If you some experience injecting botulinum toxin’s (i.e. Botox® Cosmetic), and want more advanced Botox® and Filler training, the following Botox®/Filler Training Bootcamp is for you.

Program Summary

Presented by the IAPAM, the Dermal Filler / Botox® Training Bootcamp will give you two days of the most intensive hands-on cosmetic injectable training available in North America.

IMPORTANT NOTE: Unlike hands-on Botox® training in the US, US physicians can do this injection training under the guidance of our licensed medical director without State licensing conflicts.

Program Highlights:

The most live patients: 8-12 live patients

The lowest class ratios: No more than 2-3 physicians per instructor

You will inject all 11 areas of the upper and lower face

Over 6 hours of Hands-on Botox® and Filler training each day

Includes all cosmetic injectable product

Botox® and Filler training materials

Certificate Awarded

Botox® and Filler CME’s available for IAPAM members

Botox ® Training day:

A thorough review of the muscles of facial expression will be presented. The indications, risks and benefits of Botox Cosmetic® will be discussed for both upper & lower face. Ideal dosing & advanced Botox® injection techniques will be emphasized.

You will perform the following Botulinum Toxin (Botox Cosmetic®) procedures:

• Treatment of glabellar frown lines
• forehead lines
• periorbital rhytid
• nasalis”bunny” lines
• melomental “marionette” lines
• platysmal bands, horizontal necklace lines
• pebbly “peau d’orange” chin
• hypertrophic inferior orbiculartis ”jelly roll”

Attendees will evaluate & treat cosmetic Botox® patients for both upper & lower face. Training can be arranged on an individual basis according to your time availability. Ideal consultation skills & patient interview techniques will be focused on.

Dermal Filler (Juvederm ®, Restylane ®, Perlane ®) Training day:

A didactic presentation on the use of Restylane/Perlane® and Juvederm® for nasolabial folds, melomental folds (“marionette lines”), and lip augmentation.

Attendees will perform the following hands-on procedures with Juvederm®, Restylane® and/or Perlane®:

• Marionette Lines
• Lip augmentation
• Nasolabial Folds

Watch a short video clip on the IAPAM’s Botox Training programs:

Program Agenda

Prior to attending, you should complete the self-study program (4-6 hours).

Saturday (Botox® Training):

• 9:00am ~ Didactic lecture: Cosmetic Botox® for the Upper & Lower Face. A though review of the muscles of facial expression will be presented. The indications, risks and benefits of Cosmetic Botox will be discussed for both upper & lower face. Ideal dosing & advanced injection techniques will be emphasized.
• Demonstration of Botox for the Upper & Lower Face. Treatment of glabellar frown lines, forehead lines, periorbital rhytids, nasalis”bunny” lines, melomental “marionette” lines, platysmal bands, horizontal necklace lines, pebbly “peau d’orange” chin, and hypertrophic inferior orbiculartis ”jelly roll” will be demonstrated. Ideal consultation skills & patient interview techniques will be focused on.
• Cosmetic Botox® Injection Hands-On Experience. Attendees will evaluate & treat cosmetic Botox patients for both upper & lower face. There will be maximum of 3 attendees per instructor & a minimum of 12 patients per group. All instructors are Allergan Certified & will rotate such that the attendees will have the opportunity to work with all of the instructors.
• 6:00pm ~ Q & A Session. Attendees will have the opportunity to pose questions, review difficult cases and discuss any other issues they wish including marketing with the expert panel.

Sunday (Restylane, Perlane, Juvederm Training):

• 9:00am ~ Restylane/Perlane® and Juvederm®: A didactic presentation on the use of Restylane/Perlane® and Juvederm for nasolabial folds, melomental folds(“marionette lines”), and lip augmentation.
• Restylane/Perlane® Demonstration. A demonstration of the most advanced techniques for the correction of nasolabial & melomental folds; and lip augmentation & enhancement.
• Restylane/Perlane/Juvederm® Hands-On Injection Experience. Attendees will perform Restylane/Perlane® injections for nasolabial folds. melomental folds; & lip augmentation & enhancement under the guidance of MEDICIS CERTIFIED instructors.
• 6:00pm ~ Q & A Session, Course Evaluations Certificates presented

Note: There will be a short working Lunch each day

What others have said:

“I am pleased to send a positive report on the botox/filler training over the weekend. Patricia is a real expert both on content and on education. She taught in a calm, clear, and effective way, with a minimum of didacticism and a maximum of practicality. In the style of the best medical education, it was hands on nearly from the get-go, with demonstration, then direct supervision. The atmosphere was collegial. There was an excellent mix of patients. No time was wasted. The one-on-one training justified the cost. I particularly enjoyed the overwhelmingly favorable patient response. After years of traditional medicine, “Wow” factor is a pleasant surprise. Recommended to anyone getting started in this field.” ~ Dr. Carroll, MD, PhD

