at 2440 Louisiana NE Suite 540, Albuquerque, 87110 United States
Compassionate, Competent, Evidence-Based Medical Care for Weight and Obesity
Compassionate, Competent, Evidence-Based Medical Care for Weight and Obesity
786 FB users likes Holland Clinic, set it to 9 position in Likes Rating for Albuquerque, New Mexico in Doctor category
We have slightly changed our hours. We are open Wednesday, 2:00 P.M. to 6:00 P.M., Thursdays and Fridays, 10:00 AM-5:00 P.M. and Saturdays, 10:00 A.M. through 3:00 P.M.
Very sorry for the long delay between facebook posts. We ARE alive...
Holland Clinic will soon be offering a line of all new supplements to help boost a healthier you! More information to come.
Update: Hour Change This will be the last Friday we are open from 7am to 2pm. Starting August 30th we will be changing are Friday hours to 10am until 5pm.
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Compassion We are all just people. Some of us get sick with illnesses that bring great sympathy from others. Some of us get sick with obesity and perversely, often draw the criticism of others. Why are the obese objects of derision while a person suffering from, say, cancer is usually not? I think it has to do with the illusion (because it's not a reality) that the obese person could have prevented it while the cancer patient could not have. In truth, both conditions are diseases caused by factors over which the patient has no control. Now whenever I say this sort of thing, somebody (usually a thin person) flies into a fit and declaims that the obese person simply needed to eat less and the condition could have been avoided. And of course, in the strictest sense, that is true. Calorie restriction over a long period of time produces weight loss. So what's the problem? Well the problem is hunger. Bah! says the thin person. "It just takes willpower. Look at me!" To whit my response is generally "Oh yeah? Tell you what. Instead of proving your strength of will by merely maintaining your current weight, man-up and lose twenty pounds." "But I don't need to." comes the rejoinder. "I know. But do it anyone. Let's see your willpower at work." Is my response. Sometimes the challenge is accepted. And when it is...guess what happens... Not very much. Because the truth is that every human body has a "set-point" where the "thermostat" is dialed-in. For some people the set-point is 450 pounds and for some people it's 135 pounds. BUT--and this is crucial-- it's just as hard to lower weight below a set-point of 450 pounds as it is to drop below 135. The difference is that the person whose set-point is 135 often believes that he somehow "earned" it. He didn't. He has no more "willpower" than anyone else. He just thinks that he does and he stands in judgement of others. That is UNTIL he tries to lose weight and fails. The truth is that body weight is REGULATED by the body and it is regulated by hormones and neurochemicals that control SURVIVAL urges. And to offer a clue here, survival urges are POWERFUL (think breathing, thirst and, you got it, HUNGER). The truth is that dropping below the "set point" makes you feel like you are going to starve TO DEATH. THAT is why weight loss is so unbelievably hard and why the judgemental thin person is SO obnoxious. Anyway there are few points here. First, try to ignore the judgmentally thin. They are ignorant. Second, you can only lose weight by CHANGING the set-point, not by fighting it. Third, it is NOT your fault. NOT. That doesn't mean it's hopeless, it just means you have to fight battles that others do not. Or to put it more simply: until you have walked in someone else's shoes, refrain from judging lest ye, in turn, be judged.
Why do Some People Battle Weight and Others do Not? Why do some people eat whatever they want and never gain weight? Why do other people always monitor their diet and still struggle? The answers aren't well understood but have to do with what you might expect: genetics, metabolism and brain chemistry at least. In other words, it's not fair. Not remotely. And it's certainly not about laziness or sloth. Not to say that it's hopeless. It's not. But overweight people have to fight battles that others never will. The battles can be won but the war lasts a long time. Still, I see people do it every day.
So what are the "Tricks" that can help you eat less and burn more without getting more hungry? First of all, these are all based in the modern science, and aren't simply opinions of mine. But here goes: Eat breakfast Eat at least two meals per day Consume probiotics like yogurt daily Consume pre-biotics like "inulin" daily Reduce omega-6 and saturated fats to less than 20 grams daily Increase omega-3 fats Increase total fiver to 20 grams daily Avoid high-glycemic foods UNLESS they are mixed in with lots of fiber and/or protein. Avoid fructose (table sugar, high fructose corn syrup and fruit juices) Increase high quality protein intake (unless you have kidney disease) Eat pre-emptively (BEFORE you get hungry) Eat on schedule even if you aren't hungry Of course the devil is in the details and there is a lot more I could say about all this. That's why I spend 90 minutes with patients at their first visit. This is complicated stuff but it DOES help.
