Primary Care


It's Not You, It's Your Genes

Science tells us that your genetics has more to do with your weight than what you eat or what you do. Some people are able to eat whatever they want without seeming to gain a pound, while others gain extremely easily despite nearly starving themselves. Dr. Streff firmly believes that people are not heavy because they lack the will-power to stay lean.


Lifestyle Interventions

With that said, it is possible for us to alter weight through what we eat and we do, however there must be a purposeful and  specific plan in place to achieve this goal. Dr. Streff uses several tools for managing weight such as dietary interventions, specific activity prescriptions, and sometimes medications or surgical interventions when necessary.  He sometimes utilizes continous glucose monitoring  devices (CGMs) when there is underlying insulin resistance making weight loss difficult. In this case, a spike in glucose is used as a proxy for a corresponding rise in insulin.


Types of Diets

There is no single diet that is best for everybody, but there may be one diet that is best for a single body. He will use the type of diet which he thinks will work best for you, which may be a type of diet (like ketogenic, low carbohydrate high fat [LCHF], low-glycemic Mediterranean, vegetarian, etc), or he may calculate a macronutrient composition (percentage of protein, carbohydrates, and fat) for you to follow. He also uses tools that are dietary inteventions, but not diets perse, such as intermittent fasting (IF) and time restricted feeding/eating (TRF/TRE) as an additional means of reducing.


Calories vs Hormones

Over the last 80 years there has been an insistence on counting calories and treating all macronutrients the same, "A calorie is a calorie" as the saying goes. This theory of weight management is called either, the "Conventional Model" or the "Energy Balance Model" (EBM), which focuses on calories in being less than calories out (CICO). It is true that to lose weight, energy into the system must be less than the energy used by the system (otherwise you'll store energy... as fat). However, it's not true that your body treats the calories you eat the same at all times. Energy balance is highly dependent on a complex milieu of hormonal responses that direct this energy utilization. This is called the "Hormonal Model". Because insulin is the predominant hormone directing energy use vs energy storage and carbohydrates cause the largest release of insulin, in the literature this model is often called the Carbohydrate-Insulin Model (CIM).


Are You Interested in Weight Loss?

Make an appointment with Dr. Streff if you'd like to learn more concerning his views on calories vs insulin and other hormones and what type of intervention may be best for you to achieve a healthier self.