1. "Phat" is Good / "Fat" is Not Good
2. Cancer - One Hidden Cost of Obesity
3. Being Overweight Hurts Your Body…AND Your Pride
4. Craving Those Double-Stuffed Oreos
5. “Slow Metabolic Syndrome”

“PHAT” is Good/ “FAT” is Not - Robert Posner, M.D.
At the risk of placing my advancing age on display, when I was a teenager, “burning a CD” would have meant setting fire to a Certificate of Deposit, “raving” would have meant saying some really great things about something and being “Phat” would have meant that someone misspelled the description of someone being overweight. Certainly, the vernacular of teenagers has changed dramatically since the 1960s, but there also is something else that has changed significantly, and that is the increasing prevalence of obesity in the adolescent/teenage population.

Recent statistics demonstrate that the scope of the obesity problem in children and adolescents is increasing dramatically. Some reports document a greater than 40% incidence of obesity in teens and adolescents in the United States, and the numbers are increasing. There have been a number of hypotheses as to why weight problems are becoming epidemic in this age group. Some experts feel that the proliferation of “fast-food” restaurants has contributed greatly to this national problem. From “Super sizing” the meals for only a few cents more to offering “2 for 1” meal deals, the multibillion dollar fast food chains certainly know how to get our youth to fill their plates up with mouth-watering, fat-laden burgers, fries, Tacos and all of the other tempting delights that increase our children’s waistlines. Another large school of thought is that the era of computers and hand held video games has resulted in much less physical activity for our youth. Moving a computer mouse with one hand while eating chips with the other is not exactly an ideal way of burning off calories. Running and playing stick ball in the streets has been replaced by playing Gameboy® in an air conditioned bedroom.

Studies clearly demonstrate that overweight children and adolescents are much likelier to become overweight adults. There is growing evidence that overweight and obese teens have a 50% chance of becoming overweight/obese if neither parent is obese and that increases to 80% if one or more of their parents are overweight or obese. The medical consequences of obesity seem to appear in the news almost daily, but just to reiterate, people who are obese suffer from an increased incidence of heart disease, diabetes, strokes, arthritis, colon cancer, breast cancer and most recently, even Alzheimer’s disease has been linked to obesity. It is well-known that the obese and the overweight also have shorter lifespans; we all know how dangerous the extra weight can be. Aside from the medical complications of obesity, an often ignored consequence of weight problems are the social ramifications associated with this situation. How many overweight teens shy away from fun social events such as dances and proms or even going shopping with their friends? I had one young patient tell me she did not want to go to the mall with her friends anymore because they did not make clothes in her size. I felt terrible for her. However, she was a smart girl and felt she had to do something about it and I knew I could help her. How many overweight children are viciously ridiculed by other children in school or on the playground? Being overweight hurts the body…and the pride.

As parents of an overweight child or teen, what can we do to help the problem? First, it is important to be able to discuss these issues in an open, helpful manner. As you and I know because we have been there before, youngsters are fearless when it comes to “later in life” consequences. They never think about things like strokes, diabetes, colon cancer, etc. because those are problems that affect “old people”. Perhaps, if there has been a relative that they have seen suffer from one of these afflictions, the child or teen may be able to relate better to the dangerous risk associated with weight problems. Another method may involve asking your primary care physician to sit down with your child to discuss in frank terms some of the detrimental health consequences of being overweight. In my internal medicine practice, I have often had high school students spend an afternoon seeing patients with me observing first hand some of the negative effects of long standing weight problems. A parent can also help to increase a child’s activity and exercise levels. Go play a game of basketball with your child or take a walk or go for a bike ride in the park to burn those calories.
Concerning the approach to the overweight child or teen, an important step is to keep healthier foods around the house. It is of course difficult to control your child’s eating behaviors when they are out with their friends, but it is definitely important to encourage your child to make healthier choices when they are out. A chicken selection as opposed to the double burger with cheese would be much more prudent and avoiding the super sized fries also is helpful. Take the plunge and remove the junk food from your home. If it’s not there they won’t eat it! Furthermore, set an example for your children. If you expect them to watch their calories and exercise more, you should be prepared to do the same. Beware of supplements and products that make ridiculous claims such as: “Take our pill, exercise less, eat more and lose pounds a week!” We all know that if it were that simple, there would be no weight problems at all.

