Episode 4: A Scientific Approach to Health With Tony Orlando, Fit Body 360

What does it take to cure diseases, not just manage their symptoms? This is Inside the Cure from Allure Medical and its founder, Dr. Charles Moak. He explores world renowned healthcare that benefits patients and the economy. I'm Cam Carman and Dr. Charles Moak and I are joined by a very special guest, Tony Orlando from FitBody360. Thanks for being with us.

Thanks for having me.

We'll start with you Tony. What is FitBody360 exactly and how is it helping people?

So at FitBody360 we apply the best science in the industry along with our expertise to really help people transform their lives. So it all starts with a DEXA scan and most people don't know what a DEXA scan is. What DEXA does is it gives us three critical health markers that everybody should know. Our body composition, which is going to look at our body in detail, where our fat is our lean tissue. And it's going to look at it by percentage, by pounds, and it's going to give us a very clear, accurate picture of where we are from our health and fitness, bone health. So we can measure bone density in a very accurate way to determine if a client has osteoporosis to help them prevent fractures in the future. And really the game changer that's come out in the last few years is the measurement of visceral fat. So visceral fat is our hidden fat. It's very dangerous fat. And what we've been finding is that in many cases lean people that are not severely overweight have a high amount of this dangerous visceral fat which is a predictor of heart disease and type 2 diabetes. So it all starts with Edexxa. Edexa is just a critical health marker that everybody should know. And from there what we do is we learn about clients goals, their history with weight loss and diets and things that maybe have failed in the past. And then what we do from there is we measure their metabolism. So the RMR device is a technology that we employ and it gives you your actual measured metabolism which can be drastically different than your estimated metabolism. And then from there we put our clients on a macronutrient program. So macronutrients is how many calories made up of carbohydrates, proteins and fats that you should consume in a day. And we do that based on your goals to help you achieve long term health and fitness and to reach your goals.

And then tell us about the corporate wellness you offer.

So it's really, it's a, it's a big problem today. So a lot of companies are starting to become a lot more focused on their employee health and wellness. What happens with. When you have sick employees, you have a lot of problems that occur out of that. You have low productivity, you have sick days, you have catastrophic events that can occur. And with a lot of bigger corporations, they have a kind of a self insurance model where they may have just catastrophic insurance. So we work with companies to help their employees be more healthy, more fit, which in turn increases productivity, lower sick days, and it lowers the number of events which is out of pocket for the employer.

Dr. Moog, tell us about Allure Medical's involvement and a partnership with FitBody. 360.

Yeah, thanks. So I like that you said you were special. And she's introduced me normal. That's okay.

I don't know how I earned that, but thank you.

