Health Blog

Medications for weight loss (Part 1)

Allen Chapman, PA-C ,

Are weight loss medications appropriate for you? Prescription weight loss medications may be appropriate if your weight poses a risk to your health. The guidelines for using these medications recommend that they be considered in patients with a Body Mass Index (BMI) of >27 in the presence of weight related health issues, or >30 without health issues. Weight loss medications are not required for successful treatment of obesity, but they can be a useful adjunct to diet, exercise and lifestyle change.

What about homeopathic diet aids? Honestly, the vast majority of these products are useless, and some of them are dangerous. These products are largely untested, unproven, with unknown side effects and drug interactions. If the label has a warning that: ‘this product is not intended to diagnose, treat, prevent or cure any disease’, you should believe that it is true. You should never mix homeopathic weight loss remedies with prescription weight loss drugs, ever.

What should I expect from weight loss medications? In clinical trials, the prescription weight loss medications currently on the market produced an average loss of 5-8% more than placebo. It is completely reasonable to attempt to lose weight without the assistance of a medication. No medication will produce a substantial change in weight without lifestyle change. One day there will be weight loss medications which will cause substantial weight loss without lifestyle change. Today is not that day.

What weight loss medicine should I take? Unfortunately, I can’t fit detailed information about all potential side effects, drug interactions and contraindications for every weight loss drug into a document the size of this blog. Please ask your health care provider for advice and detailed information if you’re considering a weight loss medication.


You can do this, we can help

Allen Chapman, PA-C ,

help.jpgYou can do this. You can succeed in your efforts to lose weight, change your lifestyle, get back in shape and regain control of your life. The first step is choosing to believe you are capable of making these changes. Second, you have to make the decision to start. If you have made the decision to lose weight and regain control over your life, we at Alaska Premier Health can help.

Why not just do it on your own? If you are able to do so, you should. Most of our patients have tried repeatedly to either do it on their own, or on a program such as Weight Watchers. If this approach is working for you, you may not need our help. If you are not achieving the success you desire, a more intensive and individualized plan may work better for you.

What is Alaska Premier Health? Alaska Premier Health is a clinic specializing in the medical treatment of obesity. Our health care providers have received specialized training in the management of obesity. Our staff is courteous and well trained. Our entire team works hard to foster an environment conducive to your success. We will not judge you; we will help you to make the changes you desire in your life. We will partner with you to help you achieve your goals.

What can we do for you? We help our patients to clarify their goals and formulate a plan to reach them. We educate, inform, cheerlead and coach. As time passes and you make progress toward your long term goals, we will help you manage your weight loss plan with an eye toward maintaining momentum. Through serial goal setting, we will help you become more active and establish a long term exercise plan. When you’re ready for maintenance, we will help you transition to a weight maintenance lifestyle.

We can help.
H. Allen Chapman, PA-C
Physician Assistant – Certified
Alaska Premier Health


We don’t have to do what we’ve always done

Allen Chapman, PA-C

original.jpgI don’t have any willpower with food. This is the lie we tell ourselves so that we don’t feel bad about eating junk food. Lying to ourselves may make us feel better for a while, but it doesn’t help us make better choices. This belief is poisonous to our motivation to eat better and be healthier. No one is perfect; we’re not looking for perfect, we’re just looking for better than yesterday.

I get frustrated and quit. The diet industry is partially to blame for this. So many commercials seem to peddle quick fix diets or chemicals. Just sprinkle our fairy dust on your ice cream cone and you’ll lose weight. It’s dishonest; there is no quick fix. Long-term results require a long-term commitment to change. You’re tougher than you think; you can do what you decide to do. Just remember, your diet plan doesn’t have to remain the same from day one until the day you transition to weight maintenance.

I can choose to think differently. Strength and weakness are both states of mind, choose strength. You’re the captain of your ship, not the ocean. When events overwhelm plans, stay at the wheel. Some events are outside of your control; it’s how you react to those events that define who you are. Learn to identify those things you can control in any situation, and assert your control. Learning to consistently think this way takes time and practice, but the power to make better choices is already yours.

I don’t have to do what I’ve always done. Don’t define yourself as a powerless person. This simple step is the cornerstone of behavior change. So long as you define yourself as powerless to change, you will be. The fancy medical phrase is locus of control, which simply means taking responsibility for your choices. You must accept responsibility for your choices, good and bad, in order to change your behavior. Today is the day to begin making healthier lifestyle choices. Choose to live a healthier life.

H. Allen Chapman, PA-C
Physician Assistant – Certified
Alaska Premier Health


The truth about losing weight

Allen Chapman, PA-C ,

21Calorie restriction is essential. Weight loss will only happen with calorie restriction by some method. There are many approaches to accomplishing this goal. You should choose an approach that you’re comfortable with and believe you can stick to. No three day wonder diet is likely to produce lasting results. Be consistent with your diet plan, be patient with yourself, and don’t expect perfection.

