DON'T Call me FAT - UNDERSTANDING the Problem

1. General information on how we help
2. Getting Started
3. Medical Supervision
4. "Fat burning"
5. Exercise
6. The TLC program is not MediFast™, SlimFast™ and others
7. Using TLC Plans
8. How to deal with symptoms
9. That Scale, Plateaus, Transition and Weight Maintenance
10. Old Habits Die Hard
11. Pricing
12. Calculate your Body Mass

 

1. General information

How can we help ?
TLC (TerryLea Cares) is a philosophy of help and understanding. The TLC program is a physician (medical doctor) supervised weight control program with this philosophy. During the time you are losing weight, you attend counseling, worksheet and Interactive video sessions incorporating the necessary foundation to keep the weight off.

During the weight reduction phase of the TLC program, you use a special doctor designed VLCD (very low-calorie) plan and the emphasis is on behavior modification. If you change your lifestyle and break the cycle, your chances are excellent. 

The TLC program continues after you have achieved your goal weight with the weight maintenance phase.  The TLC program and philosophy will help you keep the weight off.  Our goal and philosophy is to keep the weight off for life.  With regular visits, you can achieve this and stop the maddening cycle of weight loss - weight gain - weight loss etc.

Not perfection but a more sensible weight.
Our goal is to keep the weight off for life, not perfection. You may not reach your ideal weight, but our goal is to help you reduce to a more reasonable weight and maintain that weight loss. We are realists not perfectionists.

Does the staff feel my pain and frustration?
All staff has or are experiencing their own problems with weight control and maintenance. We require that all staff members adhere to the philosophy of the TLC program. Nobody is perfect - neither is the staff. Yes, we empathize with you and understand your weight problem from a medical and personal view! This makes our TLC program very unique. How can you understand the problems of trying to lose weight and keep it off without experiencing that problem?

How is the TLC program set-up?
The program is set-up in two phases: 1. weight reduction phase and the 2. weight maintenance phase.

How does TLC weight reduction phase work?
The TLC plan uses the concept of a very low-calorie levels. This combination allows your body to lose weight rapidly while protecting your muscle tissue. And hunger is rarely present if the plan is closely followed. The counseling, worksheet and Interactive video sessions emphasize behavior modification.

How do I go into theTLC weight maintenance phase of the program?
When you are reach your goal weight, we will plan to do a gradual transition rather than suddenly jumping back into the "real world". During the transition period, your goal will be to gradually ease back into "real world" eating. Doing a careful transition protects you from experiencing a "rebound" weight gain from suddenly increasing your calorie intake. It also gives your metabolism a chance to adapt in handling "real world" food with the behavior modification learned and experienced in the program. Keep in mind that the TLC program is a philosophy that is incorporated into your life for life.

What types of people is TLC for?

• TLC has programs available for people no matter how much weight they need to lose.
• People who have a lot of weight to lose, such as 100 pounds or more.
• Individuals who are "stuck" or who can't seem to lose weight on other plans.
• People who have medical conditions such as diabetes that make it difficult to lose weight.

How fast do you lose?
Women average up to 2 to 4 pounds a week, men slightly faster (up to five pounds a week or more)

Is it safe?
The TLC program has been proven to be a very safe way for most people to lose weight, achieve their goal weight and maintain it! The doctor designed products used in the program are primarily made from soy, along with significant amounts of vitamins and minerals. By following specific protocols, you can safely use TLC even if you have high blood pressure, high cholesterol or triglycerides, or adult-onset diabetes, including if you are insulin dependent.

Has the use of a very low calorie diet (VLCD) been researched?
Research studies at Johns Hopkins University Teaching Hospital as well as the National Institute for Health have shown that the use of a very low calorie diet (VLCD) is very effective as well as safe when used under medical supervision. A VLCD without medical supervision and periodic lab testing is unsound and could cause serious problems.

Can I use  TLC  if I have less than 25 pounds to lose?
Absolutely. Under medical supervision, you will be guided gently into losing and later maintaining your weight no matter how much weight needs to be lost.

 

2. Getting Started

Should I wait until the weekend or start during the week?
You can do either one, depending on what fits best for you. The first three days on TLC are critical to your success, so plan your start-up carefully. You might look for a time when you don't anticipate any big events that involve food.

