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{
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      "memo": "Hi @evanllipkismd. Would you like to earn solid (115k SP) upvote on your latest post from @project.hope? Check out our recent post for more details. And hopefully you will find this publication worth your time and attention. We're explaining our community economy \"business model\", hoping that more people will join our efforts in the future. // LINk: https://steemit.com/hive-175254/@project.hope/project-hope-economy-explained-2021",
      "to": "evanllipkismd"
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      "memo": "Regarding the latest information and development of Steemauto. Old SteemAuto is already being switched off. Today, I would like to introduce you to new version of SteemAuto launched by one of most reputable witness. You can find it here: https://worldofxpilar.com/dash.php . I've helped testing it and it's WORKING GREAT so far (In case if you would have any questions, consider joining their discord channel: https://discord.com/invite/VAHHsmnNaJ )",
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      "memo": "Good morning. @evanllipkismd. I hope you don't mind this little memo. Today I'm celebrating 3rd BIRTHDAY since I joined Steemit and because of that special day - I've organized small POSITIVE INITIATIVE. Consider checking it out and hopefully joining. Yours, Piotr // LINK: https://steemit.com/hive-175254/@crypto.piotr/let-s-celebrate-my-3rd-birthday-on-steemit-together",
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{
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      "amount": "0.012 STEEM",
      "from": "crypto.piotr",
      "memo": "Dear @evanllipkismd, I had quite a long break from publishing my own articles since I've focused my efforts on building Project.hope community and watching it grow. Today however, I would like to share with you link to my recent publication and I surely hope to read your feedback. All valuable comments will be rewarded with solid upvote. Cheers, Piotr // LINK: https://steemit.com/hive-175254/@crypto.piotr/is-crypto-space-is-mature-enough-for-another-bull-run-i-have-my-concerns",
      "to": "evanllipkismd"
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{
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    {
      "amount": "0.011 STEEM",
      "from": "project.hope",
      "memo": "Good morning @evanllipkismd. Did you ever hear about dlease.io (dapp build on top of HIVE blockchain)? It's so far the best site allowing PASSIVE INCOME to those of us, who are to busy to curate manually and would like to rent out our HP to others (while enjoying pretty high returns). We've discovered it lately and I only wanted to share link to dlease marketplace, as I consider this dapp worth supporting and promoting: https://dlease.io/market",
      "to": "evanllipkismd"
    }
  ],
  "op_in_trx": 0,
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{
  "block": 46869364,
  "op": [
    "transfer",
    {
      "amount": "0.011 STEEM",
      "from": "crypto.piotr",
      "memo": "Good afternoon @evanllipkismd. I'm sending this memo to you because I'm helping friend of mine to get some exposure. And would like to share link to publication (motivational speech by Arnold Schwarzenegger), which I consider worth you your time and attention. Check it out and drop a comment. Let me know what do you think. (I read all comments). Yours, Piotr // LINK: https://steemit.com/hive-175254/@unbiasedwriter/without-a-vision-you-will-not-get-success-arnold-schwarzenegger",
      "to": "evanllipkismd"
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  "timestamp": "2020-09-14T18:12:57",
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{
  "block": 46060908,
  "op": [
    "transfer",
    {
      "amount": "0.012 STEEM",
      "from": "project.hope",
      "memo": "Good morning @evanllipkismd, I hope you don't mind this little memo. I would like to ask you for SMALL FAVOUR. One of our PH community members posted publication promoting our curation trail on Steemit (great way to enjoy PASSIVE INCOME without investing much time in manual curation). Would you mind resteeming this post and helping us reach wider audience? Perhaps you can consider joining yourself with some small % upvote. I would also greatly appreciate YOUR FEEDBACK. I read all comments. Yours, @crypto.Piotr // LINK: https://steemit.com/hive-175254/@alokkumar121/looking-for-passive-income-no-time-for-manual-curation-sign-in-to-new-steemauto-and-follow-our-curation-trail-today",
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{
