Dr James Schaller
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Keeping Your Waist Line Under Control So You Do Not Die: Some Hope from an Ice Cream and Chocolate Worshipper


First, I am not going to say you are a loser for not beating up your joints an hour a day four times per week. And I am not going to say "diet." My understanding is 95-99% of those who only do these things do not have five-year success.

Some patients have asked me to learn about obesity. Here are some initial ideas.

While I am taking multiple seminars on obesity treatment, I do not claim to be an expert on anything. For legal reasons assume everything I say is not FDA approved. Assume all these comments are not the "standard of medical care." (Just a couple quips for the ambulance chasing plaintiff attorneys with their $65,000 cars "serving" by taking 35% of the "lottery.")

Some Important Basics

  1. Ever notice 40 and 50 year old people tend to be heavy as compared to 25-30 year olds? Therefore, part of the problem is changing metabolism. We'll discuss later.
  2. The American melting pot has crudely 1/2 of adults in the overweight range. We have genetics from all over the world. In our ancestral countries, our genetic peers are not as overweight. The problem is more than pure genetics.
  3. Why is this worth reading? If you are a male with a waist of 40 inches (or an 18 neck) or a female with a 34-1/2 inch waist, you are in big trouble. But research shows very modest weight decreases have very large benefits. By the way, when I use a tape measure, I get much bigger numbers than from clothing sizes. Sorry.
  4. Excess weight increases risk of diabetes by thousands of percent, increases breast cancer and other major cancers and increases heartattacks. Many people do not care about this because of the "diet and exercise" models for weight loss, which makes them feel hopeless. You have a great deal of company.
  5. Let me offer some functional mild and easy adjustments, which may help you with weight loss.
    1. Consider using low dose Glucophage to decrease abdominal fat, proper insulin use and to decrease cravings. Glucophage is a pill used for diabetics for the last twenty years and has also been used in teenagers. If interested, we can discuss this as an option. We will need 45 minutes to discuss. Please note that this is an "off-label" use of Glucophage. Meaning, the FDA and the original company have not done studies on the use of Glucophage and obesity. Since it is off patent with generics, I doubt anyone will be paying for such research, since most research in and out of government in medicine is pharmaceutical company money. By the way, I once spent an hour with a nurse going into great detail on the use of Glucophage -- she was 35 pounds overweight. She decided that she would do her own "research," which is a good idea. However, she "discovered" what I had already told her. Specifically, that "Glucophage is a diabetes drug." She was stunned and asked me: "what am I doing on a diabetes drug! My family doctor is concerned." Needless to say, I was confused her doctor had not been concerned with her dangerous excess weight for five years and had not seen some material by select endocrinologists and family doctors on the use of Glucophage to decrease weight. Why am I telling you this story? Simply, if you only want FDA approved drugs used in FDA approved ways; let me find you a conservative traditional physician.
    2. Do you understand you can change how calories are stored? Based on some simple principles you may be able to store less calories of fat.
      1. First, let me define a buzzword--"the glycemic index." It is how long a food takes to become glucose -- the key sugar for energy. Here is the problem, some foods hit the body with a sugar explosion and these sugars are converted to fat in six minutes. Other foods slowly release glucose and are helpful.
      2. Never starve yourself. If you do not eat roughly every four hours, you will tell insulin, "we are in Ethiopia and you will need to store my next meal as fat."
      3. Samples of the glycemic index
        1. White sugar = 100 (the starting point)
        2. All fruit (except bananas) = 40 (since fructose based and this is a slow releasing sugar). So enjoy fruit to your hearts content, but leave most of the bananas to the monkeys.
        3. Corn Syrup = 130! A disaster. Just glue fat to your belly if you eat this poison.
      4. All vegetables that grow above the ground are good. Cut back on carrots and potatoes since they grow below the ground. A potato equals a brownie. (At least cut down or eat later in your meal after the body has been given slow sugar releasing foods first).
      5. Grains need a special comment. Have you ever noticed that a tiny seed can become a three-inch plant -- there is obviously a great deal of energy in those seeds. Here is the problem: flours are the ground up super carbohydrates found in seeds. Consider them as huge clusters of glucose. The problem is that the enzyme in saliva, amylase, makes these clusters of glucose blow apart and dissolve -- like 52 card pick-up. Then all this glucose explodes into the blood and makes fat. If you have a choice between eggs and cheese with some fruit or French Toast for breakfast, go with the former. If you must eat pasta do not fully cook it till it is soft and mushy -- I believe Italians leave it slightly hard. You can pretend you are in Italy on vacation. Harder pasta becomes sugar slower. If you want grains, try to make them as natural and whole as possible -- natural forms have coatings that slow absorption.
  6. If you want to exercise, do not abuse your joints. Unless of course you want to date an orthopedist.
    1. You must love the exercise, the company or something about it, or you will not do it a year later!
    2. If you are working 28 hours a day, you will struggle to do it, because excess work will burn out your engine's "fifth gear." Then you will want to reward or replenish your burn out with a nurture binge-certainly not exercise.
    3. Muscle burns up calories like a furnace. Careful and balanced weight training is the best exercise to build fat burning muscle. Get some tutoring by a trainer or a physical therapist so you do not abuse your joints. And do not pound the same muscle groups day after day or you will break down muscle.
  1. Consider having your hormones checked by a non-Urologist or non-Gynecologist physician, specifically a physician who specializes in age related hormone declines. The physician must be very familiar with non-drug company bio-identical hormone options. Urologists and Gynecologists are honorable specialists and surgeons, who need to know hundreds of surgeries and diagnoses. However, like most physicians, the current data they are taught is controlled by drug company reps. and drug company sponsored journal articles. (According to the Journal of the American Medical Association and the New England Journal of Medicine.)
    1. Sample hormones to check: Progesterone in the 12 days before your period if still cycling (otherwise anytime). Free Testosterone, Free T3/Free T4 (free equals unbound), thyroid antibodies(up to 5 can be checked), Free and Total PSA (men), Estradiol (both men and women), LH and FSH and DHEA-S and a Chromium level (4/5 people have none and it is an essential nutrient used by insulin)
  1. While you are getting labs, get ones recommended by the leading medical journals and the American Bariatric Society.

