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Weight Management

Body Composition Analysis (BCA)

The body is, of course, comprised of many components but those components we pay most attention to with respect to a persons weight and health are body fat, skeletal muscle and water. For health purposes, the assessment of the relative contribution to one’s overall weight from fat, muscle and water is important to estimate their impacts on health as well as providing guidelines directed toward losing weight.

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Body Composition

The body can be divided into different components, but those components we pay most attention to with respect to a persons weight and health are body fat, skeletal muscle and water. When assessing one’s body composition relative to health, the focus is primarily on body fat, and to some degree skeletal muscle.

Weight loss is focused on reducing fat levels but weight loss is generally a combination of fat loss and unwanted muscle loss. It is therefore important to distinguish weight loss as fat loss vs. muscle loss. It is also important to understand there are two types of fat: visceral fat (in the abdomen) and subcutaneous fat (under the skin) when assessing fat levels.

 

Assessing Body Composition

It is important to have goals in mind relative for achieving a healthy body composition. In most cases, the medical community focuses on distinguishing normal weight versus overweight or obesity in which obesity may be further classified as extreme obesity. However, it isn’t quite that simple.

Ultimately, the goal of assessing body composition from a medical perspective is based on associated health implications. Overall, body fat content described as percent body fat is the usual measure that drives recommendations for weight loss since the percentage of body fat has serious implications for health. However, it’s important to distinguish visceral fat from subcutaneous fat since visceral fat is known to release most of the inflammatory compounds that contribute to fat’s negative impact on health.

Moreover, the medical community has placed significance on the distinction between normal weight, overweight, and obesity. This is a grey zone area since there is a continuum between these categories. What is actually important isn’t a category, it is understanding one’s body composition and what impact it may have on one’s health. However, the medical community likes to create categories and labels because doing so helps to establish guidelines for treatment interventions based on severity of conditions. The purpose of establishing these classifications is to identify who is at most risk for fat-related diseases and their complications. Furthermore, insurance companies uses BMI categories to determine what they are willing to pay for when it comes down to treatment.

So, while we are at least for the time being stuck with oversimplified categories and labels, we can nevertheless look deeper into body composition to understand how to establish one’s goals and treatment plans.

Adipocity

Adipocity, defined as the degree of body fat accumulation, is generally categorized as normal, overweight or obese. Establishing thresholds to identify and distinguish each of these categories depends on the means of measuring adiposity and may be indirect or direct.

  • Indirect measures of adiposity include waist circumference (WC), WC/height and BMI, a measure derived from weight and height and computed as kg/m2. Indirect measures are simple and convenient but inaccurate and cannot distinguish visceral fat from subcutaneous fat (see below).
  • Direct measures of body fat, muscle and water levels (Body Composition Analysis (BCA) require specialized equipment that uses bioelectrical impedance analysis to measure body fat.

 

Indirect, Physical Measures of Adipocity

          BMI

The most common physical measure of obesity is body mass index (BMI). The BMI is calculated based on a person’s height and weight (BMI9 and is determined by the body mass divided by the square of the body height, and is expressed in units of kg/m²). Current guidance targets BMI as follows:

    • <18.5   Underweight
    • 18.5 – 24.9 Healthy
    • 25 – 29.9   Overweight  (associated with 5% incidence of metabolic syndrome)
    • 30- 34.9   Obese.  (associated with 35% incidence of metabolic syndrome)
    • ≥35   Extremely Obese

 

Limitations of BMI in Predicting Adipocity

However, BMI is a limited indicator of excess body fat and a relatively poor predictor of adiposity or risk of metabolic disease. It can lead to mis-categorizing someone with especially high (or low) amounts of muscle or body water. The major deficiency in relying on BMI to assess risk for fat-related diseases is its inability to accurately identify the amount of visceral vs. subcutaneous fat since visceral fat is more problematic than subcutaneous fat.

