Obesity Dr's BEST Tips For MASSIVE Weight Loss

yes what's up you guys welcome back to the channel thank you so much for clicking on today's video so today I'm joined by a very special guest as my friend Spencer Podolski said right you got it yes so Spencer's actually a doctor he's much smarter than I am can you kind of run through your credentials and who you are and what you do sure well so first I got a degree in exercise science and undergrad then I went on and got a medical degree at Virginia College of Osteopathic Medicine went on to specialize in family medicine at VCU then specialized further into obesity medicine and I'm actually going to get another certification in lipid ology which is like cholesterol medicine and in preventive medicine and get a masters of Public Health lots of degrees whatever but obesity lifestyle medicine doctor I think the main thing you focus on you would say is like get helping people with obesity Yeah right who's losing weight he's Madoff yeah and so if you don't if you don't follow on instagram he's one of the he's probably one of the top meme meme masters for weight loss memes he's the top meme Lord of weight loss which is very neat place to be but it works it works for you so he actually lives here in San Diego we've been trying to you know meet up because I it just makes sense right make a video talking about this stuff so I figured out have him on what I was thinking we could do is so you know kind of like a role play kind of thing so if I am somebody that's coming in to your you know your office or whatever that's you know 200 pounds overweight yeah and it's my first time meeting you and I'm saying you know I've tried everything I want to lose weight nothing's working for me I need help yeah what what do you do so I get a full assessment you know and so it's not just like hey all right let's put you on this diet plan you got to lose 200 pounds it's let's hear about your history what's your dieting history what exactly did you do to try to lose weight what's your what's your history like growing up were there any like adverse childhood experiences you know some people don't think about those types of things but something significant that happened when you're younger what was it like when you're in elementary school middle school high school college was there some point in there where you've all of a sudden gained a lot of weight or did you always have a lot of excess weight and it's very important for the language too a lot of people are used to having a real bias towards people with obesity so we do a lot of obesity sensitivity training and be like alright so when did you get fat no it'd be like so tell me actually really the ID I didn't even think of that or like I remember when I I was terrified to go to the doctor when I was younger and like my mom when my mom my mom would I did though like my mom would have to literally trick she tricked me into going at one point and I it was the worst experience I ever had because the whole time the doctor was like looking at his panel and just going like stuff like that and it was just and then they ended up having it wanting to take my heart rate or blood pressure and they had to get a bigger cuff they're like oh this isn't fitting it was just like it's like okay I get it I'm overweight and I know that trauma to your nose that's amazing yeah absolutely so with my obesity specialization we it takes practice - it's not just like all of a sudden you get this extra board certification and you're this amazing obesity doctor it takes time to practice and visual cues like body language can you tell if somebody's uncomfortable when you're starting to talk to them in a certain way and so fading that over time makes a difference so but yes family history what are other people in your family like what was your childhood like those are very important to me because those give me a clue of where to start and start working with people beyond that you know once I start understanding the dieting history like do you have any semblance of understanding what proper nutrition physical activity is some people most people have some sort of idea drinking soda probably shouldn't you know pizza every single night whatever you shouldn't eat fast food but some people just have never tried before but most people that that once they've gotten to me they've tried 10 different diets in the past so that's where I start so when you so when people are coming in and you're asking them those questions or they're like is there anything that kind of kind of pops out to you that is like pretty standard and most people that you know are trying to lose a lot of weight most people have done at you know they've done Weight Watchers and most of times they've lost you know fifty whatever however many pounds they've had significant weight loss with one or both of them whatever it was it always comes down to consistency in some sort of form of what they're trying to tell me they don't say I just couldn't say consistent sometimes they do but something about it is something whether is life maybe they just can't describe it they just couldn't stick to it and so I try to find me you know sometimes there's some like bright spots we call them like oh wait it's like you actually did well with Weight Watchers in the past or maybe you did count calories and it worked for you what was a what about that was why that helped you well I was very successful with that the low-carb worked for you why couldn't you stick to that that type of thing so those are what I'm those are things I'm trying to think of and and also like or did they dive in you know you've told me your story before and did they just get too aggressive and it was too restrictive those types of things yeah that's from what