Anyone else try Medifast and then go to WW? The food for the most part is portable as well which is rather convenient. Our lengthy website contains a Table of Contents with many links. I reached a very happy goal weight of lbs. It really is wonderful to have so many of us helping each other.
Losing weight is different for everyone. So we fit our programs to you. Our nutritional counseling programs offer one-on-one access to our registered dietitians and nutrition specialists.
Our structured weight management programs teach needed skills for living a healthier, more active lifestyle. Our weight management store provides medically supervised weight-loss products. And for those who are 80 to pounds over their ideal body weight, our advanced, personalized bariatric surgery programs change countless lives every day.
Please check the box proving that you are not a robot. Find your account number. Home Medical Services Weight Loss. Find a primary care doctor. San Diego Weight Loss An expert team to support your weight-loss goals. Finding a method that works. Choose the best doctor in San Diego for you. View doctors specializing in primary care in San Diego.
Douglas Daub "I hope that I can make a difference in the health care of the patients. Bethani Ann Bernaba "The Sharp Experience means treating one another with respect, dignity and most importantly, compassion.
Julius Conner, II "Our practice is successful because we do what is best for the patient first, the group second and the physician third. Published studies of indirect calorimetry in weight management have focused on its accuracy Frankenfeld, et al. Difference in weight loss between the treatment and usual care group were —4.
The investigators noted that study limitations include small sample size, short duration, and small treatment effect. An additional issue is the generalizability of the findings, given that, at the time of the study, the Air Force had regulations that all personnel maintain a desired body weight and body fat percentage, or these individuals could be discharged from service.
The investigators stated that future research is needed to determine the long-term efficacy of using indirect calorimetry as part of a comprehensive weight control program.
Close to one-half of cancer patients being evaluated in an outpatient cachexia clinic are noted to be hypermetabolic by indirect calorimetry. Whiting et al stated that capsaicinoids are a group of chemicals naturally occurring in chilli peppers with bioactive properties that may help to support weight management.
These investigators conducted a meta-analysis investigating the potential effects of capsaicinoids on energy intake, clarified previous observations and formed evidence-based conclusions about possible weight management roles. Medical databases Medline, Web of Knowledge and Scopus were systematically searched for papers. Of the 74 clinical trials identified, 10 were included, 8 of which provided results suitable to be combined in analysis participants.
From the studies, 19 effect sizes were extracted and analyzed using MIX meta-analysis software. Data analysis showed that capsaicinoid ingestion prior to a meal reduced ad libitum energy intake by Study findings suggested a minimum dose of 2 mg of capsaicinoids is needed to contribute to reductions in ad libitum energy intake, which appears to be attributed to an altered preference for carbohydrate-rich foods over foods with a higher fat content.
The authors concluded that meta-analysis findings suggested that daily consumption of capsaicinoids may contribute to weight management through reductions in energy intake. Subsequently, there may be potential for capsaicinoids to be used as long-term, natural weight-loss aids.
They stated that further long-term randomized trials are now needed to investigate these effects. In a systematic review, Onakpoya et al a evaluated the evidence for or against the effectiveness of glucomannan, a soluble fiber, in body weight reduction. Hand searches of bibliography were also conducted. Outcomes of interest were body weight and BMI. A total of 18 trials were identified, and 9 were included. There was a variation in the reporting quality of the included RCTs.
A meta-analysis random effect model of 8 RCTs revealed a non-statistically significant difference in weight loss between glucomannan and placebo mean difference [MD]: Adverse events included abdominal discomfort, diarrhea, and constipation.
The authors concluded that the evidence from available RCTs does not show that glucomannan intake generates statistically significant weight loss.
They stated that future trials should be more rigorous and better reported. Onakpoya et al b noted that several slimming aids being sold as food supplements are widely available. One of them is pyruvate.
Its effectiveness in causing weight reduction in humans has not been fully established. The objective of this systematic review was to examine the effectiveness of pyruvate in reducing body weight. Electronic and non-electronic searches were conducted to identify all relevant human RCTs.
The bibliographies of all located articles were also searched. No restrictions in language or time were applied. Two independent reviewers extracted the data according to predefined criteria. A total of 9 trials were identified and 6 were included.
All had methodological weaknesses. The meta-analysis revealed a statistically significant difference in body weight with pyruvate compared to placebo MD: The magnitude of the effect is small, and its clinical relevance is uncertain. Adverse events included gas, bloating, diarrhea, and increase in low-density lipoprotein LDL cholesterol. The authors concluded that the evidence from RCTs does not convincingly show that pyruvate is effective in reducing body weight; limited evidence exists about the safety of pyruvate.
They stated that future trials involving the use of this supplement should be more rigorous and better reported. The labeling of Saxenda states that liraglutide should not be used with insulin FDA, It also states that the the effects of liraglutide on cardiovascular morbidity and mortality have not been established.