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      "amount": "0.001 STEEM",
      "from": "creativeblue",
      "memo": "Test",
      "to": "evanllipkismd"
    }
  ],
  "op_in_trx": 0,
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{
  "block": 44015092,
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    {
      "amount": "0.012 STEEM",
      "from": "crypto.piotr",
      "memo": "Dear @evanllipkismd, I hope you don't mind this little memo. I'm writting to you simply because ... I would like to share with you an AMAZING NEWS. Since HF23 had happened, we've all been struggling and one of challenges we had to face was SHUTTING DOWN services provided by Steemauto. Thanks to amazing work of @steem-supporter, re-created steemauto is already up and running. With basic utility as autoupvoter and curation trail working just fine. I hope you will find this info useful. Yours, Piotr // Link: https://auto.steemdb.online/",
      "to": "evanllipkismd"
    }
  ],
  "op_in_trx": 0,
  "timestamp": "2020-06-06T12:12:33",
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{
  "block": 43368952,
  "op": [
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    {
      "amount": "0.011 STEEM",
      "from": "crypto.piotr",
      "memo": "Dear @evanllipkismd, I hope you don't mind this little memo. I would like to introduce you to new \"LEARN AND EARN\" initiative which I came up together with @hardaeborla. Check out my latest post and hopefully you will enjoy our new idea. Obviously I would appreciate every resteem and your feedback. I read all comments. Yours, Piotr // LINK: https://steemit.com/hive-175254/@crypto.piotr/learn-and-earn-our-project-hope-new-awesome-initiative",
      "to": "evanllipkismd"
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      "author": "steemitboard",
      "body": "<center>[![](https://steemitimages.com/175x175/http://steemitboard.com/@evanllipkismd/level.png?201911272339)](https://steemitboard.com/@evanllipkismd)\r\n**Congratulations @evanllipkismd**!\r\nYou raised your level and are now a **Dolphin**!</center>\n\n###### [Vote for @Steemitboard as a witness](https://v2.steemconnect.com/sign/account-witness-vote?witness=steemitboard&approve=1) to get one more award and increased upvotes!",
      "json_metadata": "{\"image\":[\"https://steemitboard.com/img/notify.png\"]}",
      "parent_author": "evanllipkismd",
      "parent_permlink": "cannabis-emergencies",
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{
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    {
      "author": "steemitboard",
      "body": "Congratulations @evanllipkismd! You received a personal award!\n\n<table><tr><td>https://steemitimages.com/70x70/http://steemitboard.com/@evanllipkismd/birthday3.png</td><td>Happy Birthday! - You are on the Steem blockchain for 3 years!</td></tr></table>\n\n<sub>_You can view [your badges on your Steem Board](https://steemitboard.com/@evanllipkismd) and compare to others on the [Steem Ranking](https://steemitboard.com/ranking/index.php?name=evanllipkismd)_</sub>\n\n\n###### [Vote for @Steemitboard as a witness](https://v2.steemconnect.com/sign/account-witness-vote?witness=steemitboard&approve=1) to get one more award and increased upvotes!",
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    {
      "amount": "0.001 STEEM",
      "from": "therising",
      "memo": "Hi evanllipkismd. On behalf of our awesome Steem community, thank you so much for upgrading your steem power. If you are interested in earning a good passive income from your SP, kindly checkout your estimated daily payout at https://delegationhub.com/therising and earn maximum 100% returns (For proof, visit https://isteemd.com) from one of the leading bot-therising (3 Million+ SP already delegated by 200+ happy delegators) of the STEEM community. Happy Steeming!",
      "to": "evanllipkismd"
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  "op_in_trx": 0,
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{
  "block": 34781271,
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    {
      "amount": "0.010 STEEM",
      "from": "smartsteem",
      "memo": "Hey there @evanllipkismd, we just wanted to congratulate you on powering up some STEEM and celebrate your growth with you! Thank you for investing in STEEM and seizing this opportunity! If you are also interested in earning a lucrative revenue with your Steempower, then we've got something for you. We are offering multiple risk-free & effective ways to invest your Steempower. For more info, feel free to visit our website: https://smartsteem.com. Warm regards, Team Smartsteem",
      "to": "evanllipkismd"