I've liked you know talking with people trying to help them it's a lot of people it's very normal and I think it's it's like I get it like you go from the normal Western diet right evening pretty much whatever you want to you're like you get so excited when you want to start a new diet like you get that I would say again dopamine it's like you get like your heart I remember whenever I would start a new diet like my heart rate would go up like I'd be thinking about it and planning it out and so instead of like you don't want to be like okay I'm gonna start new I'm gonna cut my calories by 400 it's like no man I want to see results right now so you end up cutting you know I'm gonna eat 1,200 cuz it's like the gold standard it seems like right over 1200 calories and then you can you anybody can do that for a little bit right and you're gonna see results but it's like how long is that gonna last yeah so yeah that makes sense that you would you would see that a lot yeah so on you know understanding what they've done in the past what they've been successful with what's been a roadblock something that happened in their life sometimes they just need some strategy to help them get through some barriers in life so that's I'm looking at that then you know again who they've worked with in the past coaches psychologists that type of thing then I'm looking for clues of like have they actually had labs done recently are they be significantly affected from a health standpoint so a lot of people think that obesity is just a like an anthropometric diagnosis meaning your BMI is high or you know whatever your your weight is high but we try to do what's called like a staging of obesity and that means where they are clinically like are their blood sugar issues is there some sleep apnea knee pain arthritis reflux those type things so I start looking for clues like that and of course I ordered labs to look into that like looking at like kind of like the levels of obesity yeah it's cause like obesity is such a broad term yeah you could be I think if I if I like track my BMI right now I think I'm still considered like obese because I'm pretty short and I mean boost yeah no but seriously though that's that's interesting so there's that I mean I would have always said like there's I think there's different laws are they call them classes so there's so there's a normal technically normal BMI whatever between 18 19 and 25 25 to 230 or under 30 is overweight and then thirty to thirty four point nine or 35 this is class class 1 class 2 is 35 to 40 or over 40 is class 3 or people call it morbid obesity we don't say that anymore cuz it's because of the kind of the sensitivity behind it it doesn't really tell us much yeah so then those are like the class is just based on weight and height because those are BMI and I know there's I don't know if anybody talks to you about BMI doesn't do everything it's just a screening tool my yeah mind you it's just a screening tool that's easy to do in the clinic it doesn't tell you everything of where you're storing the fat excetera but then the stages are where we actually look at the different obesity-related diseases or conditions like the arthritis osteoarthritis sleep apnea and then blood sugar blood pressure isn't something that so I know that obviously everyone's very different every every client that you're working with you know every patient that you're working with I guess is a better word so everyone's different but like if you could say like this is a pretty standard like so you've found all say you find out okay they're in class three and they have they're having some issues that gets it's very obvious like think there's something needs to happen now right like we need we need to figure this out what are the steps that you take with that person again I understand everyone's different yeah so I'll do a dietary recall of what they're doing so somehow you know I'm not one of these people that are like an insulin zealot or something like that energy balance is is the main thing we need to be looking at for some reason this person is over consuming energy and not burning enough so clearly we need to cut back on calories in some sort of way that's sustainable over a long period time especially if they have to lose 200 pounds that's not going to happen overnight it's going to take a year at least at least at least a year if not more so yeah so one of the things that I talk about having the mindset trying to help them have the mindset look whatever we do here is just gonna be the initial standpoint right here this is gonna be a long term process but so we'll do a dietary recall and then we'll start just I'll get a semblance of what they even know about nutrition as I said before and what what they can feasibly do there may be some people do well in the beginning with just meal replacements I know people don't like that necessarily shakes and whatever it's like no it's it's more of a medical thing to get people from from a convenience standpoint getting people just sticking to something and trying to at least focus on one meal per day that's at least somewhat nutritious skip a couple of meals or just drink a shake some people like that other people I can tell that they're good at counting calories and that like well look if you're you've had success with this before what can we do to make that sustainable you know the whole if it fits your macros or whatever way of tracking calories other people maybe it was just an appetite issue some people did very well on the low-carb but they didn't do it appropriately and so we may go more towards that my my thing is I like to put people on a standard three meals a day plus a snack in general it could be different for each person but focusing on the vegetables first