Robert G.

Gish MD
Please note my primary Email address: rgish@robertgish.com
Cell phone: 1 858 229 9865
My company name: Robert G Gish Consultants LLC
Please visit my website: robertgish.com for more information
6 14 2014
Weight Loss Contract
I understand that I am by calculated BMI, Body Mass Index (Website MedCalc)
Overweight: ______ BMI 25-29
Obese: _______ BMI 30-34
Morbidly obese: _______ BMI 35-39
Supermorbid obese: ______ BMI 40 +

I understand that I am at high risk of dying from: liver failure, many types of
cancer inlcuding liver cancer, heart disease, kidney failure or stroke:
____________ (initials)

I am committed to a stringent long-term goal of attaining a healthy weight:
_______________________ (initials) BMI 24 for Caucasians/other ethnic groups, BMI
22 Asians

I hereby am committed to a weight loss program that works: _________ (initials)
1) Nutrition consult
2) Log book with within a paper folder or using
http://www.myfooddiary.com/
a. daily weights
b. daily calories counts
In addition: document
c. 3 hours of exercise per week
i. heart rate over 100 for 3 hours
ii. learn to take heart rate or obtain and use a heart rate
monitor
3) Initiate an immediate 40 % calorie restriction
4) 5 small meals per day
a. Use tea cup saucers for all meals, no second servings
b. high protein
c. moderate carbohydrate
d. low fat
5) No liquids from plastic bottles, use only glass storage containers (see
information on bis-Phenols (see website: Nova, keyword
epigenetics)
6) No alcohol
7) Utilize Hungry is healthy motto
8) Fiber supplements: 3 times per day with meals
9) Sign and date this weight contract
10) Post the weight loss contract in
a. Bedroom
b. Bathroom
c. Kitchen
______________ ___________________ ____________________
Name Signature Date