Module XIV (A) - Individualized Weight Management For The Patient

Upon completion of this module, the participants will:

• Understand the multi-factorial causes of weight gain
• Evaluate genetic markers for particular foods that show benefits in weight loss
• Evaluate genetic markers for exercise recommendations bases on genetics
• Know nutritional depletions that are caused by bariatric surgery
• Learn how to replace nutrients in patients that have had bariatric surgery
• Learn individualized therapies for weight management
• Understand the role of inflammation in weight gain
• Understand the importance that allergies play in gaining weight
• Recognized that hormonal imbalances can cause weight gain including: sex hormones, thyroid, insulin, and cortisol
• Understand the value of sleep deprivation and weight management
• Appreciate the value that detoxification plays in weight management
• Know how to detoxify a patient
• Comprehend the role yeast infections may play in weight gain
• Evaluate the role of neurotransmitter function in weight gain
• Appreciate the importance psychological dysfunction has on weight gain and weight loss
• Learn nutrients that aid in weight loss
• Understand the science behind why some foods are addicting
• Know the role that stress plays in weight gain and whether a patient can successfully lose weight
• Review healthy eating programs for weight management that are individualized to the patient's needs
• Understand the importance of energy metabolism and production in weight management

Module XIV (B) - Comprehensive Weight Loss for the Integrative Physician

Upon completion of this module, the participants will:

• Coverage of the Paleolithic Diet and its principles will be reviewed and current data regarding its ability to prevent relapse and ease of maintenance will be reviewed.
• The Low Carbohydrate/Mediterranean approach will also be considered and the present nutritional literature regarding its success and failure with the American population are presented. Definitions of Low Carb, "No Carb" and "Modified Carbs" are discussed and individual patient response to these subtypes are touched on.
• Decision Principles and Guidelines are given for the attendee to use when trying to help a patient get started on a comprehensive weight loss plan that fits their needs.
• Comparison of ease of performance and data outcomes between these plans are made to help the physician make specific goals for their weight loss patients.
• Learn the concept of checking an REE for patients to see how their metabolism can be used to the patient's advantage when calculating caloric intake for a weight loss diet.
• Become familiar with sarcopenic obesity in the elderly and why it is resistant to traditional methods for weight loss.
• Understand the concept of detoxifying the body when weight loss occurs is different in the younger versus older population.
• The Older Adipocyte: Does It function the same as a younger cell and does it release different markers for weight loss?
• Learn the difference between a lapse and a relapse.
• Understand that patients who have recently lost a major amount of weight have a long road ahead, they may have the same RMR (Resting Metabolic Rate) and that biochemically, it's a struggle.
• Introduce Principles of Successful Maintenance to your patients, realistic short term and long term goals are reviewed so they can stay on track and go the distance.
• Important psycho behavioral tools towards maintenance are covered.
• Learn about the currently existing data that presents obesity as a causative effect from prior exposure and infection with viruses, especially Adeno Virus 36.
• Explore the treatment realm of protection of the immune system as a real barrier to future biochemical changes in the cell that set up the pathway for later "obesity chemistry."
• The current literature on adenovirus treatment and prevention of obesity is also reviewed.
• Novel testing methods for obesity including microbiologically based ones for infection are presented.
• A panel of immune boosting supplements that also correct obesity are given and presented for practitioners to have available to patients.
• Learn what lectins are as a class of compounds in foods.
• Modern testing methods for lectins in the diet are presented.
• Understand how lectins can contribute toward obesity in your patient and how to eliminate them.
• Teach patients to become "Lectin Aware" when they eat out at restaurants and travel so they can safely reach weight loss goals.
• Understand the incidence and impact of obesity.
• Understand the genetics and neurochemical basis of satiety and obesity.
• Understand novel therapeutic interventions to managing patients with obesity.
• Review the multitude of hormones, cytokines and other signals involved in obesity.
• Understand how the above lead to obesity and its related comorbidities
• Discuss potential treatment options considering these new related processes.
• Know the definition of human microbiome
• Learn the 4R program for gut restoration
• Know the definition and action of probiotics
• Learn the definition and action of prebiotics
• Understand the effect that diet has on the GI tract microbiome
• Learn how GI microbes are able to do all of their functions simultaneously through the sensing system found in the intestinal cells that use pathogen recognition receptors
• Know the definition of toll-like receptors and their function
• Understand the role that the microbes of the intestinal tract have on energy balance in the body and consequently their effect upon weight gain and loss
• Learn how gluten intolerance and sensitivity may play a role in weight gain
• Learn the Obesity Model, obesity statistics, and Obesity as the mother of multiple diseases
• Understand the Obesity Equation, its determinants, estimation and causality
• Understand the connection between pesticides/herbicides, common household chemicals and hormone imbalance syndrome (HIS)
• Understand why the South and the Midwest of the United States have more obesity than other regions
• Recognize the link between Hormone Imbalance syndrome and the growing food allergy and environmental allergy epidemics
• Learn the macro-diagram of hormone imbalance syndrome, its impact on obesity and associated comorbidities
• Use the obesity model to identify the steps for effective treatment of obesity and its comorbidities
• Understand the optimal food choices for optimal weight control
• Recognize the role of nutritional supplements in weight control
• To understand the triggers of immuno-inflammation
• To elucidate the biomechanisms of macrophage interactions with adipose tissue
• To illustrate how food antigens and their modification can be amplifiers of inflammation and autoimmunity
• Recognize the variety of energetic techniques and biophysical technologies which have been demonstrated to impact weight management and healthy physiology.
• Discuss the physiological parameters that have been shown to be changed by application of these techniques and technologies.
• Recognize the scientific evidence and the theories about why these approaches can impact metabolism and identify future areas of research.
• Be able to make informed choices about safe and appropriate use of energetic techniques and technologies that can benefit their patients.
• Have a clearer understanding of the obesity and metabolic syndrome problem in children.
• Know the environmental risk factors involved in the problem.
• Be able to identify obesity in children using BMI as a tool, and to identify children who have metabolic syndrome.
• Know appropriate dietary measures to recommend for metabolic syndrome and obesity in children.
• Know appropriate supplements to recommend for insulin resistance in pediatric populations.