Is there a perfect weight loss diet? No. But there are a whole lot of really bad ones. In choosing a diet to help you lose weight, choose on the basis of the following: Is it healthy? Beware diets too low in protein. We need at least 50 grams of high quality protein daily and some diets don't provide this. Be especially careful of so-called "juice diets" and very low calorie diets. Can you actually live with it forever? This is a big one. If you CAN'T, what on Earth ARE you going to do to keep the weight off? It doesn't work to "figure it out later". You need a ration long-term plan. Does it actually work? One way or another, to be effective, a weight loss diet has to alter "energy balance". The problem is that just eating less makes you hungry and that won't work in the long run. Instead you need a diet that actually makes you less hungry. That's where the "tricks" come into play. I'll talk more about those tricks in a later post.
Do you want to lose weight or do you want to be thinner? There IS a difference. Losing weight is an achievable goal attained through careful planning and effort and it can make you thinner. But just wanting the goal without the effort is a pipe dream. If you want to get there, change your life right now. Make a plan that will work in the long-term (read much and resist quick fixes) Make a plan that you can actually live with. Make a plan and write it down. Make a plan. Then follow it. Expect frustration. Do it anyway. Ignore the scale. Ignore others. You're on the right path and as long as your heart is in it, nothing can stop you.
I've also seen marriages that are beacons on a hill for all of us. I've seen men who listen and don't lecture, who support without giving advice, who love through honor and respect and who care enough to try to change when it's right. There is hope for all of us.
23 years of helping people lose weight tends to make you something a of feminist. I admit it. It's not that I think poorly of men but that I see too much of what some of them do to the women they "love". I'll even go so far as to say that for some women weight loss is a liberating act of defiance and sometimes the first step towards a better life. And I take zero credit for any of it. I've just been a witness.
I’ve been doing this too long. I’ve lost touch with how many obesity bigots still roam the Earth. After 23 years of practice in bariatric medicine (medical weight loss), the concept of obesity as a disease is so deeply ingrained in my thoughts that I seldom ever stop to question it. That is until lately. Ever since the American Medical Association bravely decided to officially recognize obesity as a disease, the bigots have been coming out in force. And the bigots are loud mouths. “It’s laziness” they bellow. “Just reduce your calorie intake and stop whining” they scream on discussion boards. “Nothing wrong with a fat person that a plane crash in the Andes can’t fix” gloats some other jerk. “It’s called ‘personal responsibility’” taunts another. Yeah right. I have said this so many times in so many ways that I could scream but I need to say it again: willpower doesn’t have any role whatsoever in weight loss…NONE…ZERO. Willpower is for football games or investing, not for weight loss. Why? BECAUSE IT DOESN’T WORK! Never has, never will. Couldn’t cannot and won’t. Why? Because hunger is a SURVIVAL URGE. That means it’s just like breathing or thirst. That means that it runs over “willpower” like a steamroller on a worm. Try to tackle hunger head on and it will pound you into dust. Sure people can resist it for a little while. With enough incentive that’s easy. But can you stay hungry the rest of your life? Not unless you’re locked in a cage with no choice. It’s NOT about “willpower”. Obesity is a disease. It’s a thousand, actually perhaps hundreds of thousands of insidious biochemical and neurochemical changes in the body and the brain that increase hunger, decrease appetite and turn a human life into a slow-moving train wreck. It’s horrible, sad, frightening and deadly and it’s a DISEASE as surely as cancer is a disease. And so I say quite sincerely to all the loudmouthed obesity bigots out there: shame on you! SHAME! How dare you presume to blame sick people for their condition! How dare you presume to compare your body to theirs! How dare you even open your big FAT mouths! If you can’t grow-up at least have the common sense to SHUT-UP!