Monday, March 12, 2012

Dieting tips for weight reduction and maintenance. (Part 1 - MYTHBUSTING)

Recently I posted on HCG diet and definitely, it is one of the most amazing diets in the world because you lose fat weight and you do not sag and you do not need to exercise much. The only problem is that it is a prescriptive diet, and the diet is super strict that you need to be under a care of a physician to ensure you are doing it properly to get the desired results.

So I decided to write this entry, for those who want to lose a few pounds and start eating healthy. The key to good weight is mainly the food you eat i.e understanding what you put in your mouth, coupled with some physical activity. First of all, let's unlearn a few things that we learnt when we where younger:

MYTH NO 1 : You will be fat if you eat fats.
Not necessarily. We need some fats to help with the function of the membranes of our cells. We also need fat for transport of Vitamin A,D,E & K in our body. In fact, you need to consume 3500 calories of fat to gain 1 pound of fat in the body. The general consensus on fat is - not to take visible animal fats and say NO to all forms of processed fats like margarine, vegetable spreads etc. If you like butter - take butter, it is much better. Cook with ONLY palm oil for high heat, olive oil for low and moderate heat. Do not use excessive heat with other forms of oils because the phenol bonds break and the biproduct can be precancerous. Low fat or No Fat foods can be more harmful because of hydrogenated fat contents, so it is safer to just take the fat. People who take good oils tend to have better skin hydration too. (Try takin virgin coconut oil/olive oil daily)

MYTH NO 2: Carbohydrates are a must in meals.
Although the old food pyramid puts the portion of carbohydrate as the lowest and most intake, studies have shown that over consumption of refine carbohydrates (i.e. white rice, white bread, pasta, mee, beehoon, white flour, processed sugar, etc) is the major cause for obesity leading to diabetes, hypertension and heart problems. YES - EATING REFINED CARBOHYDRATES LEADS TO FAT. That is why nowadays most diets focus mainly on protein and fat. We can survive with minimal carbohydrates. In the past, the carbohydrates were not as processed as it is now. When carbohydrates are processed and refined, it increases the ability of absorption into the body and leads to a quick increase in blood sugar level, which triggers high insulin release to stabilize the blood sugar level, which leads to storing of the sugar into liver and fat cells. 

MYTH NO 3: Eating Cereals and fruit juice is good.
It really depends on what type of cereal you eat. Most children contains corn syrup and colourings which studies have shown to lead to child hyperactivity. Even in fresh juices, there is a very high sugar content as a preservative as well as to give it a good taste. These are all refined sugars and get absorbed easily. Corn syrup is actually one of America's biggest bi-product because of excessive corn and studies have shown it to be highly associated with obesity. As for juices, most of the fiber content has been destroyed. Furthermore, it makes it too easy to consume more fruit sugars compared to eating the fruit itself. Some fruit juices were also reported to have traces of arsenic. So if you are craving for some juice, go for freshly made ones minus the sugar.

MYTH NO 4: Meal Replacement Drinks are the only way to keep my weight down.
Although I do admit, the meal replacements do help, but understanding what you eat is more beneficial in the long run, plus minus the cost of buying the expensive meal replacements. Imagine spending between RM 500-800 a month for meal replacements which after awhile bores you (who wouldn't be bored taking a shake drink everyday) - when you can actually spend less at a grocery store buying healthy food or eating at a healthy diner. But then you will need to know what to buy, that topic will be covered in my next blog.

MYTH NO 5: Multivitamins makes my appetite increase and hence will make me gain weight.
Although some vitamins causing appetite increase, we need vitamins and trace minerals in order for our body cells to function properly. This leads to better metabolism. Take multivitamins on an empty stomach as it will give the best absorption. Some nutritionists even recommend splitting the vitamin into two and taking it twice instead of once a day. Some people do not believe in supplementing vitamins and minerals but in view of how our foods are cooked and processed, most of the vitamins and minerals  disappear or damaged. Try to go for organic based vitamins and minerals as there is less chemicals involved.