So, you know, we've done over time ways and looked at ways to measure people's different types of fat. And what Tony's talking about is it's really called Android fat. And that's like male pattern fat, which is fat around the guts on the inside. And there's what's called gynecoid fat, which you might think is female fat, which might be in the hips and the buttocks. And we've known for years that the ratios of this male pattern fat, which could occur in women or men, but this gut fat, like the beer belly, is dangerous. And the female type fat, which would be the hips and legs, that fat typically is not nearly as dangerous. So somebody's got a big butt and big thighs and a flat abdomen. They actually have less cardiovascular problems, less diabetes than somebody who's got thin legs, a thin frame, but a beer belly. Okay? So we have fats in different compartments in our body. And the visceral fat that he's talking about, visceral just means the stuff inside your guts. So you have your muscle of your stomach, and on the outside, the stuff you can pinch an inch, that fat really is not dangerous. It's actually just subcutaneous fat. And it doesn't seem to cause us many problems. But the stuff behind the pinch, behind the inch area is the fat that has, we call cardiometabolic risks. Heart attacks, strokes, diabetes, none of these are satisfactory. Nothing that we want. And as Tony said, some people that look very fit, they have visceral fat. We see that a lot in men, and now we're recognizing it more in women. There's ratios we look at for men and women, what is healthy and what's unhealthy. We use a device called inbody. It's what we use for years. It's really easy to use in a medical office. You stand on it and use something called impedance, where you squeeze the grips. People have had that done at their gym and stuff like that. It's a good rough measure, but really not that accurate. And DEXA uses a technology kind of like X ray, where they can really get precise and look at the tissue makeup of your body. How much muscle do you have? You talked about osteoporosis. How thick are your bones? Are they thin? Do you have fat in different areas? And we can precisely measure it. Not just precisely measure. What I like about it is you can track it. So when you're stepping on the scale over and over again, things may change. But we all know that you could lose or gain muscle and you lose or gain fat. You can have different amounts of water in your body, but it doesn't really tell us, are you making yourself healthier and at allure? What we want to do is we want to make our customers healthier. And we do a lot of things that reduce fat. So we do hormone replacement for people with low testosterone. For men and women that have gone through menopause, they typically would gain visceral or Android fat over the years, and we're going to halt that. But we want to know, is that. Is something happening? Another thing he talked about was the resting metabolic rate. This is something you basically put a tube in your mouth and you blow. You just breathe normally, and it measures how much oxygen you extracted out of the atmosphere. And there's a calculation that we call the Weir formula, W I E R formula. It predicts how much energy, how many calories you burn when you're just sitting there based on how much oxygen you extracted out of the current existing atmosphere. And with that, we'll know that your metabolism might be high or low. If your metabolism is low, there's something wrong with you and you need a medical evaluation, and we might have to look at it. You have low thyroid, you have some other hormone. That's usually an issue of hormone issues or could even be some other more significant issue. If it's on the high side, that's not actually healthy either. A lot of people say they want to boost their metabolism. Well, boost your metabolism and you actually die sooner. I mean, that's kind of disheartening to think, but the fastest metabolism, you actually die sooner. We all kind of have, like a normal metabolism. So fast metabolism leads off all Kinds of inflammation and inflammatory markers that hurt us. And a low metabolism harms us by the fact that tends to make us put on fat. If you were going to have choose one or the other, you might want your metabolism a little low for longevity, but not for gaining weight. And as Americans, we have an issue where we have too much abundance of food supply. So people that have the ability to lower their metabolism, actually that's protective. In reality, we select it out for that. If we look at how human beings grew through natural selection, there was absolutely no benefit for survival to live a long time because you had your children when you were young. So when we look at survival of the fittest or Darwin theories, the ability to live a long time was not really a selective process for us as human beings. But particularly the ability not to eat all the time was. And we had major periods of famine in the history of the world, in the modern world in the past thousand years or 2,000 years, where significant portion of the population was wiped out because we ran out of food. And that's where our ancestors came from as people that didn't need to eat so much. So we actually selected for lower metabolism species. So high metabolizers actually died off during those times. High metabolism has other things besides not being able to survive during famine. I won't get into that. I talked about it before. More inflammation, more cancers. But we are at a relatively low metabolism species. We're designed to probably eat a lot less than we do now. We weren't really designed to eat three meals a day plus snacks. And right now we're seeing a lot of problems with obesity related to our modern food supply. Not understanding that we don't need a high metabolism. Not understanding that metabolism boosters probably backfire. And the people that sort of get away with it, they're just kind of lucky. My joke has always been, you know, there's always that one woman who she eats whatever she wants to, never gains weight, all she wants to eat. She's fine. She's called a be ch. I'm not gonna say that. Yeah. This is not. But it's not something that is really normal in humanity. Okay. So they get away with it when they're young. You know, your kids. I was at home last night and my son and his buddies are. And they're eating five guys burgers. I'm thinking, didn't you just have that last night? Night before, night before, night before. And they're all skinny, right? Well, just wait, buddy. You know, just wait till you're older and it won't happen. So what I like about Tony's program is we don't have the Dex in our office. Not practical in the medical office, not for us anyways, is we can work with somebody else that will not only do the Dex, but if their metab normal or a little low, a little high normal, they're in a certain range. They can kind of work with them on the foods they're eating. He talks about the macronutrients, and that's what food makeup you should be consuming. Because right now, there's a craze on this whole keto diet. High protein, high fat, high carbohydrate, low protein, low fat, low carbohydrate. It's probably based on your body's needs. And there's maybe more that we don't know about it than we do know about it right now, but we're learning fast. And that could be a whole nother podcast, because I am an expert in these different diets. But the thing is, and I've tried them all, and the keto diet, I've tried it, and it's like, kind of gross eating all that fat. But it does work for some people. Not everybody happen to eat a high carbohydrate diet because I eat mostly just plants, but I eat kind of plants that don't lead to high glycemic load, so they don't bother me. Like, my genetics are predisposed not to eat a lot of animal products or fats. So we're all different and we can figure that out and make you healthier. So what I'm excited about is being able to, you know, our customers are coming in wanting to do some