Categorizing can also fail to take into account the differences in body composition related to age, gender, ethnicity and race. For example, non-Hispanic black populations have lower visceral fat  levels compared to others with similar BMI and waist circumference measures. Further, fat redistributes from subcutaneous to visceral fat with age. Furthermore, BMI only takes into account body weight, it does not distinguish between its main components, ie, fat mass and lean mass. The inability to distinguish the different contributions to body weight, of fat and non-fat tissue (such as muscle and bone, which have greater densities than fat), explains why the BMI might overestimate adiposity in muscular and lean body builds. Therefore, individuals with an atypical body build (high muscle mass and low height or vice versa) may be classified in the wrong categories.

A 2014 study determined that 17.3% of women and 31.6% of men who were identified as obese according to BMI were misclassified according to sex-and-age-specific %BF criteria (see below). On the other hand, only 80.1% of women and 53.9% of men who were classified as obese using sex-and-age-specific %BF thresholds had BMI in the obese range. As a corollary, 19.9% of women and 46.1% men with high %BF were overlooked as being obese according to BMI criteria.

Furthermore, BMI underestimates adiposity in elderly men (aged 70 years and older). Paradoxically, the 2014 study also suggests that the BMI markedly underestimates adiposity in young men (aged 20–29 years). It seems likely that for this group, body fat contributes more, and lean tissue less, to body weight than in other groups. Differences in body composition might be related to an increasing prevalence of growth hormone deficiency with increasing age, resulting in loss of lean tissue and increases in body fat .

The authors concluded that their findings have public health implications, as the prevalence of adult obesity using a BMI threshold may underestimate the true extent of obesity in the white population, particularly among young and elderly men.

Additionally, while the focus of effort to reduce the future cardi-metabolic consequences of obesity such as type two diabetes has been  on treating obesity, approximately 10–20% of diabetes cases correspond to non-obese individuals as assessed by BMI. Clearly, other factors play significant rules, especially Visceral Fat (see below).

 

Other Physical Biometric Measures

Other commonly applied measures in obesity assessment, especially central (visceral) obesity, are waist circumference (WC – measured at the level of the belly button), and waist-to-hip ratio (WHR). Like BMI, they are both based on simple physical measurements and are easy to calculate but they have poor reproducibility and remain crude estimates of individuals level of visceral fat and lack a meaningful means of monitoring change associated with someone’s weight loss.

The waist-to-height ratio (WHR) is considered superior to waist circumference alone as a cardio-metabolic disease risk marker and a WHR >0.5 is the diagnostic cut-off value for obesity and may also predict elevated visceral fat levels.

 

Visceral Fat

In addition to measures of obesity, the accumulation of abdominal (visceral) fat is also associated with an increased risk of developing cardio-metabolic complications. Current research has determined that a visceral fat level is a stronger predictor of these complications than obesity.

Direct measures of visceral fat are considered more accurate in predicting cardio-metabolic complications than WHR or BMI, particularly in individuals with a BMI level below the standard cut-off values for diagnosing obesity.

Direct Measures of Adipocity

Body Composition Analysis (BCA)

When one is making an effort to lose weight, it is important to evaluate one’s body composition through the use of a Body Composition Analysis (BCA). BCA refers to the description and quantification of the various components that make up the human body. This provides a full breakdown of one’s percent body fat, percent skeletal muscle mass, percent body water and a measure of one’s visceral fat level. Moreover, one will be able to calculate the daily calorie needs for maintenance of one’s current weight and from that one will be able to identify a definitive target calorie intake to allow a predictable rate of reliable weight loss.

Percentage of Body Fat Content (%BF)

While thresholds for overweight and obesity are currently defined by body mass index (BMI), it is a poor substitute for measuring the actual amount of fat in the body (percent body fat, %BF). Percentage Body Fat (%BF) content rather than BMI is a more meaningful indicator of actual obesity. It is based on the percentage of body fat content which can be measured using a Body Composition Analyzer (BCA) which use bioelectrical impedance analysis to measure body fat. While technology  can provide estimates of %BF, one needs to establish %BF thresholds that define “normalcy.” In this case, “normal” may be defined as a value range that does not confer increased risk for the cardio-metabolic diseases associated with having elevated levels of fat tissue.