MYTH NO 6: You Should NOT eat late at night because it will just turn to fat.
It is not what time you eat, its how many calories you consume within a period of 24 hours. A full grown adult needs approximately 1200-1600 calories a day depending on sex and body built. However, in Malaysia, a lot of us tend to over eat because we are not aware of how much calories we take in a meal. A simple plate of nasi lemak is 680 calories, a roti canai is 360 calories, lasagna is 390 calories per serving, a KFC snack plate minus the drink is 890 calories. Despite this fact, I would still not recommend people to sleep late because when you stay up at night, you tend to consume more food that is required i.e. munching snacks, teh tariks and you don't really notice because you're hanging out. 

MYTH NO 7: I Can always do a Crash diet when my weight goes up.
Although crash dieting is one way of getting the weight down in the short run, it may stop weight loss in the long run. Most of the time, crash diets involve completely abstaining from foods hence you not only lose some fat, but also your protein mass and connective tissue. In fact, when you starve yourself, you lose your sugar stores first, your protein stores break up and fat is the last to go. This leads to lesser lean mass and thus less energy is needed to sustain your body functions, so less calories are used. Losing weight fast also causes your skin to sag more because of the loss in connective tissue. The best way to lose weight is to target long term, by changing the way you eat, understanding what to eat.

MYTH NO 8: I Can eat anything if I exercise.
This may sound right but it is still not true. Depending on what type of exercise we do, the calories burned are just a few hundred for 30 minutes, compared to the intake we take in a day. Therefore, even though we go to the gym, we still need to watch what we eat, as sometimes easily in 1 meal, we can be consuming 1400-2000 calories (especially buffets). Too strenous exercise breaks down protein stores more than fat, so we should make sure we keep our heart rate only between 40-60% of the max heart rate allowed for our age. Even athletes are very concern about their diet and their main focus would be on high protein and good fats for better muscle building, not high sugar foods that leads to more adipose and cellulite. (Yes, all those sweet sugary things leads to more cellulite - that's why when you are skinny you also have it).

MYTH NO 9: If I Quit smoking I will be fat.
Biologically it has no relation but psychologically, most people who try to quit smoking, tend to use a comfort food as a replacement and hence leads to weight gain. They choose things like sweets, chewing gum, biscuits, asam jeruk, etc. as an excuse to curb cravings. I have a simple technique for people to quit smoking gradually and avoid cravings. I usually tell my patients to buy a cigarette holder, and only smoke what's inside the cigarette holder for the day - and no asking ciggies from buddies. After 1 week, drop down by 2 ciggies and continue for a week, before dropping down another 2 every week. If that week you feel okay, we continue, but if not then stay on the amount of ciggies of that week for another week. Other supporting techniques would be to take coffee with no sugar, sugar free chewing gum, nicotine patches and if you have an urge to chew, then chew on healthy nuts (low sugar not fried) or vegetable sticks (carrots/celery) or fruits (apple/orange/plum).

MYTH NO 10: It is really water retention, not fat.
Fat is fat. If you really want to know what is water retention, weigh yourself in the morning and weigh yourself again in the afternoon. The weight difference is due to water. That is why when dieting, we advise you to measure your dry weight in the morning. It is the most accurate - i.e. after more than 6 hours without water, likely the body is in a mild dehydration state. Similarly when you go to beauty salons, and they measure, weigh you, wrap you up an heat you up in a warm blanket, the weight you lose is the water weight dehydrated from you which can be anything from 400gms to 2 kg. The few  centimeter lost is due to cells being dehydrated, thus becomes smaller. (Plus the fact that they wrapped you, so the body retains some of the shape for awhile before bouncing back to normal).

These are but a few of the dieting myths I have compiled. Feel free to comment and if you have any other myths that need clarifying, do email me at drmarr@faceworksclinic.com. Let's work in understanding and changing the way we think about food. 

For a more intensive prescriptive diet, please come in for a consultation at my clinic. CAll 03-21440080 for appointments.


Saturday, March 10, 2012

HCG diet - My experience.....

I am definitely a foodster - I love food, I love eating, and experimenting with different tastes. Friends on my Facebook see all sorts of delicious food being posted which definitely makes people drool. Unfortunately, like any other person, I tend to gain weight a lot on my excursions. The price for great food, is it so? So I decided (or was rather forced into) trying out the HCG diet - Personally I call it the anti-social diet because you have problems eating socially. When I first started, a lot of my friends and colleagues said I would quit half way... but hey, its the 26th day and I'm still on it, and I have lost a good 9 kilos which mainly is fat, I'm down at least 2 dress sizes, and my butt looks smaller. Yippee....But honestly, it requires good motivation, high discipline and consistency.

