>>>
>>> WE
>>> WE ARE BACK ON THIS WELLNESS WEDNESDAY.
WELLNESS WEDNESDAY. OUR DOCTORS ARE STILL WITH US
AND WE HAVE MORE HEALTH AND
WELLNESS QUESTIONS.
WELLNESS QUESTIONS. THERE ALWAYS LEFT OVER
QUESTIONS WE ARE WILLING TO GET
TO.
TO.
TO. IT
TO. IT IS
TO. IT IS GOOD TO HAVE YOU GUYS
WITH US.
WITH US.
WITH US. LET'S TALK ABOUT THE BEST DIET
NOT ONLY IF YOU HAVE A FATTY
LIVER DISEASE OR IF YOU ARE
TRYING TO PREVENT IT.
>> YES.
>> YES.
>> YES. THERE IS PROBABLY NOT ONE DIET
THAT YOU NEED TO ABIDE BY.
THE MAIN TENANTS THAT WE THINK
ABOUT OUR LOWER CARBOHYDRATE,
LOWER SUGAR.
LOWER SUGAR. YOU DON'T NEED TO BE LOW-FAT
AND THAT IS A COMMON
MISCONCEPTION.
MISCONCEPTION. WE THINK FATTY LIVER, AVOID
FACT.
FACT.
FACT. >>
FACT. >> IS THIS THE GOOD AND BAD
FATS SITUATION?
FATS SITUATION? >> YES.
>> YES.
>> YES. MONDO -- A MEDITERRANEAN DIET
PROBABLY HAS THE BEST DIET IN
TREATING FATTY LIVER AND
PREVENTION.
PREVENTION. >> SO YOU ARE LOOKING AT A
LABEL, WHAT ARE THE FACTS WE
ARE TRYING TO AVOID?
>> YOU DON'T NEED TO COMPLETELY
AVOID ANY TYPE OF FAT BUT THE
SATURATED FATS ARE THE ONES
THAT ARE PROBABLY THE WORST FOR
YOUR CHOLESTEROL AND FOR YOUR
CARDIOVASCULAR RISK OVERALL.
>> YES TO OLIVE OYL AND
AVOCADO.
AVOCADO.
AVOCADO. >> YES.
>> YES.
>> YES. >> ARE THERE MORE MEDICAL
TREATMENTS ON THE HORIZON?
>> FORTUNATELY, YES.
PART OF THIS IS THIS IS A
DISEASE THAT AFFECTS 25% OF THE
POPULATION.
POPULATION. IT IS REALLY QUITE AN EPIDEMIC
AND IT IS EXTREMELY FRUSTRATING
FOR PATIENTS THAT HAVE
OBVIOUSLY BEEN TRYING TO LOSE
WEIGHT.
WEIGHT.
WEIGHT. A
WEIGHT. A LOT OF THEM FOR MOST OF THEIR
LIVES AND NOW THEY HAVE A
DIAGNOSIS OF FATTY LIVER
DISEASE AND THE ONLY TREATMENTS
THAT WE OFFER THEM IS WEIGHT
LOSS.
LOSS.
LOSS. SO
LOSS. SO IT IS A REALLY HARD THING TO
ACHIEVE AND THE NEXT HORIZON
REALLY AND HEPATOLOGY WILL BE
FINDING TREATMENTS FOR FATTY
LIVER.
LIVER.
LIVER. WE
LIVER. WE HAVE SOME LATE STAGE AGENTS
THAT ARE LOOKING REALLY GOOD IN
CLINICAL TRIALS.
CLINICAL TRIALS. YOU HAVE A LOT OF CLINICAL
TRIALS WERE WE CAN OFFER
PATIENTS EARLIER ACCESS TO
THESE PHARMACEUTICALS WHICH
REALLY WILL BE THE FUTURE.
>> PEOPLE CAN CHECK IN TO SEE
IF THEY QUALIFY FOR THE
CLINICAL TRIALS AS WELL.
YOU SAY IT IS NOT JUST A WEIGHT
ISSUE.
ISSUE.
ISSUE. THERE ARE OTHER THINGS GOING ON
AS WELL.
AS WELL.
AS WELL. >> CONTROLLING YOUR WEIGHT IS
ONE THING AND THAT IS PROBABLY
THE BEST WAY TO MANAGE FATTY
LIVER IN OUR CURRENT
ENVIRONMENT BUT IT IS A
SYSTEMIC DISEASE SO WE HAVE TO
THINK ABOUT THE PATIENT AS A
WHOLE.
WHOLE.
WHOLE. THEY ARE AT RISK FOR
COMPLICATIONS.
COMPLICATIONS. THEY ARE AT RISK OF
CARDIOVASCULAR DISEASE.
CARDIOVASCULAR DISEASE. THE NUMBER ONE KILLER IS
CARDIOVASCULAR DISEASE.
CARDIOVASCULAR DISEASE. IT IS NOT THERE LIVER SO WE
REALLY HAVE TO THINK ABOUT
STRECK -- STRICT DIABETIC
CONTROL, GETTING THEIR
CHOLESTEROL DOWN.