All calories count. Diet composition isn’t as important as calorie restriction. Some dietary changes don’t alter your weight: cutting out caffeine, going organic or avoiding gluten. These things may be important to some folks for other reasons, but they make no difference in your weight. Try to focus your finite personal energy on the thing that is proven to help you reach your weight goal. When in doubt, cut your calories.

Some food choices do matter. It is easier to stick to a diet with an abundance of low calorie but nutrient rich foods such as fresh vegetables and fruit. In a meal with an abundance of vegetables and fruit you are able to eat larger portions of food for fewer calories. It is difficult to consistently restrict calorie intake while eating high calorie but nutrient poor foods laden with fat or sugar. Eat your vegetables and fruit. Avoid high fat and sugar added foods.

Exercise regularly. A lifelong habit of regular exercise is the cornerstone of maintaining a healthy weight. Exercise contributes a little to the pace of weight loss, improves body fat percentage, and helps us to take inches off of our waistline. Physical fitness is an independent risk factor for heart disease. Your long-term exercise goals should be to develop a sustainable routine that you enjoy, to build your routine gradually, to avoid injury and to adhere to a routine of exercising for about an hour most days.

Take the long view. It will take months of effort to undo years of poor lifestyle choices. Clamp down on your calorie intake, embrace an active lifestyle, and begin building your long-term exercise program. Try to be patient and allow your plan time to work. With a well-structured plan, you should be able to lose at least 10% from your starting weight within three months. That will be an excellent start on the new you.

H. Allen Chapman, PA-C
Physician Assistant – Certified
Alaska Premier Health


The right kind of exercise

Allen Chapman, PA-C

Exercise InfographicWhat should I do? The perfect type of exercise is whatever you will do consistently. A single exercise session per year does literally nothing. Regular exercise gives us the greatest benefit. Most people who lose weight and subsequently keep it off are regular exercisers; walking is the commonest type of exercise. There is nothing wrong with walking as exercise, and there is much right with it. It requires no special equipment and no gym membership.

When should I exercise? Whenever you will. The time of day isn’t so important. Exercise early in your day burns a few more calories per minute than exercise later in the day. A missed exercise session burns no calories at all. Once again the goal is consistency. Try to exercise every day. Exercising regularly is much more important than what you do or when you do it.

I don’t have time. Yes, you do. You just use it for other things. Start with short sessions of ten to fifteen minutes a few days per week. All that is required is body weight, gravity and commitment. Take a walk, do floor exercises, use resistance bands, watch a video, play on the floor with your kids. Just do something, and keep doing it. Set short-term goals and build gradually toward your long-term goals.

Establish a routine. The ideal exercise routine would be some form of aerobic exercise most days and strength training a few days per week. If you need to work on flexibility or balance, perhaps add yoga or something similar. You should work out for a total of about an hour per day, five to six days per week. Do this week after week for the rest of your life. You’re likely to live longer if you do.

H. Allen Chapman, PA-C
Physician Assistant – Certified
Alaska Premier Health


Today is the perfect day to begin your journey to becoming more active

Allen Chapman, PA-C

believe-in-possibilitiesDon’t focus on obstacles. When contemplating becoming more active we often think of reasons that we couldn’t possibly start today. I’ll start when the kids are out of school. I’ll start when soccer season is over. I’ll get more active when I finish my project at work. I’m just too busy to fit it in right now. My knees hurt so I can’t run. When we focus on the obstacles in our life, they can become all that we see.

Do focus on possibilities. When we commit to becoming more active we are able to see the possibilities in front of us. Take the kids on a bike ride after school. Walk laps around the soccer field during practice. Use a pedometer or activity monitor such as a Fitbit and set reasonable step goals to accomplish during the day. Swim, walk in the pool, bike or use the elliptical trainer instead of running.

Start now. Get started today, not tomorrow, Monday or the first of the month. Assert your control over the minutes, hours and days of your life. There will always be reasons to postpone, delay or wait. Choose to do what you can with what you have when you have it. If you wait for the day when you have no obstacles in your life you will never start. Carpe Diem, seize the day, it is already yours.

Maintain momentum. Once we start our new exercise routine continue to do something regularly. If you usually exercise outside, but it’s raining, do floor exercises, exercise to a video, or dance to your favorite band instead. Continue to do something regularly to maintain your routine. Any something is better than nothing plus good intentions. Never default to doing nothing. What you do matters much less than doing some something regularly.

Today is the perfect day.

