Weight Loss with HCG - New things we discovered along the way.

Weight loss has always been a major concern for me as I remembered a time when I was more than overweight. The best weight I was ever in my life was when I was 18, at the weight of 52, I was as lean as ever. But looking back, at that time my assets were not fully blown and perhaps the best I could be now is perhaps 62 kilos. (I did this once last year and everyone was worried and thought I was sick because I looked too skinny, thank you for your concern, I was just experimenting on best weight).

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If I told people that I was a heavy 89 kilos, most of them would react by saying when? But yes, this was a reality to me in the years 2006 after the delivery of Bella to around circa 2009. I was struggling with weight loss. Until I stumbled across the hcg diet which was introduced to me by one of my sifus. I believed him because the first time I met him he was twice my size (and I was fat then) and now he is smaller than me.  I owe a lot of my knowledge to his mentoring. He could explain to me things that other doctors would not even bother to understand. And I needed to know, not just because I am curious, evidence-based and critical, but also for my patients. The worst thing to be as a doctor is ignorant to all the effects and complications of the treatment that you warrant to your patient.

Well, back to HCG. In the past, we use to just explain the role of the HCG hormone that acts like a catabolic hormone in the absence of insulin. What it means is that, when there is no insulin spike in the body, the HCG at 125-250mg level acts on the fat cells facilitating transport and metabolising fats into energy. This is why it is strictly prohibited to take any form of sugar or carbohydrate during the diet phase 2 and 3a as it would cause the opposite effect. Many can argue that if they go on 500 calories of protein and fibre they definitely will lose weight but how do you explain the fat percentage loss? Starvation leads to protein breakdown and usually the fats are the last ones to go. (We've measured our patient using a complete body scan and in 1 week, she lost 3kg of fat, her protein mass remained the same). 

It sounds simple, but I believe that as patients you require guidance especially in the first attempt and going through maintenance. There is a lot of explaining to do that some clinics do not bother doing, hence you will get a more yo-yo effect on weight loss which in the long run is not good for you as it can cause more harm to your metabolism. We are playing with hormones people.... Make sure your doctor knows what they are doing. It is not a quick weight loss program.

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Along the line, we've learnt a few things. We can use HCG to increase testosterone levels in men who are young and suffers from hypogonadism. It is safer than giving testosterone directly since once you introduce external testosterone, the natural factories will decide to stop production (like 91% based on latest studies done in China). It helps reverse the conversion of testosterone into oestrogen by the aromatase enzyme. The easiest clinical signs are the formation of man boobs and the pot belly hard tummy. So if you are a guy below 60, who is overweight and have gynaecomastia and an increasing pot belly, most likely you have reduced levels of testosterone. Some guys will say, so what? But in the long run it will effect your daily performance (not to mention the performance in bed). I envy my male patients on HCG, as they seem to loose weight faster than us ladies. They kill two birds with 1 stone, lose fat and increase testosterone levels.

I've also realised after being on the program for a few years, the best  is to slowly drop your weight, year by year, and then it would last longer. So usually after new year I would be on the program again, just to lose a few more kilos and maintain it. Since last year, I've succeeded in keeping my weight less than 70kg, and my silhouette has maintained. I've also discovered that muscle building during the second phase of maintenance helps to improve body tone and sustain weight loss results. I took a new liking to pilates, and I find that despite being off for awhile my weight easily jumps back to what it is usually.

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Other things we've discovered also is that the protein intake is super important. If you are a strict vegetarian, forget it. The most you are able to lose is 4kg in 23 days. Some vegans who wanted to try, had to be on egg whites daily that it caused them to be bored. Without the protein, the weight loss was reduced.

Other benefits of the HCG diet as observed is a better glycemic control for diabetics, reduced cravings for sugar and junk food in most people, sustained silhouette despite some weight gain, and change of dietary habits. But the set back is the strict regime during the diet and the maintenance phase. So at the end of the day, it is all about will power and determination. Like I always tell my patients, the diet is a detox sacrifice for 3 months. If you do it well, it may be the first and the last time you ever have to do it. It is a personal choice. If you are willing to commit and want to change, we will be here to help guide you throughout the process.

For more information or to book appointments do contact us at drmmclinic@gmail.com or send a message to +60129660852.

Medical Aesthetics for age groups......

I went to Penang two weeks ago and enjoyed beautiful sun rises and sunsets on the beach, despite some haze but the ambiance was wonderful. The only thing was the lack of internet access in my room which made it less convenient to update my blog. Still, I did get nice writing ideas which I would like to share.

