Effective Medical Weight Loss Procedures and the Ideal Candidate
Medical weight loss is not a diet—it’s a medically-supervised, personal approach to helping people develop strategies to lose weight in a way that is healthy and sustainable. People will often pursue a medical weight loss approach after trying and failing to lose weight through other means. Often, people will seek out medical weight loss if they have a significant amount of weight to lose and they don’t qualify or don’t wish to have weight loss (bariatric) surgery. My New Beginning has helped hundreds of people in the Dallas-Fort Worth area achief their weight loss goals through our non-surgical weight loss program.
Medical Weight Loss: A Non-surgical Approach
Medical weight loss at My New Beginning helps people lose weight by combining medication therapy with an approach that addresses underlying behavioral and medical causes that may be preventing weight loss.
Through a program of personalized assessment and education, we help people find a new path for weight loss that works. Many of our patients previously felt that sustainable weight loss simply wasn’t achievable—but through our structured medical weight loss program, they were able to find the support they needed to finally lose weight.
When you come in for a consultation, we’ll discuss your medical history, past attempts at weight loss, and your weight loss goals. Then we’ll go through a comprehensive process of metabolic testing and assessment, so we can have a full picture of what may or may not work for you. Then, we’ll develop a personal plan for your weight loss, which may include:
- FDA-approved, prescription weight loss medications (pharmacological therapy)
- Vitamin and protein supplements
- Personalized nutritional assessment and meal-planning with a registered dietitian
- Behavioral modifications, including physical activity plans
- Access to the Am I Hungry ® Mindful Eating series, led by a licensed clinical psychologist
Once we’ve set up a program with you, we’ll meet monthly to go over your progress and adjust the plan as needed.
Who is an Ideal Candidate For Medical Weight Loss?
People decide to pursue medical weight loss for many different reasons. Typically, a medically-supervised weight loss program is right for someone with a Body Mass Index (BMI) of at least 30, which is considered obese.
Many people living with obesity may have what are called comorbidities of obesity, or health conditions that occur alongside of or because of obesity. Sometimes, prior to seeking medical management for weight loss, these conditions are undiagnosed. If you have a diagnosed comorbidity of obesity, participating in a medical weight loss program can be a great step in taking control of your health. Some common comorbidities of obesity include:
- Type 2 diabetes
- Hypertension (high blood pressure)
- Hypercholesterolemia (high cholesterol)
- Dyslipidemia (abnormally high lipid levels in the blood)
- Sleep apnea
- Gallbladder disease
- Thyroid disorders
- Cardiovascular disease
Weight loss surgery
Some people who have a significant amount of weight to lose may also consider weight loss surgery. One of the main qualifications for weight loss surgery is BMI. Candidates for weight loss surgery should be either morbidly obese (BMI of 40+ or 100+ pounds overweight) or obese with a BMI of 35+ and have an associated health condition like those listed above. Sometimes, people who seek medical weight loss as an option don’t quite meet the BMI requirements for weight loss surgery. Others may not feel comfortable having an invasive surgical procedure and are looking for another effective weight loss solution.
Even if a person meets BMI requirements for weight loss surgery, it doesn’t always mean surgery is an option. Some health conditions or lifestyle behaviors can increase surgical risk. If you’re interested in learning if weight loss surgery is an option, contact us.
Effective Strategies for Medical Weight Loss
Each medical weight loss plan is individually structured, but many involve the same components: pharmacological therapy (weight loss medications); changes to diet and exercise; and psychological/behavioral support.
What are the most common weight loss supplements?
Let’s talk about weight loss supplements. The bad news: there is no magic pill to lose weight. The good news: There are many highly effective, FDA-approved medications that can support a comprehensive medically-supervised weight loss program—and insurance will often cover them.
Here are currently some of the most common FDA-approved medications used for weight loss
- Orlistat: Orlistat is a lipase inhibitor. In order for the body to absorb dietary fats from food, they have to be broken down by gastric and pancreatic lipases (enzymes). Orlistat blocks these enzymes, so instead of being broken down and absorbed in the body, dietary fats leave the body in bowel movements.
Although it prevents fat absorption, it doesn’t impact sugar and overall calorie absorption—other factors that can impact weight loss and weight maintenance—so it’s still important to stick to a healthy nutritional plan. Orlistat is available over-the-counter at lower doses (under the brand Alli), but requires a prescription for higher doses (under the brand Xenical). It’s a good idea to talk to a doctor before starting any new medication, even over-the-counter medications.
- Contrave ®: Contrave is a prescription weight loss medication that works by affecting the brain’s neurochemistry. Contrave contains two prescription drugs that separately have been used for years to effectively treat depression, smoking cessation, and alcohol and drug addiction. Together, these drugs may help people feel reduced hunger and better control of cravings, promoting weight loss.
- Liraglutide: Liraglutide, under the brand name Saxenda ®, is given as an injection and requires a prescription. It works by mimicking a natural hormone that releases chemicals in the brain to regulate appetite and curb hunger, prompting weight loss.