kind of procedure to lose weight. You know, we do things like we put a balloon in people's stomach. It's called Orbera, so they're not as hungry. It's an alternative to stomach surgery for the person that's really overweight. Two minor procedures that are more cosmetic, like liposuction or doing the emsculpt to stimulate the muscle growth and burn fat. Coolsculpting. But when you do that by itself, it's just not enough. So we got to figure out what's the underlying problem. In fact, you know, if somebody comes in, they say, you know, I've got unlimited amount of money. I want you to coolsculpt or emsculpt or liposuction my whole body. If they don't make a change in lifestyle, we're not going to do it because nothing will happen. You Take somebody who weighs, let's say, 150 pounds, and they're at a stable weight for five years. Okay, now we go and do surgery and we take out three pounds of fat with liposuction, which is about six quarts. That's the most you can take out. So we're taking out three pounds of fat, and they're still eating like 150 pounds. And we took off three pounds or 147. They will grow back to 150 pounds. It might not be in the area we did liposuction at, but that homeostasis will reoccurrence, I think, about 96 or so. There was a study by American Academy of Plastic Surgery. They looked at people who had liposuction in America, and they found that about 40% of them within six months gained 10 pounds after surgery because they weren't selected properly. These were people that were gaining weight. They went to see a surgeon to solve a eating or exercise or metabolism problem, and there was a wrong procedure for them. So we want to combine. We might do a liposuction or some of these other procedures, but we wanted to combine it with realistic issues. Then the bigger issue, I think, is this type of fat. Do you have this Android or belly fat, inner belly fat, visceral fat, or do you have gynecoid fat? Gynecoid fat is very amenable to cosmetic procedures, and it's really not unhealthy fat. We want you to keep the weight off. Once we do it in the Android fat, there's nothing we can do from a medical procedure. Although we're seeing some changes with some of the newer things. We can burn some visceral fat or Android fat. But in general, this is something that you got to do by adjusting your lifestyle. And without it, you're just going to maintain sort of the dangerous, lousy, inflammatory fat, and it's a killer. If we look at things like obesity trends, they track the same thing that cardiovascular morbidity or complications occur. Cardiovascular things like strokes and heart attacks and diabetes in the way the pathway is genetic predisposition, which most of us as human beings, we are genetically predisposed because of a natural selection to get obese. That's just the way it is. I mean, that's something that's maybe sad, but that we can. You can thank your prior generations that survived famines, that we go from periods of famines to feasting. The feasting makes us that, and we select the dead out. So we just have it. Not everybody has, most of us have it. And if we eat too much and don't exercise enough, we start growing. Once we start growing, we start getting visceral fat or Android fat, or belly fat or beer belly fat. So that stuff that makes your stomach protrude. And once we get that, we get what we call a metabolic syndrome or syndrome X is different term swore, but it's where your fat is starting to cause inflammation, starting to lead to things like we call insulin resistance, where your body no longer responds well to eating carbohydrates, particularly simple carbohydrates, starches, bread. And then we start developing diabetes, and then we start developing heart disease or stroke. But any of those things are preventable. And what I want to focus on is that if you knew it, would you do something different? And there's a concept of motivation, and there's three factors that determine if somebody would change their behavior or not. And one is whether or not the consequences are positive or negative, certain or uncertain, or immediate or remote. And if your doctor says to you, well, you probably should slow down in your eating because you might develop a heart attack in 10 years, that's pretty not too helpful. But we measure you and we say, you've got too much visceral fat, which means you have metabolic syndrome, and you will get a heart attack or a stroke. Now it gives my attention and I'll make some changes. And then I can also say, and let's check on how you're doing in two or three months. That's positive, that's immediate, and that's certain. This is really how we can look at human behavior and how we can change. Because right now I think we're looking at healthcare. The advances are gonna be in immediate gratification. Right now I'm wearing an implantable blood sugar monitor, and I don't have diabetes, but everybody in my family does. And this little device called a Freestyle libre, and you pop it in your arm, lasts about two weeks. A little needle goes in a muscle, don't feel it. And I take my phone, I can check my blood sugar periodically, and it actually measures it continuously. And I found that if I ate bread at the restaurant waiting for dinner, my blood sugar was really high. But if I'm eating, I have a little bread with it. Nothing happens. Okay? Behavior change, just real freaking simple. Very simple. Because we know when your blood sugar spikes up high, our body creates a process called methylation that makes our cells age, makes actually makes our DNA age. We measure age of DNA by how many methyl groups are on it that's how we measure. It's called the Horvath clock. These are things we're seeing and the more proximate, like immediate, more certain, more positive, we'll see changes. So I'm seeing that I can person go to Tony's place and get their body fat measured and they realize they got a little Android fat and we're going to make these changes and we'll bring back in in a month or two months. Immediate, positive, certain. They see a positive change, that change will continue and then the desire to eat the way you were before will actually go away. One of my friends, he's a good friend of mine and he was eaten by all means healthy. He lost 40 pounds through watching his diet and he had a stress test and he wound up having a heart attack. Well, they did the wrong test with a stress test. What happens if we could have measured and said you are going to get a heart attack in the next five years, I could have changed his behavior and realized the diet he was eating was not the right one. This we want to do not just for our medical practice, but for our state and then for our country is change the way change the dialogue about health and giving people control versus going to your doctor every quarter until you have diabetes and now they give you a drug. That's the common right now modern US healthcare is actually disease management. It is not. Healthcare is kind of a bad word. So much be like cure, not get those words. Don't how much you want to pay for your insurance, not get, you know, or this is word sounds stupid. So we say healthcare but really just managing diseases. They do not. In fact, if you look at the Affordable healthcare Act in 2011, they had to mandate screening for cancer because insurance companies weren't required to screen for things. Okay, we had to pass a law. We don't pass a law to screen for diabetes or heart disease because we can pick it up 10 years in advance. So if we do a test on Android fat, we find out you've got a couple pounds of Android fat, belly fat, visceral fat, you're gonna get diabetes. And this is real obvious. We have unlimited amount of data supporting this. So how can we change behavior versus waiting for you to get the diabetes and then giving you a pill and managing your diabetes until you have a heart attack. Then we manage your heart attack, then we manage your premature death. So I know it's kind of gruesome, but you are special, as we said earlier.