Do I need to drink a lot of fluids?
Drinking fluids helps your body be more efficient at eliminating the by-products of fat metabolism, keeping you showing consistent weight loss on the scale.

What kind of fluids are OK?
You may drink any liquids that are considered non-caloric. This includes hot or iced tea, coffee or decaf, diet sodas, Crystal Light, Diet Kool-Aid and instant reduced-salt broth or bouillon.

Can I drink alcohol?
You should avoid all alcoholic beverages while you are on TLC. Because alcohol is metabolized similar to a carbohydrate, it will decrease "fat burning" and slow your weight loss.

Can I have regular coffee or caffeinated sodas?
Yes, but limit coffee and caffeinated drinks to one or two per day. The low-calorie level of TLC may increase your sensitivity to caffeine, causing anxiety, shakiness or other symptoms. You may prefer to use decaffeinated coffee or sodas instead.

What can I put in my coffee?
If you wish, you may use low-fat or skim milk or very small amounts of half and half in your coffee or tea. You may also use artificial sweeteners such as Splenda™ if desired.

What can I do about wanting to chew?
You can munch on celery-up to three stalks per day is acceptable. Celery is a high-water vegetable with minimal carbohydrates.

Can I eat fruit?
No, fruits contain high levels of carbohydrates which affect your "fat burning" level and slow your weight loss.

Can I chew gum?
You may use sugar-free gum or mints but limit these to five per day. Products that contain sorbitol cause gastric distress, diarrhea as well as stimulate your appetite.

What if I want to eat out at a restaurant?
Special occasion meals are easier to handle than you may think! Simply enjoy your TLC Meal at your breakfast meeting, family brunch, awards banquet or virtually any special occasion involving food! The TLC Meal can be prepared at many restaurants. Ask for our prep sheet. If you can't avoid eating something that isn't part of the TLC Meal, it may raise your daily calorie intake, and stop "fat burning" for a while. It is still best not to skip meals, even when you think you may have eaten the wrong foods or over-eaten. Resume your TLC plan as soon as you are able.

As an alternative, you can bring along a TLC supplement and ask the waiter for hot or cold water (depending on what you are eating). Then simply prepare your TLC supplement and eat it with everyone else!

3. Medical Supervision

How do I start?
First, see Dr. Battista for a general exam and blood test panel before you begin the TLC program.

What tests should I have done?
Initially, lab tests should include a CBC, chemistry panel, lipid profile, thyroid panel, and urinalysis. If you are over age 40 or have a history of heart disease, you should have an EKG and Holter monitor done as well. It is important that lab tests be done at intervals while you are on the program to monitor your metabolism. Non- compliance with lab testing can be determental and will cause you to be dropped from the TLC program. 

How often are the sessions?
Follow-up visits to the doctor with counseling sessions are done once a week. At scheduled intervals, you must have Lab tests including a CBC and a comprehensive metabolic profile that tests electrolytes, blood sugar, kidney and liver function, metabolism etc. Lab tests and doctor visits are usually covered by your medical insurance.

Can I use TLC if I'm on prescription medications?
Yes, most medications for chronic conditions such as depression, thyroid or hormone deficiency, etc. may be continued while you are on the TLC program. Check with Dr. Battista regarding dosage adjustments if needed.

What about blood pressure medications?
If you are taking blood-pressure medication, you may be able to decrease your dose or eliminate taking it, at least during the time you are on the weight reduction phase of the TLC program. This will be monitored and adjusted by Dr. Battista. Please - Do not stop or change medicines on your own! Watch for any of these symptoms that can indicate your medication dose needs to be adjusted : feeling tired, weak or "washed out," legs feeling rubbery or weak, headaches, feeling dizzy or light-headed, or becoming more fatigued after several weeks of feeling great. Do not stop or change medicines on your own - call Dr. Battista!

Can I do TLC if I'm diabetic?
If you are a Type II diabetic (adult onset) you should be able to do just fine. Monitor your blood sugar readings once or twice a day. Stay in close contact with Dr. Battista for instructions on medicine dosage changes.

