Dr. Phil Calls on Bistro MD Physician to Help In "Extreme Weight" Case

With a case of extreme obesity slowly killing a man, Dr. Phil has called in Naples bariatric physician Caroline J. Cederquist, M.D., with hopes that her expertise and her medical delivery diet can offer critical help to the situation.

On the show, set to air on January 29, Dr. Phil employs his popular team approach, and he'll have input from his usual posse of medical experts for Kevin, who at age 44 has reached the stunning weight of 715 pounds. But faced with a weight problem that extreme, not just any doctor has the depth of experience to offer meaningful help.

So Dr. Phil called in Dr. Cederquist, a board-certified family and bariatric physician who has at the core of her treatment a focus not on extreme diets or radical regimens, but on addressing the metabolic irregularities that develop in overweight people, from mild insulin resistance to full-blown Type II diabetes. These irregularities actually make it progressively easier for an overweight person to produce and retain fat, and harder and harder to for them to lose it, typically leading to a cycle of increasing gain, even if the person doesn't increase their caloric intake.

"Kevin is disabled and virtually homebound," says Dr. Cederquist. "He has gained 300 pounds in the past five years. He suffers from diabetes and severe sleep and breathing difficulties. Problems with his joints and his sheer mass make it almost impossible for him to move around, and as a result, he scarcely leaves his bed, let alone his house. Getting him from home to the Dr. Phil studios was a major undertaking."

Dr. Cederquist said Kevin had been rejected for weight-loss surgeries because the medical conditions related to his obesity make him too high-risk as a candidate for surgery. He has sunk into a depression over his worsening situation, and resorts to eating for comfort, further worsening his conditions-and his despair.

"When I met with Kevin, I felt his anguish," Dr. Cederquist says, "but it was not unfamiliar to me."

Dr. Cederquist says such despair is common, even among those with much less severe weight problems.

"These are often people who have been successful at everything else in their lives, and they cannot understand why their efforts to lose even 20 pounds are so futile," she says. "But for them, it's just not as simple as eat less, burn more. Losing weight is not just about eating less of the wrong things; it is about eating more of the right things."

Dr. Cederquist analyzed Kevin's intake logs and determined he was eating more than 4000 calories a day, mostly in low-quality junk food. Kevin had long since become diabetic and is currently injecting 600 mg a day of insulin to control his blood sugar.

"That's a massive amount of insulin. That means his metabolic abnormality, coupled with his poor-quality diet, has led to a situation where his body cells are starving," Dr. Cederquist says. "A starving organism will resist weight loss even if it is carrying 500 pounds of excess body fat, which is what is happening in Kevin's case."

Studies show that the right balance of nutrients can reverse the metabolic abnormalities of diabetes and pre-diabetes, and people can begin losing weight even before implementing an exercise program, Dr. Cederquist says. But people underestimate the amount of work it takes to plan and prepare meals every day that contain that correct nutrient balance. And that's for people without the limitations that someone like Kevin has developed.

Because Kevin's high-risk status prevents him from pursuing bariatric surgery, Dr. Phil's staff assessed a number of options for Kevin, and ultimately, Dr. Phil asked Dr. Cederquist to help with Kevin's case. She had developed a delivery diet program that specifically addresses both the practical and metabolic problems people like Kevin must overcome. The delivery diet, called BistroMD, is a home-delivered version of the diets that Dr. Cederquist prescribes for patients at her Naples clinic.

"My patients reported that they felt great, were losing weight and could reduce or eliminate their need for insulin with the dietary plans my dietitians and I created," she said. "However, it was a lot of work, and many people today have to rely on quick, convenient foods due to the constraints of their busy lives."

Kevin's life is less busy than he'd like it to be, but due to the constraints of his physical condition, he is no more able to prepare appropriate foods for himself than the busiest of dieters. The gourmet foods in Dr. Cederquist's BistroMD will help Kevin deal with both the practical and the medical challenges he faces. The meals are portion-controlled and designed to preserve lean muscle tissue as the dieter loses body fat. Because they are low in glycemic load, the foods also tend to reduce the sugar and carb cravings that lead so many to abandon their dieting attempts.

With Dr. Cederquist's supervision, and support from Dr. Phil and his team, Kevin will go on the Bistro MD diet to try to control his metabolic abnormalities so that his constant gain can be reversed. If he adheres to the diet, his insulin resistance will decrease, and his metabolic condition will stabilize and improve, says Dr. Cederquist.

"I have monitored insulin and glucose levels in my patients for many years and have been able to demonstrate improvement or normalization of abnormal, insulin-resistant lab work in as early as six weeks from the start of the diet," she says. After that normalization, weight loss becomes markedly easier, but many diets never address this need, and some radical fad diets can even exacerbate the problem. She believes Kevin could drop as much as 250 pounds over the course of a year, and a loss of that magnitude could open other options for him that could continue that progress.

While Kevin is an extreme example, his metabolic abnormalities are common and are becoming more so. Currently 70.8% of men and 66.2% of women in the U.S. are overweight. The vast majority of overweight people develop metabolic abnormalities as they gain. But insulin resistance can be improved or reversed entirely with the right nutritional program, Dr. Cederquist says, and that is the underlying principle of the Bistro MD diet. The macronutrients of the diet include adequate lean protein spread throughout the day, controlled portions of complex carbohydrates and the right amount of "good" fats.

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About Dr. Cederquist

Dr. Caroline Cederquist is board certified in family medicine and bariatrics, the specialty of medical weight loss. A National Merit Scholar, Caroline Cederquist won full scholarship to the University of Miami's Honors Medical Education program before even graduating high school, and went on to complete both her bachelor's and M.D. in six years. During her family practice residency, her clinical work with patients of all ages gave her a comprehensive view of average Americans' health issues. She observed that far too many of these were directly related to excess weight, which inspired her interest in bariatric medicine. Dr. Cederquist opened her own medical practice in Naples in 1998, and went on to obtain her board certification in bariatrics. Today, she sits on the board of the American Society of Bariatric Physicians, and the team under her leadership at Cederquist Comprehensive Weight Control includes dedicated dietitians, behavioral therapists and a nurse practitioner, all addressing the individual metabolic, hormonal, nutritional, social and behavioral needs of each patient.

About BistroMD

BistroMD is the home-delivery version of Dr. Cederquist's clinical dietary program. Troubled by the difficulty her patients had with making the time to shop for and prepare the kinds of foods they really needed, Dr. Cederquist examined the existing diet meal options and found them sorely wanting. Most were barely edible, let alone palatable, but worse, none adequately addressed the specific metabolic challenges most overweight people confront in attempting to lose weight. Dr. Cederquist set about creating pre-packaged meals that could satisfy the discriminating tastes of her Naples clientele, working with professional chefs to develop recipes for dishes both delicious and metabolically sound. Originally available only to her clinic patients, Dr. Cederquist's meals became so popular by word of mouth that some expansion effort had to be explored. Today BistroMD meals are prepared using cutting-edge food preparation technology to assure an optimal balance of preparation convenience, correct nutrient content, and peak dining enjoyment. Affordable dining plans are delivered right to the dieter's home, and take just minutes from package to plate. Bistro MD is available online at www.BistroMD.com

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