Obesity hypoventilation syndrome (OHS), also called Pickwickian syndrome, is a breathing disorder that affects some children and adults who suffer from obesity. The disorder can make it difficult to breathe, which can cause low oxygen levels and high carbon dioxide levels in the blood. Left untreated, OHS can be life-threatening, as it can lead to serious issues with the heart and blood vessels, as well as disability and death. Fortunately, OHS symptoms can be reduced or eliminated entirely with treatment. 

What Causes Obesity Hyperventilation Syndrome?

OHS is linked to being overweight or obese, but it’s unclear why the disorder affects some people and not others. There are three main components of OHS:

  • Obesity
  • Daytime hypoventilation (breathing too slowly or shallowly to adequately supply the body with oxygen)
  • Sleep-disordered breathing (such as obstructive sleep apnea)

Extra fat on the neck, chest, or abdomen can affect the ability to draw in deep breaths; additionally, it’s believed that the fat accumulation in these areas can produce hormones that affect the brain’s breathing regulation. Insufficient oxygen in the blood and excess carbon dioxide can also result in delayed nervous system response.

What Are the Symptoms of OHS?

Many of the symptoms of OHS overlap with those of sleep apnea. These include:

  • Breathlessness
  • Morning headaches
  • Feeling sluggish or sleepy during the day
  • Dizziness
  • Fatigue
  • Poor sleep quality
  • Depression and irritability
  • Loud, chronic snoring
  • Snoring that’s interrupted by choking or gasping
  • Memory or concentration issues
  • Fast, shallow breathing
  • Bluish or reddish-colored skin
  • Signs of right-sided heart failure, such as swollen feet or legs, shortness of breath, feeling tired after little effort

OHS can also cause high blood pressure (hypertension) or high blood pressure in the lungs (pulmonary hypertension). 

How is OHS Diagnosed and Treated?

To diagnose obesity hypoventilation syndrome, your healthcare provider will take a complete history of your symptoms, determine your mass body index (BMI), and assess your oxygen and carbon dioxide levels with a blood test or a pulse oximeter; having a high carbon dioxide level in your blood while awake helps distinguish OHS from obstructive sleep apnea. Additional tests, such as a chest x-ray, pulmonary function tests, or a sleep study may also be recommended to rule out other causes and determine the severity of your sleep apnea. 

If you’re diagnosed with OHS, your healthcare provider may recommend lifestyle changes to promote weight loss, such as increasing physical activity and eating a healthy balanced diet. In some cases, a continuous positive airway pressure (CPAP) machine or other breathing devices may be recommended at night to improve your breathing and oxygen levels while you sleep. 

To prevent complications, it’s essential to follow your healthcare provider’s instructions and to notify them of any new symptoms you experience, such as chest pain, swelling, wheezing, or lightheadedness. Let them know if you plan to travel by plane or undergo surgery, as these can increase the risk of serious complications. 

Get Support for Your Symptoms

If you’re currently at risk for OHS or you’ve noticed symptoms that suggest you have the disorder, it’s important to understand that there are many steps you can take right now to prevent or reverse it. Losing weight, eating a healthy diet, increasing your activity levels, and addressing issues like sleep apnea is very effective in avoiding this serious health condition, as well as other obesity-related conditions like heart diseasehigh blood pressure, and some cancers. 

However, it can feel difficult to know where to start or how to stay on track with your new lifestyle. If you’ve been struggling to lose or maintain a healthy weight, contact Dr. Jennifer Hubert. Her customized medical weight loss plans have helped many patients reclaim their health. Dr. Hubert takes a holistic approach to weight loss, with behavior modificationnutrition counselingmedical monitoring, and other tools to help you meet your weight loss and health goals. Schedule your consultation today at (707) 575-8446. 


Obesity is linked to several serious health conditions, including heart disease, high blood pressure, type 2 diabetes, and some cancers. Several studies have shown that being obese or overweight also increases the chances of developing urinary incontinence —especially for women.

What is Urinary Incontinence?

Urinary incontinence refers to the unintentional loss of bladder control, which usually leads to urine leakage. There are several different types of urinary incontinence:

  • Stress urinary incontinence: Leaking urine due to extra pressure on the bladder or pelvic floor muscles, such as laughing, sneezing, coughing, lifting heavy objects, or exercising
  • Overactive bladder: Feeling like you need to urinate 8 times or more in a 24-hour period
  • Overflow incontinence: Difficulty emptying your bladder completely, which can cause urine leakage throughout the day
  • Mixed incontinence: Experiencing a mixture of the above types of incontinence

While urinary incontinence can affect men and women, women are two times more likely to develop the condition than men. Urinary incontinence affects nearly 50% of middle-aged and older women worldwide, with varying severity. 

What’s the Link Between Obesity and Urinary Incontinence?

Although age and sex are risk factors for developing urinary incontinence, there’s a high correlation between obesity and urinary issues. Urologist Dr. H Henry Lai found that nearly 60% of the patients who were seeking treatment for urinary incontinence or an overactive bladder were obese. Although diabetes and high blood pressure can also be risk factors for urological issues, both of these conditions can be caused by obesity. Studies have found that for each 5-unit increase in body mass index (BMI), there’s a 60-100% increased risk of developing urinary incontinence. 

There are several reasons why obesity can cause urinary incontinence. First, excess weight can contribute to weakened muscles surrounding the bladder, which can make it harder to control urination. Excess body fat also creates inflammation throughout the body, which can cause muscle weakness and nerve damage over time. There is also more pressure on the abdomen, which can cause urine to leak from the bladder. 

How Can You Reduce Your Risk?

Beyond age, sex, and body weight, there are several other risk factors that can increase the chances of urinary incontinence:

  • Pregnancy and childbirth
  • Menopause
  • Enlarged prostate
  • Prostate cancer
  • Urinary tract obstructions
  • Neurological disorders, such as multiple sclerosis, Parkinson’s disease, stroke, brain tumor, or spinal injuries

If you’re already at risk of developing urinary incontinence, it’s important to be mindful of your BMI (body mass index). If you’re already overweight or obese, studies have shown that even losing a small amount of weight can reduce your risk and provide overall health benefits. A weight loss of around 8% (typically 15 to 20 pounds for the average woman) can reduce weekly urinary leakage by about 47%. 

