After trying dozens of diets, attending weight loss centers, eat­ing six cookies a day, exercising like an elite athlete, and counting calories -- women and men seek my counsel for medical weight loss. We all agree that there is an obesity epidemic. My patients tell me how much they exercise, how little they eat, and how they are unable to lose weight once they reach a certain age. Initially this was confusing to me, which is good, because it means I have something to learn. So I catapulted myself into learning bariatric medicine. Bariatricians are the physicians who teach you how to lose weight so you don’t require the bariatric surgery.

Most of us are familiar with the bariatricians who do surgery to remove a large part of your stom­ach or ties off most of it, thereby mechanically making it impos­sible to eat much more than two ounces of food initially.  People are wheeled out of the operating room, taken off many of their medications immediately, and lose enormous amounts of weight. What we are discovering with time is that this may not be the answer. New addictions are popping up, as reported on Oprah. We have fixed the damage from the leaky roof, without fixing the roof.

Our information age has pre­sented us with an interesting dilem­ma. Patients are over stimulated with proclamations and promises of losing weight with a program, pill, herb, or certain foods. There are presently two hundred medical weight loss drugs under FDA investigation. While studying in Paris, I learned of a medication named Rimonabant. Rimonabant (Accomplia by Sanofi Riventis) has been used in most European countries for a decade, and the US is awaiting approval which was sup­posed to be in February, 2007. This medication blocks the cannabanoid receptor, thereby decreasing the desire for food. Yes, certain medica­tions will help you, and I prescribe medications when necessary. Then when the brain is accessible to information, there is much learning to do. Living to be a functioning, lean,centenarian is not taught in medical training yet. Our gift of longevity mandates additional learning. The Medicare system thought the average age was going to be 65!

There are so many reasons we gain weight as we age, that my second book’s chapter entitled What Is Your Food IQ is now over fifty pages.The food/lifestyle questionnaire I have constructed has the answers at the end of the chapter. With a moderate amount of knowledge, and possibly the correct medication(s) for a brief time, there is hope. My goal is that in the future this will be taught in all schools. I gained twenty two pounds the first year of medical school and there are many reasons for that that go beyond overeating and sedentary over studying. How are we going to get lean and feel well again if human metabolism (which is how we gain and lose weight ) is not taught in our medi­cal training. You know the expres­sion, “Physician Heal Thyself.” My sixty something patients wear bikinis, and at 59, I do too.

We are obsessed with the num­ber on the scale. Please throw your scales away. I want to know your body composition, your wrist, neck, omentum, waist, hip, and thigh measurements. This story will help you. I used my electrical impedance scale with a father and a son. BOTH HAD THE SAME WEIGHT AND HEIGHT. The father had a 42 inch waist, and the son had a 32 inch waist. The father had 30 pounds more fat than his son. The father recently died at 80, which to me is young.  Do you think it is possible that the fat, which contains toxins, had any­thing to contribute to his require­ment for ten plus medications?

Hormonal replacement therapy for men and women is in a state of astounding lucid confusion. Please know, I do not prescribe synthetic hormones or anabolic steroids. However, as we age there is a down­ward spiral in the entire hormonal cascade, neurotransmitters, produc­tion of lean tissue, etc. (see Chapter Titles under Upcoming Events on my www.drrobertamorgan.com).  Our bodies do change, and with a little knowledge we can do internal plastic surgery. Our food supply has changed and requires some education regarding choices without becoming a “health nut.” Merely replacing waning hormones helps most lose ten pounds of fat.

There is a palpable media blitz with accompanying information regarding obesity. The television show Sixty Minutes showed a brain scan of what happens to your brain when you eat the Standard American Diet. The brain scan lit up like it was on cocaine. The soda machines are being wheeled out of schools. I am teaching homeless teenagers living in a shelter about nutrition, and the state is paying for their food and nutriients. Things are getting bet­ter. I have much hope that this over stimulation of medical/nutritional biochemistry information can be converted from chaos into order.