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{
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      "author": "evanllipkismd",
      "body": "![0F59A896-264D-4278-9575-7CA78FAAD566.jpeg](https://cdn.steemitimages.com/DQmcbB7WyoyJSzDrZxjmQAnEBff7EcdDdXbzt1zobhKzBeD/0F59A896-264D-4278-9575-7CA78FAAD566.jpeg)\n\nAccording to the March 19th edition of Annals of Internal Medicine, cannabis ER visits are increasing and are divided into the following categories:\n\n—Gastrointestinal symptoms like vomiting.\n\n—-Intoxication symptoms\n\n—-Psychiatric such as anxiety and psychosis (hallucinations)\n\n—-Cardiovascular\n\nThe proportion of ER visits due to edibles is rising rapidly because often there is delay in absorption and more is consumed. Additionally oral doses can accumulate in the body since the kidneys don’t clear it out as rapidly. Inhaled products act more quickly and are cleared by the body more rapidly.\n\nIn fact, the rare deaths from cannabis are reported in people consuming edibles. Psychiatric problems are the most common reason for ER visits with edibles while gastrointestinal issues are more common with inhaled products.\n\nDr.Rx: This study is useful because like alcohol marijuana is a drug with its own set of side effects. More ER visits are occurring since legalization and the proportion of visits is higher with edibles. More high quality studies are needed to better define the benefits and harms of cannibis.  \n\n![6896C7D8-2FFB-401A-98E9-E9DBA11EFB6D.jpeg](https://cdn.steemitimages.com/DQmUxNpJJjjvqdboqhQnHvzQFWELsUbgP7RzTDs6Gn7WNoS/6896C7D8-2FFB-401A-98E9-E9DBA11EFB6D.jpeg)",
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{
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      "json_metadata": "{\"profile\":{\"name\":\"Doc\",\"about\":\"Dr. Lipkis is THE RATIONAL PHYSICIAN. He combines standard medicine with complementary medicine to write health books and cherry pick the best supplements for a\",\"website\":\"http://www.DocLipkis.com\",\"location\":\"United States\",\"cover_image\":\"https://cdn.steemitimages.com/DQmUxNpJJjjvqdboqhQnHvzQFWELsUbgP7RzTDs6Gn7WNoS/FD1C8245-B11C-4747-A3E3-8CE357249F45.jpeg\",\"profile_image\":\"https://cdn.steemitimages.com/DQmUmcz52fMzfAxtjbWLjHu52Rm9bvyeVHGbajLsYkczfs3/7AFE1167-0E6D-4C4E-A9EA-29B81504C0C7.jpeg\"}}",
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{
  "block": 30677474,
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    {
      "author": "partiko",
      "body": "Hello @evanllipkismd! This is a friendly reminder that you have 3000 Partiko Points unclaimed in your Partiko account!\n\nPartiko is a fast and beautiful mobile app for Steem, and it’s the most popular Steem mobile app out there! Download Partiko using the link below and login using SteemConnect to claim your 3000 Partiko points! You can easily convert them into Steem token!\n\nhttps://partiko.app/referral/partiko",
      "json_metadata": "{\"app\":\"partiko\"}",
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      "author": "evanllipkismd",
      "body": "# **Stem Cells For Arthritis. Does it really work?**<h1>\n\n\n![18644B41-731E-4270-9D0C-20A1B5146021.jpeg](https://cdn.steemitimages.com/DQmdEHt3ReEgq8a38K6SMqmUaam1y4PA1Wco9RGaWYGWe2W/18644B41-731E-4270-9D0C-20A1B5146021.jpeg)\n\n\n\nOsteoarthritis (wear and tear arthritis) plagues millions of Americans. \n\nOsteoarthritis is an inflammatory condition that is initiated by wear and tear on the joints. The knee, hips and base of the thumb are the most common joints involved. \n\nPresent treatments include Tylenol, up to 3000mg daily, NSAIDs or antiinflammatories such as ibuprofen or naproxen, oral/injectable steroids, topical NSAIDs like diclofenac, viscous, injectable supplementation such as Synvisc or Hyalgan, acupuncture, tai chi, water therapy, physical therapy and joint replacements. \n\nHere’s the problem; NSAIDs can raise pressure and increase heart disease, steroids can increase pressure and sugar, steroid injections can weaken ligaments, joint replacements can fail and have other side effects and most of these treatments stated above need to be repeated.\n\nSo what about stem cells. We already employ stem cells in our own bodies to repair most tissues. If you break a bone, then your own stem cells differentiate into bone producing cells called osteoblasts and the bone is repaired. If we harvest stem cells from our own body, then they can be reinjected into our knees, for example, to help with pain and disability. This is called autologous donation.\n\n**Does it really work?