“Just got back from Botox and Filler Boot Camp–had a FANTASTIC experience!! Well worth my time, money and travel. Not only do I now feel much more comfortable and confident in my ability to provide a good service, but I now have a better understanding of the technical and artistic side of Botox and Dermal filler. Anyone, like myself, who hasn’t had any experience in this area of aesthetics should take this course. Even individuals who have some experience will find it extremely helpful. Besides, the folks that teach it were great. Not only technically skilled, but also fun to work with. Rest assured, I will be going back to Canada for advanced filler training after I get some experience with the basic stuff!!” ~ Dr. Elliott, MD

“This is a true hands on course, in my view, the only way one can confidently succeed in implementing such practice. It is a good follow up after Scottsdale Symposium. The case variety included the full range of Botox and filler applications currently in use. By itself, the case selection seemed an amazing task.  much enjoyed the true life - real office experience of managing patients - from the initial interview, to the co-discovery of possibilities for treatment to the actual treatment and in several occasions, short term follow up. ” ~ Dr. Lahrs, MD

“ just wanted to tell you what a great weekend I had in Toronto. Patricia and her staff are among the most talented professionals I’ve met in this field. Her scheduling was flawless, and her attention to details made the day flow smoothly. She tailored the training to exactly what I needed. She and her staff have a way of putting everyone who walks through the door of the spa instantly at ease. There is no doubt in my mind that one day with her has given me a considerable competitive edge in my market of aesthetics.” ~ Dr. Twyman

Who Should Attend?

This program is designed for physicians (MD, DO), dentists (DDS, DMD), and their medical assistants (i.e. RN, PA, NP).

When: Sept 11-12, Oct 2-3, Nov 13-14, Dec 11-12 (additional dates may also available, please call or e-mail for more info)

Where:Toronto, Canada

Price: $ 4,250 members (non-members: $5,250) - Members Save $1,000!

Includes:

• Self-study materials (clinical’s, documentation, reference materials)
• All injectable materials provided
• Patients provided
• Certificate
• short working lunch each day

You can

register via our secure On-Line Registration Form

or

download the Registration Form here and fax it to 1-866-284-9318

or Call 1-800-219-5108 x705 for more information

If you do not have any, or very limited cosmetic dermal filler injection experience, you should first attend the Aesthetic Medicine Symposium.

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Program Summary

Presented by the IAPAM, the Advanced Dermal Filler Training Bootcamp will give you a day of advanced dermal filler procedure training.

All attendees will perform Restylane/Perlane ® injections for cheek augmentation, tear trough treatments, jaw contouring and volumetric lift.

IMPORTANT NOTE: Unlike hands-on Botox injection training in the US, US physicians can do this injection training under the guidance of our medical director without State licensing conflicts.

Program Highlights:

• The most live patients: 4-6 live patients
• The lowest class ratios: No more than 2 physicians per instructor
• Covers: Brow Lift, Jaw contouring, Volumlift, Tear Trough, Cheek Augmentation, Fern Technique, Advanced lip techniques
• Over 6 hours of Hands on Filler training
• Includes all cosmetic injectable product
• Filler training materials
• Certificate Awarded
• Filler CME’s available for IAPAM members

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Program Agenda

Prior to attending, you should complete the self-study program (4-6 hours).

Friday

• 9:00am ~ Didactic lecture: Advanced Dermal Filler Procedures. A didactic presentation on the use of Restylane/Perlane® and Juvederm for cheek augmentation, tear trough treatments, jaw contouring and volumetric lift.
• Dermal Filler Volume lift Demonstration. A demonstration of the most advanced techniques for the correction of cheek augmentation, tear trough and fat pad treatments, jaw contouring, brow lift and volumetric lift.
• Dermal Filler Injection Advanced Techniques hands on Experience. Attendees will perform Restylane/Perlane® injections for for cheek augmentation, tear trough treatments, jaw contouring, brow lift, fern technique, advanced lip techniques and volumetric lift under the guidance of MEDICIS CERTIFIED instructors.
• 6:00pm ~ Q & A Session, Course Evaluations Certificates presented. Attendees will have the opportunity to pose questions, review difficult cases and discuss any other issues they wish with the expert panel.

Note: There will be a short working Lunch

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What others have said:

“I had a superb experience and learned so much from the session. I hope you continue organizing these for the benefit of the doctors and patients out there!” ~ Dr. S.R. Michigan (June ‘09)

“It has been the best “hands-on” training that I have received so far. I would highly recommend it to anyone.  I went away from there with all I needed to feel confident about doing dermal fillers and Botox.” ~ Dr. B W. S. Carolina

“Excellent Organization, Great instructions with perfect instructor-to-student ratio.””Patient volume accurate to acquire sufficient skills.” ~ Dr. A. Chmiel M.D.

