1. How is the Salvéo Weight Management Program different from other weight loss programs?
We are committed to providing the most outstanding medical experience for our patients. Through our training and experience, we bring over 19 years of medical experience to the east coast. Four out of 5 patients that enter the Salveo Weight Management program for just three months visits lose enough weight to reduce their long term risk of diabetes by 50%. Many patients are able to come off their medicines for high blood pressure, high cholesterol, and depression.
At Salveo Weight Management, we teach how to utilize grocery foods to fuel your body. We recognize, however, that sometimes it can be challenging to meet our daily nutritional needs. Our office carries meal replacements and other food items that help to keep patients on target and on their path to weight loss success!
Dr. Mackey will also treat you with compassion and understanding. It is our desire to treat you as a complete person. Some visits may focus on nutritional needs, while others may be focused on stressors that are currently in your life. We know the weight loss journey can be complicated, and we are prepared to help you every step of the way!
2. What is a realistic expectation for my weight loss?
At Salvéo Weight Management, 97% of patients lost weight by their first follow up.
We know from research (and practical experience), that long term weight loss and maintenance are more important than the first-month loss. Under the medical care of Dr. Mackey, over 80% of patients that make at least three visits to the office lose enough weight to reduce their risk of diabetes by 50%! Please remember that statistics will not predict YOUR weight loss success, however, these numbers give you some idea about our program’s history.
Excess body weight is a very complex medical disease, one that the medical community is trying to understand better. Quite often, undiagnosed medical diseases are associated with weight gain. These conditions may prevent weight loss or can be harmful to your health if left untreated. A Bariatric medical specialist can test for these metabolic conditions and treat them.
3. What should I expect at my first visit? On follow up visits?
At your first visit, you can expect:
- A full medical history and physical exam with the physician
- Body composition analysis and interpretation
- Weight, body measurements, and vital signs
- EKG and interpretation if indicated by medical history
- Individual physician counseling outlining your personal plan for weight loss
- Time to address your questions with the physician
- Ordering of lab testing
Follow up visits are typically monthly. You can expect body measurements, abbreviated physical exam, vital signs and time to review your progress with the doctor. Along your weight loss journey, additional lab tests or EKG may be indicated, but the physician will discuss these with you first. At these visits, there may be adjustments to your medications, nutrition, exercise or motivational tools. Please be sure to ask any questions you may have at any of these visits. We are here to help!
4. Am I a candidate for the Salvéo Weight Management Program?
Salvéo Weight Management provides a medical treatment program for patients who need lose weight and whose BMI is 27 kg/m2 or greater. If you have struggled to lose weight, lost and regained, or are experiencing diseases as a result of excess weight, we can help! Salvéo is experienced with patients who are considering weight loss (Bariatric or “stomach stapling”) surgery or who have had surgery in the past. Call today to schedule your physician consultation!
5. How is body composition analysis used in the Salvéo Program?
Salvéo doesn’t limit the evaluation of weight gain to just height and weight, or BMI. Our office utilizes the most advanced body composition analyzer made by Seca.
Seca’s body composition analysis allows you to experience new insight regarding your body and can offer you motivation to stay on track with weight loss. It starts with understanding the needs of your body and the proper balance between fat-free mass and fat. Understanding this is essential for optimal health and fitness. That is why it is better to measure your body composition rather than only weight, because a scale can’t tell the difference between a pound of muscle and a pound of fat. Seca now offers state-of-the-art body composition testing with the Seca mBCA 514 (medical Body Composition Analyzer), designed and validated for medical use.
There are many benefits of having the test done. It is a brief examination that is non-invasive and is finished in less than 20 seconds. The test not only provides an assessment of your general health and nutritional status, but gives you precise measurements of your fat-free and muscle mass, % body fat, skeletal muscle and much more. Plus, it identifies early indicators of various diseases.
Regular body composition testing is pivotal in maintaining motivation while losing weight and building muscle mass. By understanding your unique body design, medical history and personal needs, Salvéo Weight Management can offer you the most personally tailored weight loss program to help you achieve your goals.