**\n\nMaybe. Like arthroscopy and other procedures, the placebo effect is quite high. According to  Exp Ther Med.  2016; 12(5):3390-3400 (ISSN: 1792-0981), the effectiveness of stem cells was significant in relieving pain and improving functional status in the knee up to at least 2 years. Increasing the numbers of stem cells didn’t matter even though it did matter in previous studies. \n\nPlease know that the quality of the studies is not great and we need more randomized, controlled, double blinded studies to determine the truth but progress has been made. The following is a review of several studies published in 2018 with the corresponding conclusion:\n\nArthroscopy. 2018 Nov 16\n\nIntra-articular Mesenchymal Stem Cells in Osteoarthritis of the Knee: A Systematic Review of Clinical Outcomes and Evidence of Cartilage Repair.\nHa CW1, Park YB2, Kim SH3, Lee HJ3.\n\nCONCLUSION\n\n*Intra-articular MSCs provide improvements in pain and function in knee osteoarthritis at short-term follow-up (<28 months) in many cases. Some efficacy has been shown of MSCs for cartilage repair in osteoarthritis; however, the evidence of efficacy of intra-articular MSCs on both clinical outcomes and cartilage repair remains limited.*\n\n\n**Maybe it is all just placebo, right?**\n\nArthroscopy, according to 2 studies, doesn’t work any better than sham arthroscopy in both the young and elderly. There are exceptions but my main point is that arthroscopy is a powerful placebo. Stem cell harvesting and ultrasound guided injections may also have a strong placebo effect. Still, my  bias is that stem cell replacement will eventually supplant many orthopedic surgical procedures. Currently, small randomized controlled trials show efficacy.\n\n**How much does it cost?**\n\nThe costs vary and can range from 3000-6000 dollars a joint. Stem cells have been injected into the back, hips, knees, shoulders, other joints and tendons. \n\nBe aware that there are many fraudulent companies out there because the costs for the procedure is expensive and insurance hardly ever reimburses. This is a money maker. On the other hand, legitimate companies do exist as well.\n\n**Where should I go?**\n\nMany of these companies are scam artists and are breaking the law. Here is one reasonable suggestion:\n\nConsider Regenexx since they have done 50% of the researching the field, have the research laboratories, and have been in business the longest (since 2004). They have also conducted safety studies and found that stem cell replacement to be fairly safe for orthopedic procedures. \n\nI have no financial or scientific association with any stem cell firm. My desire is to be transparent and helpful in a very complex field.\n\n**What stem cells work the best?**\n\nThis answer is not completely known. Typically the stem cells are harvested from the fat surrounding your belly and the bone marrow in the back of the pelvis. They can also be collected from your blood. These procedures are relatively easy and involve minimal discomfort. \n\n**Are stem cells FDA approved?**\n\nNo they are not but certain methods are FDA cleared so it is OK for the doc to perform the procedure. The doc just cannot claim that his or her procedure treats any condition. \n\nThere are two categories of HCT/P (the abbreviation for human tissue).  \n\nOne is a 361 product and your doc is allowed to give it without restriction.  It includes any product from your own blood and bone marrow. It also includes your own fat with some restrictions.\n\nDocs are only allowed to reinject tissue from yourself, or a first degree relative. Your own stem cells must be injected right after collection. They cannot be allowed to grow for days or weeks. \n\nThe second product category is 351 and this means everything else, and any tissue donated from a non 1st degree relative. Umbilical cord blood and amniotic fluid would be 351 products and this necessitates a drug application which requires years of research and millions of dollars. Even if your own stem cells are grown, the FDA deems that to be a drug or a 351 product since your cells are allegedly being manipulated. \n\nUnfortunately amniotic fluid and umbilical cord blood contains very few stem cells or MSC (mesenchymal stem cells). And by the time the company gets the cells, they are almost always dead cells. Companies cannot claim to inject live umbilical cord stem cells, otherwise it is a drug and drug approvals take both time and money. \n\nTherefore you are either receiving dead cells and paying 1000s of dollars for what you thought to be live stem cells OR somehow you are receiving live cells not from your body illegally because such cells are not an FDA approved drug. Apparently, either way you are being scammed.