The labeling states that the safety and efficacy of coadministration with other products for weight loss have not been established. In addition, liraglutide has not been studied in patients with a history of pancreatitis.
Liraglutide for chronic weight management is contraindicated in the following conditions: Trial data showed that liraglutide, in combination with a reduced-calorie diet and increased physical activity, resulted in significantly greater weight loss than diet and physical activity alone. The SCALE phase 3 clinical trial program of the safety and effectiveness of liraglutide for chronic weight management included three clinical trials that included approximately 4, obese and overweight patients with and without significant weight-related conditions FDA, All patients received counseling regarding lifestyle modifications that consisted of a reduced-calorie diet and regular physical activity.
Results from a clinical trial that enrolled patients without diabetes showed that patients had an average weight loss of 4. In this trial, 62 percent of patients treated with liraglutide lost at least 5 percent of their body weight compared with 34 percent of patients treated with placebo. Results from another clinical trial that enrolled patients with type 2 diabetes showed that patients had an average weight loss of 3. In this trial, 49 percent of patients treated with liraglutide lost at least 5 percent of their body weight compared with 16 percent of patients treated with placebo.
The FDA approved labeling states that patients using liraglutide should be evaluated after 16 weeks to determine if the treatment is working FDA, If a patient has not lost at least 4 percent of baseline body weight, liraglutide should be discontinued, as it is unlikely that the patient will achieve and sustain clinically meaningful weight loss with continued treatment.
Saxenda is a glucagon-like peptide-1 GLP-1 receptor agonist and should not be used in combination with any other drug belonging to this class, including Victoza, a treatment for type 2 diabetes FDA, Saxenda and Victoza contain the same active ingredient liraglutide at different doses 3 mg and 1. However, Saxenda is not indicated for the treatment of type 2 diabetes, as the safety and efficacy of Saxenda for the treatment of diabetes has not been established.
Saxenda has a boxed warning stating that thyroid C-cell tumors have been observed in rodent studies with liraglutide but that it is unknown whether liraglutide causes thyroid C-cell tumors, including medullary thyroid carcinoma MTC , in humans FDA, Liraglutide causes dose-dependent and treatment-duration-dependent thyroid C-cell tumors at clinically relevant exposures in both genders of rats and mice. It is unknown whether liraglutide causes thyroid C-cell tumors, including MTC, in humans, as the human relevance of liraglutide-induced rodent thyroid C-cell tumors has not been determined.
The labeling states that liraglutide is contraindicated in patients with a personal or family history of MTC or in patients with multiple endocrine neoplasia syndrome type 2 MEN 2 FDA, The labeling states that patients should be counseled regarding the risk of MTC with use of liraglutide and informed of symptoms of thyroid tumors e.
The labeling states that routine monitoring of serum calcitonin or using thyroid ultrasound is of uncertain value for early detection of MTC in patients treated with liraglutide. Serious side effects reported in patients treated with liraglutide for chronic weight management include pancreatitis, gallbladder disease, renal impairment, and suicidal thoughts FDA, Liraglutide can also increase heart rate and should be discontinued in patients who experience a sustained increase in resting heart rate.
Based on spontaneous postmarketing reports, acute pancreatitis, including fatal and non-fatal hemorrhagic or necrotizing pancreatitis, has been observed in patients treated with liraglutide Novo Nordisk, After initiation of liraglutide, patients should be observed for signs and symptoms of pancreatitis including persistent severe abdominal pain, sometimes radiating to the back and which may or may not be accompanied by vomiting. If pancreatitis is suspected, liraglutide should promptly be discontinued and appropriate management should be initiated.
If pancreatitis is confirmed, liraglutide should not be restarted. Substantial or rapid weight loss can increase the risk of cholelithiasis; however, the incidence of acute gallbladder disease was greater in liraglutide-treated patients than in placebo-treated patients even after accounting for the degree of weight loss Novo Nordisk, If cholelithiasis is suspected, gallbladder studies and appropriate clinical follow-up are indicated. When liraglutide is used with an insulin secretagogue e.
The labeling recommends lowering the dose of the insulin secretagogue to reduce the risk of hypoglycemia. Renal impairment has been reported postmarketing, usually in association with nausea, vomiting, diarrhea, or dehydration, which may sometimes require hemodialysis Novo Nordisk, The labeling recommends using caution when initiating or escalating doses of liraglutide in patients with renal impairment.
Serious hypersensitivity reactions e. The labeling recommends that patients stop taking liraglutide and seek medical advice if symptoms of hypersensitivity reactions occur. Liraglutide should be discontinued in patients who experience suicidal thoughts or behaviors. Liraglutide should be avoided in patients with a history of suicidal attempts or active suicidal ideation.
The labeling states that nursing mothers should either discontinue liraglutide for chronic weight management or discontinue nursing Novo Nordisk, The labeling states that the safety and effectiveness of liraglutide have not been established in pediatric patients and is not recommended for use in pediatric patients. In addition, the cardiovascular safety of liraglutide is being investigated in an ongoing cardiovascular outcomes trial.
