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Healthcare Weight Management Articles

How to conduct follow-up appointments, Part 1 of 3: Patient’s FIRST weigh-in, the CHECKLIST Day 10

Updated: Jul 16, 2023

What you need to know is that everyone is different. Weight loss transformation although physical can be mental, emotional and even spiritual!

Patient’s FIRST weigh-in, Day 10

Some weight loss science

Some people have more insulin resistance in their system as opposed to others. Our program may be one-size-fits-all on its face, but it doesn’t mean that you shouldn’t consider tweaking the program here and there. In fact, we highly recommend you do.

Other than dancing around the fundamental principles of weight loss through science, most of your advice may simply be common sense!

The standard SOZA Weight loss diet is low-carb and mildly ketogenic. You can at ANY time push your patient towards being more ketogenic. However, going ketogenic immediately can be harder for people for the previous mentioned reason. Some people should be eased into it. From mildly ketogenic to fully ketogenic. We usually recommend at least 21 days on the standard SOZA Weight loss diet first.

The first weigh-in is important because they are putting into practice what they learned, and now would be the time to make sure they are doing everything correctly.

Here goes:

1. Did they lose weight?

When the patient comes in for their first weigh-in, they’ve usually lost a significant amount of weight. You should know however, most of this weight loss during Day 7 – Day 10 can be water weight. Getting rid of water weight is good, it is the first step before fat loss. There is a transition phase when switching from burning sugar for energy as opposed to burning fat for energy.

This doesn’t mean they didn’t lose any fat!

If your patient didn’t lose any weight which is very rare, then consider the following two points:

a. Perhaps they didn’t follow the program, because they should have at least lost water weight with low-carbs. Check their journal. Was the diet initially too hard?

There could be a ton of things that is going on, such as initial hormonal imbalances, and stronger insulin resistance. Some people just need a little more time on eating the correct foods before weight loss starts.

b. Perhaps they ARE following the diet. The patient is getting healthy before the weight loss starts to happen. That can also take a little bit of time. They just need to continue and stick with it. The weight loss will happen.

2. Are you using the supplements correctly?

Some patients do forget to take their supplements. This is due to many factors including, poor time management, they leave their supplements at home, etc.

3 sprays in the morning and 3 sprays before you sleep.

The supplements are necessary for a simple reason. It would be extremely difficult to diet to lose fat without the supplements controlling appetite, boosting metabolism, giving energy, and balancing hormones. In today’s world, supplements are extremely helpful and beneficial and can by all means be the necessary factor for success.

If you need a refresher on our supplements and what they do, read this article:

3. Are you eating nutrient dense foods? quality foods?

Ask your patient if they are eating nutrient dense foods or not. For instance, there was a patient called James, he was a truck driver in Alabama. Now James was a trooper, he lost a lot of weight and did very well. On his first weigh-in he claimed that he had some low energy. Now this is understandable, because it can happen during the transition phase from burning sugar to burning fat for energy.

However, during the conversation, we did ask where exactly did James get his food? from being on the road and all…

Turns out, the majority of James’s food were from 7-Eleven’s, Subway, McDonald’s etc. Now James was eating salads and chicken…but you can guess that these foods are NOT nutrient dense. They barely have nutrients at all!

  1. We asked James to plan better. He started taking food with him by investing in cold-storage containers.

  2. James also skipped snacks altogether and stayed longer without snacking but had three bigger main meals.

  3. Although he didn’t cut out smoking altogether, he did cut down a lot.

When James did switch over from eating better quality foods, salads etc. he felt much better.

4. Are you keeping a journal?

Several studies have shown that people who keep food journals are more likely to be successful in losing weight and keeping it off. Instead of you playing detective with endless questioning, you can just check their journal to see what they are eating and if they are eating enough.

5. Are you eating enough?

Our protocol is roughly 800 calories a day. It is high enough to be manageable and sustainable, but low enough to trigger a range of desirable metabolic changes. Not eating enough can lower the metabolism. It is not the 5-6 meals a day that keeps metabolism revving but the amount of food consumed*.

For instance, the patient can have 3 main meals but stay within the 800-calorie range. We do not recommend lower.

6. What protein are you eating?

We prefer lean cut proteins for we do not want patients getting used to animal fats. It’s fine if they eat 85% beef once or twice a week. Fat in itself does not cause weight gain. It does though, if consumed with carbohydrates.

We’ve seen that changing up the protein during the day or week shows more fat loss. Try different proteins. We have different gut bacteria, so we digest and absorb foods differently. Beef, chicken, Fish, Tofu, protein bars are all absorbed differently in our gut. Furthermore our gut bacteria keeps adapting and changing, so different proteins is good (not just protein, different foods are good).

7. Are you mixing vegetables at each individual meal?

There is a difference in this diet between vegetables and “greens.”

Example: Do NOT mix asparagus with broccoli.

You can MIX unlimited greens (lettuce, arugula all unlimited etc.) with vegetables.

Example: Add greens with vegetables (remember you can add greens with everything!!)

i.e broccoli with unlimited greens. Asparagus with unlimited greens, tomatoes with unlimited greens etc.

=>but again, NOT asparagus and broccoli.