\n\nCord blood does contain hematopoietic stem cells for bone marrow transplants but these cells are alive and such transplants are approved by the FDA for leukemia and other blood disorders.\n\nOnce again, if a company claims to be giving you live umbilical cord stem cells for healing your knee, then that company has broken the law. They are pretending to deliver a drug which has never been approved and you are being scammed.\n\nA company just can’t deliver a foreign substance to you and call it a drug. Once again to get a drug approved by the FDA requires detailed clinical studies, millions of dollars and countless applications. We are emphasizing going legal because many stem cell companies are scam artists because there is a lot of money to be made. \n\n\n\n**Ok, then why do some patients claim success with dead cells?**\n\nOften patients are receiving PRP or platelet rich plasma with the dead stem cells. PRP comes from a special filtrate of your own blood and may actually help with joint pains. This filtrate contains many growth factors with healing properties. Trouble is...many companies are charging thousands of dollars for dead stem cells plus PRP. Usually the PRP only costs a few hundred dollars a joint. \n\n**So what should I do?**\n\nAvoid the above scam. Have a reputable company harvest your own stem cells and immediately inject you. They should not advertise that the procedure is indicated for any particular condition because your own stem cells are not an FDA approved drug. But they can discuss the pros and cons of the current studies. There are reputable clinics  BUT buyer beware.\n\n**What about other stem cell projects besides the orthopedic procedures?**\n\nOther stem cell projects haven’t fared as well. Homologous (from your own body) stem cells were injected for metastatic breast cancer and proved costly and disastrous. \n\nHomologous stem cells (your own stem cells)were injected into a patient’s kidney who had lupus and he required a nephrectomy due to new tumors in his kidneys. \n\nHomologous fat cells were injected into the back of the eye for the treatment of macular degeneration and the patient went blind. \n\nA patient received stem cells from another person that were injected into his brain due to a stroke. Tumors developed and the subject became paralyzed. \n\nThe future, however, does look bright. One day we see joint replacements being replaced by stem cell technology but right now be cautious, investigate and do your research.\n\nMesenchymal stem cells (from their own fat or bone marrow) have been injected near the spinal cord in ALS and it has been tolerated well. There has been subjective improvement but more studies are needed.\n\n**Drs. Rx:**\n\n*Stem cells are the wave of the future. Discuss this article with your health care provider.Small studies especially with the knees show some efficacy. Beware of the scammers. Actually the stem cell field reminds me of crypto. Many coins are scams but a few are gems including Steem. I hope I’ve opened a few eyes in a complex field that is more like an obstacle course; you can traverse the field but watch out for the mines. Good health to all you Steemers or Stemians and it is a privilege to post. I have so much recent info that I want to pass on. So we’ll see how this post goes. I am also happy to write about areas that interest you.*\n\n![54AA06C3-E59D-4003-ADF0-7C1EEA14FFED.jpeg](https://cdn.steemitimages.com/DQmYYVjtnDQ2uagqLHovyLQtUzLiWa4BNE9bps1grE6atjt/54AA06C3-E59D-4003-ADF0-7C1EEA14FFED.jpeg)\n\nHttp://DocLipkis.com",
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      "body": "Congratulations @evanllipkismd! You received a personal award!\n\n<table><tr><td>https://steemitimages.com/70x70/http://steemitboard.com/@evanllipkismd/birthday2.png</td><td>2 Years on Steemit</td></tr></table>\n\n<sub>_[Click here to view your Board of Honor](https://steemitboard.com/@evanllipkismd)_</sub>\n\n\n> Support [SteemitBoard's project](https://steemit.com/@steemitboard)! **[Vote for its witness](https://v2.steemconnect.com/sign/account-witness-vote?witness=steemitboard&approve=1)** and **get one more award**!",
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      "body": "Congratulations @evanllipkismd! You have received a personal award!\n\n[![](https://steemitimages.com/70x70/http://steemitboard.com/@evanllipkismd/birthday1.png)](http://steemitboard.com/@evanllipkismd)  Happy Birthday - 1 Year on Steemit Happy Birthday - 1 Year on Steemit\nClick on the badge to view your own Board of Honor on SteemitBoard.\n\n> By upvoting this notification, you can help all Steemit users. Learn how [here](https://steemit.com/steemitboard/@steemitboard/http-i-cubeupload-com-7ciqeo-png)!",