Thank you.

You are special. Tony. Tony, tell us about your Typical client. Who do you see? Do you see everyday people? Do you see people who are always in shape or out of shape?

So, and that's some great insight from Dr. Mo. The doctors are getting fed up with the healthcare system too. And we know that there are a lot of people with heart disease and type 2 diabetes. This can be solved through lifestyle. And that's really the message here. But from the standpoint point of who we see at fitbody, it's really the majority of our clients are middle aged people that are just trying to get in better health, they're trying to lose weight, they're just trying to be better. And what happens is a lot of people get fixated on the scale. We push that to the side. A female could be 5, 8, 150 pounds and be super fit and super lean or she could have very high body fat. So we try to make the scale very secondary. So we look at what's going on on the inside. So that's very important. But you know, generally we do see some athletes, we see some physique competitors, but probably 80, 90% of what we see is people just trying to get in better health that have struggled over the years. They've tried diets, diet after diet. That doesn't work. And what we do is the first thing is the DEXA scan is when they get that DEXA scan it can be very surprising information. Somebody that might think they're 15 or 20% body fat, they might be 30 or 40% body fat. So it's really eye opening. But from the standpoint of visceral fat, that's a fork in the road, life changing moment. When I see that I have four or five pounds of visceral fat and then I'm at risk for a heart attack. If I'm not going to do something, then chances are I'll never make a change in our lifestyle. So it's really important. So, so we give them that information which can be surprising or shocking at the beginning and then we give them lifelong tools to make changes. I think people make it way harder than it has to be. So applying the science, applying long term tools, using macronutrient programming, because it's not about calorie, major calorie deficit, it's about eating good quality foods, eating them at the right quantity and hitting those macro numbers and if you can really come close to that, it will change your life. And we've seen people in three or four month periods of time that have very high body fat, high visceral fat, have completely Gone out of the risk zone just by lifestyle changes.