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Who Should Attend?

This program is designed for physicians (MD, DO), dentists (DDS, DMD), and their medical assistants (i.e. RN, PA, NP) with at least 6 months of dermal filler injection experienced.

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Program Details

When: Oct 1, Nov 12, Dec 13 (additional dates may also available, please call or e-mail for more info)
Where: Toronto, Canada
Price: $ 2,362.50 members ($2,625 non-members)

Includes:

• Self-study materials (training materials)
• All injectable materials provided
• Certificate
• Lunch
• Patients provided

Sign-up Today!

You can
register via our secure On-Line Registration Form

or

download the Registration Form here and fax it to 1-866-284-9318

or Call 1-800-219-5108 x705 for more information

Overview of the IAPAM’s Botox Training Programs:

Botox Training at the IAPAM Aesthetic Medicine Symposium:

Here are some of the testimonials regarding our Botox training and medical aesthetic training programs:

“I left your course feeling comfortable in advanced injecting techniques and am much more confident for when I start practice in September. I do not see how a course could provide more hands-on with such a high degree of experienced supervision. As testament to this, I have decided not to enroll in two different courses I had planned to take this fall, rather if I do decide to have additional training, I will be signing up for another session of IAPAM’s Botox Bootcamp and Advanced Filler Courses with you.” ~ Dr. Dillman (July ‘10)

“The symposium was unbelievable. I feel that I am ready to open the Aesthetic part of my practice in a month or so.” ~ Dr. Simon (April ‘10)

“The Symposium presented clinical training and common-sense business advice by knowledgeable and passionate instructors. I feel the education (lecture and hands-on time) was well worth the investment, but the extensive refresher materials provide invaluable continued reference.” Dr. Wolfe (March ‘10)

“The IAPAM conference is one of the most practical medical conferences I have attended. I appreciated the advice regarding setting up your own business and then more important, how to market your business. The written materials and DVD’s are an invaluable resource. The entire staff at IAPAM is professional and such a pleasure to work with. It is definitely money well spent.” ~ Dr. Silva (Feb ‘10)

“I am pleased to send a positive report on the botox/filler training over the weekend. Patricia is a real expert both on content and on education. She taught in a calm, clear, and effective way, with a minimum of didacticism and a maximum of practicality. In the style of the best medical education, it was hands on nearly from the get-go, with demonstration, then direct supervision. The atmosphere was collegial. There was an excellent mix of patients. No time was wasted. The one-on-one training justified the cost. I particularly enjoyed the overwhelmingly favorable patient response. After years of traditional medicine, “Wow” factor is a pleasant surprise. Recommended to anyone getting started in this field.” ~ Dr. Carroll, MD, PhD (July ‘09)

“Just got back from Botox and Filler Boot Camp–had a FANTASTIC experience!! Well worth my time, money and travel. Not only do I now feel much more comfortable and confident in my ability to provide a good service, but I now have a better understanding of the technical and artistic side of Botox and Dermal filler. Anyone, like myself, who hasn’t had any experience in this area of aesthetics should take this course. Even individuals who have some experience will find it extremely helpful. Besides, the folks that teach it were great. Not only technically skilled, but also fun to work with. Rest assured, I will be going back to Canada for advanced filler training after I get some experience with the basic stuff!!”~ Dr. Elliott, MD  (July ‘09)

“This is a true hands on course, in my view, the only way one can confidently succeed in implementing such practice. It is a good follow up after Scottsdale Symposium. The case variety included the full range of Botox and filler applications currently in use. By itself, the case selection seemed an amazing task.  much enjoyed the true life - real office experience of managing patients - from the initial interview, to the co-discovery of possibilities for treatment to the actual treatment and in several occasions, short term follow up. ” Dr. Lahrs, MD  (June ‘09)

“ just wanted to tell you what a great weekend I had in Toronto. Patricia and her staff are among the most talented professionals I’ve met in this field. Her scheduling was flawless, and her attention to details made the day flow smoothly. She tailored the training to exactly what I needed. She and her staff have a way of putting everyone who walks through the door of the spa instantly at ease. There is no doubt in my mind that one day with her has given me a considerable competitive edge in my market of aesthetics.” Dr. Twyman (June ‘09)

“I have been interested to learn more about medical spa directorship for quite a while. Upon in depth research of the the available options I have decided on IAPAM. Their two-day symposium in Scottsdale is very well executed. It is a comprehensive introduction that defines the building blocks of such practice for those who are truly interested to offer aesthetic medicine to their patients. The didactic component draws from the experience of well respected professionals in the field while it exposes the audience to a variety of styles from the initial practitioners like dermatologists to the more recent adopters like family physicians. Jeff Russell, the course director, delivers impeccable presentations, both in style and content, that provide the business foundation to succeed in such practice. The course provides introductory hands-on experience in several aspects of aesthetic medicine like Botox and filer injections. I found this course captivating and worthwhile of my time and financial investment.” ~ Dr. A.L. MD Washington (June 2009)

