Excessive weight can affect people’s health, affect mood and spoil life. 

How we diagnose obesity and eating disorder (ED)?

Patient History

Medical histories help define the degree and nature of ED. A medical history can disclose diseases that lead to ED: stress, certain prescription or illegal drugs can suggest a chemical cause, since drug effects account for 25 percent of ED cases. Cutting back on or substituting certain medications can often alleviate the problem.

Physical Examination

A physical examination can give clues to systemic problems. Abnormal secondary sex characteristics, such as hair pattern or breast enlargement, can point to hormonal problems, which would mean that the endocrine system is involved. The examiner might discover a circulatory problem by observing decreased pulses in the wrist or ankles.

Laboratory Tests

Several laboratory tests can help diagnose ED. Tests for systemic diseases include blood counts, urinalysis, lipid profile, and measurements of creatinine and liver enzymes. Measuring the amount of free testosterone and estrogen in the blood can yield information about problems with the endocrine system and is indicated especially in patients with decreased sexual desire and chronic pain syndrome.

Psychosocial Examination

A psychosocial examination, using an interview and a questionnaire, reveals psychological factors and reveal reasons for eating disorder.

How do we treat ED?

Our clinic suggests that treatments proceed from least to most invasive.

1.     Cutting back on any drugs with harmful side effects is considered first. For example, drugs for pain control work, blood pressure, asthma medications can cause weight gain. If you think a particular drug is causing problems with appetite and weight gain, tell your doctor and ask whether you can try a different class of medicine.

2.     Psychotherapy

Our clinic has several psychologist, experts often treat psychologically based ED using techniques that decrease the anxiety, depression, panic associated with abnormal appetite. The patient's family can help with those techniques, reinforcing positive self-esteem.

3.     Special diet

There are many food and food modification that might help with appetite suppression and metabolism increase. Our clinic offers dietary consultation.  This is an example of foods that might be helpful for appetite control: scallions, lamb, sea cucumber, shrimp, bitter melon seeds, ginseng, black beans, kidney beans, yams, lycii fruit.

4.     Herbal and Folk Medicine

Most herbal weight loss products work by:

·         Increasing urination and/or bowel movements

·         Stimulating the central nervous system (speeds up the body's mental and physical activity; caffeine is a central nervous system stimulant)

·         Increasing serotonin levels, a chemical in the brain that creates a "feeling of fullness"

However, herbal preparations will not produce permanent weight loss. Also, herbal weight-loss products contain many ingredients, some of which have serious side effects and can lead to dangerous health situations (toxicities). Most people who sell herbal products have limited knowledge how these products work and wouldn't be able to tell you about reported problems with the herbs or how they might affect the drugs you may be taking. Many herbal manufacturers also make "false claims" about the health benefits of these products. For all of these reasons and lack of proven health benefits, use of herbal products as weight-loss aids is not encouraged.

There are many over-the-counter and herbal products. Not all can be discussed here. Here are some key points of some of the most popular products and what ‘science' says today about their effectiveness as weight loss agents.

Over-the-counter appetite suppressants: Appetite suppressants are drugs that may help you lose weight by "tricking" your body into making you feel full and no longer hungry. Appetite suppressants can work, but they only work while you are taking them. However, long-term use can lead to addiction and create health complications. To lose weight, you must also adjust your eating habits; otherwise you will simply regain any lost weight.

Ephedrine: Ephedrine is a common ingredient in herbal dietary supplements used for weight loss. Ephedrine is also an ingredient in asthma medicine. In addition, it is used to make methamphetamine, more commonly called speed. In fact, there's only a slight chemical difference between methamphetamine and ephedrine.

Ephedrine can slightly decrease your appetite, but no studies have shown it to be effective in weight loss. Ephedrine can be dangerous. It can cause high blood pressure, changes in heart rate, trouble sleeping (insomnia), nervousness, tremors, seizures, heart attacks, strokes, and even death. Ephedrine can also interact with many prescription and over-the-counter medications. In the US, ephedra-containing dietary supplements are no longer available.

St. John's wort: St. John's wort is an herbal – also called hypericum – that has been used for centuries to treat mental disorders, nerve pain, malaria, insect bites, wounds, burns, and other conditions. More recently, St. John's wort has been studied to treat depression and suppress appetite.

5-hydroxytryptophan (5-HTP). 5-hydroxytryptophan (5-HTP) is found in some over-the-counter weight loss formulas. This extract from a West African plant seed contains an ingredient that is linked to a rare and potentially deadly blood disorder. It has not been proven to be an effective weight-loss agent. Until more is known, 5-HTP products should be avoided.