Today's entry is about medical aesthetic procedures for age based groups. It is just a simple suggestion of things you can get done based on your age to improve how you look. As I always tell my patients, it is always better to do something than nothing because by doing something, there will be some change in your end result. I would also include a rough budget of how much the procedures will pinch you just as a guide.

Early 20s (18-25)

Usually at this age group, you will not have much aging issues. However, acne control and skin tone problems are very common because in this age group, you will still have some hormonal imbalance and is more active outside. Acne treatments would include chemical peeling, extractions, hormone pills or even retinoid A to clean up the skin and control sebum production. The usual skincare would range from acidic wash to exfoliators and gel based products to cope with the active sebum productions. You need to treat acne, because if you don't, you may end up with scars. Medically, we do have oral medications to help control sebum and a change of habits is usually advised. Smoking, late nights, low personal hygiene, stress and food selection does influence worsening of acne. Treatment for acne will depend on severity. Usually doctors would charge between RM 200-RM 1000 per treatment depending on what is involved in the treatment. Skin care can range between RM 300-RM 1000 for a full range depending on brand. Some doctors will use IPL or long pulse lasers to reduce sebum production and reduce P. agnes bacteria that is abundant in acne prone skin. To even out skin tone, I normally would recommend regular skin peeling and religious use of sunblock. Laser peels are also an option but if you have acne issues, there is a high chance of acne breakouts post procedure due to heat stress.

Besides acne and skin tone, this would be a good age to fix asymmetry of the face or to augment. The skin is young, hence fillers will sit in better. But because of the young age, I normally would only recommend doing hyaluronic acid fillers (Juvederm, Teosyal, Restylane) which are non permanent because it is easier to change the look when you've decided and because as you age, a lot of your face fat pads disappear so putting a permanent structure there may look awkward after a couple of years. For face shaping, you can slim down your face with a simple injection of botulinum toxin A (Botox/Dysport). You can read more about this in my previous entry on face shaping. (http://faceworksclinic.blogspot.com/2012/03/face-shaping-it-only-takes-5-minutes.html) Filler prices would range between RM 1400 - RM 2000 per syringe depending on type and how long the filler lasts. 

Late 20s- 30s (26-35)

This is usually when a person is most prime in their life. Biologically for most people, the hormones have settled and you start losing the baby face and your face becomes more defined. The early signs of aging start appearing such as wrinkles on your forehead, frown lines, crows feet and some loss of volume especially at the malar area. (cheeks) Pigmentation problems start occurring and the skin texture becomes drier. Botulinum toxin A can help with dynamic wrinkles. Fillers can help with the slight loss of volume and also to define the face to make it more attractive. Regular peeling can help with the skin texture but a definite skin care range change need to be considered. For pigmentation, using hydroquinone will help to reduce the pigmentation substantially but requires constant use. Lasers can help to reduce pigmentation and improve the skin texture but if proper sunblock used religiously is not applied, there is a high recurrence rate and may even worsen the pigmentation. This is also the point where I would normally suggest to add serum vitamin C into the skin regime as a maintenance and preventive program to help with texture and pigments. Supplements and vitamins are also important at this point to keep the skin glowing healthy. 

Another issue would be the body contour change, where most people find that certain areas are not as attractive as before. For this, I would recommend body contouring programs using medical grade radiofrequency machines (http://faceworksclinic.blogspot.com/2012/02/radiofrequency-tightening-rf.html) , or other medical grade body contouring machines to help. For some people, they prefer mesotherapy injections to reduce fats n certain parts but this requires recurrent treatment of specific area and so may add up to be costly. Regular exercise helps, and target specific exercises are more warranted.

Late 30s to 40s (36- 45 years old)

Most people are more stable at this age but due to the aging process, coupled with stress of work and family and other responsibilities can cause you to look older than you really are. For the face, At this age, most people would start complaining of more pronounced wrinkles on the forehead, frown lines and crows feet. There would be a more marked loss of volume in the malar and lower face, especially around the mouth and the folds by the side of the nose looks more prominent. The skin texture is still good, but pigmentation is more seen if nothing has been done before. Sagging of the cheeks is felt, although not extremely obvious and causes a lot of concerns in some people. Fillers and botulinum toxin A are a good investment for non-invasive treatment to treat lines, wrinkles and volume loss. Some would consider lip fillers because the upper lip has started to thin out more and you lose that youthful look. (Check out http://faceworksclinic.blogspot.com/2012/05/sexy-lips-in-15-minutes.html) Regular chemical peeling and face tightening with radiofrequency devices or lasers would help improve overall skin texture and turgor. At this point, you should also consider having a retin-A or derivatives cream supplement to the face to help with fine wrinkles. 

