Do you accept insurance?

Yes. In Vermont we are in network with Medicaid, TRICARE, Blue Cross Blue Shield, MVP, Cigna, and United Healthcare. In Arizona, we are in network with Aetna, Blue Cross Blue Shield, and United Healthcare (not the community plan). We do not accept Medicare. Please call us if you have any questions. N.B., insurance coverage in Arizona for nutrition is not very good. Most insurance companies will not pay unless you have been diagnosed by a doctor with diabetes, chronic kidney disease, an eating disorder, obesity, etc. We find this incredibly frustrating because the best way to prevent these serious conditions is by coming to us in the first place, but they make their decisions and there is nothing we can do about it. We are happy to bill your insurance, but please understand you may be billed for the full amount due to your deductible, if any, on your plan.  Also note that you will be billed if your insurance denies coverage for nutritional counseling.


Are Metabolic Testing and Body Composition painful tests?

No, both Metabolic Testing and Body Composition Analysis are non-invasive tests, so you don’t have to worry about being poked by any needles at our office. During the Metabolic testing procedure, the patient sits in a reclining chair under a lightweight canopy hood and essentially relaxes for about 20 minutes. For Body Composition Analysis, the patient is required to lie down and have electrodes attached to the wrist and foot to pass a small and painless electrical current through the body. 


How long will it take my metabolism to improve if I am malnourished?

Your metabolism begins to improve as soon as you start to adjust your caloric intake. The length of time depends on how severely hypometabolic you are and how much repair the body needs to do and if you are able to follow the treatment recommendations. With total compliance, we have seen metabolic rates corrected in six to eight weeks.


Doesn't exercise improve my metabolism? 

Exercise may actually slow your metabolism if your body is not getting enough nourishment. The reason this occurs is because your body is trying to conserve energy stores in the body. Exercising when the body is trying to repair itself uses vital energy stores. 

If I eat more calories than my body is burning, won't I gain a lot of fat weight? 

When the body is repairing, it is using the extra calories to restore cellular integrity. The body will gradually weight restore both lean and fat weight. There may be an initial weight gain but as the metabolic rate improves this stabilizes. 


What is the difference between Body Composition Analysis and Body Mass Index (BMI)?

BMI is based on height and weight but does not take into account the body composition. BCA measures body fat, lean dry mass (muscle), total body water, intracellular water, and phase angle (which is the measurement based on the total body resistance and reactance). Often, during annual physicals the focus is on a healthy BMI, but this focus is too narrow and often misleading. 


How can I be malnourished if my body weight is normal? 

This is also an issue of how BMI is a poor indication of total health. Attaining a normal weight is not an indication that your body is burning a normal amount of calories and not breaking down it's own protein stores. It is possible to eat enough to gain weight but not improve your metabolic rate. Our tests can properly assess your body's total health and whether or not you are nourishing your body properly. 



What are the goals by which you measure success?

Our goal is for you to reach your optimal health.  Because we can measure your health from the inside with Metabolic Testing and Body Composition Analysis, we want your numbers to be within normal ranges, i.e. metabolism, muscle mass, fat-free mass, fat mass, intra cellular water and phase angle. Another goal is for you not to obsess about food, body and weight, but to be energized, active and to follow your dreams.


How long does treatment take?

This is impossible to say. If you follow our plan and your metabolism isn’t too off, it takes 6 – 8 weeks for your metabolism to recover. However, those with more serious problems often take longer to heal. We recommend that you come in once a week, since we need to see you that often to learn how your body is responding to the food plan and suitably adjust course as you are making progress.


What does a typical eating plan from the Kahm clinic look like?

There is no typical plan, since each one depends on what the machines tell us about your body, and each body is different. And each time you come by we adjust your diet depending on what has happened to your body in the previous week. We don’t recommend particular foods or recipes, we will, however tell you how many calories/day your body needs and we will translate that into food groups so that you can enjoy an endless variety of combinations. We will also guide you how to balance your customized food plan throughout the day.


Don’t others have these machines?

Yes, some nutritionists have metabolic machines and body-comp analysis. But their metabolic machines are cheaper and give far less information than ours. Our metabolic machine is usually used in large hospitals by cardiologists to see whether patients have cardiac or pulmonary problems. Unlike others, ours show if your body is breaking down muscle and organ tissues (protein substrate utilization), and can see whether you are hypo-metabolic or not. It also sees how you are metabolizing carbohydrates and fat. Other less expensive machines can’t do that, and that is crucial information for diagnosing eating related problems. Beyond it’s incredible usefulness for treating eating disorders and disordered eating, the carbohydrate substrate utilization, for instance, can guide us to screen pre-diabetes at an early stage (one of the risk factors of metabolic syndrome). Using metabolic testing and body composition analysis in tandem and making sense of the data is very difficult and requires long  training. As of now, there are only four other places in the country that know how to use these machines as we do. For most other nutritionists, using the metabolic test or the body composition analysis is an optional add-on to their treatment, for us it is utterly central to what we do and we cannot imagine working without them. To read more about the tests, go here.