- Lorcaserine: Lorcaserine is available under the brand name Belviq. It helps control appetite by activating a particular seratonin receptor in the brain.
- Phentermine: Phentermine is available by prescription only and is chemically similar to an amphetamine (a stimulant of the central nervous system). It’s used for weight loss because it can help suppress appetite for some people. Brand names for phentermine include Adipex-P, Lomaira, and Suprenza.
- Qsymia: Qysemia is the brand name of a medicine that combines phentermine with another drug called topiramate. Topiramate by itself is used to treat both seizures and migraines.In combination with phentermine, topiramate is thought to help suppress appetite, make food taste less appealing, and may help patients burn more calories.
Weight loss medications should only be used with the supervision of a doctor and they aren’t for everyone. Each medication has some risk and side effects. Remember—there is no such thing as a magic weight loss drug; medication should be used as part of an approach that includes focusing on a healthy diet and appropriate physical activity.
What are the most effective weight loss exercise plans?
Moderate physical activity is generally safe for most people, but it’s always a good idea to consult with your doctor if you’re starting a new exercise regimen—particularly if your goal is to lose weight. One of the best things about our medical weight loss program is that you have a team at your back to help advise you. We can help evaluate your fitness needs and help plan an effective, safe exercise program.
The best way to design an effective exercise plan for weight loss is to start simple and establish a sustainable routine. Starting out with an overly aggressive new fitness routine can lead to discouragement if you find that you can’t keep it up or, even worse, can lead to an injury that sets you back. The only workouts that work are the ones you do. If you’re looking for sustainable weight loss, you need to think realistically about what exercise you can fit into your regular routine and what you realistically will sustain. Establishing a regular routine will make it easier to include fitness as a permanent part of your life. This means finding exercise plans that fit into your schedule and that you enjoy.
Exercise is just one part of the medical weight loss approach. It’s important to get moving, but starting simple is a good way to go. We’ll help you put together a personalized plan, but getting started on a fitness routine for weight loss typically will follow a course like one listed below.
Start walking. Walking is not a high-intensity exercise, but combined with an overall medical weight loss plan, it’s a great way to begin building physical activity into your routine. Walking can help you burn calories and build lean muscle—muscle which helps you burn calories even faster. Walking might even be especially good at helping burn belly fat.
Start out trying to do at least half an hour of brisk walking at least three times a week. Brisk walking means you’ll be breathing harder than usual and getting your heart rate into the range of moderate intensity—you’ll be walking about 2.5 to 4 miles per hour. If you can work your way up to brisk walking most days, from 30 to 90 minutes, you should start to see results, and you’ll probably be feeling better too! Check out all the ways walking can help you lose weight.
Add in higher-intensity cardio workouts. Begin adding more active cardio exercise into your fitness routine. We consider an exercise “cardio” if it raises both heart and breathing rates strenuously enough to challenge the cardiovascular system. The challenge of regular cardio will improve the function of your cardiovascular system. Cardio workouts help support weight loss because the higher intensity helps you burn more calories. Here are some tips for getting started on a cardio workout routine.
- Start out slowly and gradually increase the frequency and duration of your cardio. A great goal is to have a 30 to 60 minute cardio workout at least 3 times a week.
- Alternate the type of cardio exercise you do to get the best benefits—variety can help keep you from getting bored, prevent injury, and can even help you overcome weight loss plateaus.
- Alternate intensity levels of your cardio—if you have a high-intensity workout one day, the next day have a brisk walk, swim, or allow your body to rest.
Some great cardio exercises for weight loss include:
- Running or jogging
- Elliptical training
- Dance workouts
- High-intensity Interval Training
- Kettlebell workouts
Incorporate Strength Training. Introducing some strength training a few days a week can really help speed up your overall weight loss or help get you over a weight loss plateau. Although muscle weighs more than fat, it also helps you burn calories more quickly, helping push weight loss efforts along. Start with just a few days a week, for about 20 minutes at a time. Check out this article on strength training for beginners to help you get started.
Sleep. Okay, so this is the opposite of physical activity, but your sleep habits have a huge impact on your overall fitness. Without proper sleep, your body may not have the energy to properly recover from your fitness routine and repair muscle. Lack of proper sleep also may undermine weight loss by slowing your metabolism and making it harder to control appetite and food cravings. Despite the importance of sleep, 1 out of every 3 Americans don’t get enough of it. So, don’t let all your hard work go to waste—make sure to hit the hay for at least 7 hours a night!
Nutritional assessment and goal-setting
One of the first steps of our medical weight loss program is to perform metabolic testing as a part of a comprehensive nutritional assessment. Your metabolism is the process by which your body breaks down the calories you consume and convert them to energy. The higher your metabolism is, the faster you burn calories and the easier it may be to lose weight.
Depending on your needs and goals, metabolic testing may comprise several individual tests.
