Weight Loss

Phentermine

Phentermine is a prescription appetite suppressant. It has been successfully and safely used for weight loss for over 30 years. Each morning you will take a tablet and throughout the day your appetite will be decreased and your cravings will diminish.

How do these medications work?

Phentermine and Qsymia both work on your fight or flight system and their main mechanism of action is as an appetite suppressant. While taking these medications your appetite will decrease significantly. Your cravings whether for sweets or savory foods will also diminish. You may also notice that you have more energy. There will also be a slight boost in your metabolism.

Do I need to change my diet while taking Phentermine or Qsymia?

The goal while taking either of these medications is to transform your diet. The path or rut that you have been on up until this point is the path that has lead you to weight gain. We want to change that! At the same time we understand how difficult change can be especially when it comes to food and habits.

While taking Phentermine/Qsymia focus on better food choices. Fresh fruits and vegetables along with lean protein such as fish, chicken or turkey are the best choices. Avoid foods that are fried, battered or breaded. Avoid foods that are processed and preserved. Remember the freshest and closest to its natural state the more nutrients and the healthier a food is.

Along with the types of foods you choose is the portion of those foods you eat. This is a great time to use one of the suggested calorie counting apps listed below. Pay particular attention to the actual serving size and the amount you are eating. Calories or Kcals are equal to energy. In order to loose weight the amount of calories in must be less than the calories out. One pound of weight equals 3500 calories. That means if you decrease your caloric intake each day by just 500 calories you will loose a pound a week!

This is a great time to figure out how healthy your diet really is. Is that snack your eating 500 calories? Or did you realize that your cereal “bowl” is actually 3 servings. You may quickly find out why fresh fruits and veggies are a great food choice. They are full of vitamins and minerals and have minimal calories.

What are the potential side effects?

The most common side effects reported and occurring in patients are: dry mouth, insomnia, constipation, nervousness and irritability. If you are having any of these symptoms they usually resolve within the first week. If these symptoms are too bothersome you may reduce your dose to ½ tablet. Other potential, but rare side effects are: shortness of breath, increased heart rate, increased or decreased blood pressure, blurred vision and dizziness. If you experience any of these symptoms go to the hospital right away. 

What is included in the program?

All office visits will be included specifically related to your weight loss program. Your initial visit with the health care provider will comprise of a medical evaluation, physical exam, laboratory work and if qualified a prescription for either Phentermine or Qsymia. A follow up visit one week after initiating therapy will be scheduled and then monthly thereafter or as indicated.

We will be available in the office during regular business hours to schedule any appointments or answer questions by phone. Any concerns outside of business hours will be handled the next business day. If you need immediate medical attention please go to your closest emergency room.

Please read all information for your prescription medication. By taking either of these medications you acknowledge and assume the risks associated with each. Phentermine and Qsymia are “stimulants”. If you are sensitive to, have any conditions worsened by or are taking medications that may interact with either of these medications please make sure your provider is aware.

We look forward to helping you shed some weight and be a better, healthier you! Please be patient with yourself during this process. You are changing patterns and habits that have been ingrained for years. If you are having any problems or concerns please contact our office.

Click here for more information on Phentermine/Qsymia.

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HCG

HCG is an injectable low dose hormone known as human chorionic gonadotropin. The program is 40 days and it requires you to be on a 500 calorie per day diet. HCG will help to keep your hunger at bay and mobilize unwanted body fat.

Before you begin.

Make sure you have all the things you will need prior to starting. You should have your Hcg and read all instructions included. Clear out your social calendar of dinner meetings and eating obligations. Purchase a scale to weigh yourself and to weigh your foods if you haven’t done so already. To mix your medications inject all 10cc of sterile water into the powder. Each day you will draw up 18 units to inject. Please make sure to follow the sterile technique described in your kit.

The first two days.

HCG medication injected does not become effective until the third day. The diet according to Dr. Simeons requires you to fatten up for 2 days. The first two days you will “eat to capacity the fattiest foods” you are capable of. Eat a bunch of fattening food for two days? YES. This helps to begin mobilizing unwanted fat and prepare you for the following 24 or 38 days. From Dr. Simeons research the patients that didn’t do this fattening up period lost less weight overall while on the HCG program than those who did.

The diet.

This excerpt below is adapted from the manuscript Pounds and Inches. It is to be strictly followed. 500 calories a day starting on the third day of injections.

Breakfast:
  • Tea or coffee in any quantity without sugar. Only one tablespoonful of milk allowed in 24 hours.
  • Saccharin or Stevia may be used.
Lunch:
  • 100 grams of veal, beef, chicken breast, fresh white fish, lobster, crab, or shrimp. All visible fat must be carefully removed before cooking, and the meat must be weighed raw. It must be boiled or grilled without additional fat. Salmon, eel, tuna, herring, dried or pickled fish are not allowed. The chicken breast must be removed from the bird.
  • One type of vegetable only to be chosen from the following: spinach, chard, chicory, beet-greens, green salad, tomatoes, celery, fennel, onions, red radishes, cucumbers, asparagus, cabbage.
  • One breadstick (grissino) or one Melba toast.
  • An apple or a handful of strawberries or one-half grapefruit or orange.
Dinner :
  • The same four choices as lunch.
  • Tea, coffee, plain water, or mineral water are the only drinks allowed, but they may be taken in any quantity and at all times.

In fact, you should drink about 2 liters of these fluids per day. Many patients are afraid to drink so much because they fear that this may make them retain more water. This is a wrong notion as the body is more inclined to store water when the intake falls below its normal requirements.

The fruit or the breadstick may be eaten between meals instead of with lunch or dinner, but not more than four items listed for lunch and dinner may be eaten at one meal.

