Weight Management
 
  Lifestyle changes are at the heart of most weight loss programs, and we have come to realize that getting people to change their habits is difficult, if not impossible. Therefore, we employ a program that is both flexible and customized for each individual participant.

In order to better customize a plan for you, we need to first identify the things that are contributing to your current metabolic state. During the initial visit, a complete medical history and exam will be performed. The exam will include blood tests looking for metabolic conditions that may be having an adverse effect on both your weight and your overall health. You will also receive an EKG and impedance cardiography. The initial consultation is used primarily to evaluate your personal weight loss goals, your personal health goals, and your current state of health. You are not likely to receive any medications for weight loss during your first visit. The reason for this is that until we have all of the laboratory results, we cannot safely develop a treatment plan that is tailored to your specific needs. You will be asked to use a blood pressure monitor and a log book with which you will record your meals and exercise routine for one week. You will be scheduled for a follow-up visit one week later.

On your second visit, you will sit down with the doctor and go over your exercise routine for the past week. You and the doctor will also review the meals that were recorded in your journal. We will review the results of the lab tests that were performed the week before, and with your doctor, develop a weight loss road map that is customized to your specific goals and needs. Any medical issues that were discovered by the labs, physical exam or history shall be addressed, and you shall be given specific advice on any dietary changes that should be made. If appropriate, medications may be prescribed. You will again be asked to keep a diet, exercise and blood pressure journal until your next visit one week later. You will be given the doctor's personal cell phone number, in case you have any issues that arise during the initial week of treatment, especially if you were given any medications, and it will be expected that you immediately call the doctor, no matter what time it is day or night, should you experience any side effects.

We use a number of different types of medications (when indicated), individually, or in combination.
  1. Fat/carbohydrate absortion inhibitors.
  2. Dopamine/norepinephrone/serotonin re-uptake inhibitors.
  3. Centrally acting appetite suppressants (traditional "weight loss" medications). 
  4. Weight loss supplements (pharmaceutical grade/non-prescription) and injections. 
After the initiation of your weight loss plan, you will be expected to come in weekly for the next month. Each time, we will review your diet, exercise, and blood pressure logs. We will do a physical exam, address any questions that you may have, and monitor your progress. On the 3rd and 6th visits, an EKG and impedance cardiography will be performed. Another round of laboratory testing shall be taken on your 6th visit. The labs that will be ordered will depend upon your specific treatment regimen and upon any issues that may have been discovered during the initial round of labs.

Upon completion of the 6th visit, the frequency of visits shall depend upon your progress, your medical condition, the types of medications that you are on, and your personal goals. In general, most patients are seen weekly until the 6th visit, then monthly for the next 3 months, then every 1 to 3 months after that. After you have met your weight loss goals, you will be seen every 3 to 6 months for maintenance. Most of the medications that you will have been prescribed will be stopped, or possibly curtailed, by then, and the frequency of your visits will largely be dependant upon you.

If you have any questions about our weight loss program, please do not hesitate to call!

Note: we recently have had several patients who were started on weight loss pills from other facilities who have developed chest pain, palpitations, and even hypertensive crisis. Apparently, they went to a weight loss doctor who simply gave them a prescription without any work-up for cardio-vascular risk. This is dangerous and unacceptable practice! Please, if you chose to start weight loss pills, do not let any doctor give them to you without an appropriate evaluation!



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