Resting metabolic rate (RMR): Your resting metabolic rate is the rate at which your body burns calories while you’re at rest. To measure your RMR, we’ll perform a calorimetry test for which you’ll be in a reclining position and breathe into a mouthpiece for 15 minutes to half an hour.
Knowing your RMR, as part of your overall nutritional assessment, helps us work with you on a nutritional plan for weight loss that gives you a personalized goal for your daily calorie intake.
Maximum volume of oxygen (VO2 Max) This is a measure of your aerobic capacity, or how effectively your body uses oxygen during exercise. To measure it, you’ll need to be engaged in an aerobic activity (such as on an elliptical, stationary bike, or treadmill), progressively increasing the difficulty of the exercise. The test duration will depend on your physical ability to engage in the aerobic activity, but usually it will be 10 to 15 minutes. During the exercise, you’ll breathe into a mask which measures the milliliters of oxygen used each minute per kilogram of body weight.
Knowing your VO2 Max can help you plan the most efficient workout for weight loss. It can provide the intel you need for the optimal heart rate you want to strive for in your fitness regimen. This way, you know the fat-burning sweetspot and can pace yourself or increase intensity as needed in your workouts.
Lactate threshold test. Have you ever exercised only to wake up the next day feeling extremely sore? Often the cause of this kind of pain is due to the production of lactic acid and other substances in the muscles which can build up during exercise. The lactate threshold test measures the point of exercise intensity before lactic acid builds up your blood quicker than it can be removed. This test requires you to engage in increasingly challenging aerobic activity and to have your blood drawn at different times throughout the process. Knowing your lactate threshold can let you know the best level of exercise intensity to plan for in order to optimize your workout.
After your initial metabolic testing, we’ll help you come up with a nutritional plan that is personalized to you, optimized for your weight loss. We also offer vitamin B12 supplementation for metabolic support. Throughout the medical weight loss process, you’ll have regular consultations with a nutritionist to make sure you’re on the right track.
Regardless of your metabolic testing results, there are some foods that are always a good idea to avoid if you’re trying to achieve weight loss. It’s probably a good idea to cut down on the following in your diet:
Sugar: How can something so sweet be bad? Well, it is. Sugar metabolizes very quickly, so after a short burst, you may feel energy-robbed, making it difficult to engage in physical activity that supports your weight loss goals. Sugar also causes your blood sugar to spike, increasing insulin levels which signals the fat cells in your body to store calories—the last thing you want your body to do when you’re trying to lose weight. Sugar can especially make fat around your abdomen stubbornly cling to you. It’s a good idea to cut sugary treats, like candies, cookies, pastries, ice cream, and other goodies out of your diet. You should also stop drinking sugary drinks like soda and fruit juice.
Fried Foods: The frying process adds a lot of calories to your food. One side of fries can’t hurt though, right? Think again—that side of fries may be as much as a third of the calories you need for the entire day. It’s not going to do your weight loss plan any favors.
Fast Food: In fact, it’s a good idea to try to banish fast food from your diet altogether, as many of the options are high in calories, fat, and complex carbohydrates, a trifecta impeding weight loss. If you must get food on the run, opt for a salad, grilled chicken option, or side of fruit instead of fries. Fast food restaurants (and any restaurants with more than 20 locations) are required to post calorie information on their menus, which can be very helpful for making good nutritional decisions if you’ve got to grab a meal on the go. If you're trying to track other info, such as carbs, protein, or fiber, you should be able to find complete info on a restaurant chain’s website.
Alcohol: Talk to our nutritionist about your alcohol intake. Moderate alcohol intake, such as an occasional glass of wine, has not been proven to be associated with sabotaging weight loss. In general, however, alcohol offers you nothing but empty calories with no nutritional benefit, and some alcohol, like beer, is relatively high in calories and carbohydrates. Some studies have shown heavy drinking can lead to weight gain.
Mindful Eating: The Psychology of Weight Loss
One of the premiere benefits of our medical weight loss program is the participation in the Am I Hungry? ® Mindful Eating Program led by Dr. Collins Hodges, one of the only licensed clinical psychologists in the Dallas-Fort Worth area trained in supporting weight loss for patients. Dr. Hodges leads our support groups. Dr. Hodges also guides our behavioral program which helps you address the psychological and behavioral causes of obesity, getting to the root of the reasons that may have made weight loss challenging for you in the past.
Mindful eating is an approach which challenges you to think critically about your relationship with food, examining what triggers you have that may cause mindless eating. Through the program, you’ll learn how to address thoughts and feelings that affect your overall eating habits. These workshops are engaging and often illuminating, helping you to recognize underlying issues that need to be addressed so that you can take control of your weight loss.
Getting Started With Non-surgical Weight Loss Treatment
Even modest weight loss is likely to provide you with health benefits. For many people who have struggled to lose weight—sometimes over and over again—medical weight loss provides the right path to achieve it. With a personalized approach and an expert team, My New Beginning offers a comprehensive weight loss program for those in the Dallas-Fort Worth area.
Contact us today to get started!