Episode 26: AMA | Keto, Lipotropic Injections & Fiber

Thank you for joining Dr. Simonds and Michelle Kennedy, NP-C for this AMA episode, streamed live from Dr. Simonds Metabolic & Weight Loss, Raleigh location. They answered your weight loss questions and gave away another $25.00 Target gift card to one lucky viewer.

Q: How important is fiber when you’re on a keto diet? Do you recommend a good source?

A: We really don’t think that the evidence for fiber is really as strong as people think. Instead, we like to use vegetables. We find that the best way to ensure adequate fiber intake is to start with a good amount of low-glycemic vegetables. Vegetables do not absorb very quickly and they take a lot with them through the intestinal tract, therefore everything moves smoothly. We’ve even heard of the recommendation from colleagues to consume at least 4 cups of leafy greens daily.

So, the first step to getting your bowels regular is to eat more vegetables. Be sure to stay away from carrots, beets potatoes, and corn due to the high sugar content affecting insulin levels. An easy way to remember is to eat any vegetable grown above the ground that’s not corn. Medications, a low carb diet as well as any dietary shift can slow down the G.I. tract. When this happens, many people turn to fiber supplements, which we don’t recommend. Many fiber supplements can contain sugars and sweeteners and can also be harsh on the system so we recommend being careful with those. Instead, we are big fans of and recommend Magnesium. Magnesium is great because it helps with the movement of the muscles in the G.I tract, which keeps everything moving along, safely without cramping and stomach upset.

Q: I’ve read conflicting information on the value of exercise in weight loss. Is it critical to success and how much do you recommend?

A: Exercise has so many health benefits, however, exercise is not as valuable for weight loss as it is for weight maintenance. Whether the goal is to lose weight or not, some form of exercise is going to help improve your health and help with blood pressure, blood sugar, sleep, and even mental health. Exercise doesn’t need to be organized or involve expensive equipment. Take a walk or just incorporate some form of activity throughout the day such as squats or parking further away in the parking lot. It all adds up and makes a big difference.

Q: Can you tell me about the benefits of your lipotropic injections?

A: We have a ton of patients that really feel the benefits of lipotropic injections. Lipotropic injections are compounded B vitamins with fat burners that are usually given weekly. Patients report better sleep, more energy, easier weight loss, and better moods. They are quick, painless, and fast-acting with many people noticing a difference in just a few hours. The best way to see if they work for you is to simply give them a try. You’ll know pretty quickly if they are helpful and if not, there’s no need to continue with them.

Q: I’ve heard that doing a strict keto diet can have negative long-term effects. Is this true? If so, how should you structure a diet plan to avoid this?

A: No, not at all! Keto is very safe when well-formulated and followed correctly. When following a keto diet, it’s important to be mindful that you’re eating enough nutrients, protein, healthy fats, and vegetables. The keto diet is so filling, that it’s easy to drastically undereat calories and nutrients.

Q: Do you recommend other ways to reduce inflammation other than a keto diet?

A: While the keto diet is very anti-inflammatory, there are certainly other ways to decrease inflammation. To reduce inflammation, stay away from refined grains, refined sugars, and ultra-processed foods. Those are examples of pro-inflammatory substances that are horrible for your health. You’re basically eating and drinking the inflammation. Stick with whole, natural, unprocessed foods instead. We also like to recommend fish oil, Omega-3, CBD oil, and turmeric for inflammation.

Q: What is inflammation and why is it bad?

A: While some inflammation is okay such as the body’s response to an injury such as swelling from twisting an ankle or healing, it’s the inflammation in the body that causes medical diseases to be concerned about. It’s important to get quality sleep, manage stress and live a healthy lifestyle to help avoid diseases and inflammation.

Q: What does it feel like to take phentermine? I’m worried I will not be able to handle it.

A: Many people are very curious about how they will react to phentermine. The best way to see how you will tolerate phentermine is really to try it. A good indicator is how well you tolerate other stimulants such as caffeine, tea, and coffee. And, if you’re able to take an over-the-counter decongestant, such as Sudafed you should be able to tolerate phentermine well too.

Most people are more focused, alert, and have a decreased appetite while taking phentermine. Some less pleasant side-effects reported are dry mouth and sleep disturbances, if taken too late in the day. There are actually weaker versions for those that don’t tolerate phentermine very well. Most people tolerate phentermine very well and are pleasantly surprised at how well it helps with weight loss. We walk all patients through the medication process and have many different options and doses available.

Q: Are you going to offer the new weight loss pill that’s out?

A: Great question! You may have heard on the news that a new anti-obesity medication, Wegovy (semaglutide) was recently approved by the FDA for weight management. This medication is actually an injection, given weekly, and will require insurance coverage. Currently, it is very expensive and can cost an average of $1000 a month, therefore it’s not a very affordable option. However, we are able to write a prescription for any patient that is interested in this medication.

Q: If I start, what can I expect and how soon do patients typically see results?

A: Most people see results very quickly, within the first week and that’s great for motivation. We recommend you weigh yourself regularly and you’ll be even more motivated as you see the scale drop.