To lose weight or maintain a healthy weight, be sure to eat a balanced diet that includes a wide variety of foods, including vegetables, fruits, low-fat dairy products, whole grains, lean meats, and other sources of protein. Avoid high-calorie foods that are low in nutrients, such as highly-processed or fried foods, refined carbohydrates, and fatty cuts of meat. Drinking plenty of water will also help you stay full, so you don’t overeat. Limit or avoid sugary, high-calorie drinks, like soda, fruit juice, alcoholic beverages, and sports drinks. 

In addition to a healthy, well-balanced diet, you should also make sure to get regular exercise. Exercise helps increase your metabolic rate, which helps your body burn calories more efficiently throughout the day. Regular exercise also helps improve heart and lung function, which makes it easier to stay active. Although exercise needs are different for everyone, research has shown that eating a healthy diet combined with 60 minutes of activity four times a week can help most patients lose around 1-2 pounds weekly.

Meet Goals with a Medical Weight Loss Plan

Whether you already suffer from urinary incontinence or you’d like to be at a healthier weight, it can be difficult to know where to start. Dr. Jennifer Hubert offers customized medical weight loss plans that take a holistic approach to your health. By combining medical monitoringnutritional counseling, and behavior modification, she’ll help you identify the best ways for you to lose weight—and keep it off. Schedule a consultation today at 707-575-THIN (8446)


Obstructive sleep apnea (OSA) is a disorder that’s becoming increasingly prevalent around the globe, with approximately one in five people affected in the United States. One of the primary conditions linked to sleep apnea is obesity—along with type 2 diabetes, hypertension, and hypercholesterolemia. Research has shown that being obese increases the risk of developing several respiratory conditions, such as asthma, OSA, and obesity hypoventilation syndrome. 

By learning more about the relationship between obesity and sleep apnea, you can better understand your risks, as well as when to see a doctor about your quality of sleep and nighttime breathing. 

What is Obstructive Sleep Apnea?

There are several different types of sleep apnea, but obstructive sleep apnea is the most common. With OSA, an individual’s throat muscles intermittently relax while they sleep, causing the airway to become blocked. A person with OSA may stop and start breathing multiple times while sleeping and have low oxygen levels throughout the night 

Obesity is directly related to OSA because it can cause fat deposits to develop in the upper respiratory tract. These deposits narrow the airway and decrease muscle activity When this happens, the amount of oxygen available in the body for the tissues and blood vessels decreases—a condition called hypoxia, one of the main contributing factors of atherosclerosis (the primary risk factor for heart disease). 

What Are the Symptoms of Sleep Apnea?

It’s very common for patients with sleep apnea to snore loudly and experience excessive sleepiness throughout the day. While these are certainly unpleasant, the more concerning issue is that sleep apnea is linked to many other medical conditions, including high blood pressure, heart attack, and stroke. Other symptoms of obstructive sleep apnea include:

  • Periods of stopped breathing while sleeping
  • Waking up abruptly while gasping or choking
  • Morning headaches
  • Mood changes, like depression or irritability
  • Difficulty concentrating throughout the day
  • Decreased libido
  • High blood pressure

In some cases, you may not be aware of breathing issues while you sleep, so it’s important to talk to a doctor if your partner or other family members mention that you’re snoring loudly, gasping for air, or have other breathing disturbances throughout the night. 

Risk Factors for Sleep Apnea

There are a number of risk factors for developing sleep apnea, but the most important ones are related to age, sex, and weight. The risk of sleep apnea increases with age but generally tends to level off around the age of 60 or 70. Men are two to three times more likely of developing sleep apnea; however, the risk of sleep apnea goes up for women after menopause. Being obese (having a BMI of 30 or higher) also increases the risk. 

Other risk factors include

  • A naturally narrow airway
  • Enlarged tonsils or adenoids
  • High blood pressure 
  • Chronic nasal congestion
  • Smoking 
  • Diabetes
  • Asthma
  • A family history of sleep apnea

Neck and waist circumference, as well as waist-to-hip ratio, are also important considerations when assessing the risk of sleep apnea. A neck circumference of 17 inches or more for men and 16 inches or more for women, for example, raises the risk of both obesity and sleep apnea. The greater a person’s hip-to-waist ratio, the higher the chances of developing sleep apnea or other obesity-related health conditions. The way fat is distributed also plays a role; a high amount of fat in the abdomen is a greater risk factor than having a higher fat accumulation on the hips and thighs. 

Interestingly, it’s also thought that sleep apnea itself can cause weight gain, although no studies have proven this definitively. OSA increases the amount of leptin in the body, a hormone that’s responsible for helping the body recognize when it’s full. Nighttime breathing disruptions trigger the release of the stress hormone cortisol, which in turn affects the release of leptin. Over time, this can contribute to leptin resistance, which causes patients to feel less satiated and want to eat more. 

Another factor that can cause weight gain is the use of a continuous positive airway pressure (CPAP) machine, one of the most common treatments used for obstructive sleep apnea. Although it’s not clear why CPAP therapy causes some people to gain weight, many doctors believe the benefits of the treatment outweigh the risks. 

Treatment for Sleep Apnea

CPAP Machine

There are numerous treatments for obstructive sleep apnea, including oral devices, CPAP machines, and even surgery. However, many patients find the long-term use of CPAP machines and oral devices cumbersome and uncomfortable; likewise, many patients want to avoid more invasive treatments like jaw surgery or tissue removal. 

