Medically Supervised Weight Loss

Why does body weight matter?

The reason to maintain a healthy body weight is your wellbeing and longevity. You want to be here for those you love for as long as possible, with a high quality of life. Body shame doesn’t, and shouldn’t have anything to do with how much a person weighs.

What is a healthy weight increases with age. A middle aged person desiring to look like a 20 year old in top athletic condition is unrealistic and unnecessary. Such a desire is more likely to lead to an unhealthy body image, risky behaviors, and even dangerously poor health.

Excess body weight can present an increased risk for diabetes, vascular disease and degenerative joint disease. Excess body weight can contribute to eventually needing knee and hip joint replacements in order to restore pain free mobility.

Body Mass Index (BMI)

BMI is a useful tool to raise the question of whether or not a person is at a healthy weight, it does not provide the answer. The question of excess weight for those who are between overweight and obese on the BMI scale is answered by body composition. Where is that excess weight located? What body tissues are causing that increased number? More fat is a problem, more muscles is not.

Once the weight question grows to a BMI that is always obese, morbidly obese and beyond, and you are not a world champion heavy weight body builder — there is the simple fact of gravity pulling down on all that excess weight. There are inherent maximum strength limits of bones and connective tissues to resist the force of gravity pulling on excess body mass. In this range of excess weight, mechanical loss of joints joins the dramatically increased risks for diabetes and vascular disease.

Between normal and overweight BMI there is a wide range of healthy space. Body composition again being the main determinant of the question of whether that weight is healthy or not, but not the verdict.

The risks of excess visceral fat

Adipose tissue that is located beneath the abdominal wall and around the internal organs that causes the belly to protrude is the excess body fat with metabolic health concerns. Fat found here is called “visceral” fat. The fat under your skin that you can grab with your hands is called “subcutaneous” fat. Beyond concerns of how you look, there is little metabolic danger from subcutaneous fat. Some extra subcutaneous fat might even be a healthy feature as we age, since it is primarily a store of energy to sustain us should we become too ill to eat for a time.

The risks of visceral fat are complicated. When fat under the abdomen expands, it becomes an out of control hormone factory that sabotages many normal, healthful functions. For men and women both, there are similar processes with negative effects in the body. For men this abdominal fat lowers testosterone levels and raises estrogen levels. In women the same process can contribute to an unhealthy and risky estrogen dominance.

For all genders there is a significant increase in the risk of developing type II diabetes through insulin resistance, vascular and joint disease through pro-inflammatory processes [1].

Everyone’s weight management plan

The longest phase of every weight management plan is the rest of your life.

Healthy eating is based on real foods that support your whole body health. Not eating foods that rapidly digest into high blood sugars. Not eating foods that are addictive, ones that increase very real cravings to eat far more than is needed for the body to sustain and fuel your activities. A healthy diet in a person with a healthy microbiome is extremely enjoyable to eat, and naturally self-limits calorie intake, because the mechanisms for experiencing satisfaction and satiety are working and supported.

Weight loss plans

There are a wide range of weight loss tools starting with will power and ending with life-risking bariatric surgery. In between there are many possible plans from calorie counting, intermittent fasting, GLP-1 agonists and the most aggressive plan provided by Dr. Clark, the Hcg diet, explained below.

How Much Will Power?

The more willpower you feel you need and feel you are lacking for weight management, the stronger the need to reset the microbiome living inside your gastrointestinal (GI) tract. Dr. Clark calls the treatment to perform this reset a “GI ecology cleanse”, a treatment that only takes two weeks to complete. Weight loss plans supervised by Dr. Clark most often start with this treatment.

When the GI microbiome is reset, the craving for food and the amount of hunger experienced reduce significantly. To eat or not eat a food should be a simple decision. Never an internal struggle requiring super human willpower.

GLP-1 Agonists for Weight Loss

Dr. Clark prescribes both semaglutide and terzepatide. These are a class of drugs derived from naturally occurring human digestive hormones. These human hormones are called “incretins.” GLP-1 is short hand for “glucagon-like peptide-1.” Both of these drugs are GLP-1 “agonists”, meaning they interact with body receptors in the same way as the natural hormone.

Semaglutide, Ozempic for diabetes and Wegovy for weight loss are only available as a patent drug with monthly costs of $1000+ in weight loss doses. Most Oregon health plans will not cover this medication even when FDA conditions are met. Indeed, doctors who work for the big healthcare systems are also not allowed to prescribe this medication or tirzepatide. This particular GLP-1 agonist at weight loss doses is often associated with undesirable digestive system effects and discomfort.

Tirzepatide, Monjauro for diabetes, Zepbound for weight loss is a multi drug with both a GLP-1 agonist and GIP (glucose-dependent insulinotropic polypeptide) included. Tirzepatide is currently available as a compounded medication which makes individualized dosing available. Using the lowest individualized drug dose that is comfortable, and produces weight loss, both saves significant money per month and reduces concerns for long term negative effects. A compounded tirzepatide weight loss program can cost as little as $280/month without insurance coverage.

