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Clinic Special through June 15, 2013!

May 15, 2013 by John M. Bills, Jr., MD

Clinic Special!

Now through June 15th, 2013 buy one shot, get another of same value free! (Limit one per week.) You may choose to get a double shot for the price of one, or you may save the second shot for a future visit. Your choice!

Sign up for our email newsletter for future good deals, recipes, and exercise and diet tips!

Just enter your name and email address in the box on the right, hit “Subscribe!”. You will then receive a confirmation email (to make sure you really requested our newsletter) and once you have confirmed the request, you’ll start receiving our regular newsletter.

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Filed Under: Uncategorized

Cardio is great, but…

April 25, 2013 by John M. Bills, Jr., MD


Cardio is great, but…

It’s not everything! When you are working on weight loss, cardio exercises such as running, biking, swimming, and rowing, are great for burning calories and if you get your heart rate up to at least 70% of maximum (see previous blog “No More Couch Potatoes”), you are also getting a heart and lung workout, which is good for you in other ways. However, you don’t have to limit yourself to cardio if you’re serious about losing weight.

If you’re new to exercise, over 40, have a health problem, or take regular medication, check with your primary care doctor before starting a fitness program.

Strength 1Strength training will burn calories and build muscle, which has a number of health benefits. Strength training generally burns fewer calories than a cardio workout, but in the long run you could burn a significant amount. The primary benefit of strength training is that it increases your RMR (resting metabolic rate). We all burn calories just sitting at our desks or driving our cars or any of the other mundane daily tasks that we do, but it’s not much. Studies show that women who participate in a strength training program for 12 weeks increase their RMR by 15% or more. That means that you burn calories not only during your workout, but during the other 23 hours of the day you burn at a higher rate, because muscle requires a lot more energy to maintain even at rest. 15% means you burn an extra 300 calories a day, which translates to over 109,000 calories a year, or over 31 lbs of weight lost! And you could be losing as much or more through cardio workouts and proper diet.

We frequently get this question from patients: What can I do to increase my metabolism? This is it! All exercise, whether cardio or strength training, helps to build muscle, which increases your metabolism.

Additionally, strength training reduces pain and dysfunction of arthritis, reduces risk of osteoporosis, and increases insulin sensitivity. Stronger muscles means better ability to do daily tasks, both on the job and at home. Exercise of all kinds reduces anxiety and depression symptoms.

Strength 2And bigger muscles makes you look hot! Guys nearly all want bigger muscles, but women are usually resistant to the idea of improving their muscle size. They are afraid to look too muscled, like the women on the cover of body sculpting magazines. I’m sure there are some who see beauty in that, but I agree – a woman whose physique reminds me of Arnold Schwarzenegger in The Terminator is not attractive. But trust me, you won’t even get close to that look without exercise becoming your “job” 4-5 hours a day. If you work out 2-4 times a week, you will improve muscle tone and size to a moderate degree. You will look better, feel better, and you’ll be healthier!

If you’re new to strength training, join a gym and get a personal trainer there to get you started right. If you want to do it alone, there are instructional DVDs for sale on Amazon, or you can look up videos on YouTube. I’m going to remind you to try MyFitnessPal app on your phone; it rocks! It will give you calories burned for your exercises as well as keep up with your food intake (it becomes an easy food diary, which is an important part of a weight loss program). I also suggest you try the WebMD site and subscribe to their weekly slideshows in your email. They have great ideas about healthy eating, exercises, and many related things. Below is the most recent slideshow. Check it out!

WebMD Slideshow 7 Most Effective Exercises

 

Filed Under: Exercise, Obesity

No More Couch Potatoes!

April 10, 2013 by John M. Bills, Jr., MD

CMC Bike Ride

Cordova Medical Clinic group bike ride on the Green Line at Shelby Farms!

I recently listened to a lecture by a bariatric physician who began his talk with this phrase: “the key to weight loss is reducing calorie intake; the key to maintaining weight loss is exercise.” Very basic, but of course, for best results, you should start both healthy eating and exercising simultaneously in your weight loss program.  What if you just dieted and refused to exercise? Some people do lose weight this way. But long-term studies have shown that more than 90% of people who have lost weight and maintained it over 5 years or more are regular exercisers. To put that another way, if you lose weight and don’t exercise, the chances you are going to stay thin are… well, slim. Very slim. (Only 10%.) No one really wants to lose weight temporarily, so if you’ve been a couch potato, it’s time for a change!