The Serotonin Formula Weight Loss Program™ and Serotonin Formula Weight Loss System™ were designed to benefit teens as well as adults. These comprehensive programs utilize a patented serotonin technology to achieve a reduction in carbohydrate cravings as well as a patent-pending Transitional Diet Plan™. The average weight loss observed with our medically supervised Serotonin Formula Weight Loss Program™ is over 30 pounds in 12 weeks. The self-help Serotonin Weight Management System™ has demonstrated a 12-week weight loss average of 20 pounds.

A bacon double-cheeseburger is Pretty Hot And Tasty (PHAT). An overweight teenager is considered FAT, and is subject to health problems and social ridicule. With a little intervention, you can be of great help to protect your child from having a lifelong battle with his/her weight.

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Cancer…One of the Hidden Costs of Obesity - Robert Posner, M.D.
All of us are aware of the association of obesity with premature coronary artery disease, stroke, diabetes mellitus, hypertension and high cholesterol levels. However, until recently, most people did not realize that there is an increased risk of cancer in the overweight population. Recent studies published in the medical literature have demonstrated a higher incidence of colon, breast and ovarian cancer in people who are obese. This cancer risk is yet another hidden cost of being overweight.

One can use a Body-Mass Index Chart (“BMI”) to determine whether a person is overweight or obese. (Use our anonymous online BMI Indicator) The BMI is calculated using the height and weight of an individual. A BMI greater than 25 is considered to be indicative of being overweight and a BMI of 30 or greater defines obesity.

The Surgeon General of the United States has labeled obesity as the nation’s largest health risk, surpassing cigarette smoking. The prevalence of obesity in the United States is greater than 40% in some studies, and is growing at an alarming rate. The recent revelations about the increased risk of cancer associated with obesity provides yet another compelling reason for the overweight individual to lose weight.

Obviously, losing weight is incredibly difficult, because if it were easy, there would be no overweight individuals. No offense meant to Jared from Subway, but if everyone could lose over 100 pounds simply by eating a Subway sandwich, then every Subway franchise would have a line greater than the box office for a Springsteen concert. The overweight person who is attempting to lose weight can be overwhelmed by the plethora of products and programs advertised to help he or she lose weight.

Buyer beware!!! There are many products that advertise themselves to be a “simple solution to weight loss”. I am certain you have seen some of these commercials and “infomercials”. Usually, there is a person telling you how easy it was to lose weight by taking the product being advertised. “I took Product “X”, ate more, exercised less, and the pounds melted away.” The person then is shown in a “before” picture (Jabba the Hutt from Star Wars looked a bit better) and then the person is shown in the “after” picture (usually, the testimonial person is in a bikini, and the picture rivals Bo Derek in the movie “10”). This is followed by some guy in a white coat, who they refer to us “Doctor”, (credentials are often not mentioned…the guy could have his Ph.D. in Scamatology) explaining to us how Product “X” blocks fat absorption, deflects carbohydrates, and eats cellulite all at the same time.

Please read the fine print. It will say: “Results seen are not typical”. This type of advertising is highly effective, because the gullible public subconsciously is hoping for an easy, quick-fix solution to their weight problems. To quote P.T. Barnum: “There is a sucker born every minute”. Don’t be one of them. These marketing companies are preying on the consumers who are uninformed and are likely to be swayed by visuals and testimonials. If something sounds too good to be true, it usually is. Therefore, I strongly suggest that before buying any weight loss supplement or product, you should request to see the supportive science and studies behind that product.

Losing weight is a function of taking in less calories than you are burning off. “Taking in” calories is your dietary intake of food and beverages and “burning off” calories is your exercise and daily activities. To lose weight, you must put yourself in a negative caloric balance. It takes burning off 3500 calories to lose 1 pound of weight. Conversely, eating an extra 3500 calories will make you gain one pound of weight.