Should I continue my oral diabetes medication?
Oral agents for diabetes may be adjusted or discontinued by Dr. Battista at the time you begin the fasting program. Otherwise within just a few days after starting the program, your blood sugar may become too low. Do not stop or change medicines on your own - discuss with Dr. Battista!

What if I'm on insulin?
Your insulin dose will be adjusted by the doctor. Monitor blood sugar readings twice a day during the early weeks, then follow Dr. Battista's recommendations. Dr. Battista will work with you to help in any changes needed for any medicine.

Can I take diuretics while I'm on TLC?
Unless absolutely necessary, avoid taking diuretics while you are on TLC. If you are currently taking a diuretic, check with Dr. Battista before making changes. You may need to wean off the medication slowly rather than stopping it abruptly.

What if I get sick?
If you become ill such as getting a cold or the flu, you can stay on TLC meal plan provided your symptoms aren't too severe. Taking antibiotics (if necessary) won't harm your TLC plan but may temporarily slow your weight loss.

What can I take for a headache?
Tylenol™, Ecotrin™, Aleve™ and Ibuprofen may be used as necessary. Avoid long-term use as these may cause stomach distress (Tylenol™ usually does not cause "stomach distress") and kidney, liver dysfunction especially when you are on the weight reduction phase of the TLC program.

What if I get heartburn?
Antacids such as Maalox, Rolaids, etc. are acceptable. You may also use acid-blockers such as Zantac,  Prilosec and related medications.

Concerning non-prescription medicines, herbal, homeopathic and Oriental remedies
Always check with Dr. Battista when taking any medicines that are non-prescription especially if you are also using prescription medicines.  Also check with the doctor if you are taking herbal, homeopathic and Oriental remedies.  Many of these need to be discontinued while on TLC. They may cause serious side effects and interfere with your metabolism while on TLC. Dr. Battista can advise you.

Will my seasonal allergy or asthma medications be a problem?
You can continue most allergy and asthma medications including inhalers, etc. while you are on TLC.

4. "Fat burning"

What is true "Fat burning"?
The nutrient balance of TLC weight reduction plan combined with the very low-calorie level causes true "fat burning". Your fat metabolizes to release free fatty acids which are converted by the liver into ketones. This mild state of "ketosis" helps your body achieve rapid fat and weight loss while preserving muscle tissue. True "fat burning" also helps eliminate physical hunger while providing good levels of energy. Initially, patients on VLCD were hospitalized under medical supervision. This was found to be unnecessary, if patients are monitored closely by their doctor as an outpatient.

Is "Fat burning" harmful?
No, the level of "fat burning" achieved is just strong enough to protect you from losing muscle tissue while giving you maximum fat loss. This level of "fat burning" with ketosis has not been shown to cause harm to the body if carefully monitored by a physician trained in VLCD. Non-physician "weight loss clinics" cannot use a VLCD beause the personnel have no medical training nor experience dealing with the medical problems that may come up with a VLCD. Many use a "pseudo" low calorie diet and "pseudo fat burning" programs.

How long does it take to get "Fat burning" started?
Plan for about three days of being on TLC for building the "fat burning" level. If you fall off the plan, it will generally take two to three days to rebuild the level again to the point where you no longer feel hunger or fatigue.

A Medically supervised VLCD - how it works.
Low carbohydrate levels in a VLCD promote a shift in one's energy use from carbohydrate to body fat. As body fat is used, the energy by-products of fat metabolism, ketones, rise in the blood. It is theorized that the presence of ketones suppresses appetite and plays a role in nitrogen sparing. The dietary fat in VLCD is a source of essential fatty acids. It also helps with the absorption of fat-soluble vitamins and serves to stimulate gallbladder motility, which may help minimize the risk of gallstone formation. Since this is a very complex balance, it must be medically supervised to avoid potential serious side effects.

5. What about exercise?

Can I exercise when I'm on TLC?
Yes you can, but we suggest limiting the amount of exercise, especially in the beginning. It takes three to four weeks for the body to adapt to the TLC plan and using the fat stores for energy. During this time, too much exercise can cause dehydration as well as decrease your weight loss and harm your muscle tissue.