How do you start an exercise program if you’ve done very little exercising in years? There’s a phrase for that, too: “Start low, go slow.” If you try to overdo it, you’re going to hurt yourself or exhaust yourself, and then you’ll give up.

Walking is easy. Most people already have sneakers, and it doesn’t require a gym membership or a treadmill. Walk outside, or at the mall in bad weather. Start with 15 minutes a day and go up by 5 minutes a week. By the end of a month, you’ll be doing 30 minutes a day.

CMC DaniIf you’re somewhat active and want more strenuous exercise, you can work up to running. This can be hard on bad joints (hips, knees, feet), and if you have these problems, you may do better with something that puts less stress on joints, like swimming or biking. Biking outside is great fun. A stationary bike is good if the weather is bad, or if you exercise at night, or if you want to watch TV while exercising. (I have a fantastic stationary bike that is silent: Tunturi E30R.) Try to find some form of exercise you enjoy. If it’s all work and no fun, it’s going to be hard to continue long-term. Vary your workouts. Try to do 2 or 3 different forms of exercise each week.

The main thing that you need to do is make exercise a priority. If it’s just one of the 10 things you’d like to do today, if you’re like most people, you’ll only get 3 or 4 of them done because our days rarely go as planned. So make exercise one of your top 2 or 3 things to do. Keep a record of your progress: put it down in a calendar or chart, and review it weekly. (If you have a smart phone, I  strongly recommend the MyFitnessPal app. It not only stores your progress, it easily calculates your food calories and burned calories for you.) If you fail, that’s only temporary. Start over by trying to analyze what caused the failure, then resuming in a way that will circumvent that obstacle.

What is the eventual goal? For weight loss, most experts suggest 60 minutes of moderate exertion 5 times a week; to maintain weight loss, 30 minutes of moderate exertion 5 times a week. Moderate exercise is when you are sweating and breathing hard, but can still talk fairly easily. If you want to be more scientific about it, you will have to use some math. You should get your pulse to 70-85% of your maximum heart rate for most of your workout. Maximum heart rate is 220 – your age. Take that number and multiply by 0.70 or 0.85 to get the range. For example, I’m 52 years old. 220-52 = 168, my maximum heart rate. 168 x 0.70 = approximately 118. 168 x 0.85 = approximately 143. So I try to  get my heart rate between about 120 to 140 beats per minute while exercising. Count your pulse for 10 seconds and multiply by 6. After you’ve done this many times, you’ll get to where you’re able to tell by feel when you’re in that range.

But remember, these strenuous longer workouts are the eventual goal for couch potatoes. “Start low, go slow.” But start, and restart if necessary. Persistence will pay off in weight loss, looking better, and feeling better.

Filed Under: Diet, Exercise, Obesity

Exercise Guidelines

February 11, 2013 by John M. Bills, Jr., MD

  1. Regular exercise is almost certainly a requirement for long-term weight loss. Researchers in Colorado and Pennsylvania studied thousands of people who lost more than 30 lbs. and kept it off for at least 2 years. The most common factor was that 91% of them were regular exercisers. Only about 30% of American adults are regular exercisers.
  2. Walk! If you don’t have an exercise habit, walking is a low-impact exercise that requires no special or expensive equipment, and you can do it just about anywhere.
  3. Balance your exercise. Aerobic burns calories better, but strength training (weights, sit-ups, push-ups) makes you feel good and gives other muscles a break. Try alternating aerobic and strength training 6 days a week, and rest completely one day a week.
  4. Start slowly and build up. Doing too much too fast can cause injury or burn-out. Start with 10-15 minutes daily, and add 5 minutes every two weeks. In just two months you’ll be up to 30 minutes a day.
  5. Exercise physiologists tell us that to maintain our weight, we need 30 minutes of daily exercise 5 times a week. But in order to lose weight, we need 60 minutes of daily exercise 5 times a week.
  6. Make exercise a priority! If you exercise after you’ve done everything on your “To Do List”, you’ll never get to it. Make exercise one of your top 2 or 3 things to do each day.

Filed Under: Diet, Exercise, Obesity

Diet Information

February 11, 2013 by John M. Bills, Jr., MD

There are dozens of diets available, and the information can be confusing. Here are some general guidelines to follow.