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      "body": "I thought this was great! I can tell you know a lot about the subject. There are a lot of factors that contribute to obesity that I don't think we as a society have considered. I think if all of us had the kinds of cravings and metabolic difficulties that overweight people deal with, we might be less inclined to feel critical, and more inclined to applaud their struggle. Especially if they overcome it.",
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      "body": "WEIGHT LOSS FOR ALL OF US--A BASIC PLAN\nBy Evan L. Lipkis MD\n\n\n\nDid you know that humans are unhealthy prey? We aren't even fit to be eaten! We are eating so much sugar and addicting foods that obesity, sleep apnea, high blood pressure and diabetes are essentially epidemics.\n\n\n\n\n\nSo follow the THE 5 Bs and BANISH the weight!\n\n\n\nBRAIN\n\n\nObesity is a disease! We need to know our enemy if we want to conquer it.\n\nThe brain (hypothalamus)  gets inflamed with obesity and won't respond normally when you are full so it's \"not in your head\" but it really is in your head since your brain develops pathological changes. So please don't get down and start to blame yourself, ok? This disease is analogous to diabetes, high blood pressure or any other chronic disease. Let me give you an example. \n\nThe Biggest Loser contestants have been followed for 5-10 years after appearing on the program. The average weight upon starting was around 300 pounds and the average weight loss was nearly 100 pounds. Now, if we fast forward to 5-10 years, the average weight was 290 pounds. Even the most highly motivated people regain the weight, because  this problem is a chronic disease that waxes and wanes. Passion is essentially battling chemistry.\n\nOK, so weight loss is a chronic disease located in the brain. But the above contestants lost the weight, so why did they regain? There are likely many explanations.\n\n1. The inflammation in the brain still existed so more calories were eventually consumed. The hypothalmus is the hunger center and it was adversely affected due to this inflammation. It didn't work well to turn down the hunger. Therefore, more hunger was experienced. This has actually been demonstrated by a clinical study performed in 2016.. Essentially the contestants battled the disease with passion and motivation. But eventially, the passion waned when the media frenzy died down and they began to gain the weight back because the chemistry took over. Genetics also plays a role as well.\n\n2. Also, when you lose weight, metabolism slows. This has been known for years.\n\n3. The contestants may have adopted a diet but not necessarily a lifestyle change. Weight loss requires a lifestyle change that you can accept and accomplish. It is not just a short term diet so that you can fit in your clothes, wow your friends or impress the media. Passion is important but adopting a lifestyle that you can follow is critical.\n\nNow don't worry, there are reasonable ways to lose weight despite the conflicting chemistry. We just needed to get acquainted with the enemy. Ok, let's get started!\n\nBEHAVIOR\n\nWhen the stomach gets distended it releases leptin that causes fullness. Since obesity is a  disease, the hunger center in the brain may not fully recognize this signal.  Here are a few behavioral tips that may be helpful.\n\n1. Be conscious while eating. Self awareness is critical because eating is almost a state of hypnosis or a trance. It's like driving a car or eating popcorn in a movie theater. Conversation during meals can lead one to shovel in the food without even realizing it. You can break this trance by doing more listening and by thinking about the food you eat. Treasuring the taste and being greatful about the meal may also increase the mindful state.\n\n2. Eat slowly, give your stomach time to release that leptin. This process may take 20-30 minutes so you can rapidly devour a lot of food before your brain ever creates that sense of fullness.\n\n3. Drink plenty of water before meals and distend the stomach! Small studies show that 2 glasses of water before each meal can result in a 10 pound weight loss.\n\n4. Test out which foods help you feel full. Usually foods that are mainly fat or protein will help to create a sense of fullness. For instance, a handful of nuts or a little dark chocolate may help. Gloppy foods such as thick soups and the like may also be quite filling.\n\nBITE\n\nWhat is the best diet? There are many great ones but the Mediterranean diet is probably the best. This diet has been shown to help prevent cancer, reduce heart disease and to decrease dementia or mental decline. Can't beat that track record, right?