What type of exercise and how much is considered OK?
If you haven't been exercising at all, you must get medical approval for an exercise program. If approved, wait three to four weeks until you have adapted to the TLC program. Then start your exercise plan very slowly. If approved, begin with gentle walking, 10 to 20 minutes per day, then gradually increase the amount. If you have been exercising prior to starting TLC, check with Dr. Battista. Usually you should cut your current plan by half during the first three weeks, then gradually build it back up.

What is the maximum amount of exercise I can do?
While you are on TLC, limit intense exercise such as running, biking or swimming to a total of 45 minutes a day. Over exercising will actually slow your weight-loss progress.

6. TLC is not MediFast™, SlimFast™ and others

How about using MediFast™, Slim-Fast™ and others?
No.  The newest MediFast™, Slim-Fast™ and similar products obtained from the Internet, non-physician clinics, drug stores, supermarkets etc. are not compatible. They are formulated to use without doctor supervision and are now used by non-physician weight loss centers for a "pseudo fat burning" which is NOT the same as the TLC program. Using them while on the TLC program will slow your weight loss and can cause harm since they are not intended to be used in a physician supervised VLCD.

How do we help ?
TLC (TerryLea Cares) is a philosophy of help and understanding. The TLC program is a physician (medical doctor) supervised weight control program with this philosophy. During the time you are in the program, you attend counseling, worksheet and Interactive video sessions incorporating the necessary foundation to keep the weight off.

How about a "weight loss center"?
These centers are designed for "your failure". They keep you coming back week after week with a commercial emphasis. TLC is not a commercial center. It is patient oriented and spread by word of mouth not advertising.

Does the staff of a "weight loss center" understand me?
All of Dr. Battista's staff experience their own problems with weight control and maintenance. We require that all staff members adhere to the philosophy of the TLC program. Nobody is perfect - neither is our staff. We understand your weight problem from a medical and personal view! This makes our TLC program very unique. How can a "weight loss center" understand the problems of trying to lose weight and keep it off without experiencing those problems? The choice is yours.

 

 

7. TLC Plans

Full plan
Requires using only the doctor designed TLC supplements with no regular food. Recommended if you have a lot of weight to lose or if you prefer to avoid all food choices. All required vitamins and minerals are included. No shots or injections are usually required.

Modified Plan
Requires using only the doctor designed TLC supplements plus a special TLC meal. The modified plan is recommended if you have social needs that make it difficult to avoid all food. A modified plan is also preferred if you have less weight to lose.

Can you alternate between the plans?
Yes. Both the full and the modified plans will maintain the protein balance and "fat burning". With TLC, you can start with a full plan, then switch to a modified plan or even go back and forth between the two options. For example, you might decide to do a full plan during the week, then switch to a modified plan on the weekend.

How much do I need?
Depending on your medical condition and testing, Dr. Battista will determine how many doctor designed TLC supplements and food you will need per day. Visits to the doctor with counseling sessions are done once a week, so you need a least a week's supply.

What if I run out or miss a TLC supplement?
As an emergency substitute, you will be given a "emergency sheet" to substitute for TLC supplements you miss. Don't do this for more than one day. If you will be away from your TLC supplements for longer than one day, you will be given a list of foods to focus on until you can return to your program. Unfortunately, "fat burning" will stop and will not return until you are back on the TLC program for awhile. Because of the very low calorie level of the TLC program, missing or skipping TLC supplements will put you below the optimal nutrient level your body needs to function. Take all supplements and make up for any missed ones on a daily basis.

Can I mix the TLC supplements for the entire day?
You can but should be consumed within 24 hours of mixing.

How about using MediFast™, Slim-Fast™, OptiFast™ and other "supplements"?
No. The newest MediFast™, Slim-Fast™ and similar products obtained from the Internet, non-physician clinics, weight loss centers, drug stores, supermarkets etc. are not compatible.

 

 

8. How to deal with symptoms

Diarrhea?
During the first week or so on the program, some people experience diarrhea from the body's adjustment to the concentration of nutrients in the TLC supplements. This will usually subside after a few days. Using too much sugar-free gum or mints can also cause diarrhea. Maalox™ may cause loose stools.

