So I’m also one of the gastroenterologists here. I specialize in nutrition. So that means I basically see people who suffer from malnutrition. So people with short bowel syndrome who need alternative ways to get nutrients in. And I also do weight management. So I also do some of the procedures that Chris mentioned, but also focus on medical weight loss, which is essentially talking about diet, exercise, and then people who qualify maybe even using medications.
So unhealthy weight loss– you know, I see a lot of people who try these starvation diets. So these different fasts, where people are just drinking water for days on end. And a lot of those diets, it’s really just not sustainable. So I think healthy weight loss is something that is going to have a sustained effect over time. And it is a pattern of eating that someone can actually stick to and continue with, as opposed to something that is going to lead to issues over a certain period of time. So there’s a lot of different very, very low calorie diets out there that for the most part will lead to weight loss.
But you can really only do those for about a month or so. And eventually, most people, all the weight is going to come back. So what we tend to focus on is really a way of eating that people can carry out throughout their entire life, as opposed to just one month or just a couple of months. Because again, like I said, we want the weight loss to be sustainable.
And when people yo-yo like that, it’s not only hard on them physically, but emotionally as well, I would imagine. Yeah. And it’s actually harder to maintain the weight loss when you go up and down. Primarily, every time you go up and down, that’s associated with hormonal changes. And that can impact your long term weight loss overall. So the way I view weight loss, it’s almost like a pyramid. And you have to have the foundation.
Without the foundation, the whole pyramid is going to fall apart. But there will be maybe multiple rungs on the pyramid or rungs on the ladder. So lifestyle modification is really the foundation. But for a lot of people– for most people– studies show that lifestyle modification on its own may not be as effective. And that’s why we provide these adjuncts. And so you have medications. You have bariatric and endoscopic therapy. Then we also have bariatric surgery. And each of them can play an important role, depending on what the individual patient is going through.
But what a lot of these diets have in common, ultimately you’re avoiding ultra-processed foods. So there’s no diet that really tells you to eat a whole bunch of potato chips. Or other ultra-processed foods. And then most of the diets really involve some sort of calorie restriction. So there’s a lot of debate out there in terms of where we should place those calories. Should those calories be mostly protein? Should those calories be less fat or less carbohydrates? But when you look at a lot of different studies, ultimately when people decrease their caloric intake– their calorie intake– people tend to lose weight. And if you add exercise to the mix, you’re even going to lose even more weight. So fundamentally, just eating less and eating more healthier foods that aren’t processed is going to be the foundation to any of these diet programs.
Now, there are some diets out there that are just unsafe. And most of those diets are really where you’re doing like 800 calories or less for extended periods of time, where you’re putting yourself at risk for starvation and also protein loss. So you know, I tend to tell people to be careful with those, and also be careful with things that sound like it’s too miraculous to be true.
So if there’s a diet that says the miracle diet, the miracle diet really does not exist. And if the diets really just focus on supplements, typically a lot of supplements don’t really lead to a lot of weight loss. So case in point, there’s like the HCG diet out there, where people are taking a lot of HCG, which is a hormone associated with pregnancy. You know, that diet has been– it’s out there in the literature. But the diet has been studied, and it’s not as effective as what people claim to be. So ultimately, what I tell people with these diets, you really have to do your research. And a lot of research should include talking to a registered dietitian. Not necessarily a nutritionist. If they are a nutritionist, you really have to find someone who’s certified, as opposed to someone who is online claiming to be a nutritionist. Which that happens.
Overall, coffee is pretty healthy. So there’s a lot of concerns. A lot of times people come in to me and in my clinic and say things like, I stopped coffee, I stop spicy foods. And I’m like, wait a minute, where did all this negative connotation come from when it comes to coffee and spicy foods and stuff like that? Because ultimately, a lot of these foods are healthy. So black coffee by itself has been associated with decreased risk of liver cancer, and maybe even decreased risk of heart disease. Now, when you add a lot of sugar and a lot of cream some of the fancy lattes and everything that have a lot of calories, that can be associated with weight loss. And also, those aren’t very healthy, because it’s again simple sugars. And that’s probably more along the lines of the processed food category.
Vegan diet, yes or no? Yeah. I mean, it depends on your taste preferences and what you’re really into. So if you want to do fruits and vegetables and be a vegan, you can do that in a healthy way. But you really have to be a healthy vegan. So I’ve seen unhealthy vegans where, they’re just eating potato chips, and they’re calling themselves a vegan. And technically, you can be on a potato chip diet and be a vegan. But that is an unhealthy diet. Or you could just eat pasta all day and be a vegan, but you’re not eating fruits and vegetables.
So I remember I was giving a community lecture, and someone came up to me and said they’re a vegan. And I asked them like, oh, what’s your favorite fruits and vegetables? And they said, they hate fruits and vegetables. And I’m like, how can you be a vegan and you hate fruits and vegetables? So that is an example of being an unhealthy began. But vegan as a whole, a lot of studies show that people may live a little bit longer, if you look at some of the Seventh Day Adventist studies. They may potentially have a decreased risk of cancer. So for some people, that is a very viable option. People who are interested in becoming a vegan, you have to be aware of the possibility of B12 deficiency. So that’s something that definitely occurs in the vegan population. But outside of that, you really just have to make sure you’re a healthy, which applies to any diet.
Keto diet, good or bad? It can be good if done appropriately. So a lot of studies show that the keto died for people who have seizures can decrease the risk of seizures. It plays a role in it, especially in people who have epilepsy. It may help out with people who have migraines. And people can lose weight with a ketogenic diet. Now, the ketogenic diet is still a relatively recent phenomenon, so in terms of long term effects, I think we need to do a little bit further studies. In terms of how it affects our gut bacteria, those studies also need to be done and are actively being done. And I think some of our researchers, specifically Jane Chang is looking at some of those, trying to answer some of those questions. But from a weight loss perspective purely, people can lose weight with a ketogenic diet. But at the end of the day, most of these diets are really restricting your calories, and really cutting back on some of these ultra-processed foods.
