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RadioMD Presents:Healthy Talk | Original Air Date: May 14, 2015
Host: Michael Smith, MD

Healthy Talk with Dr. Michael Smith, M.D. And now here's the country doctor with a city education, Dr. Mike.

DR. MIKE: My guest is Dr. Eddie Fatakov. He came from Russia to the United States and eventually made it down to the south. He dealt with some pre-teen and teen weight issues himself and has really dedicated his medical career now to not just really the weight loss part of it, but keeping it off and that healthier lifestyle.

Dr. Fatakov, welcome to Healthy Talk.

DR. FATAKOV: Thanks for having me, Dr. Mike. Glad to be here.

DR. MIKE: I went on your website. My listeners, I want you guys to go and check him out. It's www.drfatakhov.com. The book is there, the Doctor's Clinic Thirty Program and you can read a little bit about Dr. Fatakhov. We were just talking about the importance of the question "Why I am gaining weight in the first place". What do you think about that question? How important is that Dr. Fatakhov?

DR. FATAKOV: I think it is the most important question. That is the question asked by most people who come into my office. The important question is how many meals a day are you eating and are you eating breakfast? If that is the answer, that's where I start. Most of my patients—90% -- I get them to eat six meals a day and eat breakfast and drink water and get a good night's rest and then they have no troubles losing weight. It is changing habits.

A diet is temporary. We diet for reasons: for spring break, to get ready for a wedding, to lower our blood pressure, if we're on diabetic diet, to get our sugars under control. It's already pre-programmed that it's going to be temporary, it's never lifelong. If we develop good habits as a child—and there have been studies on this--they develop good habits and are going to eat healthy if their parents eat healthy. They will eat healthy the rest of their life and they will be healthy. Is it genetics or environmental? It's a little bit of both.

DR. MIKE: Besides this eating pattern, like you call a sumo wrestle, ultimately it's just pigging out at the end of the day, alcohol added in there, going to bed, not active enough. That type of pattern. Other than that, though, what are some of the other reasons you think we have such a weight issue in this country?

DR. FATAKOV: It's overindulgence and the fact that we are lucky we live in a country where food is accessible. Processed food, refined carbohydrates and there are a lot of chemicals in stuff like that and then the high fat content. They have done studies where you can eat low fat or low carb but these sugars, these simple sugars, are basically making us obese and preventing fat breakdown. They are the biggest reasons.

Then, you have the high fructose corn syrup which gets processed like sugar. Somebody eating these meals, it's no different then eating a Snickers bar. You think you're eating healthy, but you're not. And it is misleading. You go out to the grocery store and there are 50 multi-grain bread—all it is is white bread with 50 grains in it. It's not 100% whole wheat. It is just education. I think the public is not educated because there is so much information out there.

You don't know what is good or what's not. The Mediterranean diet is great, which adds lot of fat and a lot of olive oil. Healthy is different from weight loss, but people don't get that. But too much of a good thing is a bad thing.

DR. MIKE: I had Dr. Stephen Sinatra on my show once, Dr. Fatakov. He is one of the premiere cardiologists in the country, in my opinion, and he links a lot of our issues back to the 80s where fat became the culprit in all of this.

So, we got rid of the fat but then we added all this sugar. Now, we have worse heart disease and more overweight people and we are finally starting to get it that those simple sugars, those simple carbs—those are the things we need to control. Let's talk about this losing weight without feeling hungry. That is an issue. People start dieting, they start cutting calories a little bit—even on your program. Let's say they are eating their six smaller meals, but now an hour or two hours later they have all of this hunger. How do we help them control that?

DR. FATAKOV: In terms of the hunger urges, you have multiple reasons. You have the escalated hormone levels. What I tell my patients to do is that you don't want to restrict it. The word diet fails. There did a study in Psychology a few months ago. 83% of those who use the word diet, those patients fail. It is more of a program and a lifestyle. The way I designed the book is a slim phase and a maintain phase and an education phase. So, you use slim to get to your goal weight. You use the maintain phase to stay where you are at, in addition to exercise and good eating habits.

The way you do that is eating more to lose more. I provide plenty of food options. I want to be honest, nobody really likes to diet. Nobody wants to be on a diet. Nobody really cares to diet. People just want to get results and the easiest way to do that. It's not about restriction. I never want to restrict. I always want them to eat more to lose more. A perfect example, I'm giving one of my patients. She said, "I want chips and my doctor said I can't have chips." Well as soon as you say "no", she's going to get chips whether you tell her she can have them or not.

