end up with the right amount of fitness, the ideal weight range, and your healthiest body shaping while maintaining healthy bones, joints, breasts and waist. Both shape and fitness goals are often in concert, but some fine tuning may be necessary. If you suffer injury, or are slow to recover, you need additional adjustment to fitness. Your physician's exercise goals may be quite extensive, whether you have discussed or not! Fitness program goals for you includes: to maintain enough exercise to be vigorous, have better cardiovascular health, to lessen risks of strokes and blood clots, to think better, to sleep, to have better sex, to feel better, keep your weight in the healthiest range it can be, prevent obesity, and finally perhaps to look better! While all those benefits can be obtained, for long term sustaining of those benefits you have to look at exactly the relations...

meadow rue No one has patience when it comes to weight loss. Pounds seem to come on rapidly, and once we get in the mindset to get on with serious weight loss we all can fall prey to wanting it to occur quickly. But faster is not always better when it comes to the exact pace of weight loss.The best diets are enhanced in their weight loss by exercise. So get off the couch: you are only burning one calorie per minute, and do something energetic! Some calorie burn your fit bit isn't necessarily tracking: sex, that burns about 5 calories a minute. Exercising off the weight is a healthier way to do it, exercisers with a modest diet are not as likely to get into ketosis. Dieters who get into ketosis, which is the end metabolic consequence of too low a calorie count and too low a carb consumption put themselves at risk of harm. Long term they may find trouble with high blood lipids, and impaired immunity due to their white cells called neutrophils to not function, vision problems due...

If we could understand obesity, we may be able to cure it. The causes are complex Maybe the fault is not in our stars, but in our "starts" as a new a rticle about obesity due to fetal diet implies.  The obese in the world outnumber the hungry in the world. In 2006 the International Congress on Obesity found there were 1 billion obese individual in the world and 'only 600 million' hungry in the world. The numbers now are closer to 2.1 billion obese and 800 million hungry. With the current thinking that in 'large part' we get fat, merely because we can, food is abundant. Tackling the problem, regardless of the causes, according to the Institute of Medicine , the solution will be multifactorial. Under normal physiological situations we have all of our fat cells and enlargement of these existing adipocytes is the cause of fat weight gain. But under conditions of severe obesity, you have probably generated new fact cells. Those fat cells manage to generate hormo...

There are many strategies to reduce breast cancer risk, and weight loss and exercise are our front line strategy. And as a side not new studies show that even with the more serious estrogen receptor and progesterone receptor cancers exercise and weight loss will prolong survival! Too few women however realize that there are medical ways of improving breast cancer survival. F use medication to lower your breast cancer risk . The American Society of Clinical Oncology (ASCO) has changed the tenor of its recommendations in its clinical practice guideline on the use of chemoprevention for breast cancer, and they now are including the medications of raloxifene, and exemestane in the medications not just tamoxifen, and the organization is wanting more people to seriously consider these medication. Their point is that they are not seeing more people use these very effective therapies, and so awareness is not increasing, and more women and their gynos need to take note. Here is what y...

FAT? Not FAT? Which is it? Are you only relying on your scale? Get the Facts before you brag, brag, brag about all that muscle...or before you whine, whine, whine about the lack of muscle. Simple body fat analysis can give you that % of lean body mass vs body fat. And then we can talk. And what's important on a diet: maintaining that lean body mass while you loose fat, and loose abdominal fat. So when this gyno gal gets you on a diet we get you on the Lunar Prodigy for a bit of analysis. Then you can be compared to your age group, your ethnicity, and your goals. A few facts are in order to help the exercise and nutrition plan along!