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Published: Winter 2013
Ernest Croft may have retired, but he never stopped working. He stepped down from the phone company
after 30 years of service, only to start his own business in Crystal River. Like “AAA on the water,” his
company tows boaters who break down on the gulf. Though the work keeps him physically active, Ernest still
battles some serious health issues.
Ernest Croft
“I’m what they call a Type two diabetic,” he relates. “I’ve been treated for it now for about the last twenty
years. I haven’t been on insulin; I’ve been on pills.”
Ernest remarks that he was not particularly concerned about his diabetes, but admits he was not very
knowledgeable about the disorder.
“I had never been talked to about diabetes, so I didn’t know much about it. I’ve had the sugar machine around
here for years, but I never used it. I was not monitoring it because I didn’t feel like the diabetes was that bad.”
Diabetic and significantly overweight, Ernest discovered Eihab H. Tawfik, MD, and the Citrus Diabetes
Treatment Center when his personal physician retired. Dr. Tawfik is a board-certified internist who makes
weight loss and diabetes management central to his practice. At both Citrus Diabetes Treatment Center and
Hernando Diabetes Treatment Center, Dr. Tawfik offers individualized programs designed to help patients
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lose weight, manage medications and develop better, healthier lives.
It was the weight loss program that initially attracted Ernest, but Dr. Tawfik’s first order of business for him
was diabetes education.
“They assigned me a nurse for diabetes schooling,” Ernest recalls. “I had several meetings with her where she
explained diabetes and how it worked. I went through the training, and they taught me how diabetes can
affect you.”
Diabetes education
Type 2 diabetes is the most common form of diabetes, affecting 90 percent to 95 percent of the 26 million
Americans with the disease. Unlike Type 1, with Type 2 diabetes, the pancreas makes insulin, a hormone that
helps glucose get into the body’s cells to use for fuel. However, with Type 2 diabetes, the body either doesn’t
produce enough insulin or doesn’t use the insulin it does produce properly. As a result, a high glucose level
builds up in the blood, which can lead to serious complications with the heart, eyes, kidneys, nerves, gums
and teeth.
Type 2 diabetes is a chronic disorder that usually develops slowly over time. It is generally diagnosed in
adults, most often in those who are overweight because increased fat makes it more difficult for the body to
use insulin correctly. Age, family history, low activity level, poor diet and excess body weight, especially
around the waist, increase the risk of developing the disease.
Type 2 diabetes cannot be cured, but it can be managed. Eating a healthy diet, exercising and maintaining a
healthy weight may be all that’s necessary to keep blood glucose levels in the target range. When this is not
enough, a person with diabetes may need to take medications or use insulin therapy.
Diet is a critical factor in maintaining glucose control and managing weight. By eating a healthy diet, a
person with diabetes can better control the level of glucose in his or her blood. Making wise food choices can
help the diabetes patient feel better, lose weight and lower the risk of complications.
With a new understanding of his disorder and how food affects it, Ernest was now ready to tackle his weight
challenge. He had tried dieting and losing weight on his own over the years, only to gain back any weight
lost, and more.
“I was on a calorie diet and got down to two hundred eighty, which was my weight when I retired from the
phone company,” Ernest admits. “But then, my weight jumped right back up, and I put it on harder.”
He was tipping the scales at well over 300 pounds when he began the Physicians Weight Loss program.
About the program
Dr. Tawfik notes that the weight loss component of his practice has been effectively assisting patients for
approximately five years now. Based on a combination of appetite suppressant medications, vitamin
injections, and a diet program specifically tailored to each individual, patients notice dramatic weight loss
results quickly.
“Patients typically lose up to ten pounds in the first week,” Dr. Tawfik says, “with an average weight loss in
four weeks ranging between twenty and thirty pounds.”
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Ernest discovered many benefits
from his weight loss.
Statistically, obesity is defined as an excess proportion of total body fat. A person is considered obese when
his or her Body Mass Index (BMI) is equal to or greater than 30. Too much body fat can lead to a host of
distressing health issues.
Additional health conditions that can arise from being overweight can include heart disease, stroke,
osteoarthritis, gallbladder disease, asthma and sleep apnea.
“Our program not only changes our patients’ eating habits, but it also supports the development of a longer,
healthier life,” explains Dr. Tawfik.
At Citrus Diabetes Treatment Center, non-diabetic weight loss patients see Dr. Tawfik’s registered nurse on a
weekly basis. She gives them vitamin injections, takes their vital signs and manages their weight loss. The
doctor sees his non-diabetic weight loss patients once every four weeks.
“During our first consultation, we meet with our patients and review their medical and dietary histories. We
perform an EKG, take their weight and body fat measurements; prescribe applicable medications,
supplements and injections; and design an exercise and diet program tailored to meet their individual needs
and goals.”
According to Dr. Tawfik, the program is a combination of healthy eating, exercise and the proper dose of
appetite suppressants to help control a patient’s metabolism. The eating program begins with five days of
very lean protein followed by five days of higher-calorie protein – lean as opposed to very lean – giving
patients more menu options from which to choose.