       *C-reactive protein (highest sensitivity)
       *Not merely a simple 1980's cholesterol level - but lethal sub-components:

          i. Lipoprotein (a)
          ii. Apo A-l
          iii. Apo B
  1. Over weight diabetics have excess insulin production because they are trying to force sugar into cells that have narrowing insulin "doors." They have excess insulin in the early stages on their disease. Therefore, consider also getting a fasting insulin blood level.
  2. Treat any mild anxiety or depression disorder, or you will eat to nurture and sooth yourself. If you are mad at your spouse or have had past traumas you are not healed from, you may use food as a barrier or as a soother. Get a consult for your mental healing.
  3. Many hard workers eat their biggest meal at dinner. This is a very hard habit to examine, let alone change. Glucophage just before you eat dinner will cut down your appetite. The dose has to be tailored exactly to you, and one dose does not optimally fit all. Another option is to make a direct effort not to be frenzied in the early morning. Meaning, the alarm goes off and you are in a panic till you are at work or the kids are off. Instead, get up 12 hour earlier for five days and eat a huge breakfast. At dinner, if your hormones and other issues are corrected, you may eat less.
  4. If you have nutritional deficiencies - the norm in our research, have me check special research essential mineral levels. Samples include:
    • Intracellular RBC Zinc--it is involved in 300 key reactions (Nutrition Journal)
    • Intracellular RBC Selenium - prevents 4 common cancers
    • Intracellular RBC Magnesium--decreases spasms, headaches, menstrual cramps and brain vulnerability. Important for 300 enzymes. The best test may be to do a scrape of the underside of the tongue to measure true Mg levels inside the cells of the body. Some also suggest a challenge test.
    • Intracellular RBC Calcium -- excess calcium displaces magnesium inside cells.
    • Chromium level - 4/5ths of people have "non-detectible" levels. Chromium is necessary for insulin to function normally.

    *Why intracellular levels? The body will pull nutrients out of key organs and cells to keep blood levels normal. Blood is usually the last place to show a shortage.

    If you are afraid of needles to check your labs, there are quality urine tests (and one College of Pathology Certified hair test company to use which is a possible option to give you a crude general sense of your status).

  5. Some people take antibiotics with no replacement of the "good bacteria" or probiotics essential for the proper working of the complex 30 feet of intestines. Veterinarians give dogs probiotics when giving them an antibiotic! European physicians also often give probiotics when prescribing antibiotics. I also suspect that chlorinated water also sterilizes the gut just as it sterilizes pool water or drinking water (Chlorine was previously a war agent).

    What happens if I do not use a probiotic when taking antibiotics? What often happens is small amounts of bacteria and fungi, which are normal and common, explode to large unnatural amounts that coat the intestinal wall and decrease absorption, detoxification of cancer substances and nutrient production. I have large collections of blood mineral levels and highly complex stool tests - far more complex than typically done in medicine. Most hospital stool tests are very elementary and only test for parasites and possibly fatal bacteria called C.Diff.. Most hard working and sincere physicians are not aware of advanced research nutritional journals discussing critical probiotic issues and the importance of having the right good bacteria adhering to the gut lining. I just found a nutritionist on the Internet that implied this testing was "quackery." It was unfortunate she had obviously not read any mainstream academic research on probiotics recently.

    Some GI doctors mock advanced stool cultures saying: "Those eccentric bacteria and candida are commonly there in the gut." True. But they are not supposed to be present in massive amounts, as the primary bugs, and not in the absence of good bacteria. Most sincere hard working GI doctors also do not test for essential nutrients so they do not see the lack of them in the body as we have done in our research.

    Why does this relate to weight? Low nutritional absorption of good nutrients may increase appetite and cravings.

James L. Schaller, M.D.
Chester County Research Center

Bank Towers, Tamiami Trail, Naples, FL
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