“When I heard you had a cancellation, I rearranged my schedule so I could come in today.” Wendy was obviously excited about seeing me. “Thank you for fitting me in.”
“I spend over 80 minutes with each new patient, so I have to limit the number of new patients I see each week; otherwise, there wouldn’t be any time to take care of my established patients.”
“Dr. Woliner, I understand completely. I just want to get better.”
“Tell me more.”
“Ever since high school, I’ve been on one diet or another. Up until the last five years or so, I was always able to drop 20-30 pounds no problem .”
“But I’d always gain it back, and now, even when I starve myself, I can’t lose an ounce!”
“Yo-yo dieting messes up your metabolism. 65% of the weight lost is just water and muscle . Not only do crash dieters lose their hair, get gallstones, and gain their weight back within a year, they increase their cortisol levels so much that makes it hard to ever lose weight again .” I continued, “So what diets have you done?”
“What haven’t I done, you mean! Weight Watchers and Jenny Craig, of course. Diet clinics prescribed appetite suppressants, laxatives and diuretics . I even did over a dozen of the fad diets that are touted in Women’s World Weekly. Sprinkling Sensa on my food, hCG shots, and diet cookies you buy from the kiosk at the mall. I hate to admit it, but I’m one of the ones that fell for that Kimkins scam.”
“Heidi Diaz, a.k.a. Kimberly Drake, had a lot of people fooled with her “after pictures” which were lifted of off ‘Russian Bride’ websites . The trick all these diets use is that starvation itself causes a lack of appetite . ‘SNATT’ is what they call it. Slightly Nauseous All The Time.”
“Nausea was only part of my troubles. At 37, my periods stopped early, and my GYN is convinced that all these fad diets had something to do with it. My heart even started skipping a beat – my doc said ‘QT-something …”
“Prolonged QT interval. That’s serious; some people have died from that . Ironically, the most dangerous time is when you start eating again after prolonged dieting.”
“Dr. Woliner, I’m through with all those pill-mill diet clinics. So many of them wouldn’t let me use my drug plan, instead, they forced me to buy overpriced drugs right from their office. I’m coming here because I know how important it is to see a board-certified doctor, one that still goes to the hospital in case I need you.”
I finished my exam. “In addition to measuring your metabolic rate, I also want to send a note to your primary care physician, to coordinate care.”
Wendy’s metabolic rate was “minus 16%”, indicative of a slow metabolism . Blood tests confirmed CENTRAL HYPOTHYROIDISM (suppressed TSH) INSULIN RESISTANCE (elevated HOMA-IR), and ADRENAL FATIGUE (high cortisol) . I then prescribed a comprehensive plan of behavior changes, diet modification, exercise, supplements, and even some medications . Three months later, she came back to check her progress.
“Dr. Woliner, I’m no longer shedding hair in the shower, but better yet, the scale is starting to move. Just this last month, I lost another six pounds!”
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