Lingwood stated that there is a critical need for improved technologies to monitor fluid balance and body composition in neonates, particularly those receiving intensive care. Bioelectrical impedance analysis BIA meets many of the criteria required in this environment and appears to be effective for monitoring physiological trends. These researchers reviewed the literature regarding the use of bioelectrical impedance in neonates. It was found that prediction equations for total body water, extracellular water and fat-free mass have been developed, but many require further testing and validation in larger cohorts.
Alternative approaches based on Hanai mixture theory or vector analysis are in the early stages of investigation in neonates. The authors concluded that further research is needed into electrode positioning, bioimpedance spectroscopy and Cole analysis in order to realize the full potential of this technology.
These investigators reviewed available information on the short- and long-term effects of intervention treatment on body fat composition of overweight and obese children and adolescents and, to obtain a further understanding on how different body composition techniques detect longitudinal changes. A total of 13 papers were included; 7 included a multi-disciplinary intervention component, 5 applied a combined dietary and physical activity intervention and 1 a physical activity intervention.
Body composition techniques used included anthropometric indices, BIA, and dual energy X-ray absorptiometry. Percentage of fat mass change was calculated in when possible. Findings suggested, no changes were observed in fat free mass after 16 weeks of nutritional intervention and the lowest decrease on fat mass percentage was obtained.
However, the highest fat mass percentage with parallel increase in fat free mass, both assessed by DXA was observed in a multi-component intervention applied for 20 weeks.
The authors concluded that more studies are needed to determine the best field body composition method to monitor changes during overweight treatment in children and adolescents.
Two reviewers independently screened titles and abstracts for inclusion, extracted data and rated methodological quality of the included studies. These investigators performed a best evidence synthesis to synthesize the results, thereby excluding studies of poor quality.
They included 50 published studies. Mean differences between BIA and reference methods gold standard [criterion validity] and convergent measures of body composition [convergent validity] were considerable and ranged from negative to positive values, resulting in conflicting evidence for criterion validity.
These investigators found strong evidence for a good reliability, i. However, test-retest mean differences ranged from 7. However, they stated that validity and measurement error were not satisfactory. Goldberg et al stated that the sensory and gastro-intestinal changes that occur with aging affect older adults' food and liquid intake. Any decreased liquid intake increases the risk for dehydration.
This increased dehydration risk is compounded in older adults with dysphagia. The availability of a non-invasive and easily administered way to document hydration levels in older adults is critical, particularly for adults in residential care. This pilot study investigated the contribution of BIA to measure hydration in 19 older women in residential care: The authors concluded that if results are confirmed through continued investigation, such findings may suggest that long-term care facilities are unique environments in which all older residents can be considered at-risk for dehydration and support the use of BIA as a non-invasive tool to assess and monitor their hydration status.
Buffa et al defined the effectiveness of bioelectrical impedance vector analysis BIVA for assessing 2-compartment body composition. Selection criteria included studies comparing the results of BIVA with those of other techniques, and studies analyzing bioelectrical vectors of obese, athletic, cachectic and lean individuals. A total of 30 articles met the inclusion criteria.
The ability of classic BIVA for assessing 2-compartment body composition has been mainly evaluated by means of indirect techniques, such as anthropometry and BIA. Classic BIVA showed a high agreement with body mass index, which can be interpreted in relation to the greater body mass of obese and athletic individuals, whereas the comparison with BIA showed less consistent results, especially in diseased individuals.
Many retailers support the redemption of email and paper coupons via mobile devices. In addition to distributing such offers via their own email lists, SMS subscriptions, and apps, they are also often made available through coupon applications. A mobile app coupon can be either a regular coupon for redemption discount value or discount percentage used at checkout distributed by the app-makers or unique, personal sharing codes owned by each user to recruit new users with referral benefits e.
The latter form requires personal sharing on behalf of users to their personal networks. Depending on the jurisdiction , coupons may or may not reduce the sales tax which must be paid by the consumer. This is often determined by who sponsors the coupon. If the coupon is issued by the retailer, the product was never offered at the original price and the coupon represents a reduction in the amount paid and the tax. If the coupon is issued by the manufacturer, the original price is still paid but some of the price is covered by the manufacturer instead of the consumer and the full price remains taxable.
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From Wikipedia, the free encyclopedia. This article is about a document exchanged in a financial transaction. For other uses, see Coupon disambiguation. Retrieved May 8, Retrieved 20 July And Other Pricing Puzzles. Retrieved 1 July Facial tissue Napkin Paper towel Toilet paper Wet wipe. Book Newspaper Newsprint Pamphlet. Confetti Paper craft Paper toys Playing card Quilling. Beverage coaster Filter paper Form Sandpaper Security paper. Retrieved from " https: Paper products Sales promotion.
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