To establish a model of risk, research published in 2024 based on the National Health and Nutrition Examination Survey (NHANES) has determined %BF thresholds based on key obesity-related diseases, i.e. metabolic syndrome (MetSyn), defined as a group of conditions including heart disease, stroke, and type 2 diabetes. These thresholds can be compared to existing BMI thresholds of overweight and obesity.

 

%BF Thresholds for Overweight and Obesity Compared with BMI, Based on Cardio-metabolic Risk

Individuals measured by BMI as overweight (BMI 25-30 kg/m2) are associated with 5% incidence of MetSyn. Individuals with obesity (BMI>30 kg/m2) are associated with 35% incidence of MetSyn.

For men, there were no cases of MetSyn below 18%BF. A %BF threshold equivalence to “overweight” (BMI associated with 5% incidence of MetSyn) occurred at 25%BF, and “obesity” (i.e., 35% of MetSyn individuals) corresponded to a threshold of 30%BF.

For women, there were no cases of MetSyn below 30%BF, “overweight” occurred at a threshold of 36%BF, and “obesity” corresponded to a threshold of 42%BF.

Comparison of BMI to %BF illustrates the wide range of variability in BMI prediction of %BF, highlighting the potential importance of using more direct measures of adiposity to manage obesity-related disease.

 

Conclusions:

Healthy (0% incidence of Metabolic Syndrome) = <18% BF (men) & <30% BF (women)

Overweight (5% incidence of Metabolic Syndrome) = >25-30% BF (men) & >36-42% BF (women)

Obesity (35% incidence of Metabolic Syndrome) = >30% BF (men) & >42% BF (women)

 

A 2020 Study

Although it has not been clearly established as to what the actual cut-offs for %BF are for determining cardio-metabolic risk, a 2020 study evaluating 4735 (33.6% men) participants aged 45–64,  %BF gender-specific cut-offs of %BF were identified with respect to at least one cardio-metabolic risk factor. 

In this study of participants aged 45–64 , the %BF cut-offs that predict the presence of at least one cardiovascular risk factor were established as 25.8% for men and 37.1% for women. With the exception of dyslipidemia, in men and women whose %BF was above the cut-offs, the odds for having cardio-metabolic disorders ranged 2–4 times higher than those whose %BF were below the cut-offs. The authors concluded that maintaining %BF below these thresholds may appreciably reduce overall likelihood for developing cardio-metabolic diseases.

The cut-offs for %BF proposed here in men and women aged 45–64 years should not be construed as definitive thresholds for diagnosing obesity even in this age group, pending more confirmatory research. Age is a confounding factor which may strongly the %BF association with cardio-metabolic risk. Much younger, or much older individuals are characterized by physiological differences in body composition and therefore predicting the obesity-related risks in such individuals on the basis of the these cut-offs for %BF would be inappropriate.

 

Visceral Fat

Visceral Adipose Tissue (VAT) or “Visceral Fat” is a type of fat that builds up around the abdominal organs, liver, stomach, and intestines. It is different from “subcutaneous fat,” which is the fat that’s visible and is just below the skin that you can pinch. Visceral fat is significant because it is the type of fat that contributes most to the cardio-metabolic health risks associated with being overweight.

 

It has been shown that a simple estimate of visceral fat area by BCA is positively associated with insulin, triglycerides, CRP, IL-6, leptin and other inflammatory biomarkers, independent of relevant covariates including smoking, sedentary behavior, and moderate-to-vigorous physical activity. The Body Composition Analyzer (BCA) is the best means of assessing ones level of visceral fat and a good indicator of risk for cardiometabolic disease in adults.