Concerning caloric intake, it is important to limit the amount of calories being consumed, but yet still provide tasty and palatable food choices. Food cravings and stress/binge eating can sabotage your attempts to limit your portion control. At the Serotonin Formula Weight Loss Clinic, we prescribe a medication to curb your appetite and also utilize a unique scientific breakthrough: oral serotonin supplementation to curb cravings and increase energy. Serotonin Formula™ is a patented delivery system of a natural body chemical, serotonin. When this brain chemical is deficient, a person can exhibit a number of symptoms including: carbohydrate cravings and weight gain, depression, anxiety, chronic fatigue, premenstrual syndrome, perimenopausal depression, fibromyalgia and migraine headaches.

The 12-week Serotonin Formula Weight Loss Program has demonstrated an average weight loss of over 30 pounds, which greatly exceeds Weight Watchers and a number of other popular programs. Part of the program also includes a great deal of attention to the other end of the equation…calories being burned off. For the long-term success of weight loss, it is imperative that the person learns how to schedule exercise as part of their weekly routine. Obviously, a number of people have orthopedic limitations and other medical reasons why they cannot run or do other physically-demanding exercise. However, the Personal Trainer who consults for the Serotonin Formula Weight Loss Program meets individually with each patient to construct a program that “makes sense” for that person.

There are a number of people who need a medical “jump-start” in their quest to lose weight. High protein diets, such as Atkins and others, show initial success, but when the person eventually goes back to those carbs, the lost weight returns. The key to success for long-term success is behavior modification…learning how to change your eating and exercise behaviors. This is not a simple task, but yet, it is one that can be achieved.

Losing weight will help your body and your pride. You will lessen your risk of developing serious medical conditions, such as heart disease, diabetes and cancer. You will also develop more confidence and feel better about yourself.

The Serotonin Formula™ Program is a patent pending medical breakthrough weight loss program. If you have struggled to lose weight we have two ways to help whether you have 5 pounds or 100 pounds to lose:

The Serotonin Formula Weight Loss Program™

• Medically supervised by a board certified internal medicine specialist
• Utilizes prescription medication & a serotonin supplement to reduce carbohydrate cravings
• 12 weekly medical visits
• Nutritional and exercise counseling
• Average weight loss is 35 pounds
• An affordable pay as you go philosophy

The Serotonin Formula™ System

• Cutting edge self-help weight loss program
• Utilizes a unique patented serotonin supplement to significantly reduce carbohydrate cravings
• No weekly visits necessary
• Contains the Transitional Diet Plan™ and Informational audio CD with practical diet and
  exercise tips
• Average weight loss is 20 pounds
• Cost effective

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Being Overweight Hurts Your Body…AND Your Pride - Robert Posner, M.D.
You cannot pick up a newspaper these days without reading a story about the growing problem of obesity in the United States. Currently, 64.5 percent of U.S. adults, age 20 years and older, are overweight and 30.5 percent are obese. We have all been made aware of the detrimental health effects that may occur when someone is overweight. From diabetes mellitus to heart disease to cancer, it is very clear that being overweight is a significant risk factor for life-threatening diseases. The American Cancer Society recently conducted a large study of obesity and site specific malignancies. Through the follow-up year, the study was successful in tracing 93% of the one million individuals in the long-tem study. Men who were 40% or more overweight had to 73% higher incidence of cancer. For women it was as high as a 400% incidence of cancer occurring.

To make things worse, the overweight individual is often on numerous medications, including pills for high blood pressure, high cholesterol levels and diabetes. These medications often have significant side effects including fatigue, decreased sexual interest and muscle aches. We also know that if parents are overweight or obese their children have a 70-80% chance of becoming overweight/obese as well. The madness has to stop and we cannot continue to pass this on to our children. What is alarming and not discussed frequently are the negative psychological effects that occur when a person is obese or even just overweight. Many times, an obese/overweight person suffers from depression and uses food for comfort, which perpetuates the cycle.