I asked, "When are you eating chips?" She said, "In my living room when I watch TV." I said, "How far is the kitchen?" The kitchen is a walk. I told her to put the chips in the kitchen, each time a commercial break comes on she will go grab one chip, chew it and come back and sit down.

How many times do you think she is going to get up out of her favorite chair to go get chips? Now, I never said "no". Right now, if I say, "You can't have a cookie. You didn't want a cookie until I mentioned it." The whole way of thinking is now, "I want a cookie", just because I said "no". We can't take no. If you want Chic-Fil-A on Sundays, you can't have it on Sundays. It's just psychologically built in.

I never say "no" to any of my patients. I say if you're going to have your worse meal, have it at breakfast. You have the whole day to burn it. If you are going to eat bad, have it at breakfast. The food table contains plenty of fruit and vegetables and stuff like that they can have--unlimited foods. My plan is based on extensive research that has been out for several years. It's proven. That's why Weight Watchers has been so successful because it doesn't restrict people on what they can and cannot eat.

DR. MIKE: In some of your experience, what are some of the common roadblocks that people face? They are eating more. They are eating less. They are being more active. They are having some success. At that point, what are some of the things you like to warn people to watch out for so they don't backtrack on their weight loss plan?

DR. FATAKOV: You get this plateau. The first month they are motivated, they are seeing results. Then they get depressed, "I'm not losing as much weight. Once you get to that point, there might be a four week or six week plateau, then we ramp it up. We change something in their diet. We tweak things around. That's when people don't get motivated to work hard to maintain stamina. That's when we encourage them to eat better and get more exercise. Sometimes people exercise and are gaining muscle and when they look on the scale, they have the same weight.

They are not losing weight. I always make them do leg circumference and arm circumference and the inches keep dropping. So, it's just the training and counseling. When they come to the doctor's office, see a nutritionist or a personal trainer, it creates accountability. People say, "When I go to my doctor, I'm going to make sure my blood pressure is normal," and "When I go to my doctor, I want to make sure I'm not gaining weight." So, if you have that personal accountability, it reinforces it.

DR. MIKE: I have a little theory. Let me run this by you, Dr. Fatakov. See what you think about this. This is just my own little theory, my own little experience helping people lose weight. Everybody has certain flavors and textures that they enjoy. If you eliminate those, if you take those away, no matter what diet program you are on, if you take away, those flavors and textures that people enjoy that is really going to make the cheating kick in. It's going to make it hard. How important do you think it is to recognize the things that you like and try to figure out healthy alternatives so you get those same flavors and same textures? Am I on to something there?

DR. FATAKOV: You are on to something. People love bacon, right? They just love bacon, even if it's turkey bacon. If you fry eggplant – deep fried eggplant – it tastes just like bacon. It's more about the texture, just like you're saying. There are people here from different ethnicities. Some are Indian, some are from the Carribbean, some are from Russia like myself. If you go to a doctor or dietician and they say you can only have this or this and it's not culturally diverse enough or doesn't have the same texture that you're used to—you are going to cheat. I think you are on to something. That is very important. That's why having that fried eggplant tasting like bacon and being as crisp is just as important, mentally.

DR. MIKE: I had a guest on that talked about the importance of maybe having one meal on occasion where you do cheat a little bit. Not overdoing it, not overeating. You have that bacon once in a while. How important do you think it is to allow people to cheat once in a while? Is that going to be helpful in them sticking with that diet?

DR. FATAKOV: Now that's very interesting. I'm on both sides about this. They just came out with an interesting study in the Journal of Obesity. It said having one fat meal will alter your metabolism for muscle storage and muscle building for up to five days. And it could take up to two weeks to get it back into the cycle. I think having that one meal can set you back for a long time with all the hard work that paid off. Until you get to the goal weight, where you are happy at the weight, I wouldn't cheat.

DR. MIKE: You wouldn't cheat. Maybe a little bit down the line, when you are just trying to maintain, that cheat meal is okay. His name is Dr. Eddie Fatakov. You can check him out at www.drfatakov.com and I appreciate you coming on. Great job and continue your great work.

This is Healthy Talk on RadioMD.

I'm Dr. Mike. Stay well.