Southcoast Weight Loss Center - Medical Weight Management - Southcoast Health

Southcoast Weight Loss Center

     Medical Weight Management

Weight Management Treatment Options at our Center

    - F.R.E.S.H Start Program

    - Weight Loss Medication

    - Weight Loss Surgery

F.R.E.S.H Start Program
    F = Fits with your lifestyle   R = Real Food   E = Energy   S = Support   H = Healthier You

     Focuses on Therapeutic Carbohydrate Reduction (TCR) as a way to improve
       metabolic health

     What is Therapeutic Carbohydrate Reduction (TCR)?
         - Primarily a real foods, whole foods lifestyle. Beware of the word “diet.”
        - Any nutrition plan that contains fewer than 130 total grams of carbohydrate
       per day.

     Multidisciplinary program that supports you with guidance from:
         •   Physicians
         •   Nurse Practitioners
         •   Dietitians
         •   Behavioral Health Specialists

     Offers Nutrition Education and Support Groups

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Benefits of TCR

    Conditions that improve:
    Obesity
    Insulin Resistance
    Type 2 Diabetes
    Hypertriglyceridemia (High Triglycerides)
    Fatty Liver
    Hypertension (High Blood Pressure)
    Mood Disorders
    Migraines
    PCOS
    Irritable Bowel Syndrome (IBS)
     Binge Eating Disorder
     Mild Chronic Kidney Disease

    +   Conditions that make TCR more difficult (but not impossible): Type 1 Diabetes, prior Cholecystectomy,
        Developmental Delays (unless there is a support system), Severe psychiatric conditions (uncontrolled
        Bipolar, Schizophrenia, etc).

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Program Outline

     Step 1: Online informational presentation and video

     Step 2: Consultation with Dietitian

     Step 3: Consultation with Physician or Nurse Practitioner

     Step 4: Behavioral Health Appointment
        (Not all patients will require an appointment with a Behavioral
        Health Specialist)

     Step 5: Nutrition Class (optional)

     Step 6: Support Groups (ongoing)

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Consultation with Dietitian

       Weight history

     Assess current eating behaviors such as:
       • Quality of food
       • Quantity of food
       • Timing of Meals

     Personal preferences and cultural traditions are taken into account.

     Assess barriers to success, and suggest solutions.

     Emphasize less processed, more whole foods, fewer refined
        grains/sugars. Encourage protein, healthy fats and non-starchy
        vegetables at meal times

     Create a framework for a style of eating that you are agreeable to

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Consultation with Physician or Nurse Practitioner

 Medical and Weight history—Comorbid Conditions
 Patient’s main motivating factor for seeking treatment
 PCP Concerns
 Nutrition History
 Family History (including clues to genetic syndromes)
 Social history, especially substance abuse/addictive behaviors
 Potential barriers to success, including health literacy
 Medication adjustments that played a role in weight gain
 Pertinent exam
 Labs to rule out secondary causes (e.g., TSH, cortisol)

Consultation with Behavioral Health Specialist

 Referral by Physician, Nurse or Dietitian for patients who
   struggle with:
    + Specific eating behaviors such as eating disorders, emotional
       eating, food addiction

 Typically 2 individual sessions

 Continue to offer guidance and support at group meetings

Follow-up

     Follow up schedule will vary for each patient
        depending on treatment plan
       Labs (if needed)
       Troubleshooting/Predicting roadblocks
       Deprescribing
       Communication with healthcare team
       Support groups
       Liberalizing the diet once goal is reached.

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Program Rules
      We don’t make people eat anything they don’t like or that makes
         them sick

        We respect your ethical choices

         We can work within your budget. We are just taking out the food-like
         substances that don’t serve your body well

      We treat everyone as an individual and make individualized
         recommendations

      Nutrition Class and Support Groups are optional but very much
         encouraged!

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Indications for Weight Loss Medications

  Difficulty achieving healthy weight with lifestyle alone.
  Patient and prescriber agree that potential benefits outweigh
   risks.
  BMI greater than 30, OR
  BMI greater than 27 with at least one comorbid condition such
   as:
     + Diabetes type 2, impaired fasting glucose/prediabetes,
       hypertension, hyperlipidemia, obstructive sleep apnea, fatty
       liver disease, coronary artery disease, polycystic ovarian
       syndrome
     + or any of the less-frequently identified conditions associated
       with obesity such as stress urinary incontinence, arthritis,
       asthma, and depression (to name a few.)

Contraindications to Weight Loss Medication

         Pregnancy
         Breastfeeding
         Inability to follow up
         Drug interactions
         Active cancer treatment
         Narcotic abuse
         Unstable psychiatric condition
         Age (relative contraindications at both ends of the age
          spectrum)

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Please watch video on
Weight Loss Medication
By: Dr. Jessica Inwood

https://www.youtube.com/watch?v=LpNFOvNtMuk&feature=youtu.
be

Weight Loss Surgery

Types of Surgeries Performed at
Southcoast

Roux-en-Y gastric Bypass   Sleeve Gastrectomy

Who is a candidate for Surgery?

          BMI of 40 or over

          BMI of 35-40 with significant co-morbidity
             High blood pressure
             Diabetes
             Sleep apnea

          Documented dietary attempts ineffective

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Weight Loss Surgery
     FOR OUR PROGRAM…
      Weight less than 450 pounds
         + Medical weight loss for higher weights (400-450 lbs) then
           surgery

      AGE 18 or older

      Nonsmoker  Non-negotiable

      Drug and Alcohol dependence free

      No uncontrolled psychological conditions

      Patient agreeable to lifestyle changes

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Educational Seminar

                                   Surgical Evaluation

                                                           Lab work and
     3-6 months

                  Nutritional           Psychological    Testing + Medical
                  evaluation             evaluation          clearance

                            Workshops

                                    Nursing education

                                         Surgery
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Insurance Coverage

Insurance will likely cover:
   + Physical and medical workup
   + Weight loss Surgery
   + Consultation with Physician
   + Consultation with Dietitian
       + Medicare only covers nutrition visits if you have a
         diagnosis of Diabetes or Renal Disease

       **Please check with your insurance plan regarding your
       specific coverage for medical weight loss treatments or
       weight loss surgery

Mindset for Success

 Reasonable expectations

 Willingness to change your lifestyle

 Maintaining scheduled appointments

 Participation in Support Groups

 Regular exercise (if able)

 Remaining aware of food intake and body weight

Next Steps:

                    Make an appointment:

Call 508-973-1850

OR

Submit an interest form and our staff will contact you

Thank You!