Unfortunately, society as a whole tends to be very judgmental when it comes to appearance. Just by looking at the red carpet runway at the Academy Awards, it is very clear that famous people strive and are expected to be very thin. Whether it be a magazine advertisement for bathing suits or a television commercial, society places a premium on being “thin”. Whether we want to believe it or not, there is a negative social stigma about being overweight, and this has adverse ramifications at the workplace and at home. In today’s society, although it is a shame and unfair, opportunities seem to come to those that look good and appear youthful, but alas there is a solution.

In my medicine practice, I have seen a number of patients who deprive themselves of attending events that would be an incredible amount of fun because these patients are embarrassed about their bodies. Whether it be a high school/college reunion or a company beach function, the overweight individual does not want to attend these events. The person is frightened that he or she will “stand out” from the rest of the attendees because of their body shape. There is fear that other people will look much better. Therefore, the overweight person would rather “pass” on going to these events rather than reunite with their old classmates and friends.

As a board-certified internal medicine specialist and Medical Director of the Serotonin Formula Weight Loss Program™, I certainly am a strong proponent of obese/overweight people losing weight to avoid the life-threatening medical complications that may accompany the weight problem. However, I am also aware of the positive effects that significant weight loss may have on the psyche. A number of our patients who lost over 30 pounds in the 12-week Serotonin Formula Weight Loss Program™ have informed me that they are now attending special events such as parties, weddings, and class reunions which they previously would have avoided. They appear to have greater self-esteem, energy and vitality. They are more outgoing, not afraid to talk to people and more importantly not afraid to look in the mirror any more. In addition, the weight loss has enhanced their mood and increased libido and many have been able to find romance. Furthermore, shopping for and wearing a nice, new form-fitting outfit has brought a renewed sense of pride and self-confidence. It is not “vain” to want to look healthy. Losing weight not only helps the body…it also helps your pride.

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Craving Those Double-Stuffed Oreos®?-Blame It On Brain Chemicals!!! - Robert Posner, M.D.
Most women have experienced the sensation of craving chocolate and other sweets. Often, this occurs during the week or two before menstruation. Scientific research has shown that imbalance of brain chemicals may lead to a number of symptoms of premenstrual syndrome (PMS). A woman experiencing PMS may have crying spells, bloating, abdominal cramps, anger outbursts, headaches and a number of other distressing symptoms.

We all have a chemical in the brain called “serotonin”. This chemical functions as a neurotransmitter, a chemical that transports information from one area of the brain to another. Serotonin deficiency has been implicated as a major contributing cause to depression, anxiety, PMS, eating disorders, migraine headaches, chronic fatigue syndrome and fibromyalgia.
Serotonin is made inside the body from the amino acid, tryptophan. This amino acid is found in various food sources, and high amounts are found in carbohydrates, chocolate and other sweets. When a person ingests chocolate, the body converts tryptophan, the building block into serotonin.
During a woman’s cycle, serotonin deficiency may occur. When this happens, the body will send out a signal that it needs more serotonin in the form of a food craving. Therefore, when the craving occurs, this will motivate the person subconsciously to eat chocolate or other sweets that can supply the tryptophan. The affected person does not realize that the body is serotonin deficient; they only know they really want that handful of Hershey Kisses®. Of course, the aftermath of this ingestion is the weight gain, adverse cholesterol effects and other detrimental effects from excessive eating of carbohydrates.

So how do we become chemically balanced and stop food cravings? There are a number of strategies that can help raise serotonin levels. Prescription medications like Prozac®, Zoloft® and other drugs indirectly raise serotonin levels in the brain but have a number of side effects. Some dietary supplements such as St. John’s Wort and 5-HTP claim to raise serotonin levels, yet they have not been subjected to any craving inhibition studies. A new patented product, Serotab® is the first and only direct serotonin containing dietary supplement that has been shown to reduce carbohydrate cravings in a clinical study. A reduction in carbohydrate cravings is a start to weight stabilization or even weight loss.

