Episode 23: AMA | Keto, PCOS & Skin Tightening

Thank you for tuning in to watch Dr. Simonds and Michelle Kennedy, NP-C as they answer your questions on weight loss, the keto diet and more.

We are so appreciative of those that take the time to tune in Live! As a thank you, we are selecting two lucky viewers during the show to receive a $25.00 Target gift card today.

Q: How long can someone stay in ketosis and what should you consider before purposefully coming out of it?

A: For most individuals, you can stay in ketosis forever! Prior to modern times, our ancestors lived in ketosis their entire lives and it’s a natural human condition. We have found much success with the keto diet and the traditional American diet is causing obesity and other health problems. There is no reason to ever come out of ketosis unless you decide to do so. If you decide to come out of ketosis, there really aren’t any precautions that need to be taken. If you decide to reenter a state of ketosis, it’s important to monitor electrolytes to avoid the keto flu. Just remember that water follows sugar. If you come out of ketosis and start consuming carbohydrates again, you will gain some water weight. If the keto diet is working for you and you feel great, there’s really no reason to stop!

Q: Can you tell me more about services you offer for smaller weight loss (like 10 to 15 lbs.)?

A: We treat individuals with a wide range of sizes and weights. We actually have a lot of experience with patients that may not have a lot of excess weight to lose, and we don’t have any weight restrictions or minimums for patients.

Obesity is not a disease of just weight. It’s a disease of excess body fat that can happen at many different weights. We are really interested in helping people at this stage as it’s more manageable at this stage. If someone continues to gain more body fat, it begins to cause more permanent biological changes. The treatment isn’t any different for an individual that has smaller or larger amounts of weight to lose.

You must consider four things: first is nutritional approach by restricting carbohydrates (or finding an eating plan that works for you), next is physical activity, no need to join gyms formally, but just physical activities, behavioral modification, and finally is medication. Medications are extremely helpful during this process and can really jump start your weight loss.

Q: How regularly do I need to be seen and do you offer telephone visits?

A: Yes, we offer telephone visits and patients love how convenient they are. Telephone visits are offered for long-distance patients as well as patients that reside locally. Most patients regularly visit us every 30 days or once a month. And it can be individualized to meet your needs. Still, it’s every 30 days for medication refills because the accountability of regularly coming in is vital to success. We want to be there to answer your questions, monitor your progress, and make sure we are not missing something.

We do require that the very first visit is done in the office and telephone visits may proceed monthly after that. We do like patients to have an in-person office visit at least once per year or if they’ve had any major health changes.

Q: Can you tell me more about your experience with patients with PCOS? I was just diagnosed and currently take a lot of medications. My weight loss continues to stall and I’d like help.

A: We actually treat many women in the practice that have been diagnosed with PCOS. It is very common for patients with PCOS to have difficulty losing weight. The antidote to PCOS, from a diet standpoint, is carbohydrate restriction. You need to avoid sugar, rice, flour, and potatoes, or anything that will further raise your insulin level. We have found much success with weight loss medications such as Metformin along with a strict low carbohydrate diet. PCOS can be treated and even reversed with weight loss and lifestyle modifications.

We received this awesome comment from a viewer: I follow your Instagram page and just wanted to say, I love all the keto recipes you share. Makes keto fun!

Thank you so much! We definitely love to share recipes to help avoid diet fatigue and for those looking for some more variety while eating keto. You can find us on Instagram here.

Q: After losing more than 50 lbs., I have to work out a lot to tone up my body, but I’m still not happy. I’m scared of surgery. What else should I do?

A: Congratulations on your weight loss! That is a phenomenal accomplishment! Regularly working out may look a little different from what you think. It just takes a little time, continue to work out and add some cardiovascular and resistance exercises. Just be persistent and avoid eating junk foods.

We offer a painless, non-surgical body contouring and skin tightening service called InMode. Just about anybody area can be treated. We even offer a free consultation to see if you’re a candidate for this cosmetic service. Contact our Durham office for more information.

Q: Someone told me that intermittent fasting would help with that sagging skin. Is this true?

A: While we have heard about this before, we don’t have a ton of research ourselves on intermittent fasting to prevent sagging skin. We do think that fasting is a great tool for weight loss! We are also fans of using a hydrolyzed collagen supplement to help with skin elastically, joint health and healthy hair and nails.

Q: Are the collagen capsules as good as the powder form?

A: We highly recommend the powder form over the gummies or capsules. The powder form is much more accurate for dosing purposes and is completely tasteless.