So since everybody is curious about what I have been doing, I'll explain as simply as possible.

1. What is the HCG diet?
The HCG diet was founded by Dr Simeon who discovered that low levels of HCG hormone (the one that goes up in pregnant ladies) has effects on fat metabolism and facilitates fat usage as fuel when the body is in semi-starved state. He came up with a figure, i.e. 125 iu per day and coupled it with 500 calorie diet a day. However, this effect only works when there is no increase of blood sugar level or rather insulin - hence why no form of carbohydrates are allowed. The diet is very strict and you are only allowed to eat the food on the list and that is it. Dr Kevin then made a modified version which enhanced the effect and lead to maintenance.

2. What is the real purpose of the diet?
Although reporting fat loss in grams daily is perhaps the best thing about this diet, the real function of this diet is to retrain our hypothalamus to eat properly. One of the reasons people become fat or obese is because of cravings and lacking of self-control when it comes to food. They eat regardless they are hungry or not and tend to overeat so much. Foods high in sugar, preservatives and other forms of chemicals in food nowadays causes the brain to not be able to register how much food has entered the system hence the person just keeps on eating. When you abstain from carbohydrates, junk food and fastfood, the brains receptors in the hypothalamus will resensitize again, so that you do not have much cravings. That is why, once you complete the 25 days of 500 calories diet, you have another month to slowly introduce more food with simple refine carbohydrates being last and complete ban on fast food or junk food. If you don't do this, that is why you see people on this diet acting like yoyo's and at the end, think it is just a short term treatment.

3. Is this diet safe?
According to all studies and reports, it is the safest diet in the world. However, because we prescribe hormones, you MUST be under a doctor's follow-up. It is not just for the injections supply, but also motivation, weight tracking, diet tracking and to tackle issues like ketosis and hypoglycaemia symptoms . (Yes, sometimes you get it). Some doctors also prepare the food for you to eat from their clinic with some additional charge whilst on the VLCD (500 caloric diet).

4. Is 500 calories a day enough?
Yes. The reason is because when the body utilizes in-store fat, it produces 2000-3000 kcals of energy. If you eat more than 500 calories a day, some of it will be stored hence weight loss will be affected. This is also another reason why people gain weight on this diet - it acts like a double edge sword. If you eat too much, or cheat on carbohydrates, it will restore into the body hence making you bigger. (Yes, I've tested this theory on myself).

5. Since I'm producing so much energy, should I exercise?
Despite the energy produced, we do not recommend you to do strenous exercise during the course of the injections because it can speed up ketosis symptoms and you will feel hungry. Furthermore, if you do exercise during this period, you need to continue even after the diet if not your weight will go up. Even for myself, I limit my jogging activities and I reduce my weight lifting regimes to half just to keep my exercise freak bit happy. However, after you stop injecting, I would recommend a more frequent exercise like walking and weights ideally everyday.

6. Since I can only take 500 calories a day, can I fast?
The answer is no. The reason is because, you have to eat on this diet at least between 4-6 hours if not you will go into ketosis - and have symptoms like headache, nausea, disorientation etc. Another reason is that you need to be well hydrated for the burning process to be optimized, i.e. 2-3 liters of water daily. I've tried not eating for almost 8 hours and I was so disoriented I almost hit a lamp post. I've also been dehydrated (testing) and there was reduced weight loss the next morning and I felt lethargic.

7. Injections or drops?
I would have to say injections. With injections you have an option of 23 or 42 days but with the drops you definitely must do 42 days. In terms of weight loss, the injections are much more predictable compared to the drops, less plateau if you do not cheat on the diet. But not many people like the idea of jabbing themselves everyday. Even for myself I felt exhausted of jabbing my own butt for 23 days. For my patients, some of them come to the clinic daily to get the jab. So if you are not keen for injections, which drops to take? I have my own medical pharmaceutical drops provided - so not sure about the rest.