Fortunately, many lifestyle changes are very effective for milder cases of sleep apnea—and some of them have the benefit of also reducing weight. These include:

  • Maintaining a healthy weight
  • Regular exercise
  • Drinking alcohol moderately (if at all) and avoiding alcoholic drinks hours before going to bed
  • Quit smoking
  • Using a nasal decongestant or allergy medications
  • Sleeping on your side or stomach rather than your back
  • Avoiding sedatives, like anti-anxiety drugs or sleeping pills

If you’re overweight or obese, losing as little as 5-10% of your body weight has been shown to help reduce the severity of sleep apnea, and in some cases, prevent it from developing. Weight loss helps reduce breathing obstructions, improves blood pressure, and enhances overall health. 

Get Professional Guidance for Obstructive Sleep Apnea and Obesity

If you’ve been having trouble breathing at night or you struggle to maintain a healthy weight, you may benefit from a medical weight loss plan. Dr. Jennifer Hubert offers personalized weight loss plans that take a holistic approach to your health and weight loss challenges using behavior modification, nutritional counseling, and medical monitoring. Over the years, she has helped countless patients improve their health and overall sense of well-being through sustainable lifestyle changes. Schedule a consultation today at 707-575-THIN (8446)


Obesity is a serious health concern that’s associated with a number of chronic conditions, but it’s also one of the most common causes of back pain. In addition, being obese can also contribute to symptoms associated with osteoporosis, degenerative disc disease, osteoarthritis, spinal stenosis, rheumatoid arthritis, and spondylolisthesis.

How Does Excess Weight Affect the Spine?

Although some of the strongest muscles are found in the back, they can only handle so much weight and strain. For every pound a person weighs, it equals approximately 4 pounds of pressure on the spine, joints, cartilage, tendons, ligaments, and muscles. So if someone weighs 200 pounds, for example, they would have 800 pounds of pressure on their spine.

Excess abdominal fat can cause the pelvis and lower back to slant forward over time, creating a permanently arched back, which adds additional strain to the spine. The lower back (lumbar region) is particularly vulnerable to obesity-related back pain. If someone spends a lot of time sitting in a non-neutral position, the back muscles overcompensate—and more issues usually follow.

Beyond back pain, obesity can make existing musculoskeletal conditions (like herniated discs or osteoarthritis) worse and speed up their progression. This is due in part to adipose (fat) tissue causing chronic inflammation, which can lead to soft tissue degeneration. Obese patients who have spinal surgeries also tend to have a higher rate of complication and worse surgical outcomes than those who are at a healthy weight.

People who are obese or have a higher percentage of body fat are:

  • 33% more likely to have lower back pain
  • Up to 43% more likely to have chronic lower back pain
  • 35% more likely to experience severe back pain

Additionally, men are up to 50% more likely to have functional limitations or become disabled, while women are nearly 100% more likely to experience these issues.

To make matters worse, many people who suffer from obesity tend to avoid exercise due to fatigue and shortness of breath; this often contributes to further weakened back muscles and more intense pain. Over time, this can impact the ability to perform everyday tasks. For some patients, simply overcoming the fear of being in pain can be an important step in lessening it.

Am I Obese?

Back pain is strongly associated with BMI (body mass index), which considers one’s weight in relation to their height. Although the system isn’t perfect, it is a relatively good indicator of whether someone is at a healthy weight. According to the BMI, a score between 25 and 29.9 is considered overweight, while a score of 30 or above is considered obese. Approximately 36% of Americans are obese, and the number is climbing.

However, BMI isn’t the only important factor when assessing weight. It’s also important to look at where fat is stored in the body. Studies have shown that of all the areas that accumulate fat, it’s most harmful to have excess fat on the abdomen. This type of fat gets deposited around the internal organs, where it secretes hormones that are linked to serious health conditions such as metabolic syndrome, type 2 diabetes, heart disease, and high blood pressure.

Tips for Weight Reduction and Back Pain Relief

Before starting any weight loss program, it’s always a good idea to consult with a healthcare professional. When you have back pain, gentle, low-impact exercises, like walking or swimming, can help you ease into regular physical activity without straining your back or exacerbating your symptoms. It’s important to realize that some pain is to be expected as your body adjusts.

Other types of exercise you can do include:

  • Total body resistance exercise, which strengthens the major muscle groups
  • Lumbar extension exercise, which focuses on the lower back muscles
  • Pilates
  • Yoga
  • Stretching

Movement and exercise will foster blood flow and offer more relief from pain than things like bed rest or inactivity.

In addition to exercise, eating a healthier diet is an excellent way to lose weight. Focus on regular meals made up of fruits, vegetables, beans, nuts, lean proteins, and fiber-rich foods (like oats or brown rice) while avoiding foods that are overly processed and high in unhealthy fats. Pay attention to your portion sizes by using smaller plates and bowls. It’s easy to mistake thirst for hunger, so make sure you’re also drinking enough water each day.

Sleep can also affect your weight. When you’re short on sleep, it’s harder to get moving. You feel so tired that you tend to fall back on fast meals of processed foods. Research has shown that a lack of sleep can affect decision-making and impulse control, which can make it harder to make healthy choices. To help your weight loss efforts, aim to get around 7-8 hours of sleep each night.

Get Assistance with Your Weight Loss Journey

Back pain can make weight loss feel more daunting, but taking small steps to increase your activity levels while making other healthy lifestyle choices can help you reach a healthy weight and alleviate pain and discomfort.

If you’re not sure where to start or would like additional support on your weight loss journey, schedule a consultation with Dr. Jennifer Hubert. Dr. Hubert specializes in medical weight loss and takes a customized, holistic approach to her treatment plans. She focuses not only on helping you reach a healthy weight, but also on the prevention and improvement of a full spectrum of adult diseases like high blood pressure, diabetes, heart disease, and stroke. Schedule a consultation today at 707-575-THIN (8446).


Blood pressure meter and toy heart on light blue background

Since the pandemic began, doctors and scientists have been trying to understand why some people are at a higher risk of becoming infected with severe cases of COVID-19. Research has shown that one of the most significant risk factors is obesity. One study from England found a clear relationship between a body mass index (BMI) of 23 or higher and a heightened risk of being hospitalized. In the U.S., 78% of COVID-19 patients who needed hospitalization were overweight or obese.