“The IAPAM Symposium presented a common sense approach to starting an aesthetic practice, without over promising results. The faculty has a dept of knowledge that would help point new comers in the right direction. Also, I enjoyed the mix of didactic and hands-on teaching style that helped me to quickly familiarize myself with several aspects of aesthetic care. I highly recommend the experience because it would serve as a balanced building block to a successful practice. ” ~ Dr. OC O. North Carolina

“I spent $35,000 on a consultant and received less information than what I received over the weekend” ~ Dr. G.C. Florida

“The symposium was everything I had hoped for and more. Very practical and timely. “ ~ Dr. A.B. Canada

“the support you get from IAPAM afterwards definitely makes the course different than the others” ~ Dr. A. S. Illinois

“I’ve been on 3 other aesthetic training courses, this is by far the best!” ~ Dr. S.P. Arkansas “I was adequately trained at my conference in Scottsdale to dive head first into the field and I am enjoying it ” ~ Dr. B. P. Pennsylvania

“The best medical training seminar I’ve ever been on, great job!!” ~ Dr. M. K. Colorado

“the support you get from IAPAM afterwards definitely makes the course different than the others” ~ Dr. A. S. Illinois

“Great education on both procedures & business. Great to interact with people do the same business (and are not competitors!)” ~ Dr. R. N. Illinois

“This is the best medical conference I’ve been on” ~ Dr. M.A. Texas

“I like the concise nature of the presenters” ~ Dr. K. C. OB/GYN

“Great introduction stressing ethical treatments, discussion of complications, etc.” ~ Dr. S.G. Louisiana

“It was a pleasure to hear and learn from the best” ~ Dr. M.A. NY

“The treatments we received pretty much covered the cost of the weekend” ~ A. B. PA, Washington

“you all have a sincere commitment to your members and share an ethical standard of practice that is uncommon and admirable in today’s environment.” ~ Dr. J.C. MD

“We always appreciate the help and on going assistance that the IAPAM has given us since our initial training and we are very proud to be IAPAM members.” Dr. C.P. MD

“The IAPAM’s Aesthetic Practice Workshop was essential to me in starting my anti-aging center. I had the concept and the vision but no idea how to put those into a business plan format. The bootcamp gave me the tools and information needed to research my concept, learn the financials specific to my vision, and form and present that information to lenders, builders, and vendors. I would highly recommend anyone thinking of starting or incorporating an aesthetic practice attend this conference.” ~ Dr. A.W. MD, Iowa

“Very Good! Have been to prior conference in Chicago..was ok. But this conference was much more informative, hands-on, smaller in attendance. Excellent!” ~ Dr. PH MD

“I liked being able to sit & talk with speakers at lunch” ~ Dr. D.L

IAPAM hCG Weight Loss Information

Follow Jeff’s hCG Weight Loss Journey

NHLBI’s The Practical Guide: Identification, Evaluation, and Treatment of Overweight and Obesity in Adults

NHLBI’s Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults: The Evidence Report

BMI Calculator

BMR Calculator

www.weightloss.com (by Roche laboratories)

Lapband adjustable gastric banding system (Allergan)

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Vitamin B12

What It Is and How it Works?

Vitamin B12, also called cobalamin, is important to good health. It helps maintain healthy nerve cells and red blood cells, and also is needed to make DNA, the genetic material in all cells. Vitamin B12 is bound to the protein in food. Hydrochloric acid in the stomach releases B12 from protein during digestion. Once released, B12 combines with a substance called intrinsic factor (IF) before it is absorbed into the bloodstream.

All of these B vitamins help the body in converting carbohydrates into glucose or sugar, which is burned in order to produce energy for proper body function. These are often referred to as B complex vitamins, and are essential for the breakdown of fats and proteins. They help maintain muscle tone, protect the mucus lining in the digestive tract and mouth, and promote upkeep of nervous system and the organs like the liver, skin, hair, and eyes. Cobalamine is an excellent anti-stress vitamin since it is believed to enhance the health functioning of the immune system and improve the body’s ability to fight stressful conditions.

B12 injections have been found to frequently improve energy levels and general well-being. They also support thyroid function to regulate energy levels. B12 also reduces water retention owing to its diuretic attributes.

B12 Concerns

Vitamin B12 has a very low potential for toxicity. The Institute of Medicine states “no adverse effects have been associated with excess vitamin B12 intake from food and supplements in healthy individuals.” The Institute recommends that adults older than 50 years of age get most of their vitamin B12 from supplements or fortified food because of the high incidence of impaired absorption of B12 from unfortified foods in this population. Source: http://doctrim.yourmd.com

Vitamin B6

What It Is and How it Works?