 

See: Visceral Fat

 

What other information does a Body Composition Analysis (BCA) provide?

The BCA measures the mass of the 3 main body compartments: fat, muscle and water and monitors their changes over time. It also calculates caloric needs based on the input of different variables.

 

Percent Body Masses

In addition to %body fat, the BCA also measures %muscle and %body water. Monitoring the %muscle provides insight as to changes in relative muscle mass which can be useful to determine the amount of muscle mass everyones lost in the process of losing weight.

Measuring %body water generally only has significance in circumstances were an individual is retaining water, generally in the form of edema. This sometimes may explain unexpected weight gain.

The BCA also provides an estimate of visceral fat. While not a definitive measure, it does allow for relative determination and a means of monitoring response to a weight loss diet.

 

Calorie Requirements

Based on the above body mass determinations, the BCA identifies one’s  basal metabolic level and determines one basal calorie needs to sustain one’s current body weight. The basal metabolic level correlates with minimal physical activity only so it is modified by one’s assessment of their level of physical activity to establish a basic daily calorie needs. If one’s calorie intake exceeds this basic calorie need, they will gain weight and if they intake less, they will lose weight. One can then calculate a specific daily calorie deficit to determine a projected rate of weight loss.

 

                                          Monitoring Change

The BCA stores and tracks changes in one’s body composition to provide feedback regarding one’s efforts at losing weight. It graphically displays changes in one’s weight, %body fat, %muscle  and %body water over time and can track changes in visceral fat.

 

How often should one perform a BCA?

 The frequency of obtaining follow-up BCAs is individualized based on the rate of change in one’s weight or body composition. One may not expect much change in a BCA unless there is a loss of 10-15 lbs or more. The typical goal for rate of weight loss is 4 lbs/month so one might consider follow BCAs every 3-4 months.

 

How do you prepare for a BCA to get the most accurate assessment?

Please follow these steps:

  • Stay well hydrated – always consume a minimum of 64 oz. of water per day.
  • Remove all jewelry, socks, pantyhose and shoes.
  • Stand upright for at least 5 minutes prior to testing.
  • Avoid drinking caffeine on the day of your test.
  • Avoid eating 3-4 hours prior to testing.
  • Use the restroom prior to testing.
  • Avoid exercising 6-12 hours prior to testing.
  • Avoid consuming alcohol for 24 hours prior to testing.
  • Avoid Body Composition testing after a shower or sauna.
  • Avoid using lotion or ointment on hands or feet.
  • If testing in the winter, warm yourself up for 20 minutes prior to testing.
  • Avoid testing if you are pregnant, menstruating, or have medical implants such as pacemakers and othe life-sustaining medical implants.

 

Assessing Body Composition – Overweight

The common approach to individuals who are deemed overweight rather than obese based on a BMI between 25 and 30 is generally less aggressive and management compared to those deemed obese based on a BMI greater than 30. In reality however, as a chronic disease obesity is significant mostly for its predictive, implications for cardio-metabolic disease. One can argue, therefore, that the approach to treating “overweight” should be in context of other risk factors relative to cardio-metabolic disease. 

Given that abdominal (visceral) is the dominant contributor of cardio-metabolic risk compared with total fat, the determination of the level of visceral fat should provide additional risk assessment. Physical measures predictive of increased visceral fat includes waist circumference and/or determining the ratio of waist circumference and height.

Guidance for a Healthy Body Composition

In 2024, the European Association for the Study of Obesity presented “a new framework for the diagnosis, staging and management of obesity in adults to better align with the concept of obesity as a fat (adiposity)-based chronic disease.”

Their suggested  framework for obesity management goes beyond treatment focused mostly on weight, but to include a functional/ physical domain as well as a psychological domain. This would include the “overweight” population engage a larger segment of the general population comprised of “apparently healthy” overweight and obese individuals.”