To make matters worse, obesity rates have drastically increased in children and adults since the start of the pandemic, due to high levels of stress, lower activity levels, and dietary changes.

Understanding the Role of Obesity in COVID-19

Adipose (fat) tissue secretes adipokines and cytokines, two hormones that increase inflammation in the body and weaken the immune system. When patients are obese, they’re essentially in a constant state of heightened inflammation and immune dysfunction.

Recent studies have shown that the severity of COVID-19 is linked to what’s known as a “cytokine storm.” This refers to a hyper-activation of the immune system and cytokines in the body. In obese patients, the levels of pro-inflammatory hormones are already high, increasing the odds of developing a cytokine storm as a result of infection, an autoimmune condition, or other diseases.

Severely obese patients also have higher viral loads after exposure to COVID-19 than those who are at a healthy weight. Viral load refers to the amount of virus in a person’s body; the higher the viral load, the more infectious a person is. Likewise, obese patients have been found to have greater and more prolonged viral shedding—up to 48% higher and 42% longer than their leaner counterparts.

In addition, obese patients often need to be hospitalized for longer and take time to test negative. This indicates that not only does obesity increase the risk of transmission to other people, but it also increases the amount of time it takes obese patients to overcome COVID-19 infections.

Patients with obesity often experience other comorbidities that can increase the risk of hospitalization. Asthma is a common comorbidity for patients with obesity and a recognized risk factor in developing COVID-19, pneumonia, and other respiratory illnesses. Respiratory dysfunction and decreased lung capacity, for example, make being on a ventilator more challenging and predispose obese patients to hypoventilation-associated pneumonia, pulmonary hypertension, and cardiac stress.

Obesity is also associated with an increased risk of cardiovascular disease, kidney disease, and type 2 diabetes—all of which are known to increase the risk of pneumonia-related organ failure. Metabolic issues, such as hypertension, prediabetes, insulin resistance, and dyslipidemia, are also linked to an increased risk of pneumonia.

How to Protect Yourself Against COVID-19

It’s important for everyone to follow the CDC guidelines for COVID-19, but it’s especially critical if you’re at a higher risk of developing severe complications. If you’re obese, one of the best things you can do to protect yourself is to lose weight. Not only will this reduce the risks associated with COVID-19, but it will also help lower your risk of developing serious chronic diseases like heart disease, diabetes, high blood pressure, and some cancers.

Start by making small lifestyle changes, such as eating healthy meals, reducing your portion size, and increasing your daily activity. Avoid skipping meals, as this can lead to overeating later in the day. Stress and sleep also play a role in obesity, so developing good stress management skills and getting enough good-quality sleep is important for effective weight loss.

If you’re not sure where to start, or you’d like additional support on your journey, Dr. Jennifer Hubert offers personalized medical weight loss plans to help you stay on track and reach your goals. Dr. Hubert takes a holistic approach to weight loss, incorporating nutritional counseling, behavior modification, and medical monitoring. Her customized weight loss plans have helped countless patients regain their health and maintain a healthy weight. For more information, schedule a consultation at Dr. Hubert’s office today by calling (707) 575-THIN (8446).


Holiday weight gain is a valid concern for many adults; in fact, it’s not uncommon for many people to gain around 1-2 lbs. between mid-November and mid-January. On average, a traditional Thanksgiving dinner with all the fixings contains as much as 3,000 and 229 grams of fat per serving—more calories and fat than adults should eat in an entire day. Combine that with various other holiday get-togethers, busy schedules, overeating calorie-rich foods, colder temperatures, and more sedentary behavior, and it’s easy to see why holiday weight gain is a common issue.

Although 1-2 lbs. may not seem like a lot, most people who gain weight around the holidays never lose it in the new year. This means the holidays can cause an accumulation of weight year after year. Over time, holiday weight gain can be a contributing factor to obesity, heart disease, diabetes, and other chronic health issues. Fortunately, you don’t have to skip your favorite foods to stay on track with your weight. Here are some simple steps you can take to avoid gaining weight this holiday season.

Set Some Health Goals

Before enjoying the festivities, take some time to reflect on your holiday behaviors, like how much you typically eat and drink. Then, set some measurable goals to help you improve.

Weigh Yourself Daily

Daily weigh-ins have been shown to aid weight loss and help maintain a healthy weight. Being aware of fluctuations in your weight can increase your motivation to eat healthier and exercise more.

Track Your Exercise and What You Eat

Those who consistently track what they eat and their activity levels are less likely to gain weight during the holidays. For example, if you notice that you’ve eaten more calories than usual during a party, it can give you more motivation to eat healthier the next day. Likewise, monitoring your exercise can be a good way to remind yourself to stay active.

Eat Before Attending Parties

It can be hard to resist overeating at parties when you attend them on an empty stomach. Make sure to eat a healthy, filling snack before you go.

Stay Active with Your Friends and Family

After enjoying a holiday meal, many families do sedentary activities together, like watching TV on the couch. Instead, try to do some type of physical activity with your family, like taking a walk or shooting some hoops. You can also stay active during the holidays by participating in a workplace or community fitness event.

Make Healthy Modifications to Traditional Recipes

If you’re doing the cooking, switch out higher-calorie ingredients for healthier options. For example, replace the butter in baked goods with applesauce, mashed banana, or pumpkin puree and use dried fruit instead of chocolate chips or candies. While cooking, use herbs and spices to flavor dishes and utilize healthy methods like baking, steaming, or grilling instead of frying. You can also flavor your beverages with fresh-squeezed lemon or lime juice, or extracts like vanilla, almond, and peppermint.

Don’t Over-Do the Taste Tests

If you’re cooking for others, it’s always a good idea to taste your dishes—but all you need is a tiny bite. Although taste testing may not seem like a big deal, even small bites of holiday dishes can add up. It’s also a good idea to make sure you’re not hungry while preparing meals because it’s much easier to go overboard with taste testing.