things that you say are common sense diet type of stuff focus on vegetables things that have fewer calories high volume keeps you fuller longer lean proteins obviously lower calorie high protein help keeps usage satiated hard - it's also hard to store protein as fat so and I'm sure you talked about before and then just deciding on their fat in the meal versus starch and having some sort of combination of the two depending on their preferences now some people don't do well with that at all some people have to be either a low fat or low carb but that's that's my general start but again when you're just doing this in the beginning it's it's so hard to like know what's actually going to help them so I give them kind of like called a meal template or whatever yeah and so I'm not trying to turn this video into like an anti keto thing yeah I know that we have similar beliefs on that yeah so I'm curious to hear cuz I mean I get a lot of people that message me that say like I I didn't like your so Cheers you're so against keto I didn t know and it worked for me and I'm always like if it works that's great right but if you're saying if you're working with somebody and they're like I really want to do keto or you know they're I don't want to say arguing with you but they're like you know trying to make the case if I want to do keto what is like your response to that in like it you know so I asked them this I'm like look if they have a lot of weight to lose 200 pounds there are people that have been extremely successful doing a ketogenic diet due to not only the restrictive properties I know it's counterintuitive because restrictive sometimes is bad but sometimes people need that restriction because it gives them the rules and for some people that struggle with appetite the ketogenic diet may be beneficial to our souls so we talked talked about it like do you think you could stick to this for the rest of your life it's really hard to be successful in a ketogenic diet and then transit transition off if you're in if you're you know you don't have that much to lose it's not that's not a big deal but if you're talking 200 pounds you're probably going to have to stick to a ketogenic diet or close to it for the rest of your life so I generally talk to them about you know do you think you could do this help you do it but you know have you tried this in the past and many of them actually have tried it a couple times they've just always failed maybe they lost some weight and maybe they just didn't do it right so those are some things we look at yeah and so it for me like kind of what you said the issue that I have with is I think it for a lot of people when you're trying to lose weight a lot of people already put like labels on foods as bad or good right and then when you jump into keto it reinforces that right like it reinforces carbs are bad no matter what they are even if it's like even if it's a lot of broccoli right bad and so that's my main issue is that it's it's reinforcing these rules that were putting on through where I just don't think it's necessary so I talked about in my post today some people think that it's simply the insulin it's in a hormonal response and they you could technically eat as many calories as you want as long as your keto and you're still gonna lose weight or you won't gain weight and that's just simply not true so what I described to my patients are is and I do use weight loss medicines in case that they have severe appetite issues but a ketogenic diet increasing ketones in the blood may actually have a therapeutic benefit for appetite so I basically say look the calories matter the most don't think about this insulin and all this different stuff if you feel like your appetite needs some help and you feel like you could stick to a ketogenic diet fine it's a tool don't think of it as anything else so that's pretty much it I'm not I'm not a big fan of keto because I've seen so many people fail but you see on the internet lots of people have done well but we call like a survivorship or selection bias because of course you don't see all the failures you only see the super successful people yeah and just with any type of diet as well too so you could say it for other things too but I'm not a huge fan of putting people on a ketogenic diet first I have other doctor friends that do do that yeah yeah I'm I completely agree so I we've kind of already been giving tips but if there's like anything that comes to your mind you know 5 3 however many tips you want it to be like someone's watching this video right now they maybe they can't afford a coach or they're doing they have to do it on their own another option right what would what would you say to that person that's you know trying to lose 50 100 150 pounds like what would be some like tips off the top yeah I would say spaced evenly amount of meals per day I would shoot for 3 to begin with you don't need to eat more meals to speed up your metabolism most people understand that's a myth now but I still get people saying like no I need to eat more often to speed up my patella you don't need to so I would stick to probably three meals maybe a snack like an apple or something to bridge between lunch and dinner or a protein shake or something like that each meal I would I would load up at least with 2 cups of non starchy vegetables spinach broccoli whatever cauliflower carrots even sure they have a little bit of get more calories like potatoes yeah just pretty much anything that's not potatoes or corn yeah you know cuz even tomatoes and things like that really load up on them some people don't tolerate due to gut issues but if you do tolerate them they will help you just you won't be able to eat much so then get that I shoot for lean protein of course if you're doing