We are pursuing fat loss in the fastest way possible! These tips are meant to develop the right habits on our program. We understand that at times, patients can get creative in the kitchen or they may be out for dinner. What we mean, is that if a patient does mix asparagus and broccoli it is not the end of the world, and it may NOT even stop fat burning. Developing the right habits during the program is better in the long run.

Consistently mixing vegetables makes them more starchy.

8. Are you consuming enough salads / greens ?

On our program we insist on having lots of greens. The more you eat the more you increase your Ph level. Furthermore, by eating more greens you get a lot of micronutrients that add up during the week providing you a lot of energy. Some studies have shown that eating greens reduce insulin levels. The darker the leaf the better! yes please try KALE.

Here is a tip, wishbone spritzer is acceptable on the program. It may not have completely natural ingredients, but it can help patients who are struggling to add flavor to their salads. Lesser of all evils.

9. Are you having more cooked than raw vegetables? not good.

Consuming greens helps increase fiber intake, increase water intake, and provides a great source of potassium which is needed on the program. Make sure the patient is having lots of greens. Not a small side salad but a big salad.

Again overly cooked vegetables are no good. They become starchy.

10. Are you preparing your own meals? Or eating out?

The more the patient is organized and prepares in advance the better their results.

An egg omelet for breakfast at a diner isn’t the same as an egg omelet made at home. The oil is different, the quality of the eggs is different etc. Some restaurants you only must tell the waiter / waitress that you are on a special diet and cannot have oils and butter. You would be surprised to know that the cooks in the back take the extra effort to prepare a lighter breakfast for you.

Having some extra fats to keep you satiated is fine, but they should be OMEGA-3 fats and not OMEGA-6 fats.

11. Are you eating organic as much as possible?

Some patients are allergic or more food sensitive to the hormones and antibiotics of growth hormones. Furthermore, there is less nutrients in non-organic produce or animal foods. James’s story is a good example of this.

12. Are you getting enough sleep?

Studies and our experience prove that people who are not sleeping well lose less. Sleep deprivation of just two hours causes us to overeat because it increases our stress hormones. A study in the UK found that this overeating amounted to 385 extra calories. If a patient is sleep deprived, their blood sugar levels will rise during the day causing excess hunger.

Getting a good night’s sleep is all about establishing a regular schedule in which you go to bed and get up the at the same time every day of the week including the weekend. There are lots of studies on the Circadian rhythm to prove this.

13. Are you exercising?

Exercising is good on the diet because it will help maintain muscle which is important for fat loss, and hence the more muscle the higher the resting metabolic rate. It all depends on the age of the patient. What they can do as opposed to what they cannot do. Always encourage them to exercise.

14. Have you changed or started any new medication?

Some patients while on the program get started with new medications. Cortisone shots for pain increases water retention and temporarily raises blood sugar levels. Higher insulin means less fat burning. A quick google of the side effects of the medications can give a good picture. This question can be asked on every weigh-in.

15. Are you having natural sweeteners?

Having too much natural sweeteners could cause your insulin to spike thinking it’s going to get real sugar. There is no direct correlation, but some studies have shown this does happen. So, if you do have natural sweeteners do not overdo it. Learn to gradually decrease natural sweeteners or sweetness in general throughout the program.

We had a patient that stalled their weight loss because she was having 7 Zevia 0-calorie cola drinks a day.

Yes it may be a natural sweetener and allowed on the program, but be reasonable.

16. What foods do you like? what foods don’t you like?

So the purpose of this question, is to help your patient discover your patients strengths and weaknesses. Help your patient by giving them ideas on what they should eat. For instance some patients say, “I can’t eat cooked veggies…”

Well make sure they eat raw veggies.

17. Is your patient over 40?

They need more protein. Not much more, but eating more (not much more!) should help with maintaining muscle. Being over 40 means you are more susceptible to muscle atrophy. Make sure they are also staying active. Remember the more muscle, the higher the metabolism.

18. Are you organized? planning properly?

Like in question 18, encourage your patient to take advantage on what they are good at as opposed to what they are NOT good at. Tell them to keep a daily scoreboard.

  • Some patients don’t take the time to plan their day, or their week properly.

  • Some patients love to cook and prepare their own food.

  • Some patients don’t like to cook. Where do they eat? where do they shop? what are they eating?

  • If your patient likes to exercise , then help them incorporate a fixed exercise regimen into their schedule. So at the of the day they can refer to how many steps they took. Iphone apps now have such features.

  • Again the journal is a great way to be organized. Encourage them to write in it even at the end of the day

  • If your patient is not planning properly, then they expend a lot of wasted brain energy on what to eat and what not to eat at lunch. What a silly way to burn glucose. However it does unfortunately.

19. Are you stressed?

Did you know bad stress can spike insulin? unfortunately stress can cause more. Straight up havoc on your body.

20. Do you have support outside of the clinic? at home?

Willpower is overrated. Get all sugary treats etc. out of your kitchen. If you have kids, then ask your kids to HIDE them. If you cannot find them, then you won’t eat them!

Family and friends supporting your patient is key to success. A supportive environment, or better yet, if someone else is doing the diet will be great!


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