 

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Other Resources for Help

 

References

Body Composition

Body Composition – Obesity

    1. Optimal Body Fat Percentage Cut-Off Values in Predicting the Obesity-Related Cardiovascular Risk Factors- A Cross-Sectional Cohort Study – 2020
    2. A new framework for the diagnosis, staging and management of obesity in adults – 2024

Body Composition – BMI

    1. Body mass index is a barrier to obesity treatment – 2024

 

Body Composition – BMI vs Percent Body Fat

    1. Defining Overweight and Obesity by Percent Body Fat instead of Body Mass Index – PubMed – 2024
    2. Assessment of Age-Induced Changes in Body Fat Percentage and BMI Aided by Bayesian Modelling- A Cross-Sectional Cohort Study in Middle-Aged and Older Adults – 2020
    3. Body mass index and measures of body fat for defining obesity and underweight- a cross-sectional, population-based study. – 2014pdf

 

Body Composition –Visceral Fat

    1. Age-related increase in visceral adipose tissue and body fat and the metabolic risk profile of premenopausal women – 1999
    2. Editorial – Importance of body composition analysis in clinical nutrition – 2023
    3. Visceral Adipose Tissue- The Hidden Culprit for Type 2 Diabetes – 2024

Body Composition Analysis (BCA) – Overviews

  1. Body Composition Analysis – Patient Preparation handout
  2. Measurement of visceral fat by abdominal bioelectrical impedance analysis is beneficial in medical checkup. – PubMed – NCBI
  3. The clinical importance of visceral adiposity – a critical review of methods for visceral adipose tissue analysis – 2012
  4. The use of bioelectrical impedance to detect excess visceral and subcutaneous fat – 2007
  5. Reliability-of-bioimpedance-in-the-assessment-of-visceral- 2023
  6. A Simple Estimate of Visceral Fat Area by Multifrequency Bioimpedance Analysis Is Associated with Multiple Biomarkers of Inflammation and Cardiometabolic Disease_ A Pilot Study – 2023
  7. Visceral fat area measured by electrical bioimpedance as an aggravating factor of COVID-19- a study on body composition – 2023
  8. Measurement of visceral fat by abdominal bioelectrical impedance analysis is beneficial in medical checkup – PubMed – 2008

 

Obesity – Visceral Fat

Visceral Fat – Overviews

    1. Pathophysiology of Human Visceral Obesity – An Update

Visceral Fat – Biomarkers

Biomarkers – Overviews

    1. Association of Inflammatory and Oxidative Status Markers with Metabolic Syndrome and Its Components in 40-to-45-Year-Old Females_ A Cross-Sectional Study – 2023
    2. The Preventive Mechanisms of Bioactive Food Compounds against Obesity-Induced Inflammation – 2023
    3. Biomarkers of dysfunctional visceral fat – PubMed – 2022
    4. Leptin and Inflammation – 2008
    5. Reliability-of-bioimpedance-in-the-assessment-of-visceral- 2023
    6. A Simple Estimate of Visceral Fat Area by Multifrequency Bioimpedance Analysis Is Associated with Multiple Biomarkers of Inflammation and Cardiometabolic Disease_ A Pilot Study – 2023
    7. Visceral fat area measured by electrical bioimpedance as an aggravating factor of COVID-19- a study on body composition – 2023
    8. Measurement of visceral fat by abdominal bioelectrical impedance analysis is beneficial in medical checkup – PubMed – 2008
    9. Visceral and Subcutaneous Adipose Tissue Volumes Are Cross-Sectionally Related to Markers of Inflammation and Oxidative Stress – 2007
    10. Biomarkers of dysfunctional visceral fat – ScienceDirect
    11. The Triglyceride_High-Density Lipoprotein Cholesterol (TG_HDL-C) Ratio as a Risk Marker for Metabolic Syndrome and Cardiovascular Disease – 2023