HCG Diet — a Serious Weight Loss Plan

Dr. Clark’s experience supervising the HCG diet reveals that women can reliably lose 1-4lbs of excess body fat per week over an 8 week dieting period. The typical loss is around 2.5lbs per week or 20lbs over the 8 weeks. Men lose more weight under the same plan with 2.5-7lbs of weight loss per week possible. The typical loss for a male is 30+ pounds over 8 weeks.

There is an underlying bio-physiological effect from small daily doses of the Human Chorionic Gonadotropin (HCG) hormone stimulating human adipose (fat) cells to produce significant amounts of leptin, a satiety hormone [1]. The full set of mechanisms of action of HCG on adipose cells has not been fully examined by basic scientific research. Leptin release is a meaningful clue to understanding the signaling mechanisms. Leptin is a hormone that signals a satisfied appetite in those who are not leptin resistant. Leptin resistance is reduced by the “GI ecology cleanse” treatment described above.

Early pregnancy, which the Hcg hormone in the HCG diet mimics, normally causes weight gain to support the energy needs of pregnancy. Taking Hcg hormone along with a normal calorie intake would be expected to cause fat increase. What Dr. Simeon observed way back, and why this dieting strategy persists, is that pregnant mothers suffering starvation didn’t suffer hunger the same way as non-pregnant women. While birthing normal weight babies at the expense of their own shrinking body mass.

Hcg hormone stimulates increased testosterone production in men, and has no known “gender bending” effects on sexual identity or gender expression.

While we don’t have all the final details completely mapped to the satisfaction of all scientists and various naysayers — the simple clinical truth is the Hcg hormone is a useful tool in a managed weight loss plan. Clinical observation is that those taking the hormone while pursuing a properly designed and supervised diet plan rapidly lose significant body weight while experiencing minimum sensations of hunger and distress. Maintaining abundant energy for non strenuous activities of daily life.

HCG Diet Risks and Why You Need Medical Supervision

These are the primary concerns for harm with an improperly designed and/or unsupervised Hcg diet.

1. Starvation delirium and dehydration. In the context of the Hcg diet profound fatigue and symptoms of delirium have been reported. This is prevented by making sure the dieter has appropriate nutritional supplementation as part of the diet design. While aware of this potential, Dr. Clark has so far been able to help his patients avoid this highly undesirable state while achieving significant weight loss. Weekly doctor visits allows for troubleshooting and heading of potential trouble.

2. Gall bladder disease. This is a risk from any “crash” diet scheme, including extended fasting. The digestive process needs to be stimulated daily for the release of cholecystokinin (CCK) [2] which stimulates gallbladder contraction and expulsion of its contents into the small intestine. Without daily gallbladder contractions, cholesterols, which collect in the gallbladder from normal liver function, can precipitate into gallstones. The diet plan supervised by Dr. Clark is designed to stimulate daily CKK and gallbladder emptying to prevent gallstone formation.

3. Constipation. Because of the caloric restriction associated with a properly designed HCG diet, a slowing of bowel habit is expected. One small stool every day or one medium to normal size one every other day are normal following Dr. Clark’s diet plan. If the time between bowel movements increases to more than every other day, then constipation needs to be treated proactively and not allowed to persist beyond two days.

4. Loss of muscle mass. The HCG diet is controlled starvation. Properly designed and followed, normal metabolism is preserved with the dieter’s caloric needs being met from the energy stores found in their fat cells. As long as there is excess body fat, fat metabolism can keep a person alive for a very long time while preserving muscle mass. Body fat however is a poor source of quick energy. Activities of daily living like walking can be continued under calorie restricted fat metabolism. Anything vigorous or quickly energy taxing will force the body to find a quick acting energy source. In the case of the HCG diet after a week of calorie restriction, the only available quick energy source is body structures made of protein. While a properly constructed diet plan will provide enough protein to support normal metabolism and hormone function, it is not enough to be used as an energy source, nor to rebuild muscles broken down by heavy exercise.

   Muscle toning is important to the goals of losing weight and maintaining weight. Toned muscles have a higher metabolic rate than untoned muscles 24 hours a day whether resting or actively exercising. The time for muscle toning exercise is before and after, but NEVER during an HCG diet.

5. Uneven hunger sensations. For the HCG diet to work with the dieter experiencing the least amount of hunger sensations, it is important for there to be very regular patterns of daily habits. Good sleep, regular bedtime and waking times should be within an hour of the same time everyday. Likewise it is extremely important to take in the planned eating within an hour of the same times each day. Travel, holidays and important social events such as family weddings should not be planned during an HCG diet. The time period set aside to pursue the diet should avoid these variations in a person’s normal routine — in order to have the best experience and outcome. Work, school, and home activities can all be conducted as normal while on the diet.

6. Miscellaneous problems. Every so often a patient will find themselves retaining water or suffering adrenal maladaptation symptoms during the weight loss period. Treatments for these symptoms need to be added as soon as noticed to ensure the continued ability to function in normal life while maximizing weight loss results during the dieting period.