Could you give us an idea of the kind of dietary tinkering that you usually suggest?
Sure. For one of my patients, who had difficulties with keeping her proportions reasonable.....she found her own solution. She found a beautiful ceramic plate that was divided into four sections. (Wish I could find this plate. It is really attractive.) She used it to help her reduce the amount she ate. This was after her husband (who was overweight & wanted to participate) and she sat down and wrote down a list of 30 favorite food products (low glycemic index)(means it does not jack up the blood glucose) and constructed their own menus for a month. Within six weeks, they had lost 26 lb (12 kg) between them. This really motivated them both. Basically, this was a low-low-carb, low-cholesterol, 2,200 calorie diet limiting servings of meat to chicken (no skin), fish (not fried) or turkey to 3 oz per meal. What I love about this particular family is that this gentlemen was on fire with enthusiasm and he was able to highly motivate his wife. With minor adjustments to their chosen diet, and walking for 45 minutes 3 x week, and coming to the mission dance 2 x month, they were able to lose a substantial amount of weight (over 50 kg). This patient no longer needed Metformin. We see them ever 3 months or when they need a change. They have been able to maintain the weight loss.
Their 30 foods (CHOOSE ONE)( 3 oz skinless chicken)(6 oz Atlantic cod grilled)(baked turkey breast)(6 oz beef tenderloin shared)(1 lamb chop grilled) (CHOOSE ONE) (1/2 c brown rice)(1/2 c. whole wheat elbow)(CHOOSE ONE)(3 Tbsp olive oil)(3 Tbsp grape seed oil)(1 Tbsp cholesterol free margarine or 1 tsp butter) (CHOOSE ONE) 1 cup beans, 1 cup carrots, 1 small sweet potato, 1 cup spinach, 1 cup green peas, 1 cup squash, 1 cup eggplant, 1 cup okra, 1 cup turnip greens, 1/2 ear of corn, 1/3 cup corn, 1/2 cup turnips, 1/2 cup beets, or 3 cups mixed salad; (CHOOSE ONE) 1 apple, plum, pear, apricot, 1/2 banana, 1/2 orange, 1 slice pineapple, 1/4 mango, 1/2 cup grapes (CHOOSE ONE) 1 slice sugar-free coffee cake, whole grain bread, sugar-free pie, 1 cup sugar free pudding, 3 sugar-free cookies.
Another patient, (young) could stay away from his craving for sugary drinks by totally replacing all he drank with bottled water or tap water. He also started to play soccer with his chums in the neighborhood. You may laugh, but he lost 5 kg which motivated him to start choosing more healthy foods to snack on and eat, generally. The mother thought he needed a specific diet, and since he was not to happy about giving up his french fries and cheeseburgers daily, I suggested to her that we start first with the 20+ soft drinks. After all, this young man walked the office with a Mountain Dew in his hand. Later, with his mother's he, he constructed his own low-carb, high-fiber, low-cholesterol and high-protein diet. Over the past year he lost a total of 32.6 lbs (14.7 kg). His self-esteem and grades in school greatly improved. It does not matter the age. Young as this 17 year old or as old as I am, we all have our own requirements and we change only when we want.
There is a high success rate with this clinic, but we also have failures. I never blame the patient, because it is the treatment that has failed the patient. I will work on one with metric conversion.
I can share the low-glycemic food list with the forum, if you like. I will have to change it to a PDF file, but I am more than willing to share.