Chitosan: This dietary supplement is made from chitin, a starch found in the skeleton of shrimp, crab, and other shellfish. There is a concern that people with allergies to shellfish might also be allergic to chitosan. Chitosan works by binding with fat in fatty foods, moving it through the digestive tract, and then passing it out of the body in bowel movements without the fat being able to be absorbed. Some research suggests that combining chitosan with a calorie-restricted diet might result in a small amount of weight loss. But taking chitosan without cutting calories doesn't seem to cause weight loss.

Pyruvate: Pyruvate is formed in the body during the digestion of carbohydrates and proteins. According to some studies, it may have a slight effect in helping you shed pounds. Found in the form of pyruvic acid, pyruvate is in many different types of foods, including red apples, cheese, and red wine. Pyruvate appears to be safe, but its claims of boosting metabolism, decreasing appetite, and aiding in weight loss need further study.

Aloe: Aloe (often called aloe vera) is a plant related to cactus. Oral forms of aloe are added to herbal weight-loss products. Oral aloe causes bowel movements and many aloe weight-loss products are marketed as "internal cleansers." The use of aloe supplements has not been shown to be effective for permanent weight loss. Taking oral aloe can lead to side effects such as abdominal cramping, diarrhea, electrolyte disturbances, and decreases in potassium. Therefore, taking oral aloe is likely unsafe, especially at high doses.

Cascara: Cascara is only marketed as a dietary supplement. It is a common ingredient in weight loss products and is mostly used as a laxative for constipation. Misuse of this herb has caused disturbances in electrolytes (such as potassium and sodium). Electrolytes help your body maintain normal functioning. Do not take if you are pregnant or lactating (can be passed into breast milk). Cascara may interact with medications such as digoxin and diuretics.

Dandelion: Dandelion is a natural diuretic (a substance that makes you urinate more often). This is how it causes weight loss. Dandelion has been known to cause allergic reactions. People who are allergic to ragweed and related plants (daisies, chrysanthemums, marigolds) are likely to be allergic to dandelion.

Glucomannan: Glucomannan is a sugar made from the root of the konjac plant (Amorphophallus konjac). It is available in powder, capsules, and tablet forms. Glucomannan might work in the stomach and intestines by absorbing water to form a bulky fiber that treats constipation. It may also slow the absorption of sugar and cholesterol from the gut. Glucomannan tablets are not considered safe as they can sometimes cause blockages of the throat or intestines. Glucomannan may interfere with blood sugar control. Blood sugar should be closely monitored if you have diabetes and use glucomannan.

Guarana: Made from the seeds of a plant native to Brazil, guarana is an effective central nervous system stimulant. It is used as a weight loss product due to its stimulant and diuretic effects. Guarana contains caffeine and may cause high blood pressure. Some of the extracts have been known to interact with anticoagulants (i.e., warfarin [Coumadin®]) and lengthen bleeding time if there was a health emergency. Many advertisements state that guarana is free from side effects; however, this statement is not true. Side effects from guarana may include nausea, dizziness, and anxiety. People who take guarana on a regular basis and suddenly reduce the amount they've been taking may experience caffeine withdrawal symptoms.

Yerba mate: Also known as Paraguay tea, yerba mate is a strong central nervous system stimulant (the doses typically used mimic that of 100 to 200 milligrams of caffeine). The main reported side effects excessive central nervous system stimulation (speeding up the body's mental and physical activity) and high blood pressure. Yerba mate has not been proven as a weight-loss aid. A few cases of poisoning (leading to hospitalization) have been reported with use of this product. When taken in large amounts or for long periods of time, yerba mate increases the risk of mouth, esophageal, laryngeal, kidney, bladder, and lung cancers. This risk is especially high for people who smoke or drink alcohol.

Guar gum: Also known as guar, guar flour, and jaguar gum, guar gum is a dietary fiber obtained from the Indian cluster bean. Guar gum is often used as a thickening agent for foods and drugs. It has been studied for decreasing cholesterol, managing diabetes, and for weight loss. As a weight-loss product, it helps move foods through the digestive tract and firms up stool. It can decrease appetite by providing a "feeling of fullness." However, like glucomannan, guar gum and guar gum preparations have been linked to causing blockage in the esophagus. The water-retaining ability of the gum permits it to swell to 10- to 20-fold and has led to gastrointestinal blockages. Guar gum can also cause large swings in blood glucose (sugar) levels. Diabetic patients should not use these preparations.