Biomarkers – Adinopectin

      1. The role of fat topology in the risk of disease. – PubMed – NCBI

Biomarkers – IL-6

      1. Metabolic obesity: the paradox between visceral and subcutaneous fat. – PubMed – NCBI

Biomarkers – Hypertriglyceridemia

      1. Hypertriglyceridemic waist – a useful screening phenotype in preventive cardiology? – 2007

Visceral Fat – Exercise

    1. Effect of exercise training intensity on abdominal visceral fat and body composition

Visceral Fat – Genetics

    1. Genetic and behavioral influences on body fat distribution. – PubMed – NCBI
    2. The genetics of fat distribution – 2014

Visceral Fat – Stress

    1. Interleukin-1 beta – a potential link between stress and the development of visceral obesity – 2012

 

Obesity – Comorbid Conditions

Obesity – Fatty Liver

    1. The role of visceral and subcutaneous adipose tissue fatty acid composition in liver pathophysiology associated with NAFLD. – PubMed – NCBI
    2. What non-alcoholic fatty liver disease has got to do with obstructive sleep apnoea syndrome and viceversa? – PubMed – NCBI

Obesity – Kidney Disease

    1. Association of visceral fat area with chronic kidney disease and metabolic syndrome risk in the general population

 

Obesity – Metabolic Syndrome

    1. Association of visceral fat area with chronic kidney disease and metabolic syndrome risk in the general population
    2. Abdominal Obesity and the Metabolic Syndrome – Contribution to Global Cardiometabolic Risk – 2008
    3. Metabolic syndrome and adipose tissue: new clinical aspects and therapeutic targets. – PubMed – NCBI
    4. Subcutaneous and Visceral Adipose Tissue: Their Relation to the Metabolic Syndrome: Endocrine Reviews: Vol 21, No 6

Obesity – Oxidative Stress

    1. Oxidative stress drivers and modulators in obesity and cardiovascular disease: from biomarkers to therapeutic approach. – PubMed – NCBI
    2. Visceral and Subcutaneous Adipose Tissue Volumes Are Cross-Sectionally Related to Markers of Inflammation and Oxidative Stress – 2007

Obesity – Sleep Apnea

    1. Visceral fat and respiratory complications – 2004
    2. What non-alcoholic fatty liver disease has got to do with obstructive sleep apnoea syndrome and viceversa? – PubMed – NCBI

 

Wt Loss Program – Appetite Suppressants

Appetite Suppressants – Prescription Medication List

  1. Adipex (Phentermine)
  2. Belviq (Lorcaserin)
  3. Bupropion
  4. Contrave (Bupropion/Naltrexone)
  5. Invokana (Canagliflozin)
  6. Naltrexone
  7. Orlistat (Xenical, Alli)
  8. Qsymia (Phentermine and Topiramate)
  9. Saxenda (Liraglutide)
  10. Topamax (Topiramate)
  11. GLP-1 Receptor Agonists
  12. Wegovy (Semaglutide)

 

Appetite Suppressants (Rx) –  Semaglutide

    1. Semaglutide Medications – Information
    2. Ozempic Information
    3. RYBELSUS Information
    4. Wegovy Information
    5. Effect of Continued Weekly Subcutaneous Semaglutide vs Placebo on Weight Loss Maintenance in Adults With Overweight or Obesity – PMC – 2021
    6. Review Wegovy (semaglutide)- a new weight loss drug for chronic weight management – 2022
    7. Once-Weekly Semaglutide in Adults with Overweight or Obesity – 2021
    8. Once-Weekly Semaglutide in Adults with Overweight or Obesity – PubMed – 2021
    9. Effect of semaglutide and liraglutide in individuals with obesity or overweight without diabetes- a systematic review – 2022
    10. GLP-1-Medications-Article-References-and-PubMed-Links
    11. Sublingual Semaglutide Supportive deposition
    12. The Impact of GLP1 Agonists on Bone Metabolism: A Systematic Review.- 2022
    13. Efficacy and safety of dulaglutide 3.0 and 4.5 mg in patients aged younger than 65 and 65 years or older: Post hoc analysis of the AWARD‐11 trial – 2021
    14. Safety of Semaglutide – 2021
    15. Semaglutide for the treatment of overweight and obesity_ A review – 2023
    16. Two-year effects of semaglutide in adults with overweight or obesity_ the STEP 5 trial 2022
    17. Semaglutide for the Treatment of Obesity – 2021