Vitamin B6 is a water-soluble vitamin that exists in three major chemical forms: pyridoxine, pyridoxal and pyridoxamine. It performs a wide variety of functions in your body and is essential for your good health. For example, vitamin B6 is needed for more than 100 enzymes involved in protein metabolism. It also is essential for red blood cell metabolism. The nervous and immune systems need vitamin B6 to function efficiently, and it also is needed for the conversion of tryptophan (an amino acid) to niacin (a vitamin).

Hemoglobin within red blood cells carries oxygen to tissues. Your body needs vitamin B6 to make hemoglobin. Vitamin B6 also helps increase the amount of oxygen carried by hemoglobin. A vitamin B6 deficiency can result in a form of anemia that is similar to iron deficiency anemia.
An immune response is a broad term that describes a variety of biochemical changes that occur in an effort to fight off infections. Calories, protein, vitamins and minerals are important to your immune defenses because they promote the growth of white blood cells that directly fight infections. Vitamin B6, through its involvement in protein metabolism and cellular growth, is important to the immune system. It helps maintain the health of lymphoid organs (thymus, spleen and lymph nodes) that make your white blood cells. Animal studies show that a vitamin B6 deficiency can decrease your antibody production and suppress your immune response.

Vitamin B6 also helps maintain your blood glucose (sugar) within a normal range. When caloric intake is low, your body needs vitamin B6 to help convert stored carbohydrate or other nutrients to glucose to maintain normal blood sugar levels. While a shortage of vitamin B6 will limit these functions, supplements of this vitamin do not enhance them in well-nourished individuals.
Vitamin B6 can help with weight loss through a stimulating effect of the thyroid. This can be especially helpful for hormone balance in women when water retention is an issue. Lastly, patients seem to find the pyridoxine alleviates cravings consistently.

Concerns and Other Issues Associated with B6

Too much vitamin B6 can result in nerve damage to the arms and legs. This neuropathy is usually related to high intake of vitamin B6 from supplements and is reversible when supplementation is stopped. According to the Institute of Medicine, “Several reports show sensory neuropathy at doses lower than 500 mg per day”. As previously mentioned, the Food and Nutrition Board of the IOM has established an Upper Tolerable Intake Level (UL) for vitamin B6 of 100 mg per day for all adults. “As intake increases above the UL, the risk of adverse effects increases.” Source: http://doctrim.yourmd.com

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For more detailed information on B6 and B12 along with more information on providing medically supervised weight loss to your patients, please visit the IAPAM’s hCG Weight Loss Training program. Or contact the IAPAM at 1-800-219-5108 x708.

This content is taken from the IAPAM’s Medically Supervised Weight Loss training program.  The program is designed to help physicians incorporate a medical weight loss program into their medical practice.

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An increase in physical activity is an important component of weight loss therapy, although it will not lead to substantially greater weight loss over 6 months. Most weight loss occurs because of decreased caloric intake. Sustained physical activity is most helpful in the prevention of weight regain. In addition, it has a benefit in reducing cardiovascular and diabetes risks beyond that produced by weight reduction alone. For most obese patients, exercise should be initiated slowly, and the intensity should be increased gradually. The exercise can be done all at one time or intermittently over the day. Initial activities may be walking or swimming at a slow pace. The patient can start by walking 30 minutes for 3 days a week and can build to 45 minutes of more intense walking at least 5 days a week. With this regimen, an additional expenditure of 100 to 200 calories per day can be achieved. All adults should set a long-term goal to accumulate at least 30 minutes or more of moderate-intensity physical activity on most, and preferably all, days of the week. This regimen can be adapted to other forms of physical activity, but walking is particularly attractive because of its safety and accessibility. Patients should be encouraged to increase “every day” activities such as taking the stairs instead of the elevator. With time, depending on progress and functional capacity, the patient may engage in more strenuous activities. Competitive sports, such as tennis and volleyball, can provide an enjoyable form of exercise for many, but care must be taken to avoid injury. Reducing sedentary time is another strategy to increase activity by undertaking frequent, less strenuous activities. Source: NAASO/NHLBI

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Long Term Weight Loss and Exercise Studies

Long-term weight loss after diet and exercise: a systematic review.

Source: International Journal of Obesity (London) 2005 Oct; 29(10): 1168-74
Diet associated with exercise produced a 20% greater initial weight loss. (13 kg vs 9.9 kg; z=1.86-p=0.063, 95%CI). The combined intervention also resulted in a 20% greater sustained weight loss after 1 y (6.7 kg vs 4.5 kg; z=1.89-p=0.058, 95%CI) than diet alone. In both groups, almost half of the initial weight loss was regained after 1 year.