\n\n\nInsulin makes the body deposit fat so we gotta dampen the insulin response by decreasing carbs or choosing the right ones:\n\n1. Eat vegetables. Potatoes, carrots, corn and beets, these are the veggies NOT to eat.\n\n2. Eat fruits...best are apples, grapes, grapefruit and any berries as these fruits will produce less of an insulin response than other sweeter fruits.\n\n3. Lessen the grains, rice, bread, pasta, chips, potatos and desserts.\n\nIf we added fish, whole grains and olive oil to the above foods, then we have the Mediterranean diet! This lifestyle change will not only help you lose weight but it improves your health too. \n\n\nBRAWN\n\nWhat's the best exercise? The one that you will do!  Portion control is more important for weight loss than exercise but exercise is excellent at helping you maintain your weight. Additionally, working out can help improve mood, prevent cancer and reduce heart disease. Here are a few tips.\n\n1. Make it fun. If you can regiment yourself to workout every morning, then I'm in awe. Most of us want exercise to be fun. We are more likely to exercise if we enjoy it. Walking with another person, playing sports and participating in group classes are just a few examples. Remember to stretch before and after an activity and remain well hydrated.\n\n2. Another way is to incorporate exercise into your normal day. Take the stairs, park farther away and walk during part of your lunch break. Also, somebody needs to walk the dog. Picking up the poop might even be considered  weight lifting!\n\n3. Don't be a warrior and stay in the ballgame. If you are going to play basketball once a week, then you might be more likely to experience an injury than if you worked out more frequently.\n\n4. Start slow and do a little exercise everyday or every other day and develop a habit. Guidelines say to get 180 minutes of exercise per week. The important point is just to get started. Exercise that is longer and slower is probably more effective for weight loss than shorter, high intensity workouts.\n\n5. Watch TV BUT move during each commercial. That's 20 minutes of exercise every hour!. Cycle (a little floor device) stretch, lift light weights...all while your sitting on the couch!\n\nBIOLOGICS\n\nYou'll get by with a little help from your friends and your friends are drugs. I mean prescription drugs not street drugs!. Why fight the battle of hunger? You don't get extra brownie points for doing that. \n\nUse your resources. Drugs work and remember we are indeed treating a disease. Yes, I know...OMG it's a drug! \n\nHave no fear, some of us  drive a car, stuff our tummies, smoke anything, drink the booze, text till we drop,  watch TV for hours and much more. Our medicines are FAR LESS risky.\n\nNearly every alternative or natural agent just is not proven to work. Green coffee bean is promising but more studies are needed.\n\nMedicines approved for weight loss include phentermine, diethylpropion, Xenical, Belviq, Qsymia, Contrave and Saxenda. The first two listed are generics. Talk to your health care provider about prescribing a medicine, especially if you cannot lose weight or if you begin to regain weight after shedding the pounds. Technically, these agents are recommended if you are obese or if you are significantly overweight and have a cardiac risk factor (high cholesterol, high blood pressure, smoking, diabetes).\n\n\nLet's wrap up and introduce a few more points.\n\nLosing weight is a journey and not a goal. It is a lifestyle change and not a diet. It is a matter of developing good habits through repetition. Even getting regular sleep helps you lose weight. Weight Watchers remains one of the best ways to lose weight through the power of the group. Clinical studies verify this common method.\n\nBE KIND TO YOUR BODY. DEVELOP NEW HABITS AND NO LONGER PUT DIESAL FUEL IN THE GAS ENGINE. Your car will never get home. It's the same deal with your body. The Mediterranean lifestyle is an excellent way to lose weight and improve your health.\nLowering your carbs is one of the most effective ways to lose weight.\n\nMake exercise fun or at least incorporate it into your day. \n\nBe accountable and report regularly to your dietician, healthcare provider or even a good friend.\n\nFood is thy medicine, use it wisely and you can soon be fit to be eaten!\n\nConsult with your healthcare provider about possibly using a medicine in addition to a healthy lifestyle if needed.\n\n\nAll The Best,\n\nEvan\n\nEvan L. Lipkis MD",
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