 

Appetite Suppressants (Rx) – Wegovy (Semaglutide)

    1.  Effect of Continued Weekly Subcutaneous Semaglutide vs Placebo on Weight Loss Maintenance in Adults With Overweight or Obesity – PMC – 2021
    2. Singh G, et al. J Investig Med 2022;70-5–13. doi-10.1136 jim-2021-0019525 Review Wegovy (semaglutide)- a new weight loss drug for chronic weight management – 2022
    3. Once-Weekly Semaglutide in Adults with Overweight or Obesity – 2021
    4. Once-Weekly Semaglutide in Adults with Overweight or Obesity – PubMed – 2021

Appetite Suppressants –  CAM

    1. Appe-control and Hunger Block

 

 

Wt Loss Program – Diet

Diet – Guidelines

 

Diet – Fasting

  1. Calorie restriction increases life span: a molecular mechanism. – PubMed – NCBICalorie restriction increases muscle mitochondrial biogenesis in healthy humans. – 2007
  2. A double-blind, placebo-controlled test of 2 d of calorie deprivation – effects on cognition, activity, sleep, and interstitial glucose concentrations – 2008
  3. Fasting and refeeding differentially regulate NLRP3 inflammasome activation in human subjects – 2015

Diet – Foods

  1. Chia Seeds
  2. Pistachios
  3. Fiber

 

Diet – Supplements

Supplements – Vitamins

Vitamins – Overviews

    1. Vitamin status in morbidly obese patients – a cross-sectional study – 2008

Vitamin C

Vitamin D

    1. Decreased bioavailability of vitamin D in obesity – 2000
    2. Higher visceral fat area increases the risk of vitamin D insufficiency and defic
      iency in Chinese adults – 2015
    3. Obesity and vitamin D 2004
    4. Rising serum 25-hydroxy-vitamin D levels after weight loss in obese women correlate with improvement in insulin resistance. – PubMed – NCBI
    5. The Effect Of Vitamin D Supplementation On Serum 25OHD In Thin And Obese Women – 2012
    6. The Longitudinal Association of Vitamin D Serum Concentrations & Adiposity Phenotype – 2013
    7. Vitamin D and Its Relationship with Obesity and Muscle – 2014
    8. Vitamin D supplementation enhances the beneficial effects of weight loss on cardiovascular disease risk markers – 2009
    9. Update on vitamin D – pros and cons – 2015

Diet – CAM Supplements

  1. Multi-Nutrient Supplements
  2. NRF2 Activators
  3. CoQ10
  4. Nicotinamide Riboside (NR)

 

 

Wt Loss Program – NLAL Lipolysis

NLAL Lipolysis – Handouts

  1. NLAL Lipolysis
  2. NLAL – Patient Treatment Info

NLAL Lipolysis – References

  1. Fat Liquefaction – Effect of Low-Level Laser Energy on Adipose Tissue
  2. Application of low-level laser therapy for noninvasive body contouring. – PubMed – NCBI
  3. Body contouring using 635-nm low level laser therapy. – PubMed – NCBI
  4. Efficacy of low-level laser therapy for body contouring and spot fat reduction. – PubMed – NCBI
  5. Independent evaluation of low-level laser therapy at 635 nm for non-invasive body contouring of the waist, hips, and thighs. – PubMed – NCBI
  6. Low-level laser therapy as a non-invasive approach for body contouring: a randomized, controlled study. – PubMed – NCBI