Make Healthy Selections

When faced with a big holiday spread, opt for healthy choices. Fill half of a small plate with vegetables, a quarter of the plate with lean protein (like turkey or chicken), and the remaining quarter with starches or grains. If you have the option, choose whole grains. Avoid eating things that are smothered in a heavy cream sauce or fried.

Choose Healthy Beverages

High-calorie beverages such as punch, eggnog, and alcohol can be contributing factors to weight gain during the holidays. Alcohol, in particular, can increase your appetite and cause you to take in more calories than you typically would. Choose healthy low-calorie drinks instead, like sparkling water.

Eat Mindfully and Skip Seconds

The sights and smells of holiday foods can make it easy to overeat—especially when you’re distracted. To prevent this, avoid eating when you’re in the middle of a conversation or watching TV. Be mindful while eating and allow yourself to truly taste and savor the foods. Avoid grabbing seconds and remember that it takes 25 minutes for your brain to register you’re full. If you want to have dessert, choose a single dessert item (rather than sampling everything on the dessert tray) and reduce the amount you eat during the main meal.

Get Support from Friends and Family

Research has shown that having someone to provide encouragement and accountability can help prevent holiday weight gain. Ask a friend or family member to send you a reminder about tracking your food intake and activity levels or tell them how they can help support your holiday health goals. Keep in mind that there are plenty of ways to enjoy the holidays that don’t involve food, like taking a walk to look at holiday lights, ice skating, taking an art class, a game night, or local community events.

Get Plenty of Sleep

Sleep deprivation is very common around the holiday season. When you don’t get enough sleep, it can make you feel hungrier, consume more calories, and be more sedentary. Sleep deprivation has also been linked to lower metabolism.

Control Your Stress Levels

Let’s face it; the holidays can be stressful. High stress levels can lead to chronically high cortisol, which can cause you to crave higher-calorie foods and contribute to weight gain. For this reason, it’s important to control your stress levels—especially during the holidays when there’s usually an abundance of unhealthy foods. Find a stress-relieving activity you enjoy and can stick with, such as exercise, yoga, meditation, or deep breathing.

Make Every Day Count

It’s easy to adopt an “I’ll start eating healthy tomorrow” mentality around the holidays, but this only prolongs unhealthy habits. Instead of procrastinating on your weight goals, make a decision to set limits for yourself, and don’t feel uncomfortable or guilty for saying no to unhealthy foods or habits. Keep in mind that you might also slip up a couple of times—and that’s ok. Simply pick up where you left off and make healthier choices at your next meal.

Get Additional Support for Your Weight Goals

Although it can feel daunting to maintain a healthy weight during the holidays, it’s not impossible. Following the above tips can help you stay weight conscious throughout the holiday season—they might even help you lose weight! If you feel you could use additional support, Dr. Jennifer Hubert offers holistic medical weight loss programs that have helped countless patients lose weight and lead healthier lives. Schedule a consultation today at (707) 575-THIN (8446).


As people age, it’s not uncommon to develop fat in the abdominal region; this is often due (in part) to the act that muscle mass tends to decrease with age as body fat increases. Although belly fat can affect self-esteem or the ability to fit into your favorite clothes, studies have shown that it has a significant impact on your overall health.

Health Risks Associated with Belly Fat

Excess belly fat has been linked to several serious health conditions, including:

Due to these risks, it’s important to not only monitor your weight, but also the accumulation of fat around your midsection. There are three types of belly fat, but visceral fat is the most worrisome. Visceral fat sits deep around the organs and has been associated with numerous health problems. Even if you’re at a healthy weight and BMI (body mass index) you can still develop an excess amount of visceral fat.

Exercises for Getting Rid of Belly Fat

Fortunately, adding more physical activity to your daily routine is a very effective way to reduce unwanted belly fat. Although spot-training is a myth—there’s no way to remove fat from only one area of your body—some types of exercise are more effective for belly fat away than others. Here are a number of exercises that have proven benefits for helping to slim your waistline.