CONCLUSION: Diet associated with exercise results in significant and clinically meaningful initial weight loss. This is partially sustained after 1 year.

Effects of the Amount of Exercise on Body Weight, Body Composition, and Measures of Central Obesity

Source: Cris A. Slentz, PhD; et al. Archives of Internal Medicine. 2004;164:31-39.
In non-dieting, overweight subjects, the controls gained weight, both low-amount exercise groups lost weight and fat, and the high-amount group lost more of each in a dose-response manner. These findings strongly suggest that, absent changes in diet, a higher amount of activity is necessary for weight maintenance and that the positive caloric imbalance observed in the overweight controls is small and can be reversed by a modest amount of exercise. Most individuals can accomplish this by walking 30 minutes every day.

It should also be noted other studies say the amount of daily exercise should be closer to 1 hr a day. (Successful Weight Loss Maintenance. Wing, Rena R.; Hill, James O. Annual Review of Nutrition v. 21 (2001) p. 323-41)

Exercise and Abdominal Obesity

No one will dispute the fact if a patient exercises regularly, the benefits are both physical and mental. The patient will most certainly benefit from a cardiovascular workout and a resistance workout. It is also known that building muscles takes a larger amount of calories than doing only cardio work.

Many patients are concerned about getting rid of the spare tire, and are very distressed that they just can’t. One study found limited evidence suggesting that “exercise-induced weight loss” is associated with reductions in abdominal obesity as measured by waist circumference or imaging methods; however, at present there is insufficient evidence to determine a dose-response relationship between physical activity, and abdominal or visceral fat. (Physical activity, total and regional obesity: dose-response considerations. Medicine and Science in Sports and Exercise. Volume 33(6) Supplement, June 2001, pp. S521-S527)

For more information on providing medically supervised weight loss to your patients, please visit the IAPAM’s hCG Weight Loss Training program. Or contact the IAPAM at 1-800-219-5108 x708.

According to the National Institutes of Health (NIH), treatment of an overweight or obese person incorporates a two-step process: assessment and management. Assessment includes determination of the degree of obesity and overall health status. Management involves not only weight loss and maintenance of body weight, but also includes measures to control other risk factors. Obesity is a chronic disease; patient and practitioner must understand that successful treatment requires a lifelong effort. Convincing evidence supports the benefit of weight loss for reducing blood pressure, and lowering blood glucose.
Overweight and obesity are serious and growing health problems, and are not receiving the attention they deserve from primary care practitioners. Among the reasons cited for not treating overweight and obese patients is the lack of authoritative information to guide treatment. This Practical Guide to the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults was developed cooperatively by the North American Association for the Study of Obesity (NAASO) and the National Heart, Lung, and Blood Institute (NHLBI). It is based on the Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults: Evidence Report developed by the NHLBI Expert Panel and released in June 1998. The Expert Panel used an evidence-based methodology to develop key recommendations for assessing and treating overweight and obese patients. The goal of the Practical Guide is to provide you with the tools you need to effectively manage your overweight and obese adult patients in an efficient manner.
Managing overweight and obese patients requires a variety of skills. Physicians play a key role in evaluating and treating such patients. Also important are the special skills of nutritionists, registered dietitians, psychologists, and exercise physiologists. Each health care practitioner can help patients learn to make some of the changes they may need to make over the long term. Organizing a “team” of various health care practitioners is one way of meeting the needs of patients. If that approach is not possible, patients can be referred to other specialists required for their care.

Who succeeds in maintaining weight loss? A conceptual review of factors associated with weight loss maintenance and weight regain.

Source: Obesity Reviews: an official journal of the International Association for the Study of Obesity, 2005 Feb; 6(1): 67-85

According to our review, successful weight maintenance is associated with more initial weight loss, reaching a self-determined goal weight, having a physically active lifestyle, a regular meal rhythm including breakfast and healthier eating, control of over-eating and self-monitoring of behaviors. Weight maintenance is further associated with an internal motivation to lose weight, social support, better coping strategies and ability to handle life stress, self-efficacy, autonomy, assuming responsibility in life, and overall more psychological strength and stability. Factors that may pose a risk for weight regain include a history of weight cycling, uninhibited eating, binge eating, more hunger, eating in response to negative emotions and stress, and more passive reactions to problems.

For more information on providing medically supervised weight loss to your patients, please visit the IAPAM’s hCG Weight Loss Training program. Or contact the IAPAM at 1-800-219-5108 x708.

The rate of success in patients that are not supervised during treatment is considerably lower than those who are supervised by a physician that adheres strictly to the protocol.

Part of the physicians responsibility is to supervise, advise, guide and control hCG patients health before, during and after treatment. The physician needs to be able to establish which patients are good candidates for treatment with hCG, and together with their patient set realistic expectations that will give them a successful outcome.

