On the subject of weight loss, much has been written. On medical weight loss, less so. And on functional weight loss, even fewer words. Dr. Girish Kalva, though, seeks to change that. As a board-certified practitioner at Rising Health Specialty Clinic in Holladay, Utah, he specializes in functional weight loss. He’s helped his patients lose a combined 3,000 pounds. He has over 25 years of experience in prevention, nutrition education, diabetes, obesity, and hypertension—all part of his holistic approach to health. Dr. Girish believes that lifestyle changes are a crucial part of patient care. “I want everyone to move in the right direction by not just reading and listening but by implementing changes in their lives to see the difference it makes,” he explains. In a recent presentation to a group of Utah functional practitioners, he laid out his holistic, no-medications-allowed approach to medical weight loss.

“The biggest burden on Western diseases is weight,” he says. “If you get the weight off, inflammation goes down. Once inflammation goes down, blood pressure goes down, sugars go down, etc., in most cases.” That’s why he focuses on weight loss first and foremost. And, whereas many weight loss programs start off with the elimination of certain obvious foods, he goes above and beyond. In his three-phase program, he asks his patients to start by eliminating some surprising things and making some replacements.


Get silver fillings removed

Silver fillings are a mixture of silver and other metals dissolved with mercury, and mercury can cause a toxicity that impairs thyroid function.

Change cosmetics

Patients should look closely at the labels of their cosmetic products to see if they contain phthalates, which have been linked to weight gain in mice. This has been attributed to the plastics in which the cosmetics are encased or packaged, although the causal evidence isn’t clear.1

Change toothpaste

Although the levels of fluoride in many toothpastes are generally safe, too much can contribute to thyroid dysfunction. This according to the International Academy of Oral Medicine and Toxicology. So instruct your patients to look for toothpastes without fluoride.

Replace the dinnerware

Did you know china and glassware could be a good way to remove barriers to medical weight loss? According to Dr. Givri, plastic dinnerware can leach chemicals that have estrogenic activity. Indeed, a 2011 study by American scientists Yang, Yaniger, Jordan, Klein, and Bittner, revealed that most plastic products release estrogenic chemicals. In peri-menopausal women with declining levels of progesterone, this can lead to estrogen dominance. And a common symptom of that is weight gain.

So the main first-phase goal is to remove all barriers to medical weight loss as much as possible, especially those things that harm thyroid function. Then, it’s all about gut motility.


“Just those changes alone,” says Dr. Givri, “causes a lot of weight loss.” In his program, which is group-based, primarily online, and conducted in four-month increments, he aims for his patients to lose about a pound a week. So, at the end of the four months, they will have lost about 20 pounds. If a patient hasn’t lost that much at that point, then he looks at gut motility. A slow gut is one in which food sits for too long, rotting. He spurs gut motility by recommending magnesium, among other things. “Magnesium is a part of 200-300 biochemical reactions in the body, everything from ATP production to insulin release and metabolism.”

This, in addition to exercise, apple cider vinegar intake, and changes to sleep routines, accounts for much of the weight loss in the second phase of his program. He also looks at hormone levels at this point, assuming they’ve started to lose weight: “Then, whatever supplements I recommend to them after that,” he says, “the dosing will be for their new weight, not their original weight.”


Whereas removing barriers to healthy thyroid function has been the focus of the previous phases, phase 3 is all about giving it all the encouragement it needs. He adds ashwaganda and maca for adrenal support. He vigorously watches vitamin d levels in his patients to aid in thyroid conversion. He also advises patients to again look more closely at their nutrition labels. “The biggest [cause] of a slow thyroid is too much iron from the diet,” he says. “Too much iodine is the biggest blocker of proper thyroid function. If they’re not getting enough iodine because of the things they’ve taken out of their diet for weight loss, you have to add it back in through supplementation.” Dr. Givri also reports that a side benefit of focusing on the thyroid is an increase in gut motility. This is also when he looks at TSH, free T3, and others.
For more details about the lab results he looks for to guide his patients’ journeys, as well as the benefits and recommended administration of apple cider vinegar and how to help patients with problems like SIBO, watch the full lecture here!



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