Health and wellness is a rapidly evolving field. As a specialist in bariatric surgery and minimally invasive general surgery, Dr. Sepehr Lalezari’s approach to medicine is quite different from that of his colleagues. Conventional medicine is centered around early detection and treatment of disease whereas functional medicine is centered around disease prevention and maintenance of health. As an expert in weight loss who deals with both the medical and surgical aspects of obesity, the link between health and disease prevention could not be more evident to Dr. Lalezari. Trained at the prestigious Johns Hopkins Hospital, Dr. Lalezari is the foremost expert in weight loss and bariatric surgery in Los Angeles.

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The first step in starting a weight loss program is to understand the fundamentals of weight loss. Before deciding on a weight loss plan it is important to understand some key terms. First of all, it is important to know what a calorie is. A calorie is a unit of energy that the body uses for fuel. There are usually 4 calories per gram of protein and carbohydrates and 10 calories per gram of fat.

What are macronutrients?

Macronutrients are the bulk of what we eat and are what provide energy. These include protein, fats, and carbohydrates.

What are micronutrients?

Micronutrients are the vitamins and minerals found in food. They do not necessarily provide direct energy but are important for your body’s vital functions and biologic pathways which convert food into energy.

What is the first step in selecting a diet?

Set goals! Ask yourself, what are you trying to achieve? What is your ultimate goal weight and over what timeframe are you trying to achieve this goal? Make sure that your timeframe is reasonable. On average a weight loss of 2-3 pounds per week is healthy and achievable if you are obese BMI 30-40. Keep in mind that the higher your BMI and the higher your starting weight it is easier to lose more weight per week. A goal of losing 5 percent of your total body weight is a great start. Remember not to get discouraged, weight loss takes time!

How does calorie restriction help you lose weight?

The body can be thought of as a grain farm, and calories can be thought of as grain. The body only uses a certain amount of energy and the more energy that is placed into the body, the body stores for a later time. This is what happens with grain production as well. The more grain that is harvested that cannot be sold is stored in silos for a later time. The silos in this analogy is your body that stores the fat. In order to use up the grain in the silos, there has to be less grain harvested. Thus, if you eat less food the body has to burn up its store to supply you with the energy you need to run your body’s vital systems.

How to set a calorie limit when selecting a diet?

Studies show that most patients will lose weight with a calorie restriction of ~1,000 kcal per day. Therefore, one should aim to limit daily caloric intake to 800-1,200 kcal. per day while aiming to be at or below 1,000 kcal.

Does severe calorie restriction help you lose more weight?

Studies do not show that very low-calorie diets 400-800 kcal per day help patients lose more weight than diets 800-1200 kcal per day. This may be attributed to the change in the body’s basal metabolic rate which tends to slow down with severe calorie restriction.

What is the best diet? Keto, Low-carb, low-fat, Mediterranean diet, etc?

The best diet is one that you can adhere to. No one specific macronutrient is the culprit for weight gain. Most diets fail because people cannot adhere to them long term. Again, the best diet is one that you can follow long term. As long as you are restricting your caloric intake and burning more calories than you are consuming you will lose weight. The important thing to remember is that it will not happen overnight. Don’t check the scale daily!