Weight counseling

Our Physician-supervised weight-loss programs provide treatment in a clinical setting with licensed healthcare professional. Our program offers services such as nutrition education, physical activity and behavioral therapy.

The cost to participate in a physician-supervised weight-loss program is comparable to the cost of weight-loss programs that do not have a physician on site, for example Weight Watchers and others. Health insurance companies may cover some or all of your treatment if you have heart disease, metabolic syndrome, diabetes or a pre-diabetic condition.

The Initial Consult: Our physician or physician's assistant specializing in obesity treatment provides the initial consultation. The initial consult involves a focused medical evaluation for diseases related to obesity. In addition, the medical professional will obtain a weight history, which includes past diet attempts, and may conduct a thorough psychological history.

Many patients come to our clinic with undiagnosed diabetes, high cholesterol, thyroid disorders or abnormal liver tests. Several blood tests are often drawn.

Overall, the Physician management of obesity includes:           

• Behavior modification     
• Diet      
• Exercise              
• Pharmacotherapy

Diet and Behavior Modifications: After the initial assessment, many of the follow-up appointments are with registered dietitians or mid-level providers who are certified in obesity management as well as exercise.

Getting a handle on eating behaviors is key to making significant long-term changes. While it may be difficult to keep food logs that require writing down all food eaten, this exercise has been shown to be important for long-term success.

With all the variation in serving sizes, most individuals do not have a good understanding of how many calories are actually consumed in one day. Therefore, it is recommended that, for at least the first six to eight weeks, individuals keep a complete food log. This will also help dietitians get a better handle on areas of the diet to focus on at follow-up visits.

Dietitians also work with patients using individualized meal plans for various lifestyles and medical conditions. Many medical conditions, such as insulin resistance, can make it difficult to lose weight on traditional low-fat diets. The dietitian can work individually with the patient to find a meal plan that works for him or her. Also, dietitians teach patients how to actually make the changes such as: how to shop; cooking ideas such as easy preparation methods or healthy recipes; and how to eat out at restaurants.

Follow-up Visits: Patients are given the opportunity to revisit a topic or obtain more information on an area of interest during follow-up visits. The frequency of and interval between follow-up visits is determined on a patient-by-patient basis. Monthly visits are encouraged until initial weight-loss goals (5 to 20 percent of body weight) are achieved. At that point, three, six or 12-month follow-up visits are encouraged as needed for individual patients.

Weekly weigh-ins are a useful tool to hold individuals accountable. Patients are frequently given a meal and exercise plan by their healthcare provider and told to return in two to three months. Getting weighed on a weekly basis (at the same time and day of the week and using the same scale) helps to keep dieters on track. Just knowing there will be a weekly weigh-in decreases caloric consumption. On the other hand, daily weigh-ins are not recommended since small, incremental changes often cause frustration and result in failure.

It is also recommended, if possible, that the weekly weigh-in occurs outside of the home. Being weighed in the presence of another person increases accountability and has been shown to decrease caloric intake per week by nearly 20 percent.

Weight Maintenance: Many people can follow a diet and lose weight, the challenge, however, comes in maintaining the weight-loss. Any changes in eating and exercising behaviors must become habitual, which takes time. Most programs offer monthly visits that provide behavior modification help (strategies to help change habits) that encompass things such as: record keeping; eating behavior and associated activities; eating slowly; portion control; vitamins, minerals, fiber and water; enhancing exercise; attitudes, self-esteem and quality of life; and holiday and stress eating.

Realistic Expectations: Unrealistic goals of a comprehensive weight management program often result in failure. This methood should not be expected to achieve "ideal" body weight, often set as a measure of success. A modest weight-loss can offer profound benefit in preventing or delaying the onset of co-morbid medical problems and should be viewed as a success.

This realistic goal of a 5 to 15 percent weight-loss from initial weight will keep one focused, as well as improve their quality of life and help manage any obesity co-morbid medical problems.

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