Gurgling stomach, cramps?
If you experience gurgling stomach, abdominal cramping, bloating or diarrhea, you may have lactose intolerance or a shortage of the enzyme that breaks down milk products. Try Lactaid pills, a non-prescription enzyme that helps your body digest milk components. Take 1 to 3 regular strength pills with each TLC supplement to control the symptoms. You may be able to stop taking the pills after 2-3 weeks. (Lactaid is available at grocery stores or pharmacies. Also see Heartburn? below)

Heartburn?
Use antacids such as Maalox™, Tums™ as desired. (Maalox™ may cause loose stools and Tums™ does the opposite.) You might also take an acid-blocker medication such as Zantac™ or Pepcid AC™ for a couple of weeks until you no longer experience the symptoms

Constipation?
You will probably have bowel movements less frequently than normal because of the decreased food intake. If you have hard stools or feel constipated, try the following solutions. Drink more fluids, increase exercise. Take a sugar-free fiber product such as Metamucil. Take 1-2 tsp. dissolved in water once a day. You may use stool softener pills or laxatives if necessary.

Hunger that doesn't go away?
If you continue to struggle with hunger beyond the first week or two, your stomach may be excreting more acid than needed for the small volume of food intake. This can create a "gnawing" sensation in your stomach that feels exactly like hunger. If you have a history of having an ulcer or gastritis, you can be particularly prone to this type of hunger problem.

To manage hunger that won't go away, consider taking an acid-blocker medication such as Zantac™, or Pepcid AC™. Also, use of antacids such as Maalox™, Tums™ may help. You will find these in drug stores or grocery stores

Feeling cold?
The low calorie level of TLC causes your body to decrease its metabolism which can make you feel cold more easily. Try drinking hot liquids or taking warm baths. Be prepared for this by keeping a sweater handy.

Bad breath?
As your body metabolizes fat stores, the ketone by-products can cause a slight breath odor. You can also experience a dry mouth as a result of being slightly dehydrated from being on TLC. To remedy both of these symptoms, drink a lot of water and other fluids, use breath sprays or products such as Breath Assure, and brush your teeth, including your tongue, several times a day. You can also use sugar-free gum or mints, but limit these to five a day.

Skin rashes?
Some people develop a mild skin rash on their chest, neck or face during the early weeks on TLC. Most skin rashes seem to be related to the high-protein balance of the program, and they disappear within a week or two. If a rash itches or feels uncomfortable, ask your doctor about taking an antihistamine such as Benadryl™ or Claritin™ to control the symptoms. You can also apply a cortisone cream to the rash to speed healing.

What can I do about hair loss?
A small percent of the people who use a very low calorie diet may struggle with hair loss, especially ones who are on the program for three months or longer. To minimize this problem, Dr. Battista may prescribe a special pill that contains extra B vitamins, extra zinc and biotin that are all helpful for decreasing the problem. Hair loss is not permanent and re-growth typically occurs within a couple months of going off the weight reduction phase of the program. Please don't take extra vitamins on your own without consulting Dr. Battista as the wrong dose or combination can be detrimental.

How long can I stay on the TLC plan?
As long as you are doing well and making progress, you should be able to stay on TLC for as long as it takes to reach your desired goal weight. Some programs recommend taking a break from a fasting plan after 16 weeks; however, research has not shown this to be necessary with the TLC program. To lose a lot of weight, such as more than 100 pounds, you may need to be on the program for a long time.

 

9. That Scale, Plateaus, Transition and Weight Maintenance

Not perfection but a more sensible weight.
Our goal is to keep the weight off for life, not perfection. You may not reach your ideal weight, but our goal is to help you reduce to a more reasonable weight and maintain that weight loss. We are realists not perfectionists.

Why did the scale go up?
The amount of weight you lose will fluctuate from week to week. Often the scale will be affected by things that cause you to retain fluids, such as PMS, not drinking enough water, illness, stress, too much exercise and even temperature extremes. Don't panic if the scale doesn't move for several days or even goes up. If you stay solid on your program, the scale will eventually show results.