Herbal diuretics: Many varieties of herbal diuretics are very commonly found in over-the-counter (OTC) weight loss products and herbal weight-loss products. Most of the diuretics used OTC come from xanthine alkaloids (like caffeine or theobromine). You should avoid preparations that contain juniper seeds (capable of causing renal damage), equistine (neurotoxic—can cause brain damage), and horse tail or shave grass (contain several dangerous ingredients that can lead to convulsions or hyperactivity). Most of the herbal diuretics are not dangerous but can interact with certain drugs (such as, lithium, digoxin, or conventional diuretics such as furosemide or hydrochlorothiazide). Most of the herbal diuretics do not provide enough diuresis (water loss) to be considered effective.

Inulin: We could all use digestive support from time to time, especially if we’re not consuming a high-quality diet. For a healthy stomach and digestive tract, inulin is a must. While you can’t digest this water-soluble dietary fiber, you won’t feel good without it. It’s found in many natural plant foods and is known as a prebiotic and recent research indicates it has much more far-reaching effects than just keeping your tummy happy. Inulin is a heterogeneous mixture of fructose polymers found in nature as plant repository carbohydrates. This dietary fiber survives your stomach acid and passes into the small intestine. Along the way it mixes with water, ferments, and then becomes food for life-supporting probiotic bacteria of the large intestine. This bacteria includes things like bifidobacterium and lactobacilli. When you keep bacteria like these fed, they keep out unwanted bacteria like E. coli and Clostridium difficile and fungus like Candida. Inulin has many researched benefits, including weight, cholesterol, and blood sugar support. Here are a few of the many benefits you can get from inulin.

5.     Medications for weight loss

There are a lot of medications for weight loss and our Center will be happy to recommend medication that is right for you.









Generic name: phentermine systemic

Brand names:  Adipex-P, Fastin, Ionamin, T-Diet, Suprenza, Phentercot, Phentride, Zantryl, Atti-Plex P, Pro-Fast SA, Oby-Cap … Show all

Drug class: CNS stimulants, anorexiants









Generic name: lorcaserin systemic

Brand name:  Belviq

Drug class: anorexiants
















Generic name: megestrol systemic

Drug class: hormones/antineoplastics, progestins


Efficacy rating







Generic name: phentermine / topiramate systemic

Drug class: anorexiants


Efficacy rating







Generic name: oxandrolone systemic

Drug class: androgens and anabolic steroids


Efficacy rating







Generic name: oxandrolone systemic

Brand name:  Oxandrin

Drug class: androgens and anabolic steroids



Efficacy rating







Generic name: liraglutide systemic

Brand names:  Saxenda, Victoza

Drug class: incretin mimetics


Efficacy rating







Generic name: liraglutide systemic

Drug class: incretin mimetics


Efficacy rating







Generic name: liraglutide systemic

Drug class: incretin mimetics

Bupropion / naltrexone

Efficacy rating







Generic name: bupropion / naltrexone systemic

Brand name:  Contrave

Drug class: anorexiants/anti-depressants

   Contrave is a new medication, combination of Naltrexone and Wellbutrin. On        Sept. 11, 2014 it was approved by FDA as a new prescription for weight loss, but many people are using it off-label for addiction control. Contrave combines two drugs already on the market: bupropion (Wellbutrin), an antidepressant, and naltrexone, an anti-addiction drug.

6.     Acupuncture.

Acupuncture is an effective way to control appetite and fight obesity. It addresses energy and blood flow in the body. In Traditional Chinese Medicine (TCM), energy (Qi) flows in channels called meridians. These channels course the entire body and supply energy and stimulate blood flow to all areas. If a meridian is blocked, there will be stagnation and dysfunction. Acupuncture helps increase the circulation of your body’s Qi energy and blood, encouraging your body to do what it should do naturally. Acupuncture is also a balancing therapy, returning the body, mind and spirit to a balanced state. Used for thousands of years to treat ED, Acupuncture, along with Chinese herbs, offer powerful tools. They can be safely used as a replacement for and along with Western therapies. Many people may be concerned about the placement of needles, but they are not placed in or near sensitive private areas. Needles are placed in the extremities, back and stomach, according to whole body treatment principles. Acupuncture does not have any serious side effects, and because acupuncture reduces stress, you will look better and feel more relaxed.

7.     Botox (Dysport, Xeomin) Injections.

Drugs for treating weight can be taken orally, but might be injected directly into the forehead and skull. Exact mechanism of action unknown, but there are studies that showed high efficacy and safety of Botox injections for appetite control and mood stabilization.