H. Allen Chapman, PA-C
Physician Assistant – Certified
Alaska Premier Health


Staying motivated

Allen Chapman, PA-C

Depositphotos_48761663_m-1024x654.jpgAvoid frustration. Frustration’s favorite food is hope. Focus on the signs of progress. If you don’t lose weight this week, remember the progress you’ve made so far. Try to remain hopeful by focusing on those things you can do to improve yourself. Assert your control over those things and let the rest go. Clarify in your own mind why losing weight and getting in shape is important to you.

Stay focused on the reward. Instead of thinking about what you’re giving up, think about what you’re achieving for yourself. Envision the future you, what do you like about yourself? What kind of life will you live? Whenever you’re feeling tempted, just remember why you’re doing this. You are a capable person who can reclaim control over your life, choose to view yourself that way.

Keep your eyes on your goal. We all experience the world from our own perspective and through the lens of our self-image. Remember how far you’ve come on your journey. Partner with a supportive friend or find a coach to help you through the process. A coach can help you hold yourself accountable. Increased accountability will make you more consistent on your plan. Keep your perspective focused on the goal, and maintain a positive self-image.

Don’t expect perfection. Don’t expect that you will be perfectly compliant with your plan all of the time. You just need to be good enough, often enough, to make steady progress. Steady progress following the first few weeks of brisk weight loss is typical of patients who end up losing a lot of weight. The enemy of good enough is better. Don’t expect perfection, it will destroy your motivation when it turns out you’re merely human. Be consistent with your plan and be patient with yourself; you can do this.

H. Allen Chapman, PA-C
Physician Assistant – Certified
Alaska Premier Health


Measuring progress

Allen Chapman, PA-C

trees-progress.jpgHow do I know I’m making progress?

There are many ways to measure your progress. The easiest is weighing weekly, which is also important in maintenance. Your progress may also be gauged with waist measurement and body composition testing. After a few pounds of weight loss your clothes will begin to fit better. People with chronic illnesses such as high blood pressure or diabetes will likely experience improvement in their numbers after a loss of as little as 5% from their starting weight.

How about physical fitness? The first thing most people notice is improved energy. You will likely find it easier to manage your activities of daily living. Your resting heart rate and exercise tolerance will also improve over time. You won’t see improvement in every measure every week, but you should see progress somewhere if you’re paying attention.

What should I do to make steady progress? Have a plan for controlling your calorie intake and increasing your activity. Stick to your plan as best you can, and be prepared to modify your plan as the weeks pass. With regard to your weight, you only control what you eat and what you do. Many factors influence your weight; most are outside of your control. It is not useful to expend time or energy on the factors you can’t change; this will drain your motivation to address the things you can change.

Keeping track of your progress will help you stay motivated. There are many phone apps which you can use to track your data. You could simply keep a journal on paper. Taking a full body selfie at the beginning of your journey, and then periodically as you make progress can make it easier to actually see how far you’ve come. Tracking progress visually and with hard data is a hallmark of obesity medicine and helps patients appreciate the progress that they’ve already made. Keep your eyes on the prize.

H. Allen Chapman, PA-C
Physician Assistant – Certified
Alaska Premier Health


Dieting to lose weight

Allen Chapman, PA-C

calorie-counting-vs-clean-eating1.jpgReduce your calorie intake.
As I mentioned in an earlier post, it is essential to reduce calorie intake in order to lose weight. Regular exercise can boost the pace of weight loss a little, not a lot. Yes, you can out eat any exercise habit. Find a structured diet approach that you’re comfortable with and go for it.

Be as consistent with your diet as you are able to be.
The degree of calorie restriction and consistency on your plan are the primary drivers for weight loss. To steadily lose weight you must consistently reduce calorie intake below maintenance calories for your current weight. The first three months usually produces the fastest weight loss. Typically people make the majority of their total progress within the first six months of their weight loss plan.

Someone has to count.
One successful approach to losing weight is calorie counting. The single most important thing to consistently do to succeed as a calorie counter is to actually count calories. Watching what you eat is not calorie counting, it’s wishful thinking. Journal your food intake throughout the day, accurately estimate serving sizes, and use a reference of some sort to estimate your calories. This is counting calories.

Use single-serving foods.
If you don’t want to bother with counting calories for yourself, you could follow a pattern diet using single-serving foods instead. Diet plans using prepackaged, single serving products tend to produce more consistent day to day calorie intake. That consistency produces a faster pace of weight loss for most folks. Approaches which use this strategy usually produce more weight loss during the first few months, which frequently translates into a lower ending weight.

Let someone guide you.
Having an obesity specialist, coach or mentor to guide you through this process can help you to reach your goals. Maintaining your weight loss momentum during those crucial first few months is likely to increase your total weight loss. A coach can also help you to gradually transition from your initial weight loss diet into a maintenance diet for your new weight.

H. Allen Chapman, PA-C
Physician Assistant – Certified
Alaska Premier Health


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