8. What are the things I need to have at home to start this diet?
Simple things. A weigh to measure every morning after your first pee with minimal clothes on. (This is your dry weight). A kitchen weighing scale to measure your 100gms of protein a meal. (I prefer you to measure your own meal and decide what proteins to take). A non-stick pan to cook the protein. 

9. Should I be on supplements?
Yes and no. I would only recommend a multivitamin in the morning with water. Because you are going on a strict diet, you require to supplement this because if you fall sick, you cannot take much medication. I would also recommend calcium - ideally coral calcium, because you will get some cramps after the second week due to lowering levels of calcium in the body. A colon cleanse before you sleep is recommended although I only took one every 3 nights since I couldn't stand the diarrhoea I get the next morning. L-carnithine supplements before you sleep because L-carnithine make the fats more available as fuel to your body. Be careful of supplements that have a lot of sugar in it because it will disrupt the diet.

10. I'm on the diet and I have the urge to cheat - can i cheat with 1 spoon?
No. Even 1 spoon is hazardous. I was preparing lasagna for a function in my office and I took 1/2 spoon of red sauce and 1/2 spoon of white to taste. The next day, my weight went up by 400gms, and the next day it went up another 300gms despite adhering to the diet, so I drank more water and went on strictly white protein and salad - and it went down 400gms, then subsequently another 500gms. I would have lost an extra 700gms or more if I did not taste the sauces. Another time was at a dinner and I ate extra angus steak, maybe 50gms more and my weight went up, stayed up for 2 days. It takes about 2-3 days after you cheated to get back on tract. So ask yourself. is it worth cheating?

11. With so much weight loss, wouldn't I sag?
The best thing about this diet is also the fact that you lose the fat, but the hormones keep your skin tight, so you do not sag.

This is a prescriptive diet and I would recommend those interested to come in for a proper consultation with me in my clinic. For those who find me to far, you can also visit my friend Dr Kuljit at Damansara Height Wellness Clinique - the guy who actually put me up to it. He also provide food for you during this diet.

For those interested, do call my clinic at 03-21440080 for a consultation.

Sunday, February 26, 2012

Want bigger breasts?

Yesterday I attended a very interesting session with Dr Yap in Prince Court Medical Center. It was a small group of women discussing about breast implants and breast augmentation. Dr Yap is a very experienced plastic surgeon who use to practice in UK, but decided to come back to Malaysia to be nearer to his family.

What was interesting in this session was it was attended by all ages of people ranging 30s to 60s of multiple races and nationality. It was more of an informal Q&A session after Hi-Tea sponsored by Allergen, which was the company that supplies high grade silicone implants.

The session started with Dr Yap showing the breast implant and the two common shapes i.e. round or tear drop. Then he called a volunteer from the audience to stand on one of the implants with all her weight (shoes off of course). The lady who stepped forward could be around 80kgs or more perhaps, and the best things was, the implant did NOT break. It feels natural and appears natural too. (We had a live model showing us her results).

Dr Yap then explained about the different types of implants in the world, and so far the best is still high grade silicone implants which if the implant is well-manufactured, and inserted properly without any damage to it, would well last a long time. The other popular implant in the market was the saline implant which he does not use anymore. It came about during the ban on silicone implants in the states in the 1970s. Although some would feel safer with saline implants, the fact is, the lining of the implant was still made of silicone. As for durability, it has a high leakage rate of up to 25% within a year of the procedure and subsequently more. Another problem was the sound of water with every movement which sometimes causes sea sickness in some women.

Other things asked during this session:
1. What size of implants are there?
Anything from 120ml to 600mls or even custom made for the individual.

2. What size should I put in?
Depends on the time done and the measurements taken based on the individual cavity.

3. Will I get cancer from it?
There is no risk for Cancer with silicone implants except for a small minority Dutch race that develops CA with silicone implants (i.e. 2% of the world population). They believe it to be a hereditary factor involved.

4. Will the implant break when I go on a plane.
No

5. Will the implant break if I fall on it?
If undefective - No.

6.How long after putting in my implants can the breasts be handled?
At least 1 month - 6 weeks. (Note to the men)

7.How often do I need to change them?
Up to the individual. Ideally, if you want to change size at least 1 year from original operation. Otherwise, it even lasts more than 20 years.