No medicines or cosmetics other than lipstick, eyebrow pencil and powder may he used without special permission. The 3 ounces of meat must he scrupulously weighed raw after all visible fat has been removed. To do this accurately you must have a scale. Those not uncommon patients, who feel that even so little food is too much for them, can omit anything they wish.

There is no objection to breaking up the two meals. For instance having a breadstick and an apple for breakfast or before going to bed, provided they are deducted from the regular meals. The whole daily ration of two breadsticks or two fruits may not be eaten at the same time, nor can any item saved from the previous day be added on the following day. In the beginning patients are advised to check every meal against their diet sheet before starting to eat and not to rely on their memory. It is also worth pointing out that any attempt to observe this diet without HCG will lead to trouble in two to three days.

It should also be mentioned that two small apples weighing as much as one large one never the less have a higher caloric value and are therefore not allowed though there is no restriction on the size of one apple. Some people do not realize that chicken breast does not mean the breast of any other fowl, nor does it mean a wing or drumstick. The most tiresome patients are those who start counting calories and then come up with all manner of ingenious variations which they compile from their little books. When one has spent years of weary research trying to make a diet as attractive as possible without jeopardizing the loss of weight, culinary geniuses who are out to improve their unhappy lot are hard to take.

Making up the Calories

The diet used in conjunction with HCG must not exceed 500 calories per day, and the way these calories are made up is of utmost importance. For instance, if a patient drops the apple and eats an extra breadstick instead, he will not be getting more calories but he will not lose weight. There are a number of foods, particularly fruits and vegetables, which have the same or even lower caloric values than those listed as permissible, and yet we find that they interfere with the regular loss of weight under HCG, presumably owing to the nature of their composition. Pimiento peppers, okra, artichokes and pears are examples of this.

While this diet works satisfactorily in Italy, certain modifications have to be made in other countries. For instance, American beef has almost double the caloric value of South Italian beef, which is not marbled with fat. This marbling is impossible to remove. In America, therefore, low-grade veal should be used for one meal and fish (excluding all those species such as herring, mackerel, tuna, salmon, eel, etc., which have a high fat content, and all dried, smoked or pickled fish), chicken breast, lobster, crawfish, prawns or shrimp, crabmeat or kidneys for the other meal. Where the Italian breadsticks, the so-called grissini, are not available, one Melba toast may be used instead, though they are psychologically less satisfying. A Melba toast has about the same weight as the very porous grissini which is much more to look at and to chew.

Just as the daily dose of HCG is the same in all cases, so the same diet proves to be satisfactory for a small elderly lady of leisure or a hard working muscular giant. Under the effect of HCG the obese body is always able to obtain all the calories it needs from the abnormal fat deposits, regardless of whether it uses up 1500 or 4000 per day. It must be made very clear to the patient that he is living to a far greater extent on the fat which he is losing than on what he eats. Many patients ask why eggs are not allowed. The contents of two good sized eggs are roughly equivalent to 100 grams of meat, but unfortunately the yolk contains a large amount of fat, which is undesirable. Very occasionally we allow egg - boiled, poached or raw - to patients who develop an aversion to meat, but in this case they must add the white of three eggs to the one they eat whole. In countries where cottage cheese made from skimmed milk is available 100 grams may occasionally be used instead of the meat, but no other cheeses are allowed.*

How will I feel?

If you are strictly following the calorie restriction you should notice approximately a 1‐2 pound per day loss starting on days 4/5 of injections. You should not feel hungry and may notice increased urine excretion. Towards the end of your program you may notice muscle weakness. This is related to fat being removed from around your muscles and will improve in 1‐2 weeks after treatment stops. Overall you should be feeling lighter and thinner.

Exercise?

During this time we would like for you to stay active, but not to be exercising intensively. 500 calories per day is very low and is fine to maintain normal activities of daily living, but not an extreme exercise program.

The last injection.

After the last injection you must stay on the 500 calorie diet for 3 more days. Why? Because HCG will still be circulating in your body and you cannot return to normal eating while it is present otherwise a rapid weight gain will ensue.

Reintroducing food.

When the three days of dieting after the last injection are over, the patients are told that they may now eat anything they please, except sugar and starch provided they faithfully observe one simple rule. This rule is that they must have their own portable bathroom-scale always at hand, particularly while traveling. They must without fail weight themselves every morning as they get out of bed, having first emptied their bladder. If they are in the habit of having breakfast in bed, they must weigh before breakfast. It takes about 3 weeks before the weight reached at the end of the treatment becomes stable, i.e. does not show violent fluctuations after an occasional excess. During this period patients must realize that the so-called carbohydrates, that is sugar, rice, bread, potatoes, pastries etc, are by far the most dangerous. If no carbohydrates whatsoever are eaten, fats can be indulged in somewhat more liberally and even small quantities of alcohol, such as a glass of wine with meals, does no harm, but as soon as fats and starch are combined things are very liable to get out of hand. This has to be observed very carefully during the first 3 weeks after the treatment is ended otherwise disappointments are almost sure to occur.*

When to return?

We would like to see you at the office every other week while on the program. It is important for us to monitor your weight loss, check your vital signs and see how you are feeling.

We will be available in the office during regular business hours to schedule any appointments or answer questions by phone. Any concerns outside of business hours will be handled the next business day. If you need immediate medical attention please go to your closest emergency room. We look forward to helping you shed some weight and be a better, healthier you! Please be patient with yourself during this process. You are changing patterns and habits that have been ingrained for years. If you are having any problems or concerns please contact our office.

As with any medication there are inherent risks. Please be aware that Hcg is not FDA approved for weight loss. By receiving Hcg from our office you assume any and all risks associated with Hcg and a calorie restricted diet.

Click here for more information on HCG.