Controlling food cravings is very difficult using willpower alone but medical professionals can help. As chemical imbalances are more understood, perhaps someday we can walk by the grocery store shelf and reach for the chocolate-flavored serotonin bar instead of the Oreos®!!!

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“Slow Metabolic Syndrome” (Or Why You Gain Weight Just by Looking
at That Twinkie®) - Robert Posner, M.D.
As a practicing internal medicine physician, I frequently have patients who come to my practice very frustrated with their inability to lose weight. Despite intensive efforts at dieting and exercise, they find that losing weight is incredibly difficult, if not impossible. They are convinced that there is something wrong with their “hormones” or that they have a thyroid hormone deficiency. Laboratory blood testing almost always shows that everything, including thyroid levels is “normal”. This results in even further despair because there seems to be no answer for their malady. I have termed this condition, “Slow Metabolic Syndrome.”
Unfortunately, it seems to mostly afflict females over the age of 35. Although, there are some females under age 35 and males of all ages who may also experience symptoms. As Slow Metabolic Syndrome has not been defined previously in the medical literature, I would like to point out some of its salient features:

• Weight gain despite no change in eating patterns
• Dieting attempts not producing weight loss
• Attempts at aerobic exercise not producing weight loss
• Chronic fatigue without specific localizing causes
• Depression/frustration with weight and fatigue issues
• No evidence of low thyroid levels or other chemical imbalances

What is the best approach to helping someone with Slow Metabolic Syndrome? Weight loss will occur if a person is able to achieve a negative caloric balance, i.e. calories being taken in are less than the calories being burned off. Yet, as we age, it is very clear that gaining weight becomes much easier and losing weight becomes much more difficult, despite attempts at caloric restriction and increasing exercise. With Slow Metabolic Syndrome, the problem seems to be more on the caloric burn-off side of the equation as opposed to the caloric intake.

As we get older, certain hormonal and neurotransmitter (chemical messenger) changes take place. In females, estrogen levels begin to fall culminating in full-blown menopause. Declining female hormone levels also have an effect on other body chemicals including adrenal gland hormones and other important vital brain messengers. Serotonin is a very vital neurotransmitter and as estrogen levels fall, this causes a decline in serotonin levels. Serotonin deficiency has been implicated as a major contributing cause of depression, chronic fatigue, carbohydrate craving and anxiety. It is a distinct possibility that serotonin imbalance is a major contributing factor to Slow Metabolic Syndrome.

The normal “aging” process can produce a slowing metabolism, but direct attempts at raising estrogen levels in females via hormone replacement therapy (“HRT”) or testosterone in males via an androgen tablet or gel does not result in a reversal of symptoms. In the quest to help their patients, physicians will often prescribe thyroid medication, vitamins, antidepressants or other medications and supplements that have a dubious role in treating “Slow Metabolic Syndrome”.
Selective, artificial serotonin-raising agents such as Zoloft® and Prozac® have similarly demonstrated disappointing results. These medications only work at a specific serotonin receptor site and not at multiple sites. Other appetite suppressants, such as phentermine and Meridia® alone have not shown any promising results either.

During my research on direct, oral serotonin supplementation, and implementation of direct serotonin supplementation via the Serotonin Formula Weight Loss Program™, we have found a high level of success in treating Slow Metabolic Syndrome. Combining direct oral serotonin supplementation with a prescription appetite suppressant, and reinforcing behavioral modification techniques as to eating and exercising patterns has shown exceptional promise in helping patients lose weight and improve their global sensation of well-being. Addressing the serotonin imbalance state with direct oral serotonin supplementation appears to allow other modalities of treatment to have a much greater impact.

Unfortunately, life is sometimes unfair, and for those of you who suffer from Slow Metabolic Syndrome, it is incredibly frustrating to fight what seems to be a losing battle. Perhaps, armed with the right ammunition---in this case, a comprehensive approach to the underlying chemical imbalances contributing to this syndrome, the battle can be won!!!

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