8. When I grow old and start sagging, will the breasts with implants sag too?
You would expect some degree depending on skin laxity.

9. How long should I wear the support garment?
At least 6 weeks.

10. How long does the scar take to heal? 
Usually the outer part about 6 weeks, but for complete scar maturity about 1 year.

Interested to know more - You can contact my Consultant Sister Kay at sisterkay@meditourmalaysia.com .

Disclaimer: I don't do surgical breast implants.



Saturday, February 11, 2012

Radiofrequency Tightening - RF

I think a lot of us are aware about radiofrequency devices which are used for tightening and contouring. Beauticians and doctors alike are fascinated by the discovery of what these machines can actually do. However, in the past a lot of misconceptions have been translated to patients and customers by over promising results and also lack of understanding of what it actually does. 

So what is the science behind radiofrequency treatments? The idea of radiofrequnecy is tissue heating. We all believe that when our skin tissue is heated to temperatures between 40-45 degrees Celsius, the collagen remodelling cascade will start and correct the damaged collagen strings to give us tighter skin.Whether this is completely true or not, or how long should the heat be administered, there is no hard and fast rule, but most believe more than 1 minute. Histological cross sections of skin treated with heat does show a realignment of the collagen fibres and a better structure is formed but whether this applies to all machines that produces heat to the body, it is still unknown. As for fat reduction, most slimming centers would say that the radiofrequency will liquidify the fat due to the heat, but this is not true at all. Heat from the radiofrequency device, or whatever device that increases the tissue temperature merely increases vasodilatation of the small capillaries surrounding the fat cells hence allows more free fatty acids to enter the bloodstream and be used up by the body. What about the instant tightening and slimming effect? I guess the best explanation would be cell dehydration and shifting of fluids into other spaces. Also our elastin fibers recoil to the heat, thus giving a more tighter look.

After reading the technical details behind the technology, you would start wondering whether it would really work. From my observations and trying out many radiofrequency devices in the market, I do believe that they do give significant improvement, but it will be dependent on:
  1. The machine as to how much energy does it really transmit to the body and how deep does it go.
  2. The ability to achieve the temperature of  >41° and duration it can be sustained.
  3. The technique of the user to achieve and overall tightening or slimming effect.
  4. The frequency of treatments that shouldn't lapse too far apart from each other to get a cummulative effect. Once a week is ideal, and not more than 1X a month. Too frequent may run health risks instead.
  5. The cooperation from the patient to also help maintain the effect via home products for tightening or good diet and exercise.


There are many radiofrequency devices in the market from the lux brand once like Thermage, to others like Relax-F, Accent-RF, Thermacell, etc. Some RF devices are used by beauticians in salons which gives pretty good results but temporary because the energy allowed in their machines are not as advanced as the ones sold to doctors. Yes, there are differences, that is why the price differs greatly as well.

In my clinic, I use a Relax-F and after experimenting on the machine a lot, I find that the best results can be achieved when the treatments are done on a weekly basis with a minimum of 4 sessions. Subsequently, the result can last as long as 6 months given a proper diet and exercise. Otherwise, a maintenance session once a month has proven to benefit the patient to have a better result. It is non-invasive, not painful and most patients say it feels like going for a hot-stone massage. It is also extremely good for post-partum ladies who have loose skin and water retention post pregnancy to tighten up their abs if they are not keen for tummy-tucks. 

Other benefits of Relax-F:
     * Skin tightening and rejuvenation
     * Improvement of scar appearance (also stretch marks)
     * post liposuction treatments for smoother skin 
     * Acne treatment
     * Long-lasting body contour
     * Cellulite reduction

Currently we are having radio-frequency promotions for tummy - kindly refer to Spring Promotions post at http://faceworksclinic.blogspot.com/2012/02/spring-promotions.html . For more info or appointment please contact us at 03-21440080 or info@faceworksclinic.com