  1. Crunches. Crunches rank as one of the top exercises for burning fat and strengthening your core. Lay down flat with your knees bent while keeping your feet off the ground. Place your hand behind your head or keep them crossed over your chest and raise your upper body towards your knees. Make sure to breathe at a steady, even, and controlled pace.
  1. Walking. Walking is a simple and gentle way to incorporate more exercise into your day; it also has a positive impact on your metabolism and heart rate. Even better, walking is an exercise that can be done without any additional equipment—and you can squeeze it in between breaks at work. Aim for a 30-minute walk and walk at a pace that elevates your heart rate.
  1. Swimming. Swimming is an exercise that works all parts of your body and helps with overall fat loss. You can find specific exercises to do in the pool, or simply spend time swimming for 20 minutes straight to keep your heart rate up.
  1. Zumba. Zumba is a fun, high-intensity exercise that can help you improve your cardiovascular health, burn fat, and lower blood sugar and cholesterol levels. One study conducted with 19 women between the ages of 18 and 22 found they burned an average of 9.2 calories per minute—significantly more than step aerobics, power yoga, advanced Pilates, and cardio kickboxing.
  1. Vertical leg lifts. Leg lifts are a great exercise for your abs and obliques, as well as reducing belly fat and toning your body overall. Lie down on your back and place your palms below your hips. Slowly raise your legs to a 90-degree angle. Make sure to keep your feet pointing at the roof and your knees straight. Pause for a moment, then lower your legs down while exhaling.
  1. Cycling. Cycling burns a significant amount of calories and raises your heart rate, so it’s a wonderful exercise for overall fat loss and strengthening the cardiovascular system.
  1. Burpees. Burpees work your core, chest, shoulders, lats, triceps, and quads—and they get your heart pumping. Stand with your feet shoulder-length apart and lower your body to the ground to do a squat. Place your hands down on the floor next to your feet and hop your feet backward, so that your chest touches the floor. Then, lift your body into a plank position and jump, placing your feet outside of your hands. Put weight on your heels and jump upward, keeping your arms above you.
  1. Mountain Climbers. Mountain climbers are moving plank exercises that work your core along with the hamstrings, shoulders, triceps, and quads. Start in a plank position with your hands placed directly under your shoulders. Pull your right knee to your chest, then bring it back into a plank. Do the same with your left knee, and then continue alternating sides.
  1. Side-to-Side Medicine Ball Slams. This is a dynamic exercise that doesn’t target any one muscle group, but it’s very effective in toning your obliques. Stand with your feet shoulder-width apart, with the medicine ball on the ground on one side. Pick up the ball and rotate your body to slam the ball down near the opposite foot. Pivot your feet and bend your knee to form a split squat position while catching the ball. Keep alternating sides, making sure to keep your core tight each time you bring the ball over and to the side.
  1. Incline Running. Running at a slight grade instead of a flat surface can increase your total calories burned by as much as 50%. You can run up a hill outside or use an inclined treadmill. Start by walking or jogging for 5-10 minutes and gradually pick up the pace; then, run for 5-10 minutes. It’s not necessary to sprint; you just want to make sure you’re working hard enough that it would be difficult to hold a conversation. Drop your pace back down to a jog; keep alternating between jogging and running with 5-10 minute intervals for around 30 to 45 minutes.
  1. Rowing. A rowing machine is an excellent way to increase your heart rate and exercise your legs, core, arms, shoulders, and back. Start with 20 seconds of rowing, then rest for 10 seconds. Repeat these steps 8 times and try to beat your previous distance. After completing a four-minute circuit, row 500 meters at a fast pace; make a note of the distance you rowed and try to beat it at your next workout.
  1. HIIT. Short, high-intensity workouts are among the most effective ways to burn fat. High-intensity interval training alternates between exercises that work different muscle groups, like squats, push-ups, kettlebell swings, and more. Start with a 10-minute warm-up, then spend 30 seconds doing as many reps of one exercise as possible. Rest for 30 seconds, then move on to a different exercise. Do this for 10 rounds. One of the great things about HIIT is that you can choose any of your favorite exercises—but make sure each one works a different set of muscles to allow the others to recover in between reps.
  1. Strength Training. In addition to cardio exercise, strength training can also help you lose fat and improve muscle tone. Try adding in some dumbbell squats, bicep curls, and dumbbell overhead lunges.
  1. Yoga. Although yoga won’t help you burn as many calories as lifting weights or HIIT workouts, it’s an excellent exercise for improving endurance and building muscle—both of which are essential for boosting your metabolism. There are many different types of yoga, but some of the most effective poses are the plank, chair, wheel, and Chaturanga.

Regardless of the exercise you choose, try to aim for at least 30 minutes of aerobic or cardio exercise daily. It’s also important to make sure you enjoy what you’re doing, so take some time to explore different excises to find ones you’ll be able to stick with. After all, you want to feel motivated to exercise and look forward to your daily routine!

Additional Support is Available at Dr. Hubert’s Office

Belly fat can be stubborn, and unfortunately, there are no quick solutions to get rid of it. Weight loss requireDr. Hubert’s offices effort, commitment, and perseverance. Making a point to exercise regularly is a highly effective way to reduce belly fat and improve your overall health and well-being.

If you’re not sure where to start or you’d like additional support on your weight loss journey, a medical weight loss plan can help. Dr. Jennifer Hubert offers personalized weight loss plans that take a holistic approach to your health and weight loss challenges. Over the years, Dr. Hubert’s weight loss programs helped numerous patients develop sustainable, healthy habits that help them lose weight and keep it off. For more information, contact Dr. Hubert’s office to schedule a consultation.


Dementias, including Alzheimer’s disease, are a growing concern worldwide. As of 2020, an estimated 55 million people were living with some form of dementia; that number is expected to nearly double every 20 years, reaching as high as 139 million people by the year 2050.

Belly Fat

Dementia remains a puzzle to the scientific and medical community, but recent studies have suggested there’s a potential link between belly fat and cognitive decline. Women, in particular, appear to have an increased risk. For older women, having excess belly fat was found to increase their risk of dementia by 39% within 15 years, as opposed to those with a normal waist circumference.

What is Dementia?

Dementia is a general term, rather than a single disease, that covers a variety of medical conditions—including Alzheimer’s. These conditions are marked by abnormal brain changes that cause a decline in cognitive abilities, as well as changes in behavior, feelings, and relationships that are severe enough to impact patients’ daily lives and their ability to function independently.

Dementia can present differently from person to person; some examples of symptoms include:

  • Difficulty keeping track of personal items, like wallets or purses
  • Memory issues, poor judgment, and confusion
  • Difficulty communicating or understanding speech or writing
  • Getting lost in familiar places
  • Repeating questions
  • Impulsive behavior
  • Losing interest in activities
  • Trouble paying bills or handling money responsibly
  • Hallucinations, paranoia, or delusions
  • Losing balance or other mobility issues
  • Taking longer to complete everyday tasks
  • Insensitivity to other people’s feelings
  • Using unusual words to refer to familiar objects

Many types of dementia are progressive; the symptoms often start off subtle and get gradually worse over time.

The Link Between Belly Fat and Dementia

One recent study conducted by the British Journal of Nutrition looked at the link between obesity and cognitive abilities in adults aged 60 and older. Adults over the age of 60 are most affected by dementias—particularly Alzheimer’s disease. Likewise, they also make up a significant percentage of those who struggle with obesity; nearly 10% of people over the age of 65 are obese.

Although obesity was found to have a link to cognitive decline, researchers found the biggest connection between dementias and belly fat—specifically, waist-to-hip ratio (WHR). This is because centralized body fat is inflammatory tissue, which is widely recognized as a risk factor for cognitive issues. It makes us feel tired and depressed, and affects our ability to concentrate. As abdominal size gets larger, the memory center in the brain shrinks.

