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#150: Mark Dedomenico, MD, Connie Guttersen, RD, PhD- Cultivating Weight Loss Habits and Mindset

by Mike Mutzel


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Mike Mutzel Podcast High Intensity Health


About Connie Guttersen, RD, PhD and Mark Dedomenico, MD

Connie is a leading nutritional and dietary expert. She has spent her career focusing on developing flavorful and nutritious approaches to healthy eating and weight reduction. A registered dietitian and nutrition instructor at the world famous Culinary Institute of America, Dr. Guttersen developed the Standards of Care for the Obesity Treatment Center in Bellevue, Washington, as well as served as a nutritional and dietary consultant for a broad range of corporations and Fortune 500 companies.

Mark is a former cardiovascular surgeon who played a key role in developing the procedure known as Coronary Bypass Surgery along with Dr. Lester Sauvage. Working together as two of the initial founders of the Hope Heart Institute, they also created some of the most significant developments in heart surgery.

In 1992, Dr. Dedomenico began a new research project devoted to the treatment of early stage metabolic disease to prevent individuals from later needing cardiovascular surgery or medications to control hypertension, high cholesterol and diabetes. The research led to the creation of the 20/20 LifeStyles program. In 2002, 20/20 LifeStyles was selected as a credentialed provider of Microsoft’s weight-management program.

Connect with Mark and Connie

Books Discussed in this Podcast

The Love Diet: A Personalized, Proven Program That Changes the Way You Feel to Transform the Way You Look

The New Sonoma Diet®: Trimmer Waist, More Energy in Just 10 Days

Interview Show Notes

01:49 Breaking the Guilt Cycle: It takes gaining a real understanding of what is happening with emotional eating. It is one thing to recognize that this occurs, but how do you get over it? The Love Diet addresses this.

02:37 Isolation and Eating: Eating because no one loves me is very common. Smart people tend to isolate themselves. In the Love Diet program, there is a session with a psychologist once a week for the first 6 weeks and there is a group therapy session (aka workshops) 10 times during the program. There is not enough time for psychoanalysis. They work on habits. After about 2 weeks of thinking rather than reacting, it gets easier and easier to change the habit.

05:50 First Week Dietary Changes: Participants are instructed to remove from their homes food/beverages that are not on their diet. The diet change is so effective, that they are not hungry and habits are easier to manage. We have a tight bond with the food in our kitchen.

07:03 Chemical and Emotional Reasons for Eating: If you get too much sugar, you want more sugar. Carbohydrate is a nice name for sugar. Today’s bakery/bread section of the store is huge in comparison to 50 years ago and the products are all made with refined flour that becomes sugar in our bodies. Your body thinks that you should weigh what you weigh right now. It is your set point. When you lose weight, your body believes that you should be at your set point and works to get you there. It takes 6 months to a few years to reset the set point. Your body does not know that you were losing weight for your health. To your body, you are not getting enough food.

09:12 The Diet: The diet focuses on decreasing sugar, processed foods, added sugars, grains and starchy vegetables. The moment that they stop to eliminate the cravings for sweets and stop sugar intake, participants do well. Hunger disappears, energy levels rise and blood sugar levels are more stable. If you eat 3 meals a day and 2 snacks, you raise your metabolism. If you fast for 10 hours, including your 8 hours of sleep, it raises your metabolism.

10:54 Gut Bacteria and Calorie Absorption: Imbalanced bacteria in the bowel can increase absorption of additional calories by 140 to 180 per day. That is 15 pounds per year. Dysbiosis of gut bacteria can come from artificial sweeteners and other chemicals in our foods. Probiotics may or may not work. It is difficult to determine since we do not know what the real balance is supposed to be. Gut bacteria are challenging to study because they do not grow in air and there are at least 400 species.

13:30 Water and Fiber: Participants drink at least 64 ounces of water a day. It helps to wash out endotoxins produced by pathogenic bacteria. Certain fibers help good bacteria to grow, so the more fiber the better. Getting our diets back to what they should be will help balance digestive bacteria.

14:27 Inherited Bacteria: Depression, anxiety, diabetes, and obesity may be from bacteria from your family. Dr. Dedomenico used to run insulin levels on all patients at the beginning of the program and every one had elevated levels and was insulin resistant. At the end of the program everyone had normal levels. They were able to break the insulin resistance with diet and exercise. Insulin can make you hungry.

15:34 How It Started: Dr. Dedomenico was a cardiovascular surgeon and started the Hope Heart Institute in Seattle. He invented surgical procedures and wrote numerous papers. He wanted to focus on how to keep people from requiring the surgery. Through their weight loss program, they are able to give people the same 15 years of extra life that the surgery did, but with weight loss.