“Our medications suppress the appetite significantly and increase the metabolism,” the doctor notes. “When
the metabolic rate goes higher, patients are basically burning fat cells to accommodate the high metabolism.
They’re eating less and getting rid of more.”
Non-diabetic and diabetic weight loss patients alike are monitored regularly. Another crucial component of
his practice, Dr. Tawfik assures, is that patients receive medical check-ups while they are on the weight loss
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program. “When they come to the office for their diet injection, we measure heart rate, blood pressure,
etcetera. If there’s even a slight increase in those areas compared to the last visit, it becomes a medical visit.”
Such instances are rare, the doctor stresses, but the ability to respond to medical concerns immediately is an
important benefit of choosing Citrus Diabetes Treatment Center and Citrus Physicians Weight Loss.
Diabetes and weight
“Approximately fifty percent of our weight loss patients have diabetes,” states Dr. Tawfik. “It’s a real danger
to be obese if you are already diabetic, or if not, there’s the risk of developing the disease because of the extra
weight.”
For his diabetic patients, Dr. Tawfik says treatment typically necessitates a visit to the office every week. “As
patients lose weight, their insulin requirements decrease, so it becomes critical to make the proper
adjustments.”
Additionally, the doctor shares, unlike most of the traditional diabetes medications that often make patients
gain weight in the long run, he is particularly pleased with the results of the medication called Victoza, an
injectable insulin that helps to regulate blood glucose.
The drug obtained FDA approval in early 2010, acknowledges Dr. Tawfik. It is a member of a class of drugs
known as incretins, which are gastrointestinal hormones that increase insulin secretion.
“One of the main jobs of incretins, once they are secreted by the small intestine in response to food, is to
increase insulin production from the pancreas and slow the absorption of glucose from the gut,” he reports.
This helps to regulate the amount of glucose in the blood.
In the end, the results include better glucose control, in addition to weight loss.
“Weight loss for patients with diabetes can make all the difference,” Dr. Tawfik affirms. “And in some cases,
patients can eventually be freed for life from insulin injections or other diabetic medications, if the weight
loss is significant enough.”
The many benefits of weight loss include increased energy level, reduced blood pressure, reduced aches and
pains, improved breathing, better sleep, and increased mobility.
Weight risks
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Leon Williams
As Leon Williams’ weight increased, so did his health complications. He was sluggish and slept all the time,
he was falling, his blood pressure was out of control, and he developed Type 2 diabetes. It had an impact on
his lungs and breathing as well. He was on supplemental oxygen and was prone to pneumonia. Leon’s joints
were also affected, making it difficult for him to walk; he had serious damage to his knee. His weight
contributed to the formation of benign tumors, one of which led to the development of lymphedema in his
groin. Leon effectively became disabled. At this point, he weighed more than 400 pounds.
Leon admits he has been struggling with his weight most of his life, but now he found himself at a critical
juncture.
“My wife and I were talking about it,” Leon recalls. “I told her that I’ve got to lose weight. I don’t want to
die, plain and simple, I don’t want to die. If I don’t lose weight, that’s what’s going to happen.”
Leon tried to lose weight on his own, and he tried several weight-loss clinics. Nothing produced lasting
results. He says it was by chance that he found Dr. Tawfik and Citrus Diabetes Treatment Center. Finally, he
also found success.
“I’ve lost one hundred and twenty pounds,” he says happily. “It actually didn’t take me a year to lose it. I
need to lose probably another one hundred pounds. I need to get down to the low two hundreds.”
He praises the staff of the Diabetes Treatment Center, with whom he is working very closely. With their help,
he is managing not only his diabetes, but some of his other conditions as well.
“I probably will be coming off of the diabetic medicine soon,” Leon offers. “I’m coming off of the oxygen
real soon and the blood pressure medicine, I’m hoping.”
Leon likes to crow about his new look whenever he can. He has some before and after photos that he likes to
show to friends to get their reactions.
“I’ve actually got a shot I’m really proud of, and every chance I get I show people. They look at it and say,
Oh, my gosh! What did you do? How did you do that?”
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A plan that works
Most patients are surprised by the effectiveness of the program, Dr. Tawfik shares. “Their first impression is
often, Wow, how could I do that? There is no way. But then they come back a week later and say, Doc, I
couldn’t believe it. Those medications worked.”
Leon likes to show off his
weight loss accomplishments to
his friends.
Ernest and Leon are good examples of the effectiveness of Dr. Tawfik’s program. Each has achieved
significant weight loss and has his diabetes well managed.
“It was amazing. They put me on some pills that made me not hungry,” Ernest describes. “I’ve lost over one
hundred pounds, and I want to get down to [weighing] two hundred pounds. It’s been about five months now.
It’s a work in progress.”
The program has also helped Ernest keep his diabetes under control: “My sugar has been normal ever since
I’ve been on the diet.”
Leon is especially proud of his new body.
“My wife went out and bought me two pairs of jeans,” he relates. “I wore them once. I can’t wear them
anymore. They’re too big.”
Ernest enjoys the collateral benefits that come from dropping so much weight. A new medication has eased
the pain in his knee joints, but he also credits the weight loss for contributing to his relief and mobility.
“When I was overweight, I was toting enough weight for two people.”
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