Guide Review- Cèsar A. Lara, M.D. Center for Weight Management

Many diet and fitness regimens encourage you to see your physician before beginning a weight-loss program. Some people do so for guidance, and others look to physicians that focus only on weight loss to help them with their goals.

My 10-year-high school reunion is coming up, so in January, I became curious about medically supervised weight loss. I talked about it with my primary care physician, who suggested changing my diet and exercising, but I knew immediately I would need some hand-holding to get through it with any real results.

So I turned to Dr. César Lara of Tampa . I met one of his patients at a women’s health expo last fall, and was impressed with her results — more than 40 pounds off for more than a year. Through his basic medically supervised weight-loss program, Lara’s clients lose an average of one to two pounds every week. It’s designed so that patients can maintain the loss once the program has ended.

While everyone’s experience will vary, here’s how my program went.

The first visit

During the initial visit, expect blood tests, an EKG and a lot of discussion. If the doctor determines you’re not really serious, he may tell you outright that you should rethink it and come back when you’re ready to commit. But if he determines you’re ready to move forward, he’ll lay out a success plan that you can start as long as you’re medically cleared. Reasons for not being medically cleared can include anything from allergies to high blood pressure, in which case he’ll find another route for your weight-loss goals.

Green lighted

Once you’re cleared, everything changes. Say goodbye to cookies, candy, bread, pasta — basically all carbohydrates and your former fatty lifestyle. I said hello to a gallon of water a day, 12 ounces of proteins and eight teaspoons of sugar from sugars found in fruits and veggies only.

To maintain one’s current weight, the Food and Drug Administration recommends ingesting 2,000 calories daily.

To lose weight, many doctors and nutritionists say to drop 500 calories from the equation either by consuming less calories or by doing physical activities that burn 500 calories daily. In my case, my diet consisted of somewhere in the neighborhood of 800 calories a day, which is fairly typical.

The first week

In your first week you can expect to be consuming a lot more water and eating only protein until your body hits ketosis, a state of elevated levels of ketone bodies in the body. Your body burns fat the most while in this state.

Adjusting to the new rules of eating and drinking will be rough. Things you ordinarily grab on the go will have to be modified. Once you hit ketosis you’ll most likely breathe a sigh of relief to be able to add more variety in the way of fruits and veggies.

Typical day of dieting

You will wake up at a specified time each morning, as Dr. Lara recommends seven to eight hours per night to maximize weight loss. That’s normal for most people regardless of diet, but on this diet, the hours you sleep will be implemented as part of your daily regimen. So expect an assigned bedtime.

You will take appetite suppressants, fat burners and supplements throughout the day, based on your needs.

Eggs, cheese, lean meats, salads and fruits will become your normal breakfasts, lunches and dinners. You will be expected to have three meals a day and three snacks.

Due to the stimulants in your medicine, you can expect the doctor to tell you to remove caffeine from your daily diet, too. Short of a morning cup of coffee or tea, caffeine is no longer allowed.

Happy hour after work may turn into unhappy hour, because the only alcohol permitted on this diet is two ounces of silver tequila, vodka or silver rum, and the only thing it can mix with is a zero-calorie concoction such as No-Carbarita Margarita Mix. That was two ounces total per day, not per drink.

Exercise

In the first two weeks exercise won’t be required because your body will need time to adjust to the major changes in diet. If you are already on an exercise plan you should slow it down drastically to three to four days of walking.

If you are not exercising yet, don’t begin until the third week. While adjusting to the new dietary restrictions, working out would take more energy than you can handle, and exhaustion or passing out could be a side effect.

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In the third week you can begin walking three days a week for about 30 minutes a day. You will check in with a nurse every week and the nurse can let you know if you need to increase the amount of exercise or not. For most patients the ultimate goal will be to work out three to four times a week for at least 30 minutes of moderate intensity exercise. For me, walking and yoga haven’t been that hard to get used to doing weekly.

The meals

Some folks will find that the meals will get boring. Eating the same stuff every day can get old. Lara gave me a CD of recipes designed to help change things up. There are also hundreds of recipes online that you could use; the only catch is that the meals will probably be more expensive than stuff you’re used to eating. For example, a pound of lean ground beef can cost up to twice that of market ground beef.

My experience

In the 16 weeks that I’ve been on this diet, I have had great results. I’ve lost 40 of the 50 pounds I wanted to lose. The program has been expensive, but I look at it more as an investment in my health. The first visit is $245 and the second and subsequent visits are $65 each. The fees include your visit with the medical assistant, your weekly vitamin B injection and a week’s supply of your FDA approved appetite suppressant, if prescribed.

For more information on Cèsar A. Lara, M.D. Center for Weight Management, visit the center's website.

The writer was provided with a discounted program for the purpose of the review.