8.     Fat melting injections (Lipostabil)

Lipostabil – injectable liposuction alternative melts your fat! The new drug, Lipostabil, made of phosphatidylcholine (a type of lechithin), has recently been shown to cause permanent localized fat loss when injected into your body fat much in the same way that liposuction does. Imagine an injectable liposuction without the need for the surgical procedure. Normally used to lower triglyceride and cholesterol levels, when injected locally, Lipostabil functions through an enzyme that dissolves the fat surrounding blood vessels and reportedly melts it away. Doctors are hoping that Lipostabil will do to the liposuction procedure what Botox did for the face lift -- make it largely unnecessary.

In patients treated with Lipostabil, the only side effects were bruising that lasted for about three days. And a treatment only requires topical anesthesia. In Europe and South America, they have been injecting it for about 15 years into arteries.


The best application of Lipostabil is stubborn pockets of fat that are resistant to diet and exercise. Indeed, this may be the perfect substance to put the finishing touches on a prize-winning physique. This is certainly something that will have an enormous appeal as soon as it is perfected -- and you heard it here first. Fat is removed permanently with these injections, and it helps with body sculpturing.

9.     Body sculpturing wraps, creams, sprays

Some of the ingredients used in spa treatments -- rosemary, honey, butter, clay, chocolate, eucalyptus.  These ingredients are used in various types of body wraps to decrease fat and body volumes.

Getting a body wrap can feel good. Some spas promote body wraps as a relaxing, moisturizing treat.

Others, though, tout specific body wraps as a way to detoxify, slim down, or deal with cellulite -- claims that may go too far.

When body wraps were first offered decades ago, linen sheets were used, today we use elastic bandages, cellophane. The wraps were then mostly called herbal wraps. "'Body wraps' is a term that came to mean more than herbal wraps," she says, adding that they became popular in the 1980s and '90s. Eventually, plastic or thermal blankets replaced the linen sheets.

Body wraps are often done in a darkened room with flickering candles, soft music.

When you're entirely wrapped with your arms at your sides, the electric thermal blanket is pulled up. The blanket's heat is typically hot enough to make you sweat throughout the course of your 30-minute downtime.The final step is to rinse and apply lotion.

10.  HCG

hCG stands for human chorionic gonadotropin, natural hormone found in pregnant women. It can reset your metabolism and make you less hungry on an ultra-low-calorie diet.  hCG can control your hunger,  so you lose as much as a pound a day without feeling hungry or weak. The hCG diet limits you to 500 calories a day for 8 weeks while taking hCG, either by getting a shot or by taking a “homeopathic” product, such as oral drops, pellets, or sprays, which you can buy at the store.  .  You won't be eating much while being on hCG diet. The diet lets you have two meals a day, lunch and dinner. Each meal has to include one protein, one vegetable, one bread, and one fruit.

None of this is approved by the FDA for weight loss. The shots themselves are legal, as long as a health care provider gives them to you. The Food and Drug Administration (FDA) is advising consumers to steer clear of these "homeopathic" human chorionic gonadotropin (HCG) weight-loss products.  They are sold in the form of oral drops, pellets and sprays and can be found online and in some retail stores. 

11.  Laser for fat melting and sculpturing

A new, minimally invasive treatment that uses lasers to melt fat could replace liposuction and the "tummy tuck." Fat-melting action of laser lipolysis is a minimally invasive treatment, has the added benefit of producing new collagen (collagen is the main protein that gives the skin its tone and texture). Additionally, the laser causes the collagen to contract, which tightens the skin. This tightening alleviates the fear of skin sagging, a common complaint after standard liposuction. Laser lipolysis also enables the removal of more fat than standard liposuction. Ultrasound-assisted guidance of a fiber-optic laser during laser lipolysis can be used on many parts of the body and results in excellent sculpting with tight skin.

Prior to treatment, each person had measurements recorded including weight, diameter of the area treated and skin tightness. At each follow-up appointment the diameter of the treatment areas was measured and recorded. Skin tightness was also recorded against control criteria.

The laser's thermal (heat) energy melts the fat and standard liposuction removes it from the body.  Patient follow-up was daily for a week and then at one, three and six months. All treated areas showed improvement in reducing fat bulk as well as tightening skin. The laser uses targeted energy to "zero in" on the fat, without affecting the other tissue, enabling a faster recovery.

Rejuvenation Center successfully works under the direction of Marina Shulga.She is plastic surgeon and doctor of the highest category with 20 years of experience in the field of aesthetic medicine.

A wide range of services, professional and unique equipment.



E-mail: rejuvenationcenter@yahoo.com

Phone: (+1) 305 682-9997

3575 NE 207th street, suit B-3-A,
Aventura, Florida.33180


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