19:03 Creation of the Program: Dr. Dedomenico knew that they needed to change what was going on in patient’s heads. No one loved themselves. He brought a psychologist on board at the beginning. Habits needed to be changed. Dietary changes are lifelong. 20/20 Lifestyles has been in practice for over 20 years and has acquired a great deal of wisdom working with over 11,000 patients, learning things that were not captured in medical journals. You don’t only learn from people who do well. You learn a great deal from people who do poorly.

21:57 Binge Eaters: They help over half of their binge eaters lose weight. The program looks deeply into why they binge eat. There are binge eater workshops so they begin to understand each other. Binge eaters represent 15 to 20 percent of all people who are overweight. More than likely the morbidly obese person is a binge eater. Though the Love Diet Program does better than other programs with binge eaters, it is their most challenging group. 20/20 Lifestyles measures success on behaviors which reach beyond the scale. That is empowering.

24:36 20/20 Lifestyle’s High Success Rates: Most people are able to reach a normal body mass index. It depends upon how long they remain in the program, how much the weigh and how much they have to lose. Average weight loss is 1% or 2% per week.  Dr. Dedomenico worries about their clients who binge eat and do not lose weight. It is a work in progress. He is determined to find the answer.

25:52 Genome Research: Dr. Dedomenico is about to begin running genomes on patients past (over the past 20 years) and present. This, along with records of environmental factors, will help them predict the weight gain and weight loss process. It may assist in determining the heartrate at which an individual burns fat or burns sugar. The formula used in today’s methodology for determining this does not apply to everyone.

27:38 Changing Environment and Self Talk: A study of Vietnam vets found that when they returned home, heroin addictions disappeared. Visualize yourself in a better place. Deal with your trigger. Identify foods that are trigger foods, which are usually sweet/salty/fatty combinations of foods. Who you surround yourself with is very important. Do your friends and family want you to succeed or do they want to keep you unsuccessful at dieting? Personal and family dynamics are part of the treatment process at 20/20.  They have a video for the participant’s family (including the kids), reminding them that participation in the program is done out of love for the family.

31:05 Sleep and Stress: When we are sleep deprived and stressed, it changes our hormone levels, like cortisol, and drives the “seeking for food” appetite hormones. Lifestyle is critical.

32:13 The Necessity of Self-Compassion: Many of their patients have failed at diets, bringing a high level of stress, distrust in diets and lack of love for themselves, shame and guilt. When the shame cycle is broken, patients can be brought to the pivotal components of the program: self-acceptance, self-respect, and self-love, which leads to respecting your body. It is the premise of the book and the program. One strategy is to pretend, act as if you love yourself and for the next two weeks, in everything you do, act as if you love yourself. All of a sudden you realize that you do love yourself.

35:26 Tracking Tools/Modalities: If your body is losing weight and you are going below your set point, your body thinks that you have run out of food. Your body slows to conserve. We easily and unconsciously cut our steps from 10,000 per day to 1,500. Using a pedometer is important. 20/20 also has a food tracking ap on their web site that is supervised by a dietitian. People who plan and track are more successful. 20/20 also uses a plate concept. Eat from a plate, not a package, and participants are given guidelines on how to plate their food. Dinner plates a few decades ago were about 9 inches and now they are 14 to 16. The bigger the plate, the more food you are going to eat. They have a specific diet to guide them through food groups.
42:49 What is This Book About? The book includes wisdom along with medical practice. Wisdom is intangible to the success of a diet. It is written from a patient’s perspective. The first step is to like yourself. It does not matter what is making you sick. When you like yourself, you are half way home to making yourself well.

46:26 Dr. Guttersen’s Morning Routine:  She visits with the kids during breakfast. She drives them to school and works out at the gym, getting some time for herself.

46:41 Dr. Dedomenico’s Morning Routine: He has breakfast and goes to the gym. He utilizes MBWA = management by walking around.

47:19 A Favorite Herb, Nutrient or Botanical: Dr. Guttersen makes a ritual of having a cup of tea in the afternoon and evening to get her to slow down and relax. Dr. Dedomenico has been giving his patients omega 3 fatty acids for the past 53 years. He says that they are the fountain of youth, they are anti-inflammatory and balance omega 6s. The year after having his patients take fish oil, he started giving his patients aspirin for the prostaglandins and other benefits. Controlling sugar is critical. He participates in 20/20s anti-aging program and has been taking hormones for 35 years.

51:32 One Health Tip: Dr. Guttersen and Dr. Dedomenico would tell them to treat your body like it is someone you love. We need to take care of each other.

Related Podcast

Episode #63: Mark Houston, MD- Heart Disease, Leaky Gut and High Blood Pressure

  1. I only listened to this (didn’t watch as I was doing other things). One of the most fair-minded, solidly based, reality situated heart-based discussions about eating and food and fat loss and habits, you name it, I have ever heard. I’ve irdered the book from the library (they have it!), and have been to the website. Thanks for this one!!

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