Female, age 43 – Pregnancy-related weight gain, hypothyroid, migraines, pain

43 y/o female with 2 children born by cesarean section in 2003 and 2005. Gained a significant amount of weight with each pregnancy and never got back to pre-pregnancy weight. History of hypothyroidism for several years. Was taking Levothyroxine(T4) .075 mg daily when first presented. Had history of frequent migraines (2-3 times a week) for the last 2 years. Had back pain, muscle pains daily and could not exercise due to her weight, shortness of breath, overwhelming pain and exhaustion for 2-3 days when she did try to do exercise. At her office visit to the GYN 9/12 she asked for help to change what was happening to her. That physician referred her to me for the SHAPE Program.

First visit was in early December 2012. She weighed 227 lbs and was 5 ft 5 in tall (BMI 37.8). Waist was 45 inches and she was a dress size 22-24. Her blood sugar indicated a pre-diabetic state. Blood pressure was 132/80. Urinalysis showed no abnormalities and the pH was 6. After counseling and instruction on the program, she decided to start it in early January 2013. She was very focused due to her desire to change her life and followed the program precisely. She lost 10 lbs the first week and 17 lbs at the time of her first follow up visit 2 weeks after starting. Urinalysis was normal with moderate ketones and pH of 5.5. She said she had lost two pants sizes and her pain in her knees and feet were much improved. She told me that after the first 3 days, she has never had another migraine headache.

Last official follow-up visit was four weeks after starting the program. Her weight was 204 lbs and urinalysis again was normal with moderate ketones. We talked about extending Phase I then transitioning to Phase II. She was asked to call me with any questions or concerns and to use the SHAPE website resources as needed. I knew she still wanted to lose at least another 30 lbs. but assumed she transitioned to Phase II since she did not return for follow-up UA’s.

She stopped by the office last week (Sept. 2013) to get another bottle of the SHAPE Drops. She was now on Phase II but wanted to continue the supplement as she felt better when she was taking them. Her weight was now 150 lbs (BMI 25) and she planned to continue her weight loss to a goal of 135 lbs. She was now a dress size 8 petite and medium petite tops. She was determined to maintain her new lifestyle and good health. She runs 2-3 times per week and recently ran a 5K successfully. She is training for another as childcare permits. She thanked me for changing her life – there is no better music to the ears of any health care provider!

Submitted by Dr. Octavio Chirino

Dr. Todd’s Teaching Assessment

Being an OBGYN, Dr. Chirino would certainly agree that it is common for some women to gain excessive weight during pregnancy and struggle to lose it post-pregnancy. With each successive birth, it becomes more and more challenging to lose the excess weight. Hypothyroidism is common and type 2 diabetes is simply waiting to manifest itself.

This is the type of patient the SHAPE Program was developed to help. Two obvious comments need to be spoken:

  1. It is best to monitor all patients in Phase I with the urinalysis. Unfortunately, we all have these patients who don’t adhere to our guidelines. This is unfortunate.
  2. It is awesome when patients understand the big picture and are self-motivated, choosing to embrace a lifestyle that supports health and continues to work toward their health transformation.

Be sure to explain the importance of the urinalysis for long-term success. It is wise to have the patient do a urinalysis and have a short visit each time they purchase a bottle of the SHAPE Drops.

With that being said, please understand we open our initial conversation regarding the SHAPE Program by asking if they are ready to make the necessary changes to ReClaim their health. We explain this is not simply a weight loss program but rather a program that is geared to help them restore their health. Not only do they need to be committed in Phase I, we need them to commit through Phase II and into Phase III.
Our best hope of long-term success is monitoring the patient through all three phases. Once they reach their health goals, it is important you set up a follow-up schedule so you can help monitor their success.

I like to see my patients once a month for three months after they have reached their goal. Then I push it out to every other month, then down to once a quarter, twice a year, then annually.

I also have an honest conversation about the potential to derail and self-sabotage. If they find themselves falling back into old, unhealthy eating habits, schedule an appointment and regroup before they completely fail and find themselves back at square one.