Weight Management

We talk about weight management a lot at SocolMD — but only because because its a major driver for age-related disease.

The difference in long-term risk between people can be measured by looking at their waist circumference, which raises a some really valuable points.

First, we’re moving away from terms like “obese” and “overweight” to describe body composition.  BMI is out the door too, because none of these terms tell us anything about body composition, which is the real thing that we should be follow.  So what’s the new term these days to describe suboptimal body composition?  It’s “overfat.”

Now, abdominal overfatness is the most unhealthful state in the spectrum. Abdominal overfatness promotes insulin resistance, cardiovascular disease, diabetes, arthritis, dementia, cancer and mental health disorders. Adding to the complexity of the overfat state are the hormonal impairments which amplify the problem and promote becoming more overfat.

Our Performance Medicine practice specializes in resolving weight management challenges mindfully and responsibly, with the broadest toolset available. Individuals are introduced to best practice for their body during their journey and benefit from routine testing to guide program design and long-term performance.

In the United States, 90% of adult males are overfat.  Fifty percent of children are too.¹  

Understanding how fat is overfat requires a measure of body fat percentage. Body mass index, or BMI, misclassifies 50% or more of those with excess body fat who may have increased health risks.¹  When we use body fat percentage as a benchmark, 32-35% body fat in a woman and 19-24% body fat in a man is just about right.

Men are naturally leaner than women for biological reasons. Women have extra body fat because of hormones, breast tissue and their physiology.

Body fat percentages increase with age for both sexes – which is why there are ranges in the numbers we’re quoting.

Abdominal overfatness promotes chronic inflammation.  This drives insulin resistance, which promotes heart disease and other metabolic changes.

People who find themselves living in this space are in a vicious cycle that can be really hard to break.

The chronic inflammation driven by abdominal fat impacts the entire body, which is why apparently unrelated conditions such as heart disease, thyroid dysfunction, and some forms of dementia and even cancer can be tied to weight.

• Postmenopausal breast
• Colorectal
• Distal esophagus
• Stomach
• Pancreas
• Liver
• Gallbladder
• Endometrium
• Ovary
• Kidney

In the opinion of Dr. Socol, there is no best plan since whatever plan is on the table needs to be mindful of the individual needs of the patient, their medical history and the medical literature.  In practice, this means several things:

1. Weight and our ability to maintain a healthful weight are influenced by numerous factors. Some are in the control of the individual, such as what we choose to eat, and some are not, such as genetics and the environment that existed inside the mother’s womb. Blending these influences into a workable platform requires support, dialog and testing to help preserve focus. The Performance Medicine practice at SocolMD specializes in this level of consideration and care.  
2. Some weight loss plans offer short-term gains at the expense of long-term health.  Other prescriptions predispose individuals to a lifetime of cyclical weight management challenges that become harder and harder to manage over the life of the individual. Dr. Socol explores these advanced concepts with all patients in the interest of following best-practice.

Weight management services at SocolMD integrate nutrition, exercise, and metabolic and hormonal optimization strategies into a comprehensive solution that drives results and improvements in body composition.

Yes. Weight reduction surgery improves weight by limiting how much food a person can eat or how much food they can absorb.  

SocolMD specializes in helping bariatric surgery patients outperform expectations and transition into a new lifestyle.

The practice focuses on:

• Providing bariatric surgery patients with an evidence-based environment to explore their unique nutritional needs;
• Assessing for micronutrient deficiencies that can lead to a loss of bone mineral density, anemia and vitamin deficiencies;
• Creating an exercise program that understands the needs of individuals in this environment;
• Identifying metabolic and hormonal deficiencies that are strongly associated with obesity and then provide an informed setting to explore treatment options that promote faster recovery, better performance and long-term health;
• Transitioning patients from their initial weight loss goals to a performance mindset.

References:

¹Overfat Adults & Children in Developed Countries:  The Public Health Importance of Identifying Excess Body Fat

²Comparison of general obesity and measures of body fat distribution in older adults in relation to cancer risk:  a meta-analysis of individual participant data of seven prospective cohorts in Europe.