Thursday, February 2, 2012

New Service from Faceworks.... Milk Peel

We are proud to introduce our latest peel from Dermaceutics - Milk Peel. Milk Peel is a much stronger peel than the classic glycolic peel of 20% because it combines 50% glycolic with 10% lactic acid + salicylic acid making it penetrate deeper but with less pain. In combination with our whitening Intense C serum, you can see how it instantly lightens superficial pigmentation and even the deeper ones. Look closely at the picture and you will also notice an improvement in texture and reduction of fine wrinkles and this is just immediately after. Some people may experience some redness which normally subsides within the day. As for peeling? Well, some may have some peeling which I describe like having dry glue on your face and peeling it off, otherwise most are fine. The trick to a better lasting results is applying lots and lots of moisturizers and serums immediately after and up to a week since the penetration of products will be superb during this period. Oh.... And do not forget sunblock as it is a must. This short procedure only takes 40 minutes to complete with the given results.





Feel your skin dull and non-radiant, starting to see those big pores and fine wrinkles forming, No time to take off from your busy schedule?? This is definitely the right peel for you. Don't settle for any peel, Choose MILK PEEL - the immediate solution with minimal downtime.


To know more or to book appointment, do call us at 03-21440080 or email to info@faceworksclinic.com

Wednesday, February 1, 2012

Valentine Specials......

It's February again... and Valentine is just around the corner. Looking for that perfect gift for your loved ones? Faceworks Clinic has come up up with a few interesting gift ideas: 



































Information about the gift sets:

1. Neostrata Skin Active Set - For sensitive and aging skin.Also good for those you want a more natural way of reducing fine lines especially around the eyes. Contains apple stem cells and glucosamine to help plump up your skin. Long term use has shown to help reduce wrinkles and rosacea. Now promo price at RM 488 only (Normal Price: RM 575/=)

2. Ideal Gift for your mum - This gift set combines 3 important elements - Vitamin E with placenta oil from Norefal is a wonderful moisterizing serum to help return the supple softness of your skin. Nectifirm from Revision is an advanced neck firming cream to help reduce those neck wrinkles. And the set will not be complete without Heliocare Sunblock Gel - SPF 50 UVA/UVB protection that is suitable for this tropical climate. Promo price RM 550/= only. (Normal Price RM 688/=)

3.For Eyes & Neck Rejuvenation - Obagi Elastiderm is clinically proven to improve fine wrinkle appearance around the eyes. The decolletage set is a wonderful kit to reduce sunspots on the neck as well as other pigmentation around neck and chest area. Promo price: RM 580/= only. (Normal Price RM 840)

4. The Beautiful Eye Set is the complete set for maintenance of younger eyes. The elastiderm is in gel form thus reduces risk of oil seed formation around the eyes with heavier creams. ElastiLash helps to condition the eye lashes to be stronger, and grow faster and longer. And what more to flaunt the look with KISS mineral make-up mascara to enhance your healthy eyelashes. Promo Price: RM 480 only. (Normal Price: RM 657/=).

5. Whiten Me Supplements. A complete 2 month supply of White Beaute melano blocker combined with Tiox-C glutathione and vitamin C tablets to get that overall lightening of your skin tone. Promo price RM 735/= only (Normal Price RM 918/=).

6. Something For the Men - Foltene Men Hair Care System. Complete set with shampoo, conditioner and treatment for 1 month. Promo Price RM 300/set. (Normal Price RM 400/set)

7. Something For Her - PK24 Female Esteem - Natural 24 hour tightening cream. Rekindle those honeymoon moments with this natural cream that tightens up instantly and lasts up to 24 hours. Because of its long lasting effect, adding this to your shower routine daily is simple and easy. Promo Price: RM 500 only (2 tubes) - (Normal Price RM 590/=)

8. Caviarlieri Love Sets - Get this super supplement at RM 3500 for 3, RM 6600 for 6, and RM 12,000 for 12 boxes. Caviarlieri is the only supplement you would need to boost up your vitality, increase your energy and mood, improve your skin texture and glow, and make you look younger by the day. (NP per box: RM 1300/=)

9. Kiss & Blush Set from KISS Mineral Make-Up. Get this cool make-up set for your sister or your girlfriend. Choose 2 from our 5 different lipstick colours together with our cheek blusher in pink rose and get a FREE lip plumper worth RM 99/=. Whole set promo price at RM 240/= only.

So what are you waiting for? Call us today to book your gift hamper at 03-21440080.