An Inside Look at Medically Supervised Weight Loss ProgramsMarch 2, 2020
Medically Supervised Weight Loss
If you are exploring the idea of a medically supervised weight loss program it is important to be an informed consumer. Unlike some purchases, this will be an investment in yourself so you want to have a clear list of your personal needs and the expectations you have of the program.
Components of a Medically Supervised Weight Loss Program
One of the things to share during the initial meeting is a history of previously followed weight loss programs and which have been the most and least effective. Since I work for a practice that provides a Medically Supervised Weight Loss Program (MWL), I always ask patients why they think this program will be different. This helps them to better understand their own needs and then together the members of the clinical team can help the patient to set realistic goals.
NYBG has a medical weight loss program that includes several people on its interdisciplinary team. This article will describe the role of each practitioner and how each member plays a part in the process.
The physician will first meet with the patient and assess if the patient is a suitable candidate for the program and discuss possible options. This meeting will include a review of their health history, diagnosis, prescribed therapies, a request for recent blood work, and a review of weight loss plans previously followed by the patient. As an example from our program, a MWL plan usually consists of various phases and initially may include some meal replacement food or drink.
Protein shakes have become very popular and are used as part of many weight loss programs. I think that a patient should ask questions about products and supplements being prescribed as part of the program. Any supplements that promise weight loss should be discussed in detail so that a patient fully understands what they are putting in their body and how these products may actually facilitate weight loss if used consistently. Protein shakes are just an easy way to replace unhealthy selections and can actually be used indefinitely.
Many programs like ours sell their own products and these are often comparable to various products sold online or in local stores. The reason these products are effective is because they are replacing unhealthy food choices and they are mostly comprised of protein, which can increase satiety.
For example, if a patient starts drinking a shake for breakfast in place of a breakfast sandwich they are now consuming approximately 160 calories instead of 500 calories found in that sandwich. This significant reduction in calories and nutrients like fat and carbohydrates will result in weight loss. The next phase of the diet should help the patient transition to eat whole foods with more control since they have had a chance to detox for a few weeks. The physician will also determine if weight loss medications are a suitable option.
Our patients are often encouraged to get started with the program and then medications can always be added later if weight loss is less than optimal. These medications are generally appetite suppressants and will have to be used long term so it will require the patient to learn about the drugs and gain some insight and be aware of possible side effects from long term use. There may be several options and the patient should be their own advocate. It is very important that a patient makes a commitment to dietary changes and not rely solely on medications and supplements to work magic. For many, these prescribed therapies can be helpful as they reduce appetite and subsequently intake, which results in weight loss.
The Clinical Psychologist is an integral part of this interdisciplinary team at NYBG and patients are encouraged to follow up monthly. For most people, the challenge with weight loss and weight maintenance has underlying issues. Like any challenge in life, it’s important to work through the obstacles or barriers that have made this so difficult in the past. Anyone can lose weight but keeping it off is the hardest part.
While this takes hard work and commitment, for many understanding behaviors and how emotions affect so many facets of our lives is vital for long-term success. These obstacles can be emotions like feelings of depression or anxiety but also variables that trigger different emotions. If someone has a stressful job, hectic home life, or other factors that trigger emotional overeating then these should be identified.
It is important for the patient to understand that these variables will not change with weight loss but they can learn to manage stress and implement techniques provided by the psychologist. Another thing that can be helpful is attending support groups amongst peers. This allows the patient to hear that they are not alone as weight loss is a struggle for many people and remains prevalent. The psychologist can be instrumental in providing both insight and techniques used to work through these concerns.
The Dietitian will be at the forefront of this weight loss program. An RD should be able to assess your nutritional needs and help you to formulate a plan that facilitates weight loss. The most important part of the plan will be whether it is sustainable. All too often patients come into my office and express that they have met with a dietitian in the past and the experience was not what they expected. They are often given what they feel are cliché’ recommendations about eating small frequent meals throughout the day. While this may be a helpful practice to maintain normal blood glucose, avoid grazing and overeating at meals, nutrition is not a one size fits all practice.
A patient should feel heard and like any other relationship, this needs to be the right fit. As a practitioner, I know it is important to listen to people’s needs and the variables that affect their lives. That will include an assessment of daily intake, food preferences, schedule, family dynamics, and occasionally mean. Once that information is provided then a Registered Dietitian can formulate a plan that is realistic and manageable for the patient.
If a patient works rigorous hours and has to on occasion work through meals, it may not be appropriate to tell them to make time for lunch in the middle of a busy day. A reasonable solution may be to use a protein shake during the day to avoid a long lapse between meals. At New York Bariatric Group, the Dietitians are able to provide the patient with resources that will assist them for the duration of our program. They are given access to a library of heart-healthy recipes and this exemplifies that food can be tasty without tipping the scales. That library also includes fitness videos so they can workout at home. The idea is to make these resources available at all times so they can adapt to a lifestyle instead of viewing the program as a plan that has an end in sight.
The most important part of our program is monthly counseling with an RD and those visits can be done virtually which eliminates travel time and allows the patient to check-in routinely even if their personal schedule has time restraints. Our patients really enjoy this aspect because they can remain accountable while receiving on-demand counseling offered on the weekends and outside of traditional business hours during the week.
Medically Supervised Weight Loss Programs
Medically Supervised Weight Loss Programs can offer tools and support but the patient has to be an active participant. Patients often report that they have tried numerous programs but were not consistent in their efforts and could not remain on the program long term. If a product is suddenly discontinued or is no longer available or affordable then the patient should still be able to lose weight and not forfeit their goals. I often hear this phrase ”the program worked but then I gained all the weight back”. I always explain that every program requires a plan or next steps for weight maintenance. If a patient stops a plan and reverts backs to old habits then rapid weight gain is inevitable. So keep these ideas in mind, shop wisely, and remember that support and guidance are valuable and should be factored into your selection process.
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ABOUT THE AUTHORShara Lazar, RD, CDN has spent many years counseling patients with health concerns such as hypertension & diabetes which led her to help people reduce the risk of developing these health issues & improve the quality of their lives. She joined New York Bariatric Group with eight years of bariatric nutrition expertise & is passionate about fitness. She helps patients to integrate nutrition & exercise into their lives with a practical approach and support.
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