From the Practice
Blog
Notes, essays, and clinical reflections from thirty-five years of endocrine practice.
SEO Essay
Metabolically Healthy Obesity: Can a Person Be Obese and Healthy?
The controversy over whether normal blood tests truly protect an obese person from future risk.
Read Essay →
SEO Essay
Fatty Liver and Obesity: Why Silent Liver Disease Is Often Ignored
How liver fat, insulin resistance and obesity reinforce one another and why early recognition matters.
Read Essay →
SEO Essay
Obesity and Sleep Apnea: Should Every High Risk Patient Be Screened?
How poor sleep can worsen appetite, insulin resistance and weight control, and who needs assessment.
Read Essay →
SEO Essay
Visceral Fat Treatment: Why Waist Size May Matter More Than Weight
The medical importance of abdominal fat compared with the number on the scale.
Read Essay →
SEO Essay
Normal BMI but High Body Fat: Are Thin Patients Being Missed?
Why normal weight does not always mean low metabolic risk, especially when visceral fat is high.
Read Essay →
SEO Essay
Weight Loss Plateau: Hormones, Metabolism or Poor Compliance?
A fair examination of the most common reasons weight loss stops and how they should be investigated.
Read Essay →
SEO Essay
Weight Regain After Dieting: Patient Failure or Treatment Failure?
Why biological adaptation, environment and inadequate follow up may explain repeated regain.
Read Essay →
SEO Essay
Gastric Balloon for Weight Loss: Treatment or Temporary Food Restriction?
The realistic benefits, limitations and recurrence questions surrounding gastric balloons.
Read Essay →
SEO Essay
Weight Loss Surgery Versus Medical Treatment: Are Patients Operated on Too Early?
When surgery is appropriate and when structured medical treatment deserves more time.
Read Essay →
SEO Essay
Bariatric Surgery: Does It Treat Obesity or Bypass It?
A balanced discussion of major metabolic benefits, surgical risks and what surgery cannot solve alone.
Read Essay →
SEO Essay
Mounjaro Versus Ozempic: Which Weight Loss Injection Is Better?
A public friendly comparison of tirzepatide and semaglutide without reducing treatment choice to one number.
Read Essay →
SEO Essay
Ozempic and Muscle Loss: Drug Effect or Incomplete Treatment Plan?
How rapid weight loss, low protein intake and inactivity may affect lean mass during GLP-1 treatment.
Read Essay →
SEO Essay
What Happens When You Stop Ozempic? Weight Regain and the Untreated Cause
Why appetite and weight can return after treatment, and what this does and does not prove.
Read Essay →
SEO Essay
Weight Loss Injections: Medical Breakthrough or Lifelong Dependency?
Why long term therapy may be appropriate for some patients and concerning for others.
Read Essay →
SEO Essay
Ozempic for Weight Loss: Is Appetite Suppression the Same as Treating Obesity?
The benefits and limits of semaglutide when the underlying drivers of weight gain remain unaddressed.
Read Essay →
SEO Essay
PCOS and Weight Loss: Should Metabolic Health Be Treated Before Fertility?
How obesity, insulin resistance and reproductive goals interact in women with PCOS.
Read Essay →
SEO Essay
PCOS Treatment: Are Birth Control Pills Treating the Disease or Hiding Symptoms?
A balanced look at symptom control, fertility, insulin resistance and long term metabolic care in PCOS.
Read Essay →
SEO Essay
Normal Thyroid Test but Still Gaining Weight: What Could Be Missing?
Why weight gain may continue despite normal TSH and why thyroid disease should neither be ignored nor overblamed.
Read Essay →
SEO Essay
Normal HbA1c but Insulin Resistance: Can Standard Tests Miss the Problem?
A careful discussion of glucose, insulin and when broader metabolic testing may be useful.
Read Essay →
SEO Essay
Insulin Resistance: The Hidden Reason Some People Cannot Lose Weight?
What insulin resistance means, how it may affect appetite and fat storage, and why it is often misunderstood.
Read Essay →
SEO Essay
Calories Versus Hormones: What Really Causes Weight Gain?
Energy balance is real, but hormones influence hunger, storage and expenditure. Both sides of the debate are examined.
Read Essay →
SEO Essay
BMI Versus Body Fat: Is BMI Misleading Obesity Treatment?
The strengths and limitations of BMI compared with waist size, visceral fat and body composition.
Read Essay →
SEO Essay
Is Obesity One Disease or Many Different Diseases?
Why patients with the same BMI may have very different causes, risks and treatment needs.
Read Essay →
SEO Essay
Dietitian or Endocrinologist: Who Should Treat Obesity?
A practical comparison of nutritional care, endocrine diagnosis and when multidisciplinary treatment is needed.
Read Essay →
SEO Essay
Should Hormone Tests Be Done Before Starting a Weight Loss Diet?
The controversy between routine testing and selective medical investigation before treatment begins.
Read Essay →
SEO Essay
Why Two People Eating the Same Food Gain Different Weight
Genetics, hormones, muscle mass, sleep and metabolism may explain why identical meals do not produce identical outcomes.
Read Essay →
SEO Essay
Can Parents Pass the Fat Gene to Their Children?
How FTO variants, family habits and childhood environment may combine to influence obesity risk.
Read Essay →
SEO Essay
Does the FTO Gene Make You Hungrier Than Other People?
A balanced review of FTO, appetite, food cravings and why hunger may differ between individuals.
Read Essay →
SEO Essay
Can You Beat the Fat Gene? Genetics Versus Lifestyle
Does carrying an FTO risk variant make obesity unavoidable, or can lifestyle and medical treatment reduce its effect?
Read Essay →
SEO Essay
What Is the FTO Gene? Can the Fat Gene Really Cause Obesity?
A public friendly explanation of the Fat Mass and Obesity Associated gene on chromosome 16q12.2 and what it can and cannot explain.
Read Essay →
SEO Essay
Discretion as a Medical Standard
Why privacy is part of serious care for distinguished patients.
Read Essay →
SEO Essay
Remote Care from Anywhere in the World
How international patients can begin private endocrine assessment remotely.
Read Essay →
SEO Essay
Fatty Liver and the Hormonal Axis
The dangerous loop between liver fat, insulin and endocrine dysfunction.
Read Essay →
SEO Essay
PCOS Weight Gain Is Not Laziness
How ovarian, adrenal and insulin systems drive weight gain in women.
Read Essay →
SEO Essay
The Thyroid Weight Trap
Why thyroid dysfunction must be investigated in serious obesity care.
Read Essay →
SEO Essay
Insulin Resistance and the Fat Lock
How high insulin can make weight loss biologically resistant.
Read Essay →
SEO Essay
Nano-Dosing: The Art of Strategic Sequence
Why precision, timing and sequence matter more than blind high dosing.
Read Essay →
SEO Essay
Inside the Exact Diagnosis Process™
Three stages of investigation before medical weight loss treatment begins.
Read Essay →
SEO Essay
The Seven Hormonal Systems That Collapse Together
A clinical explanation of convergent endocrine failure in obesity biology.
Read Essay →
SEO Essay
16q12.2: The Single Cause of Global Obesity
Why one chromosomal locus, and not lifestyle, sits beneath the world obesity epidemic.
Read Essay →