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Bonita & Estero Magazine

Keep Lean, Healthy and Fit

Private Physicians of SWFL’s four practitioners: Drs. Raymond J. Carrelle, Gary M. Price, David L. West and Andrew J. Oakes-Lottridge

Eat less, exercise more. Calories in versus calories out. Just don’t eat it. How many of you have heard those statements as the key to weight loss? If you are among the 70 percent of Americans who have an issue with weight, I suspect you have heard them at one time from a doctor, nurse, dietician, trainer, friend or family member.

It seems so simple, but as a physician who treats people who struggle with weight issues, I can tell you it is not. Every person’s weight struggle is unique—so an individualized plan is needed.

Problems with excessive weight are a multifactorial situation involving complex interactions between our biology, environment, social factors, psychology, food quality and socioeconomics. Inflammation and a condition called insulin resistance are very common. That’s why the American Medical Association now recognizes obesity as a chronic condition, the same way we classify conditions such as high blood pressure, diabetes and asthma.

There are many, many types of diets and the truth is that there’s no best diet. They all work if you adhere to them. The key is finding a diet plan that fits your lifestyle, food likes and your abilities.

If a diet seems too challenging, then it’s not the right one for you because you’re unlikely to stick with it for the long term.

If you don’t like to cook, you’re unlikely to become a master chef—but that doesn’t mean there aren’t simple changes that can help you.


It’s important to look at this not as a “diet” but as a lifestyle change. It’s better to make some small changes that you can maintain. Radical changes that aren’t sustainable lead to yo-yo dieting and a roller coaster of weight loss and weight regain.

From a health standpoint, losing 5 to 10 percent of your excess body weight improves your overall health and reduces chronic disease risks. This is an achievable goal for most people.

People may exceed this amount of loss, which is terrific, but it’s important to remember that this small amount of change can have a big impact on health. It can be easy for people to feel like they’re failing because they didn’t lose the amount of weight they wanted to.

The following are some of the key things I focus on with my patients when I’m starting them on their weight-loss journey: Motivation—Why do you want to lose weight? Be very specific: I want to be able to keep up with my kids or grandkids;

I don’t want my knees to hurt anymore; I want to fit into my clothes better. Knowing your motivations will help you through the tougher times when you may feel like giving up.

Structure—Have a plan for your day. What am I going to have for breakfast, lunch and dinner? What am I going to eat

at the restaurant tonight? Do I have healthy foods available in my house?

Accountability—How do I hold myself accountable to my plan? Helpful tools include keeping a daily food journal, weighing in at office visits or at home, and online support groups.

Set Small, Achievable Goals—For my patients, our goal is to lose 1 to 2 pounds per week. While it may take longer for some- one to reach their goal, they’re more likely to make the changes that will allow them to maintain it. Meeting these small goals helps to build confidence and positive self-esteem.

Review Medical History and Medications—People may not realize that some of their health issues or medications can contribute to weight gain. Addressing those issues or making changes in medications may help with weight loss.

Nutritional Education—Learning about nutrition can help people understand how certain foods affect the body, especially regarding inflammation and insulin resistance (as mentioned earlier).

Eating Triggers—It’s important to reflect on what makes a person want to eat. In many cases, it’s not a hunger issue: Do you eat when you’re upset, angry, bored, tired? Do you crave certain foods? Do I need to remove certain foods from my house for now?

Weight-Loss Medications—Many people don’t know that there are medications that can help with weight loss. These are not the cure, but are tools to help them.

A comprehensive program is key to being successful. I use this analogy of weight-loss treatment: It’s a chair in which each leg represents a component—medical, nutrition, behavior, exercise. And if you’re missing one of the four, the chair falls over.



Dr. Raymond J. Carrelle is a family medicine physician with Private Physicians of SWFL, a concierge medical practice, and is a diplomat of the American Board of Obesity Medicine. He went to medical school at the University of Miami, did his residency at Albany Medical Center in New York and has practiced for more than 20 years. For the past six years, his practice has incorporated the treatment of weight problems.