For the body, you can still opt for body contouring and tightening programs but the expectations should be more realistic. There will be improvement although subtle, and you may need to consider options of skin lifts and fat grafts to get a more marked improvement. Weight control can be achieved by modifying the diet and exercise and I do suggest most everybody above 36 with BMI more than 25 to go on HCG diet (http://faceworksclinic.blogspot.com/2012/03/hcg-diet-my-experience.html) to not only lose the excess weight and reduce body fat percentage but also to retrain yourself to a much more healthy diet and lifestyle. If done properly, you will be able to maintain your weight and enjoy a better life. It also helps increase personal health consciousness as only organic and non-processed meats are allowed during the diet.

After 46 (46 to 65 or more)

At this age, the skin texture is more wrinkled and you will need more moisturizers to help maintain suppleness. Laser resurfacing treatments are a good investment as it helps to improve your skin texture and tightens it as well. Radiofrequency device tightening of the face is another method to help improve sagginess. At this point, fillers are used for volumnization, and a lot of fillers would be needed to have a good effect. (At least 3 syringes per sitting usually). Semi permanent fillers (Aquamid) can be considered for structures like lips and cheek. Mesotherapy treatment with PRPs (http://faceworksclinic.blogspot.com/2011_02_01_archive.html) or non-cross link hyaluronic acid fillers (Dermaqueen, Restylane Vital, Juverderm Hydrate, Teosyal Redensity) is also an option to increase hydration of the dermis layer. Skin peeling is still a good way to maintain the skin. Surgical options would be fat graft to the face and face lifts. Vitamin E  and hyaluronic acid topical creams can help maintain hydration as dryness is always a problem. 

After 46, a lot of our natural hormones start to decline. Because of this, we will have vague tired symptoms that we cannot explain. Another thing that you should consider is to undergo anti-aging consultation and the use of bioidentical hormones to help supplement the decline of hormones. The blood test are expensive (a complete test would cost around +/- RM 1000). The hormone supplements are in cream form. Please be sure to go to a proper anti-aging doctor (trained) because not all doctors are trained properly.

This is just a rough guide of procedures you can do at the certain age. However, the current environment pollution, poor diet and nutrition, work stress and health problems can always make you look aged more than you really are. A proper consultation can help give you a good idea of the possible intervention to help make you maintain a healthy and youthful you. But one thing for sure, you need to start taking care of yourself early, to stay younger longer.

Any enquiries please email to info@faceworksclinic.com or call 03-21440080 and book an appointment to see me.

HCG diet - My experience.....

I am definitely a foodster - I love food, I love eating, and experimenting with different tastes. Friends on my Facebook see all sorts of delicious food being posted which definitely makes people drool. Unfortunately, like any other person, I tend to gain weight a lot on my excursions. The price for great food, is it so? So I decided (or was rather forced into) trying out the HCG diet - Personally I call it the anti-social diet because you have problems eating socially. When I first started, a lot of my friends and colleagues said I would quit half way... but hey, its the 26th day and I'm still on it, and I have lost a good 9 kilos which mainly is fat, I'm down at least 2 dress sizes, and my butt looks smaller. Yippee....But honestly, it requires good motivation, high discipline and consistency.

So since everybody is curious about what I have been doing, I'll explain as simply as possible.

1. What is the HCG diet?

The HCG diet was founded by Dr Simeon who discovered that low levels of HCG hormone (the one that goes up in pregnant ladies) has effects on fat metabolism and facilitates fat usage as fuel when the body is in semi-starved state. He came up with a figure, i.e. 125 iu per day and coupled it with 500 calorie diet a day. However, this effect only works when there is no increase of blood sugar level or rather insulin - hence why no form of carbohydrates are allowed. The diet is very strict and you are only allowed to eat the food on the list and that is it. Dr Kevin then made a modified version which enhanced the effect and lead to maintenance.

2. What is the real purpose of the diet?

Although reporting fat loss in grams daily is perhaps the best thing about this diet, the real function of this diet is to retrain our hypothalamus to eat properly. One of the reasons people become fat or obese is because of cravings and lacking of self-control when it comes to food. They eat regardless they are hungry or not and tend to overeat so much. Foods high in sugar, preservatives and other forms of chemicals in food nowadays causes the brain to not be able to register how much food has entered the system hence the person just keeps on eating. When you abstain from carbohydrates, junk food and fastfood, the brains receptors in the hypothalamus will resensitize again, so that you do not have much cravings. That is why, once you complete the 25 days of 500 calories diet, you have another month to slowly introduce more food with simple refine carbohydrates being last and complete ban on fast food or junk food. If you don't do this, that is why you see people on this diet acting like yoyo's and at the end, think it is just a short term treatment.