Medical supervision is key in order for patients to obtain optimal results using hCG. In 1973 Dr. W.L. Asher and Dr. Harold W. Harper published the results of a double blind study aimed to evaluate the effects of hCG on weight loss, hunger and feeling of well being in the American Journal of Clinical Nutrition.

The results obtained described an increased weight loss in patients undergoing treatment with hCG vs. placebo. More importantly, there were significant differences in terms of lack of hunger and increased feelings of wellbeing. Patients with hCG were more consistent in their adherence to the diet and were able to complete the course of treatment more successfully. These double blind studies were performed under supervision of physicians strictly following indications as set out in the Simeons protocol.

Dr. Asher and Dr. Harper then replicated the same study, this time on patients that were supervised by physicians, but using Simeons’ programs modified to varying degrees. The physicians had little or no experience with the protocol, and none of the programs considered the rigidness of the original plan. One physician allowed patients to self administer hCG injections at home, and diets, although respecting the caloric intake, were not strict as to the ingredients allowed.

Results of this experience were surprisingly negative. Drop out rate was significantly higher than those experienced in the previous study. Weight loss showed no difference between hCG and placebo treated patients, and in some cases were even below those achieved by placebo treated patients under strict supervision.

It is clear that the success of hCG for weight loss is strictly linked to medical supervision and strict adherence to the medical protocol designed by Dr. Simeons. Source: Oralhcg.org

For more information on providing medically supervised hCG weight loss to your patients, please visit the IAPAM’s hCG Weight Loss Training program. Or contact the IAPAM at 1-800-219-5108 x708.

This content is taken from the IAPAM’s Medically Supervised Weight Loss training program.  The program is designed to help physicians incorporate a medical weight loss program into their medical practice.

The Atkins Diet

The Atkins Diet represents a departure from prevailing theories. Atkins claimed there are two main unrecognized factors about Western eating habits, arguing firstly that the main cause of obesity is eating refined carbohydrates, particularly sugar, flour, and high-fructose corn syrups; and secondly, that saturated fat is overrated as a nutritional problem, and that only trans fats from sources such as hydrogenated oils need to be avoided. Consequently, Dr. Atkins rejected the advice of the food pyramid, instead asserting that the tremendous increase in refined carbohydrates is responsible for the rise in metabolic disorders of the 20th century, and that the focus on the detrimental effects of dietary fat has actually contributed to the obesity problem by increasing the proportion of insulin-inducing foods in the diet. While most of the emphasis in Atkins is on the diet, nutritional supplements and exercise are considered equally important elements.

Atkins involves the restriction of carbohydrates in order to switch the body’s metabolism from burning glucose to burning stored body fat. This process (called lipolysis) begins when the body enters the state of ketosis as a consequence of running out of excess carbohydrates to burn. Dr. Atkins in his book New Diet Revolution claimed that the low-carbohydrate diet produces a “metabolic advantage” where the body burns more calories, overall, than on normal diets, and also expels some unused calories. He cited one study where he estimated this advantage to be 950 calories (4.0 MJ) a day.

The Atkins diet restricts “net carbs”, or carbohydrates that have an effect on blood sugar. The effect is to decrease the onset of hunger from low blood sugar. Dr. Atkins says in Dr. Atkins’ New Diet Revolution (2002) that hunger is the number one reason why low-fat diets fail. Though studies show the efficacy of the Atkins approach after one year is the same as a low-fat diet, Dr. Atkins claimed that it was easier to stay on the Atkins diet because dieters did not feel hungry or “deprived”.

Net carbohydrates can be calculated from a food source by subtracting sugar alcohols and fiber (which are shown to have a negligible effect on blood sugar levels) from total carbohydrates. Sugar alcohols need to be treated with caution, because while they may be slower to convert to glucose, they can be a significant source of glycemic load and can stall weight loss. Fructose (e.g., as found in many industrial sweeteners) also contributes to caloric intake, though outside of the glucose-insulin control loop.

Preferred foods in all categories are whole, unprocessed foods with a low glycemic load. Atkins Nutritionals, the company responsible for marketing the Atkins Diet, recommends that no more than 20% of calories eaten while on the diet come from saturated fat.

According to his book, Atkins Diabetes Revolution, for people whose blood sugar is abnormally high or who have type-2 diabetes, this diet decreases or eliminates the need for drugs to treat these conditions. The Atkins Blood Sugar Control Program (ABSCP) is an individualized approach to weight control and permanent management of the risk factors for diabetes and cardiovascular disease.

South Beach Diet

The South Beach diet is a diet plan started by Miami, Florida area cardiologist Arthur Agatston, which emphasizes the consumption of “good carbohydrates” and “good fats”. Dr. Agatston developed this diet for his cardiac patients based upon his study of scientific dieting research.

