On April 13, 2015, 65-year-old Dick Pierson looked down at the scale. It read 265 pounds.
He’d been diabetic for 25 years and was taking half a dozen pills and two different kinds of insulin each day. Each time he returned to the doctor, they’d just prescribe him more.
“It finally occurred to me that the path of taking more medication was not the answer,” Pierson said. “If I want to fix myself, I have to do it some other way. It was obvious that keeping up with more medication and putting on more weight was not the way.”
So he turned to his former doctor, Dr. Charles Pruchno, who after more than 20 years as a kidney specialist, opened a private practice — the Health Transitions Clinic — in the Physicians’ Clinic of Iowa Medical Pavilion in Cedar Rapids last year.
Pruchno designed a medically supervised weight loss program for individuals with diabetes or other medical issues associated with obesity that follows a low-to-no carbohydrate diet.
“Carbohydrates are our poison,” he said, explaining that 70 percent of the population is carbohydrate sensitive. The more carbohydrates we consume, the more overweight we become.
“We’re gaining weight because we’re surrounded by carbohydrates that are good tasting and inexpensive,” he said. “We’re eating an unnatural amount of carbohydrates every day... . That’s ultimately what has led to our nationwide obesity epidemic, which has fueled the secondary type two diabetes epidemic.”
For most people, it’s simple: eating fewer carbohydrates means weight loss. But for diabetics, carbohydrates are the main driver of blood sugar elevation and therefore medication, Pruchno said. But increasing medication will inevitably fail, because diabetes is a progressive disease. If no action is taken to improve the patient’s diet, the only option is to continue increasing their medications.
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“We underemphasize the diet to our detriment and we have a really bad concept of what constitutes a good diet,” Pruchno said.
Most people believe the best diet for losing weight is a low-fat diet, he explained. But, “the bottom line is, if you eat a low-fat diet, that means you’re eating a high-carb diet,” and the problem with that is “you’ll be more hungry,” he said.
“If you were to choose a diet high in fat, the chances are the fat will stay in your stomach longer, keep you satiated, and you’d be less likely to be hungry and eat more,” he explained. “I see a lot of people snacking four or five times a day and they’re feeling hungry all the time even though they weigh 300 pounds. You put them on this diet for about a week and they stop being hungry.”
The proof is in the carb-free pudding.
In the last year alone, Pruchno has helped 140 people lose a cumulative total of two tons, averaging 30 pounds per person. Three have lost more than 100 pounds, and several have either eliminated or significantly reduced their medications.
Pruchno’s 10 month program — which costs $1,200 out of pocket, the rest is typically covered by insurance — begins with an evaluation and a do- and do-not-eat “bible.”
After three weeks of avoiding carbs, people typically drop 15 to 20 pounds.
“If you really want to lose weight, it’s amazing how quickly the weight loss goes,” Pruchno said. “But it takes a very long time to change habits.”
“Phase one” of the program starts with two shakes and one small meal each day for two weeks, where patients often lose another 15 to 20 pounds. Then, in “phase two,” they switch to one shake and two meals a day and are given a FitBit to track their progress. In phase three, exercise is introduced, with a goal of just 30 minutes each day to maintain their weight. At graduation, patients receive a cookbook to keep them on track for the future.
“Almost everyone will fall off track a couple times,” Pruchno said, but with daily weigh-ins and weekly meetings with Pruchno, they’re kept accountable.
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“You’re much more willing to do something if you know somebody is watching,” Pruchno said.
Ultimately, though, the program is designed to teach people to learn to fend for themselves, no longer needing Pruchno’s watchful eyes.
“We give them the same message and keep pushing so that when they fall off, we can pick them back up until they no longer fall off,” he said. But in order to be successful, he said patients have to have “100 percent emotional investment” in the program because it’s more than just a diet, it’s a lifestyle change.
Jeannette Mankin had been overweight most of her life. She’d tried programs like Weight Watchers “countless times,” always losing and inevitably regaining the weight she’d lost. With Pruchno’s program, she’s dropped more than 110 pounds, and this time, she thinks she’s shed the weight for good.
“He taught me a different way to eat,” she said of Pruchno. “He really has gotten me aware of how food affects your body.”
Pierson, down 70 pounds and off most of his medications, said Pruchno is truly saving his life.
“If 25 years ago I would have started this, my life would be some place different,” he said. “I’ve resolved myself to stick to it. I know if I keep it up, things will be better for me. I know it’s really easy to backslide — it’s like being an alcoholic. That’s the dark side for me, and I’m not going to the dark side.”
What: Learn about the program from Dr. Charles Pruchno
Where: Physicians’ Clinic of Iowa Medical Pavilion, third floor community room, 202 10th St. SE, Cedar Rapids
When: 7 p.m. Thursday
Cost: Free, register at (319) 247-3899 or www.healthtransitionsclinic.com/free-seminar