WHR is a better indicator of measuring belly fat than BMI, especially in older people. As people age, they lose muscle mass and develop more fat; women especially are more likely to notice an increase in belly fat as they get older, even if they aren’t gaining weight. This is thought to be due to decreasing levels of estrogen after menopause. Loss of muscle mass also affects the rate that the body burns calories, making it harder to maintain a healthy weight. Genetic factors can also play a role.

The study found that central obesity appears to increase the risk of dementia in three ways:

  • Inflammation
  • Metabolic disturbances, like insulin resistance
  • Lack of exercise

In addition to dementia, the researchers recommended that belly fat should be considered a risk factor for other health conditions, including heart disease and diabetes. Belly fat is an endocrine organ that has been found to secrete hormones and chemicals that are strongly linked to the development of serious diseases. Body fat in general has also been linked to the buildup of amyloid proteins or brain lesions, which have a known association with dementia.

What’s Considered a Healthy WHR?

A healthy WHR is considered to be 0.85 or less for women and 0.9 or less for men. To determine your WHR, divide the circumference of your waist by the circumference of your hips, making sure to measure the smallest part of your waist and the widest part of your hips. If your ratio is over the healthy measurements, it’s an indicator of central obesity and that you may have a greater than average risk of cognitive decline as an older adult.

How to Prevent Dementia

To prevent dementia, it’s important to monitor both your BMI and waist circumference; unhealthy levels of both factors have been long attributed to metabolic dysregulations that can lead to serious chronic health conditions.

If you’re currently at a healthy weight, maintain it. If you’re overweight or obese, it’s important to lose weight. Follow a healthy diet, increase your physical activity, and limit your alcohol consumption. Between BMI and WHR, it’s best to focus on your waist size, as BMI doesn’t present the full picture when it comes to body weight and obesity.

Making healthy lifestyle changes is the best way to prevent dementia, as well as heart disease, type 2 diabetes, stroke, high blood pressure, metabolic syndrome, and some cancers. If you’re having trouble knowing where to start, or you’d like extra support on your health journey, contact Dr. Jennifer Hubert’s office.

Dr. Hubert takes a holistic approach to internal medicine; she treats the whole person, not just the disease. As an internist, she focuses on the prevention and improvement of a full–spectrum of adult diseases with the goal of nurturing and improving your physical health and overall sense of well-being. Schedule a consultation today at 707-575-THIN (8446).


Obesity is associated with a higher risk of developing dementia up to 15 years later, according to a new study by the UCL Institute of Epidemiology & Health Care. The good news is that there’s also evidence that weight management could play a substantial role in reducing the risk of developing Alzheimer’s disease, Lewy Body dementia, and other losses of cognitive function.

The Connection Between BMI, Belly Fat, and Dementia

Research published in the International Journal of Epidemiology suggests middle-aged people who are obese have an increased risk of developing dementia by as much as 31% compared to those whose body mass index (BMI) is within the healthy range. However, it’s not just about BMI—research has also shown that central obesity (excess belly fat) is a contributing risk factor.

Heartbeat line on red apple and stethoscope, healthy heart diet concept background

BMI, which is one of the most common ways to measure obesity, is based on the relationship between a person’s height and weight. A BMI of 18.5 to 25 is considered healthy; greater than 25 is overweight and greater than 30 is considered obese. However, BMI doesn’t measure body fat or take into account muscle mass—which could put someone who has high muscle mass in the obese range even if they’re healthy.

A better indication of obesity is a person’s waist-to-hip ratio (WHR). Overall, belly fat was found to be a better predictive factor in dementia than BMI alone. Women who had a WHR greater than 0.85 and men with a WHR greater than 0.90 are considered centrally obese. In addition, people who have a healthy BMI but are centrally obese have approximately twice the risk of developing dementia than people who have a high WHR.

In addition, excess belly fat in otherwise healthy middle-aged adults correlated with having smaller brain volumes. This suggests there may be a link between belly fat and brain shrinkage, which may be a contributing factor to the risk of developing dementia later in life. Belly fat is harmful to the brain because it contributes to increased inflammation, insulin resistance, and the risk of developing diabetes.

Gender also plays a role in the risk of dementia. Women with excess body fat had a 39% increased risk of dementia compared to those who had a healthy level of abdominal fat—however, an increased risk wasn’t found among male participants.

Furthermore, the study found that the link between obesity and dementia was independent of other risk factors, such as smoking, hypertension, diabetes, or a genetic predisposition for dementia.

Prevention Through Lifestyle is Key

The results of this research stress the importance of maintaining a healthy weight, particularly later in life. The benefits also extend beyond dementia prevention; obesity is associated with a number of serious diseases and health conditions, including type 2 diabetes, heart disease, high blood pressure, stroke, and some cancers. Fortunately, the risk of developing dementia and other serious health concerns can be mitigated or avoided completely by maintaining a healthy lifestyle through diet and exercise.

If you’re currently in the overweight or obese BMI range, or you have a low WHR, taking steps now to lose weight can have significant benefits for your health. If you’re not sure where to start or would like support on your weight loss journey, you may want to consider a medical weight loss program. Dr. Jennifer Hubert is a board-certified physician specializing in internal medicine and medical weight loss. She takes a holistic approach, focusing on the prevention and improvement of a wide range of adult diseases through nutritional counseling, medical monitoring, and behavior modification. To schedule a consultation, contact Dr. Hubert’s office today at 707-575-THIN (8446).


Type 2 diabetes is a chronic disease that affects around 34.2 million (10.5%) adults in the United States. The symptoms develop gradually; left untreated, complications from diabetes can be disabling or life-threatening. Fortunately, pre-diabetes and type 2 diabetes are largely preventable with healthy lifestyle changes.

What is Type 2 Diabetes?