  1. Low-carb diets work, but they provide little fiber. The average American only eats 11 grams of fiber a day, and we’re supposed to eat 25-30 grams. The low-carb dieter probably eats much less than 11 grams. This diet can work well, but you may need to supplement with extra fiber.
  2. Low-fat works, and is healthy. In general, if you follow USDA food pyramid guidelines, you’ll be eating the right proportions. Fat has about 9 calories per gram, while carbohydrates and protein have only 4 calories each. Also, low-fat dieters retain muscle mass better than low-carb dieters.
  3. Though protein seems good, be careful how you eat it: meat and dairy have lots of protein, but are usually high in fat. Some are low-fat. Learn to read labels, and don’t buy products that have more than 2 or 3 grams of fat per serving. Legumes (beans and peas) are high in protein and fiber. Just be sure they weren’t prepared “southern-style” – with a hunk of fat in the cooking pot.
  4. If you’d like calorie guidelines, most people lose weight steadily while eating 1000-1200 calories a day for women, 1200-1500 for men. If you work out for 30-60 minutes, add another 300 calories to your daily intake.
  5. Portion control is also important. Besides looking carefully at the kind of food you eat, make certain you don’t get too much of a good thing. Most brand-name healthy frozen meals have about 240 to 350 calories in them. If you wash the plastic containers they come in and save them, they can give you a good idea about how much of your home-made healthy foods you should dish out for your meals: just fill the container with your own food, and don’t eat more than what fits into it.
  6. Keeping a food journal is very helpful, and can be easily done on your smart phone. It tracks your daily calories and nutrition information, and can also track your exercise and weight. There are several available, but we like MyFitnessPal.

Filed Under: Diet, Exercise, Medications

Who Qualifies?

February 11, 2013 by John M. Bills, Jr., MD

We will treat adults 18-64 years of age with appetite suppressants. If your Body Mass Index (BMI) is 30 or greater, you qualify. If your BMI is 24.5 to 29.5, you qualify if you have a family history of diabetes, hypertension, heart disease, stroke, high cholesterol, or obesity. Anyone who does not qualify will receive a refund of his or her office visit fee.

Teenagers from 16-17 years old may also qualify, but they must have a parent with them to sign the consent form on the first visit and have a BMI of 27 or greater. Patients 65 years old or more will not be prescribed appetite suppressants, but may be treated with Xenical.

We can treat diabetics. We also treat patients with hypertension, but your blood pressure must be under good control with your medication. We do not treat patients with previous history of heart attack (myocardial infarction), congestive heart failure, or angina.

Filed Under: Clinic visits, Medications, Obesity

Follow-up Visits (usually 20-30 minutes)

February 11, 2013 by John M. Bills, Jr., MD

Follow-up visits are once every 4 weeks, and are generally much quicker than your first visit. They follow the same steps as your first visit, except there is no paperwork for you to fill out.

Filed Under: Clinic visits, Medications, Obesity

Your First Visit (usually 30-60 minutes)

February 11, 2013 by John M. Bills, Jr., MD

You will fill out a health history, and you will be given a handout with information about the medications we use. If you haven’t had labs done in the past year, we suggest that you have them done at our clinic or with your primary care physician as soon as possible. However, most of our patients are getting labs with their own physicians, and we do not require that you do it at our clinic.

A medical assistant will check your blood pressure, pulse, height, and weight, and then you will go to an exam room. The doctor or nurse practitioner will see you and discuss diet, exercise and medications. A brief heart and lung exam is performed, and then you’ll receive your prescription. You may fill your prescription at our clinic, or you can take it to your pharmacy. Your visit will be private, unless you wish otherwise – some of our patients come with a friend, family member, or coworker, and they sometimes want to be seen together.

Filed Under: Clinic visits, Medications, Obesity

Weight Loss Information

February 11, 2013 by John M. Bills, Jr., MD

We only see walk-ins – no appointment necessary. Just be sure to be here at least 30 minutes before our lunch break or at least 30 minutes before our closing time. We are always willing to take as much time as necessary to answer your questions.

We treat patients from 16 to 64 years; those under 18 must have a parent with them on their first visit. Those over 64 can be treated with Xenical, but not appetite suppressants.

Our general guide for treating weight excess is BMI (Body Mass Index). We will calculate your BMI for you: it is based on height and weight ratios. A normal BMI is 19 to 24, and the statistically healthiest people are those with a BMI of 21 or 22. To qualify for appetite suppressants, your BMI must be 24.5 or higher.

By state law, we can only prescribe 30 days of medication at a time, and we must recheck you in the office before continuing therapy.

If you need more information about diet, exercise, or behavior modification, please ask – we’ll be glad to help!

Filed Under: Clinic visits, Diet, Exercise, Medications, Obesity

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