Southcoast Weight Loss Center

Medical Weight Management

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

- Weight Loss Medication

- Weight Loss Surgery

Weight Management Treatment Options at our Center

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F.R.E.S.H Start ProgramF = 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:ObesityInsulin ResistanceType 2 DiabetesHypertriglyceridemia (High Triglycerides) Fatty LiverHypertension (High Blood Pressure)Mood Disorders MigrainesPCOSIrritable Bowel Syndrome (IBS)Binge Eating DisorderMild 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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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)

Program Outline

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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

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

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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.

Follow-up

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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!

Program Rules

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.)

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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)

Contraindications to Weight Loss Medication

Please watch video onWeight 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

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Who is a candidate for Surgery?

BMI of 40 or over

BMI of 35-40 with significant co-morbidityHigh blood pressureDiabetesSleep apnea

Documented dietary attempts ineffective

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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

Weight Loss SurgeryFOR OUR PROGRAM…

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Educational Seminar

Surgical Evaluation

Nutritional evaluation

Psychological evaluation

Workshops

Nursing education

Lab work and Testing + Medical

clearance

Surgery

3-6 months

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!