a ketogenic diet you want fatty or protein and pretty much no starch but I would I would do more of high amounts of lean protein including Greek yogurt is fine plain by the way don't get the yeah oh yeah despite it tasting pretty good yeah I egg whites and we could get a whole video about cholesterol I'm getting my lipid ology Board Certification I know extensive amount of data on cholesterol so I'm not against whole eggs at all but like the fat from the whole eggs can really add up so in general I do a lot of egg whites it can really fill you up and share through a whole egg in there for your fat amount and then first starches you know people think of like oh you should go low-carb because like you know carbs are bad clearly but the carbs people are usually eating are like donuts yeah croissants cookies pies so not only are those foods high in carbohydrates and sugar but they're also high in fat and just you know I don't know if anybody's use the term on here hyper palatable but basically super yummy that it almost hijacks your appetite reward center to where you eat more than you you probably would compare to another food that's not like that so things like lentils or even boiled potatoes I tend to go more towards lentils and legumes there they're really hard to overeat especially if you don't put a ton of seasoning and things on them so um those are the kind of the starches that I push people towards very filling hard to overeat them and then and then trying to have like about the next tip would be having like five to ten what I call go-to meals so very you just you can eat the same things over and over again sure some people are going to get bored and maybe start adding other go-to meals but variety actually makes people eat overeat mm-hmm you know I talked about having buffets where you can go and grab a little bit of everything as opposed to just one one stint or a couple sides you can grab a little bit of everything and you actually eat more when you have a variety of food so in general I have people eat the same things over and over again and that actually helps and it can help you standardize the meal size for you so you don't have to you don't have to get your scale out and weigh everything and we call it like a food Tetris yeah it's kind of a funny term because yeah you with an if it fits your macros type of diet you could you could technically eat everything you could weigh out every morsel of food and this and that but like that gets very tedious becoming and it can become like obsessive yeah you know I probably don't need to get into it here but I did it for a bodybuilding competition it despite knowing a lot about food and understanding psychology and everything about weight loss it it made me feel obsessive similar to how you described off the air but um so finding your go-to meals eating similar foods and getting used to them finding ways to make them taste good and then as you're doing that adjust you know as you're losing weight if you understanding you know pounder to half a percent to a percent of your body weight per week that tends to be the goal don't you know understand that this is going to be such a long-term process especially 200 pounds that like they're gonna be plateaus and there's gonna be times where your weights going to start going up get back get back on track go back to your go-to meals find some way to get consistent I mean that's that's it yeah that's it see people want to get into some weird weird types of dietary patterns fasting can help for those who just may be eating three meals a day does it active is actually worse for somebody so maybe eating one meal a day actually for some people is awful because they binge eat on that one meal and they eat a full pizza in because they're so hungry but maybe the fasting actually helps with that person satiety and hunger cues that they actually under ate for the for the amount of the day and they actually lose weight and keep it off it's so understanding that person adjusting you don't need anything fancy but really understanding it's a long term process yeah yeah there's definitely again that's the thing with with weight loss I've always said it's a very personal journey they go on you know there's there's definitely things that I think are gonna be you know useful for everybody you know being in a caloric deficit finding out how many calories you're burning so you know how many should be losing or eating to lose you know things like that but then when it comes from there like some people like you said might do well on five meals versus some of that's like I like to eat two meals or one meal everyone is so different so I totally agree and then kind of in the same vein but you know we talked about like tips that you should look to try and do but is there anything that you know because you've worked with so many people helped you lose weight like you like things to that you should definitely avoid is there anything that comes to your mind oh this kind of I don't know yeah things to avoid getting into the to the magic magic mindset supplement minds mindset you know when you're doing well do not look at your friend who's scorching their way maybe that cut all their calories and doing some sort of fad diet you know they're doing Akita ketogenic diet like oh look I lost 20 pounds this this week or something like that don't don't get off of what your you're doing because you'll go huh there's that meme or the girl and the guy it's it's so funny cuz it's true it's like you have the key to Jannah that looks good it's a shiny object syndrome or whatever you want to call it so stick to what you're doing especially if it's working you know baby find some clues if it's whatever you're doing it's not working maybe you do need to find some clues