That's wonderful. Dr. Moka, I want to go back to you for a second. Can we talk about Emsculpt? A lot of people don't know what that is.

Yeah, thanks. That's something I'm kind of excited about it because it's the first, I think biologic hack since the gym for getting muscular and burning fat. So, you know, we have think about our history, our ancestors, we were designed to be active all the time, either running from threats or get figuring out how to eat. And then we got better food supply really in the 50s and 60s. And then we had more sedentary jobs, less physical jobs, which is nice for our lifestyle but not necessarily nice for our bodies. So we started using the gym. That's kind of a new concept of going to the gym and working out. And now we're learning there's all kinds of things we could do at a gym to be more effective. You've heard of hit or high intensity interval training or blood flow restrictive training. It's really kind of exciting, even like the way we exercise. There's been a lot written on this and a lot of research into it. We also found that. What happens if we can take a device that can cause muscle contractions without any effort and do it at a extremely high intensity and make it not hurt while you're just laying there? What would happen? Well, there's a device that first got FDA cleared about a year and a half ago. It's called Emsculption. And he uses an electromagnetic pulse. It's like a disc, almost like a medium sized dinner plate. And it sits on your abdomen or your butt or different ones for different muscles. And it sends it in a half an hour, sends through 20,000 what's called super maximum contractions. Contraction is harder than you can do on your own. And you just kind of lay there and you feel this tightness over a period of about a half an hour. And it's these pulses that are going on very, very fast. And it's. I wouldn't say it's painful or uncomfortable. It just feels weird. Very weird. And when we first do it, we usually do it four times. You do it at a lower energy and we crank it up over the first 10 minutes or so. Because you got used to that weird feeling. Yeah, not painful, intense and weird, but very tolerable. And you do this four times over two weeks and we see a 20% increase in the muscle thickness and a 20% reduction in the immediate area of Fat. And we've also noticed is that people that do have Android fat or visceral fat, they typically don't have a lot of subcutaneous fat on their stomach because it's on the inside. They also lose that. So that's pretty exciting is that we want to see how we track these people along. We add in to lifestyle, diet and exercise. Can we add in an external device that takes no effort? That is intense. It takes no effort. How far can we take this? How far can we maintain it? That's pretty exciting. There's other things we can do as well, like maybe optimizing your hormones, optimizing your exercise based on your genetics. We've actually there's ways that you can check your genetics and see what type of exercise can benefit you most, what time of the day you should. So a lot of things we'll see in personalized medicine that can really make us. I think realistically we're looking at much more. My number is 153. That's how long I tend to live. And I had to backwards engineer how to make it happen.

If anyone can do it, I'm sure it's.

I mean, realistically, I've done things where I measured my genetic age and my cardiovascular age and my brain age, and I've reversed all of them for the last three years. So I'm getting younger. I still don't have any hair, if I can get the hair one. So I don't really know that hair is definitely a problem. The gray and the baldness, you know, it's kind of like I'm just kind of stuck with that. But the other stuff, I'm going to fix the things that really matter. So I'll be a 153 years old with no hair and bald like I am now. But the reality is this stuff is coming, the technologies are coming, and there's things we can do to see if we can break the concept that we're supposed to get diabetes, get heart disease, get neurocognitive decline, which I think is the biggest risk we'll have next brain decline, and then go to nursing home or assisted living and die. I think we'll see that really shift in the next few years as we have more control. Because in the past, we would go see a doctor to manage the disease. Now, what can you do to not get it in the first place?

Right. All a very interesting, fascinating concept. And I want to thank you both for being here. Thank you, Tony Orlando and Dr. Moak. And for more information on what we've been talking about today. You can go to our website. It's alluremedical.com. thanks for listening to Inside the Cure with Dr. Charles Moak. See you next time.