Module XIV (C)

Upon completion of this module, the participants will:

• Understand how Physique Optimization can add revenue to your medical practice
• Recognize different types of eating plans utilized in bodybuilding and fitness professionals
• Review a number of objective measurements including the importance of body composition in tracking
• Discuss how to alternate caloric load and macronutrient shift according to goals and results
• Review the importance of a pre and post workout meal
• Discuss some basics of exercise prescription for those looking to optimize their physique
• Understand advanced bio-marker testing for cardiovascular risk stratification and individualized treatment
• Understand how diet and lack of exercise induces inflammation
• Recognize the role of inflammation in heart disease and weight loss
• Improve patient outcomes in both cardiovascular disease and weight loss by following bio-markers
• List the factors that make up the metabolic syndrome and how it relates to weight gain, weight loss, heart disease, strokes, and diabetes.
• Name the factors that are implicated in causing the metabolic syndrome and why there is disagreement with experts on the definition, cause, and treatment.
• Describe the diagnosis of the metabolic syndrome including labs, history, and physical examination.
• Illustrate how the liver is involved with the pathogenesis of disease and how weight gain, particularly around the organs, is a toxic response to liver stress.
• Describe lifestyle and behavioral interventions, medications, and other interventions for the prevention, treatment and cure of the metabolic syndrome.
• Using the skills acquired as a functional medicine provider to assess and evaluate the bariatric surgery patient
• Learning the difference between treating gastric bypass, lap band and gastric sleeve patients and realizing that these patient have similar and different needs.
• Addressing nutritional, hormonal, deficiency in a patient population that is volume and calorie restricted
• Formulating diet, exercise, vitamin, plans, from immediately after surgery to many years post-surgery while also realizing that the patient needs constant education and emotional support to attempt to achieve a healthy lifestyle.
• Recognizing and treating dumping syndrome
• How to help a bariatric surgery patient who has regained weight
• The functions of insulin
• The functions of the counter--‐regulatory hormones
• The relationship between insulin and the counter--‐regulatory hormones
• Learn the difference between insulin sensitive and insulin resistance
• Learn how to diagnose the early stages of insulin resistance
• Understand what the process of healing insulin resistance looks like , i.e., why the patient gains fat weight as they become more insulin sensitive
• Understand the mechanism of weight gain
• Understand why less calories and/or more exercise works in the short term but not necessarily in the long term
• Learn how the counter--‐regulatory hormones plateau weight loss
• Understand the pathophysiology of Type II DM
• The common drug therapies and new modalities
• The physiology/endocrinology by which diet and lifestyle modifications improve insulin sensitivity
• Learn the stages of change model: To have a working knowledge of the stages of change model and learn to work with people in each stage of change.
• Be Able to use Provider Tools: To be able to use a simple tool to facilitate change in your office visits.
• Learn 3 options to approaching patients who need to make changes: To have 3 stylistic approaches to change depending on how much time you have.
• Apply what you learn to your own life: To be able to make your own life changes easier.
• To define how satiety signaling is affected by Energy Balance, Adipose Biology and Metabolic Efficiency, and ways to know which area may be affecting a patient's outcome.
• To define lifestyle intervention as a synergy of signals which work to trigger intracellular activities- ultimately driving changes in physiology and weight.
• To outline key clinical studies that can form the basis of a rational lifestyle intervention approach for weight management in an aging population of patients.
• To understand the role of macronutrients, micronutrients and phytonutrients in weight loss
• To understand the role of nutrient quality, quantity and ratios in weight loss research
• To understand how different foods and actives assist in weight loss mechanisms
• To understand the importance of the meal size, snacking, frequency of eating, and time of day in contributing to body weight
• To understand how emotional eating and stress eating can result in dysfunctional changes in eating behavior
• To understand the importance of mindfulness and relaxation in establishing good eating behavior

Module XIV (D)

Upon completion of this module, the participants will:

• The main components of losing weight and getting better together
• The 8 circles of health/healing
• Ways to boost group motivation
• Specific important health numbers to measure
• Specific steps in helping people lose weight and change
• Specific steps to enhance decision making skills
• The impact of ADD, anxiety, depression and addiction on group function
• Specific behaviors to avoid for health
• Specific weight loss and health actions to take
• 4 questions for optimal mental health
• How to implement the program’s principles during travel
• 4 ways to influence loved ones, community and world to lose weight and get healthy