but just stick to your path supplements out there don't fall into the mindset that you got to try you know garcinia cambogia green coffee bean raspberry ketone whatever they don't work yeah I promise you that we have pharmaceutical drugs that work in the brain if you do have severe appetite issues that I do Stu prescribe what are those yeah ever did you kind of talk about I've never heard of that yeah so it's it's this is kind of the whole idea of the obesity medicine but you know ideally we wouldn't have to use pharmaceuticals ideally we wouldn't have to do surgery as we've talked about before but these two icon tools they work up in your brain if you're struggling with hunger they do not work automatically they're not they aren't fat burners yeah it's not gonna take calories away from yours yeah thank you eight no so we call them centrally acting meaning in your central nervous system as opposed to working peripherally meaning burning burning fat likes DNP I don't know if anybody needs an illegal it's illegal yeah a drug but these these drugs work centrally in your brain so one of the oldest ones called phentermine it's an amphetamine like medicine that's not addictive that one works up in a few receptors in the brain there's some new gut we got peptides that we can prescribe that we use for type 2 diabetes that actually help people immensely with appetite and glucagon like one peptide that they're injectables where you don't feel the needles tiniest subcutaneous then there's a few other things like wellbutrin which is a antidepressant medicine it works with dopamine and norepinephrine but then there's some other parts of the brain that may work with especially when you combine it with a naltrexone which is an anti alcohol drug and so they thought they think that maybe with its wellbutrin is also used for smoking to smoking cessation so combining it with these this other medicine naltrexone synergistically in the brain it actually increases your satiety helps you stay fuller longer and may actually help in that reward pathway where some people just can't help themselves but snacking on you know chips and candy and stuff like that despite understanding that they're full then there's a few other medicines out there as well but the idea is that like look we treat type 2 diabetes and all these other met and all these other conditions with medicines you have you know Big Pharma shell and whatever and there's big money out there but truly if there's a way to give people tools to manage this hunger after they've failed so many times that's the key cuz like like you said we don't need to rev up metabolism we need to help people just eat fewer calories in a sustainable manner and some people just struggle with that but yeah so and so with the the medicines like we were kind of talking about this before we film but like that's usually that would be like a last kind of effort right it's not like you that they walk in like here's the medicine yeah so there are clinics that do this we call em phentermine factories you pay whatever it is 50 hundred bucks a week and you go and get your small little doses of phentermine and it doesn't matter pretty much who you are you're going out with phentermine and that's not the way you're supposed to do it you because these these drugs aren't necessarily benign we want to use them we want to make sure there's more benefit than risk big it's possible there's more if somebody's not losing weight and they're just using it for the crash diet or something that's probably risky yeah so ideally we're picking out people and individualizing say this person's struggled with dieting all the time they've tried so many times and sometimes that I said this before sometimes people don't know that they're hungry and that's the reason why they just can't stick to a diet we can do all the behavioral therapy we can vegetables lean protein starch and fat to preference bla bla bla bla bla but for some reason they the receptors in the brain aren't functioning properly and you give them medicine it takes the edge off to where they now they can stick to it these aren't magic so like I could give a it I could give a patient that I don't do any counseling with a medicine maybe they will respond extremely well in Allston they'll just eat to a normal satiety but in a lot of patients if you don't discuss it as a tool they'll just they'll just keep eating the way they are and they don't even have any semblance of understanding their own internal hunger cues and things like that other people that think that they their metabolisms broken and they've tried everything give them a medicine point they lose 50 to 100 pounds because now they're like oh you know what it is easier to stick to the diet and they don't really tell you that it was harder before so certain things but again it's it's no magic bullet it only in there are a lot of non responders and then there are people that respond very well and those are the people you you it's probably a better benefit yeah also man well I think we've been talking for a while I want to say thanks for coming over if there's people that want to find you or they or they fine well biggest place is Instagram now at doctor Nadal ski dealer yeah I love it on the screen teal cool and then I'm part of the Renaissance period crusoe Renaissance period ization calm all right cool man all right face it that's a good one all day the warning sign and when there are flashing lights or wig legs don't attempt to cross until they come to a complete stop [Music]

Channel: ObesetoBeast

Views: 111,837

Rating: 4.8797736 out of 5

Keywords: weight loss tips, fat loss tips, how to lose weight, dr nadolsky, spencer nadolsky

Id: ptwyGvKn9p0

Length: 28min 9sec (1689 seconds)

Published: Fri May 10 2019