Dr. Agatston believes that excess consumption of so-called “bad carbohydrates”, such as the rapidly-absorbed carbohydrates found in foods with a high glycemic index, creates an insulin resistance syndrome—an impairment of the hormone insulin’s ability to properly process fat or sugar. In addition, he believes, along with many physicians, that excess consumption of “bad fats”, such as saturated fat and trans fat, contributes to an increase in cardiovascular disease. To prevent these two conditions, Agatston’s diet minimizes consumption of bad fats and bad carbohydrates and encourages increased consumption of good fats and good carbohydrates.

The diet has three phases. In all phases of the diet, Dr. Agatston recommends minimizing consumption of bad fats.

Master Cleanse

The Master Cleanse detox diet, also known as the Lemonade Diet, was created by Stanley Burroughs in 1941 and made popular by Peter Glickman through his book Lose Weight, Have More Energy and Be Happier in 10 Days, which promotes Burroughs’ regimen to a modern audience.

Although the recipe varies from source to source, the ingredients are generally the same. The Master Cleanse involves eating no solid food. Instead, you drink a mixture of lemon juice, Grade B/Medium maple syrup, water and Cayenne pepper.

Cookie Diet

“Dr. Siegal’s Cookie Diet” is the brand name of Dr. Sanford Siegal’s diet cookies, shakes, soup, and nutritional supplements, which he created in 1975. Dr. Siegal’s Cookie Diet products are made in Dr. Siegal’s South Florida bakery and are available online and through physicians to whom he supplies them. This is now a franchise.

The Ornish Diet: Eat more, Weigh Less

The Ornish diet was developed by Dean Ornish, MD. Ornish was the first physician to demonstrate that heart disease can be reversed by natural methods, including specific dietary and lifestyle changes. Ornish counsels that we will find success not by restricting calories, but by watching the ones we eat. He breaks this down into foods that should be eaten all of the time, some of the time, and none of the time.

The following foods can be eaten whenever you are hungry, until you are full:
• Beans and legumes
• Fruits — anything from apples to watermelon, from raspberries to pineapples
• Grains
• Vegetables

These foods should be eaten in moderation:
• Nonfat dairy products — skim milk, nonfat yogurt, nonfat cheeses, nonfat sour cream, and egg whites
• Nonfat or very low-fat commercially available products –from Life Choice frozen dinners to Haagen-Dazs frozen yogurt bars and Entenmann’s fat-free desserts (but if sugar is among the first few ingredients listed, put it back on the shelf)

These foods should be avoided:
• Meat of all kinds — red and white, fish and fowl (if we can’t give up meat, we should at least eat as little as possible)
• Oils and oil-containing products, such as margarine and most salad dressings
• Avocados
• Olives
• Nuts and seeds
• Dairy products (other than the nonfat ones above)
• Sugar and simple sugar derivatives — honey, molasses, corn syrup, and high-fructose syrup
• Alcohol
• Anything commercially prepared that has more than two grams of fat per serving

If one sticks to this plan, then one will meet Ornish’s recommendation of less than 10% of calories from fat, without the need to count fat grams or calories.

Weight Watchers

Weight Watchers was founded by Jean Nidetch, a Brooklyn homemaker, in 1963. Today Weight Watchers is an international company which operates in over 30 different countries; most of them under the local language equivalent phrase to weight watchers.

The thrust of the Weight Watcher´s program is on regular meetings, monitoring and encouragement, through self-help group type sessions. The dieter aims for a target weight or BMI (body mass index) of between 20 and 25. If one’s body mass index is below 20, then the subject is considered too thin, if it is over 25, the subject is overweight, if it is between 20 and 25, the subject is within the ideal weight range. People can aim for a BMI outside the 20 to 25 parameters as long as they have a doctor’s permission.

Weight Watchers Inc. says that establishing a support network at the start of any weight-loss attempt is crucial for both short and long term success. Success in the WW program hinges on the dieter attending regularly and receiving positive reinforcement.

Comparison of the Atkins, Ornish, Weight Watchers, and Zone diets for weight loss

Source: JAMA, 2005 Jan 5; 293(1): 43-53
160 overweight people were randomly assigned to one of the four diets. They followed a supervised program for two months and were left to continue the diets on their own.

After only two months, 22 percent quit the study. After a year, 35 percent dropped out of Weight Watchers and the Zone diets, and 50 percent quit the Atkins and Ornish plans.

People who stayed on their diet for a full year did experience weight loss.
• 6 percent weight loss for the Ornish program (low fat).
• 5 percent weight loss for those on both Weight Watchers and the Zone diets.
• 4 percent weight loss for Atkins dieters (low carb).

For more information on providing medically supervised weight loss to your patients, please visit the IAPAM’s hCG Weight Loss Training program. Or contact the IAPAM at 1-800-219-5108 x708.