3. Is this diet safe?

According to all studies and reports, it is the safest diet in the world. However, because we prescribe hormones, you MUST be under a doctor's follow-up. It is not just for the injections supply, but also motivation, weight tracking, diet tracking and to tackle issues like ketosis and hypoglycaemia symptoms . (Yes, sometimes you get it). Some doctors also prepare the food for you to eat from their clinic with some additional charge whilst on the VLCD (500 caloric diet).

4. Is 500 calories a day enough?

Yes. The reason is because when the body utilizes in-store fat, it produces 2000-3000 kcals of energy. If you eat more than 500 calories a day, some of it will be stored hence weight loss will be affected. This is also another reason why people gain weight on this diet - it acts like a double edge sword. If you eat too much, or cheat on carbohydrates, it will restore into the body hence making you bigger. (Yes, I've tested this theory on myself).

5. Since I'm producing so much energy, should I exercise?

Despite the energy produced, we do not recommend you to do strenous exercise during the course of the injections because it can speed up ketosis symptoms and you will feel hungry. Furthermore, if you do exercise during this period, you need to continue even after the diet if not your weight will go up. Even for myself, I limit my jogging activities and I reduce my weight lifting regimes to half just to keep my exercise freak bit happy. However, after you stop injecting, I would recommend a more frequent exercise like walking and weights ideally everyday.

6. Since I can only take 500 calories a day, can I fast?

The answer is no. The reason is because, you have to eat on this diet at least between 4-6 hours if not you will go into ketosis - and have symptoms like headache, nausea, disorientation etc. Another reason is that you need to be well hydrated for the burning process to be optimized, i.e. 2-3 liters of water daily. I've tried not eating for almost 8 hours and I was so disoriented I almost hit a lamp post. I've also been dehydrated (testing) and there was reduced weight loss the next morning and I felt lethargic.

7. Injections or drops?

I would have to say injections. With injections you have an option of 23 or 42 days but with the drops you definitely must do 42 days. In terms of weight loss, the injections are much more predictable compared to the drops, less plateau if you do not cheat on the diet. But not many people like the idea of jabbing themselves everyday. Even for myself I felt exhausted of jabbing my own butt for 23 days. For my patients, some of them come to the clinic daily to get the jab. So if you are not keen for injections, which drops to take? I have my own medical pharmaceutical drops provided - so not sure about the rest.

8. What are the things I need to have at home to start this diet?

Simple things. A weigh to measure every morning after your first pee with minimal clothes on. (This is your dry weight). A kitchen weighing scale to measure your 100gms of protein a meal. (I prefer you to measure your own meal and decide what proteins to take). A non-stick pan to cook the protein. 

9. Should I be on supplements?

Yes and no. I would only recommend a multivitamin in the morning with water. Because you are going on a strict diet, you require to supplement this because if you fall sick, you cannot take much medication. I would also recommend calcium - ideally coral calcium, because you will get some cramps after the second week due to lowering levels of calcium in the body. A colon cleanse before you sleep is recommended although I only took one every 3 nights since I couldn't stand the diarrhoea I get the next morning. L-carnithine supplements before you sleep because L-carnithine make the fats more available as fuel to your body. Be careful of supplements that have a lot of sugar in it because it will disrupt the diet.

10. I'm on the diet and I have the urge to cheat - can i cheat with 1 spoon?

No. Even 1 spoon is hazardous. I was preparing lasagna for a function in my office and I took 1/2 spoon of red sauce and 1/2 spoon of white to taste. The next day, my weight went up by 400gms, and the next day it went up another 300gms despite adhering to the diet, so I drank more water and went on strictly white protein and salad - and it went down 400gms, then subsequently another 500gms. I would have lost an extra 700gms or more if I did not taste the sauces. Another time was at a dinner and I ate extra angus steak, maybe 50gms more and my weight went up, stayed up for 2 days. It takes about 2-3 days after you cheated to get back on tract. So ask yourself. is it worth cheating?

11. With so much weight loss, wouldn't I sag?

The best thing about this diet is also the fact that you lose the fat, but the hormones keep your skin tight, so you do not sag.

This is a prescriptive diet and I would recommend those interested to come in for a proper consultation with me in my clinic. For those who find me to far, you can also visit my friend Dr Kuljit at Damansara Height Wellness Clinique - the guy who actually put me up to it. He also provide food for you during this diet.

For those interested, do call my clinic at 03-21440080 for a consultation.