What can I do about a plateau?
Plateaus can occur at any time during the weight reduction phase. During these times, your body seems to take stock, and for a brief period, attempts to hold on to the fat stores. It's as though your body reshuffles its weight status while assessing whether it's safe to continue losing. Once it feels settled, your system will kick back in and allow your weight to drop again. If you experience a weight-loss plateau, there are other indications of progress such as wearing a smaller size of clothing. Discuss these plateaus with the doctor at your weekly visit.

How do I transition from weight reduction to the weight maintenance phase?
When you reach your goal weight, we will plan to do a gradual transition rather than suddenly jumping back into "real food". During the transition period, your goal will be to gradually ease back into eating regular food at the same time you slowly wean off the TLC supplements.

Doing a careful transition protects you from experiencing a "rebound" weight gain from suddenly increasing your calorie intake. It also gives your digestive system and metabolism a chance to adapt to handling regular food again. It is best to stretch your transition over a period of three to six weeks so your body can gradually adapt to the changes.

What is the TLC (TerryLea Cares) weight maintenance phase of the program?
During the weight maintenance phase of the program, you continue the counseling, worksheet and video sessions incorporating the necessary foundation to keep the weight off.  The TLC program and philosophy will help you keep off the weight off.   Our goal and philosophy is to keep the weight off for life.  With regular visits, you can achieve this and stop the maddening cycle of weight loss - weight gain - weight loss etc. The TLC program is a philosophy that is incorporated into your life for life.

Will I gain all the weight back?
You will also maintain your success by making long-term changes in your lifestyle such as healthy eating, consistent exercise and using the TLC philosophy. You also need to continue to work on how you cope with life so that you don't reach for food when you are experiencing stress, depression or other emotional needs. This has been taught in the TLC program. We recommend maintenance regular check-ups with Dr. Battista.

Can I go back on the TLC weight reduction program phase if I gain back some weight?
Absolutely. If you gain back more than 5 to 10 pounds, we recommend that you immediately return to the weight reduction phase of the TLC program for a brief period. This will help your body adjust to staying at a lower weight and prevent you from regaining what you worked to hard to lose. Notify Dr. Battista........we're here to help not criticize. Remember that proper weight control is lifelong.

Can I use the TLC supplements products as part of my long term food plan?
Yes you can. In fact, many people will use one or two TLC supplements a day as part of their maintenance plan. This provides structure while allowing flexibility in your meal plan.  Incorporating the TLC product into your diet once or twice a day and practicing what you learned in the TLC program will help to keep the weight off. Use a TLC supplement as a protein source in your meal, adding other foods such as fruits, vegetables or a salad to maintain a healthy nutritional balance.

 

 

10. Old Habits Die Hard

Passing by a candy dish, seeing scrumptious pictures of food on TV, or the aroma of freshly baked cookies can tempt you. Unfortunately, there are many visual cues and situations that could lead to relapse. The sight or smell of food, time of day, social events and activities, and certain feelings or moods can trigger the urge to eat even when we're not physically hungry. It's important to recognize triggers to prevent yourself from relapsing into old habits.

Common triggers include:

Take the time to identify the triggers that urge you to abandon your weight maintenance plan. Once you recognize your triggers, plan in advance for how to deal with these challenges to prevent yourself from relapsing.

Here are a few strategies to help you gain control:

 

11. Pricing

Office visits, counseling, video programs and consultations are covered by most insurance. TLC supplements are not covered by insurance and are purchased in the office.

How much do TLC supplements cost?
TLC supplements cost about $10/day. Most people find the cost of TLC products comparable to the amount they're already spending on groceries and dining out. Did you know that the average adult spends nearly $16/day on food? Between the grocery store and fast food, we spend much more money on food than we realize -- and we often don't make the healthiest of choices. At $10/day, TLC products represents significant cost savings for many people. When you also consider the additional benefits inherent - doctor-formulated, vitamin-fortified, portion-controlled, TLC products are an even greater value for you!

 

12. Body Mass

Calculate your Body Mass.......CLICK HERE

ANTI-AGING & FAMILY MEDICINE

©2005-9 JOHN M. BATTISTA, M.D. All rights reserved

JOHN M. BATTISTA, M.D.
561 DUNCAN AVENUE SOUTH
CLEARWATER, FL 33756
(727) 446-3346

www.DoctorBattista.com