Tiny doctors examining heart health flat vector illustration. Cartoon medical specialists doing checkup of blood pressure, pulse rate and cholesterol. Cardiovascular disease and cardiology concept

If you’ve been diagnosed with type 2 diabetes, it means your body has difficulty regulating and using glucose (sugar) as fuel. Glucose is the main source of energy for your cells; insulin, a hormone produced by the pancreas, helps move glucose to the cells in your body. With type 2 diabetes, the pancreas doesn’t produce enough insulin, and the cells have trouble responding to it. This causes the glucose to stay in your blood, essentially starving your cells. Over time, this can also cause circulatory, immune, and nervous system disorders.

Although type 2 diabetes is more common in adults, rising childhood obesity levels have led to more cases of the disease in younger people. Type 2 diabetes can’t be cured, but taking steps to lose weight, increase your activity level, and eat a healthy diet can help you manage it. If caught early enough, healthy lifestyle changes can prevent, delay, or even reverse the disease.

Am I at Risk of Developing Type 2 Diabetes?

Risk factors that can increase your chances of developing type 2 diabetes include:

  • Having prediabetes
  • Being over the age of 45
  • Being overweight or obese
  • A family history of the disease
  • High blood pressure
  • Low levels of HDL (good) cholesterol or high triglycerides
  • A history of gestational diabetes while you were pregnant
  • A sedentary lifestyle
  • A history of heart disease or stroke
  • Polycystic ovary syndrome (PCOS)
  • Smoking
  • Being of African American, Hispanic, Native American, Pacific Islander, or Asian American heritage
  • Areas of thick, darkened skin near your neck and armpits, which indicate insulin resistance

If you’re at risk of developing type 2 diabetes, it’s important to focus on making healthy lifestyle changes. Not only can this prevent the disease, but it can also help prevent other serious health conditions, such as heart disease, high blood pressure, stroke, and some types of cancer.

How to Prevent or Delay Type 2 Diabetes

Here are some steps you can take to prevent or delay type 2 diabetes. If these changes feel overwhelming, try taking on one step at a time.

Lose Weight

Losing even a small amount of weight has been shown to be incredibly beneficial in reducing the risk of diabetes. One large study found that people who lost 7% of their body weight had their risk decrease by nearly 60%. Once you lose the weight, make sure to keep it off.

Increase Your Physical Activity

Regular exercise can help you lose weight, lower your blood sugar, and increase your body’s insulin sensitivity. Aim for getting at least 30 minutes of exercise five days a week, like swimming, brisk walks, running, or biking. If you have a sedentary job, break up periods of inactivity by taking a few minutes to stand or walk around every 30 minutes.

Eat Healthy, Fiber-Rich Plant Foods

Plant foods contain a variety of nutrients, including vitamins, carbohydrates, minerals, starches, sugars, and fiber. Fiber-rich foods, in particular, aid weight loss; they also reduce the risk of diabetes by lowering blood sugar, slowing the absorption of sugars, and restricting the absorption of dietary fats and cholesterol.

Try to incorporate more of these foods into your diet:

  • Whole fruit
  • Non-starchy vegetables, like broccoli, leafy greens, and cauliflower
  • Legumes
  • Whole grains

While you should try to eat a variety of foods from each food group, it’s best to limit red and processed meats. Instead, eat lean meat like fish or chicken.

Reduce Your Total Carbohydrate Intake

When it comes to carbs, quality and quantity matter. Many studies have shown a correlation between frequently eating refined carbs and sugary foods. While all carbohydrates stimulate the release of insulin, refined carbs are digested faster—which gives them a more immediate impact on blood sugar and causes it to raise quicker.

However, it’s still important to manage your overall carb intake, rather than focusing on limiting refined carbs or foods with added sugars like bread, pasta, sweetened cereal, soda, and candy. One easy way to reduce your sugar intake is to replace sugary beverages like juice or sodas with water.

Eat Healthy Fats

Dietary fat is part of a healthy diet, but since it’s high in calories it should always be eaten in moderation. Focus on eating “good” unsaturated fats (monounsaturated and polyunsaturated fats), which will help promote healthy cholesterol levels. Some examples of good fats include:

  • Olive, canola, sunflower, safflower, and cottonseed oils
  • Fatty fish, like tuna, cod, salmon, and mackerel
  • Seeds and nuts, such as flaxseed, pumpkin seeds, almonds, and peanuts

Trans fats should always be avoided; limit your intake of saturated fats by switching to low-fat dairy products and lean meats.

Reduce Your Portion Sizes

Eating too much food in one sitting has been shown to raise blood sugar and insulin levels, particularly in people who are more at risk of developing diabetes. One easy way to manage your portion sizes and have a balanced meal is to divide your plate in the following way:

  • ½ plate of non-starchy vegetables
  • ¼ plate of complex carbs, such as fruit or whole grains
  • ¼ plate of lean protein

If you eating at a restaurant with large portion sizes, ask for half a portion or eat an appetizer as your main course. When you need a snack, put the amount of food you want in a separate bowl instead of eating straight from the bag or box.

Quit Smoking

If you smoke, you should quit. Not only is smoking linked to type 2 diabetes, but it can also cause or contribute to other serious health conditions. Although it’s not fully understood how smoking contributes to the risk of diabetes, it’s thought that it may increase insulin resistance and prevent insulin secretion. The more frequently you smoke, the higher the risk. However, one study found that the risk of diabetes decreases over time after stopping.

Professional Support for Diabetes Prevention

Whether you’re currently at risk for diabetes, have prediabetes, or you want to be proactive with your health, there are many steps you can take to prevent the disease. Making healthy lifestyle choices like losing weight, eating plant-based and fiber-rich foods, and exercising are very effective—and they can also prevent other serious health conditions like heart disease, high blood pressure, and some cancers.

If you’re not sure where to start, or you’d like additional support on your journey, Dr. Jennifer Hubert offers personalized medical weight loss plans to help you stay on track and reach your goals. Dr. Hubert takes a holistic approach to your health, incorporating nutritional counseling, behavior modification, and medical monitoring. Her customized weight loss plans have helped countless patients in Santa Rosa regain their health. For more information, schedule a consultation at Dr. Hubert’s office today by calling (707) 575-THIN (8446).