CHOLESTEROL DOWN. AND WORKING WITH OTHER
PROVIDERS TO TAKE CARE OF THE
WHOLE PATIENT.
WHOLE PATIENT. >> WHICH LEADS ME DIRECTLY TO
DOCTOR LUND BECAUSE WE ARE
TALKING ABOUT BREAKING HABITS.
OBVIOUSLY, YOU HAVE A LOT OF
MOTIVATION IF YOU ARE FACING A
DIAGNOSIS LIKE THIS BUT LET'S
TALK ABOUT HOW WE GET TO THE
ROOT CAUSES WHETHER IT IS WHAT
WE EAT OR WE DO SOMETHING ELSE.
YOU SAID WE CAN SEE A
PROFESSIONAL BUT WHAT ARE YOU
TRYING TO DELVE INTO EXACTLY?
>> WE ARE REALLY TRYING TO
DELVE INTO THE AMBIVALENCE
BEHIND WHAT IS DRIVING YOU TO
STAY IN THAT PLACE WHERE YOU
ARE CONTINUING TO BITE YOUR
NAILS.
NAILS.
NAILS. >>
NAILS. >> ARE WE GETTING SOMETHING OUT
OF IT?
OF IT?
OF IT? >>
OF IT? >> YES.
>> YES.
>> YES. SECONDARY GAINS WHICH WE ARE
NOT ALWAYS AWARE OF WHAT THOSE
ARE SO THAT IS WHY WORKING WITH
SOMEBODY TO REALLY UNCOVER ON A
DEEPER LEVEL WHAT IS DRIVING
OUR BEHAVIOR.
OUR BEHAVIOR. >> MAYBE IF I AM BITING MY
NAILS, I DO IT BECAUSE I GET
SOME ANXIETY RELIEF BUT WHERE
IS THE ANXIETY COMING FROM?
>> EXACTLY.
>> EXACTLY. >> SO ONCE WE MADE THE CHANGE
THAT YOU IDENTIFIED AND I
IDENTIFIED FOR MY OWN LIFE IS
THAT MAINTAINING THOSE CHANGES
CAN BE HARD, WHAT IS THE
DIFFERENCE IN THE WAY WE NEED
TO THINK ABOUT THINGS TO GO
FROM THE CHANGE PHASE TO THE
MAINTENANCE PHASE.
MAINTENANCE PHASE. >> WHAT WE REALLY NEED TO DO
FIRST AND FOREMOST IS WE WANT
TO REMIND OURSELVES ON A DAILY
PLACES -- BASIS IS WHAT IS THAT
INTRINSIC MOTIVATOR, WHAT IS
THAT INTRINSIC REASON FOR WHY
WE WANTED TO MAKE THAT CHANGE?
WE CAN POST STICKY NOTES AROUND
OUR HOUSE TO REMIND US.
VERY SIMPLE STRATEGIES AND
TACTICS TO REMIND OURSELVES WHY
DO WE DO THIS IN THE FIRST
PLACE, WHERE DO WE WANT TO GO?
WE WANT TO REPLACE TRIGGERS FOR
THE BEHAVIOR WITH OTHER THINGS.
>> THIS IS REALLY IMPORTANT.
LET ME STOP YOU THERE.
WE WILL BREAK A BAD HABIT AND
REPLACE SOME OF THOSE TRIGGERS
OR THINGS OR BEHAVIORS WITH
SOMETHING ELSE.
SOMETHING ELSE. GIVE ME AN EXAMPLE OF HOW THAT
WOULD WORK.
WOULD WORK. >> EXACTLY.
>> EXACTLY. IF YOU ARE HAVING THAT RIDGE TO
BITE YOUR NAILS, PRIOR TO
ACTUALLY MAKING THE CHANGE, YOU
NEED TO DECIDE I KNOW I'M GOING
TO CONTINUE TO HAVE THE URGE TO
BITE MY NAILS, WHAT CAN I DO IN
THE PLACE OF BITING MY NAILS
WHEN I HAVE THAT URGE AND THAT
IS THE KIND OF THING.
SO IT COULD BE AS SIMPLE AS
GETTING A GLASS OF WATER.
IT COULD BE AS SIMPLE AS
SENDING A TEXT TO AN
ACCOUNTABILITY BUDDY WHO IS
GOING ALONG WITH YOU AS A
SUPPORT IN THE CHANGE PROCESS.
IT COULD BE AS SIMPLE AS
FINDING THAT STICKY NOTE.
YOU REALLY JUST WANT TO STOP
AND CHANGE GEARS AND REBOOT
WHEN YOU ARE HAVING THAT URGE.
>> THAT MAKES MUCH SENSE TO ME
AND I THINK THAT REQUIRES THAT
WE PREPLAN.
WE PREPLAN. WHEN YOU ARE IN THE MOMENT
LOOKING AT THAT COOKIE, TOO
LATE.
LATE.
LATE. >>
LATE. >> PRECISELY.
>> PRECISELY. >> THAT IS WHY REALLY