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Making sense of weight loss methods, surgeries and more

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If you’re struggling to achieve a healthy weight by the diet and exercise method, but have been unsuccessful, where should you turn? These days there is no shortage of advice available…

But not everyone offering you information on how to finally lose weight has your best interest in mind. To some, you’re just another deposit at the bank. You deserve safe, sensible and reasonable guidance. And the best way to start is by examining your options…

Extreme measures

Being overweight can be the cause of great unhappiness, but for people who are very overweight — or obese — it can also cause physical disability.

Two out of every 3 adults in the U.S. are overweight — it is this country’s most prevalent disease and leads to many more. Weight can increases your risk of type 2 diabetes, high blood pressure, sleep apnea, arthritis, depression, back pain, and more.

In these circumstances, an initial consultation is a good time to consider surgery or a non-surgical body “contouring” device to shrink fat pockets. But you need to fully understand what you could be facing…

Bariatric surgery

If you believe you may be a potential candidate of bariatric surgery — someone who is obese and suffers from type 2 diabetes, hypertension, high cholesterol levels and sleep apnea, it’s important to know the risks and benefits and be prepared for the lifestyle changes that will be required following surgeon.

There are now several different gastric bypass procedures available to reduce your stomach size so you feel full quickly and don’t eat so much. This also changes the way food gets digested and reduces food calorie absorption.

The common weight loss surgical procedures are roux-en-y gastric bypass ($25,000 to $35,000+), laparoscopic adjustable gastric banding (Lap-band); sleeve gastrectomy (my recommendation — $9,500 to $24,000); and duodenal switch with biliopancreatic diversion (each $17,000 to $25,000). These prices include surgeon, anesthesia, operating room, lab/X-ray, and follow-up appointment fees.

It’s helpful to talk to someone who has chosen this weight loss route. If that’s not possible,


Many people are quick to jump on the liposuction bandwagon… Until they realize the pain and cost. Nobody wants that. Surgery liposuction surgery costs $2,500 to $5,000 per site (such as love handles), plus the operating room and anesthesia adds another $2,200 or more depending on where you go.

Non-surgical body contouring

Non-surgical body contouring is an alternative to bariatric and liposuction surgery, and helps reduce fat pockets. A big positive for this method is that it is not invasive, has little if any down-time and costs less. But results are much less dramatic.

There are a few different ways you can have it done, including extracorporeal shock wave therapy; radiofrequency; high intensity focused ultrasound; low level laser/light therapy, intense pulsed light(IPL), and Cryolipolysis (e.g. Zeltiq, coolsculpting). You can read more about these technologies for removing stubborn fat, here. Like with surgery, you will want to read about the adverse effects and risks too.

Effective, slow and relatively inexpensive medical weight loss

Patients who visit me at my office near San Diego are seeking effective and relatively inexpensive weight loss treatments. They don’t want weight loss surgery or liposuction.

Most importantly, they understand that to lose weight — and not rebound within 3-6 months — slow and sure is the most reliable method for permanent weight loss. By “permanent,” I mean to lose weight, and be able to keep it off, without tremendous struggle or starvation dieting.

If you were to visit me, during our initial consultation, we would begin with a thorough medical history to discover the following:

  • Your experience with diets, exercise,
  • Your past medical history. This included your medical conditions and hormone imbalances contributing to weight gain, and any medications, xenobiotics, or any other condition blocking your ability to lose weight.
  • Any previous abnormal lab test results; what lab tests are needed
  • What supplements and/or medications you have used previously and how well they worked
  • How much time you are prepared to devote each day to weight loss, including food preparation and exercise
  • How motivated you are to lose weight
  • What has stopped you from losing weight until now: thoughts, emotions, social factors?

We would discuss key weight loss approaches available today including their benefits and drawbacks. These are:

  • Proper weight loss mind-set (and any contributing emotional factors)
  • Nutrient-rich nutrition: what is it and how to enjoy implementing this into your life
  • Hormone balancing
  • Supplements pills and injections to induce weight loss and cleanse your liver
  • Prescription pills to promote weight loss
  • The hCG weight loss method

Of course, it’s not possible for everyone to visit me in my clinic. But I can offer as much guidance as possible through my posts…

Cleansing is a critical first step

Current medications, as well sneaky chemicals you’re exposed to, may be blocking your ability to lose weight. Any molecule that is unnatural to your body is a candidate to disrupt normal cell-to-cell communication, including delicate communication of hormone molecules to their target tissue cells. Some of the worst include:


  • Antidepressants (e.g. prozac, zoloft, zyprexa, paxil). For example, zyprexa made by Eli Lilly caused 20 pounds or more weight gain in 30% of users after the first year of use according to a study.
  • Antihistamines; lithium (for bipolar disorder);
  • Chemotherapy;
  • Contraceptives and hormone replacement (synthetic estrogen progesterone);
  • Corticosteroids (prednisone) if used longer than 2 months;
  • Diabetes medications: diabeta, diabinese (for diabetes);
  • Prevacid® and Nexium® (for heartburn);
  • Depakote (for seizures)
  • Promethazine (for nausea);
  • NSAIDs (Ibuprofen, for pain relief);
  • and synthetic estrogens or progesterone can cause you to gain weight.

Xenobiotics: These unnatural biologically active chemicals are hormone-mimickers and contribute to abnormal weight gain. That’s because adipose (fat) tissue is a reservoir for inflammatory chemicals. They can be found in pesticides, industrial compounds, cosmetic ingredients, medications and even synthetic hormone medications that are absorbed into your body through foods, plastics, and personal care products. If they are not sufficiently detoxified by your liver or eliminated via your sweat, urine or stool, then they will remain stored in your fat for years. They are then gradually released from adipose cells into your bloodstream and get in the way of proper metabolism and hormone function. An example of this is a faltering thyroid that causes your weight to climb.

First you need to learn how to eliminate your ongoing exposure to xenobiotics from what you ingest or apply to your skin/hair. If possible talk to your doctor about any medication from the lists above, and avoid plastics and personal care products that are problematic.

Then clean residual from your body by eating nutrient-rich, high fiber, mostly raw whole-food nutrition. These foods are naturally high in micronutrients, phytochemicals and fiber, which consistently keep your metabolism running clean and your bowels moving. You can also supplement with green superfood nutrient powders (in your smoothies) and do a whole day of just fresh juicing every 3 months.

Then, what other ways are there to eliminate xenobiotics from your body?  Here are the basic ways to do this:

  • Intestinal cleansing
  • Far infra-red saunas
  • Herbs and supplements to enhance liver detoxification
  • Specific detox formulas available commercially.

I describe these in detail in a previous article.

Additionally, you may consider a bile system cleanse twice yearly, which helps to cleanse your liver waste material (bile). Your liver drains out chemical wastes into the biliary tract. Bile is the fluid that carries it out and dumps into the small intestine to be carried out in your stool. You can find instructions for my favorite half-day protocol for a bile system cleanse in my free e-book, Doctor’s Inside Secrets for Natural Cleansing and Detoxification, just click here to get it, and see page 45.

Balancing hormones also extremely important

Medical conditions, including hormone imbalances, can easily block your ability to lose weight. You may need lab tests done and also symptom questionnaires to determine not just if your levels are low, but if your hormone function is sub-optimal. This is quite a common finding with low thyroid function, and the other hormones cortisol, and the sex hormones. I discussed these in detail in these articles: Stubborn hormones profoundly affect your weight and Wrangling hormones to improve weight, mood, sleep and energy.

If all this seems too much to consider, then maybe you want to look again at surgical and device weight loss methods, but remember, things are not always as easy as they seem. Surgery is a serious undertaking.

Next week, I’ll have some information for you on the best supplement pills and lipotropic injections to induce weight loss and help cleanse your liver.

To getting and staying slim — and feeling good,

Michael Cutler, M.D.

  1. http://skinplicityofcary.com/blogs/skinplicity-of-cary/17013259-the-uglier-side-of-laser-ipl-radiofrequency-fat-slimming-treatments-and-ultherapy
  2. http://www.drmichaelcutler.com/
  3. Adeshina F, Todd EL. Organochlorine compounds in human adipose tissue from north Texas. J Toxicol Environ Health. 1990;29:147-156.
  4. Lim JS, Son HK, Park SK, Jacobs DR Jr, Lee DH. Inverse associations between long-term weight change and serum concentrations of persistent organic pollutants.  Int J Obes (London); 2010 Sep 7.
  5. Roundtree R. The Use of Phytochemicals in the Biotransformation and Elimination of Environmental Toxins. IN Medicines from the Earth 2003: Official Proceedings. Brevard, North Carolina: Gaia Herbal Research Institute; 2003:115-128.
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