 

 

Maladaptive Eating

Eating Behavior – Emotional Eating

  1. Emotional Eating

Eating Behavior – External Eating Cues

  1. External Eating Cues

 

Eating Behavior – Cravings

  1. Food craving – new contributions on its assessment, moderators, and consequences – 2015
  2. Pickles and ice cream! Food cravings in pregnancy – 2014
  3. Relationship of cravings with weight loss and hunger – Results from a 6 month worksite weight loss intervention – 2013
  4. How Relevant is Food Craving to Obesity and Its Treatment? – 2014

Cravings – Treatment

Cravings Treatment –  CAM Supplements

    1. Quercetin
    1. Synaptamine

Eating Behavior – Binging  (BED)

BED – Overview

    1. Binge Eating Disorder – Recognition, Diagnosis, and Treatment

BED – Dopamine </sp an>

    1. Binge eating disorder and the dopamine D2 receptor: genotypes and sub-phenotypes. – PubMed – NCBI
    2. Dopamine for “Wanting” and Opioids for “Liking” – A Comparison of Obese Adults With and Without Binge Eating-2009

 

BED – Treatment

BED – Treatment, Overview

    1. Current and Emerging Drug Treatments for Binge Eating Disorder – 2014
    2. Pharmacological management of binge eating disorder – current and emerging treatment options

BED -Treatment, Bupropion

    1. Bupropion for Overweight Women with Binge Eating Disorder – Randomized Double-blind Placebo-controlled Trial – 2013

BED -Treatment, Chromium

    1. Chromium Picolinate – Summary
    2. A Double-blind, Randomized Pilot Trial of Chromium Picolinate for Binge Eating Disorder – Results of the Binge Eating and Chromium (BEACh) Study – 2013
    3. Dietary chromium supplementation for targeted treatment of diabetes patients with comorbid depression and binge eating. – PubMed – NCBI

BED -Treatment, Contrave

    1. Treatment of Binge Eating Disorder in Obesity: Naltrexone: Bupropion Combination Versus Placebo – Full Text View – ClinicalTrials.gov

 

Maladaptive Eating – Reward Deficiency Syndrome

  1. Clinically Combating Reward Deficiency Syndrome (RDS) with Dopamine Agonist Therapy as a Paradigm Shift- Dopamine for Dinner? – 2015

“Dopamine for Dinner” by Joan Borsten, 2014

Avaliable online at Amazon.com: Kindle subscriber: free;  Kindle book: $9.95  Paperback: $149.00

“Dopamine for Dinner,” is the first Malibu Beach Recovery Diet Cookbook, based on their famous low-glycemic diet. The recipes developed by four accomplished chefs are both pleasant eating as well as healthy. Based on the use of low glycemic index foods, the recipes emphasize nutritious eating in a manner that promotes maintaining high brain levels of dopamine and serotonin as a means of supporting healthy brain chemistry.

Emphasis on Education

 

Accurate Clinic promotes patient education as the foundation of it’s medical care. In Dr. Ehlenberger’s integrative approach to patient care, including conventional and complementary and alternative medical (CAM) treatments, he may encourage or provide advice about the use of supplements. However, the specifics of choice of supplement, dosing and duration of treatment should be individualized through discussion with Dr. Ehlenberger. The following information and reference articles are presented to provide the reader with some of the latest research to facilitate evidence-based, informed decisions regarding the use of conventional as well as CAM treatments.

 

For medical-legal reasons, access to these links is limited to patients enrolled in an Accurate Clinic medical program.

 

Should you wish more information regarding any of the subjects listed – or not listed –  here, please contact Dr. Ehlenberger. He has literally thous
ands of published articles to share on hundreds of topics associated with pain management, weight loss, nutrition, addiction recovery and emergency medicine. It would take years for you to read them, as it did him.

 

For more information, please contact Accurate Clinic.

 

 

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