6. Will medication be part of my weight loss program?
When appropriate, the use of appetite suppressants or other medications may be incorporated into the weight loss plan for a patient. Some of the medications that may be considered for patients include:
Saxenda is a medication approved by the FDA in December of 2014 for the treatment of obesity in conjunction with a comprehensive weight management program. A glucagon-like-peptide-1 (GLP-1) agonist, it is an injectable medication similar to Victoza which is approved for the treatment of diabetes. It has shown promise as a weight loss medication since its approval in December 2014, especially in combination with a program such as Salveo Weight Management. Saxenda works by enhancing satiety (feeling of fullness) and reduction of portion size/calories. Saxenda is not appropriate for all patients, so the physicians will discuss all options with you.
Contrave is an FDA approved medication that combines naltrexone and bupropion. Both of these medications have been available for years. Naltrexone is designed to treat addictive behaviors and bupropion has been used to treat depression and tobacco addiction. Combined, these medications have had great success in assisting patients lose weight in combination with a comprehensive weight management program. The physicians will be happy to work with you to decide what is best for your weight loss needs.
Phentermine was first approved by the Food and Drug Administration in 1959 as a short term (a few weeks) adjunct in a regimen of weight reduction based on caloric restriction. The most common and most extensively used medications in this category are phentermine, phendimetrazine and diethylpropion. The Obesity Medicine Association (OMA) and other obesity organizations have reviewed the medical literature and believe that, under physician supervision, the extended use of these medications is safe. Salvéo physicians will screen for any medical conditions that would make their use unsafe. OMA physicians also understand that medication use alone is not sufficient for the safe and long term maintenance of weight loss. Therefore, Salvéo only prescribes these medications when medically appropriate, under close medical supervision and when combined with our comprehensive weight management program.
Qsymia is a medication used for weight loss. In clinical trials, Qsymia was associated with modest but statistically significant weight loss when compared with placebo. This weight loss was associated with improvements in weight-related comorbidities such as improved glycemia, decreased blood pressure, and improved cholesterol. Qsymia is a combination of two medications that have been available for years. Topamax is an antiseizure medication and phentermine is an appetite suppressant. Every medical treatment for weight loss must be accompanied by a comprehensive program. You can discuss with the Salvéo physicians if this medicine might be right for you.
Belviq is a medication that works centrally (in the brain) to help with satiety (feeling full). This leads to reduced food consumption and weight loss. The exact mechanism of action is not known. We have read the research and are following the ongoing studies regarding this medication. Every medical treatment for weight loss must be accompanied by a comprehensive program. Please ask the Salvéo physicians if this medicine might be right for you.
7. What is a Bariatrician?
A bariatrician is a physician (MD or DO) who has, under the direction of the American Board of Obesity Medicine (ABOM), elected to receive additional training in the field of Bariatric Medicine (non-surgical treatment). The Obesity Medicine Association (OMA), The Obesity Society and other organizations offer extensive continuing medical education in the management of obesity, ensuring that their members are updated on the latest research and evidence-based medicine. The society also active politically and testimony before the American Medical Association was instrumental in the decision to declare obesity a disease. This opens doors to reduce stigma and discrimination as well as improved treatments and research.
While any licensed physician can offer a weight loss program, bariatricians are uniquely equipped to address the needs of those seeking treatment for excess body weight. They have the specialized tools, techniques, and understanding to offer patients individualized treatment and to identify common roadblocks along the weight loss journey. They offer a comprehensive program of nutritional education, exercise, lifestyle changes, behavioral interventions and, when appropriate, the use of appetite suppressants or other medications. Bariatric physicians regularly share useful medical information, thus improving the treatment of obesity for all.
8. Does Bariatrics mean Surgery?
Bariatrics is the field of medicine that focuses on the disease of obesity and the science and medicine related to weight loss. The use of the word “bariatric” is relatively new and comes from the Greek root bar- ,(weight) and the suffix -iatr (treatment). Recently, due to an increased number of weight loss surgeries being performed, the word is commonly associated only with surgical treatment for weight loss.
Surgeons who perform weight loss procedures are called “bariatric surgeons.”
Physicians who treat patients with non-surgical treatments for weight loss are “bariatric physicians” or “bariatricians.”
Many times, the two types of doctors work together to provide the most comprehensive treatment available for their patients.
It is important to recognize that weight loss surgery can be a very useful intervention for some, but not all, patients. And, it is important that any patient who undergoes weight loss surgery continues to follow a lifetime of care with a physician who understands bariatric medicine. Prevention of weight regain following weight loss surgery is essential.
9. How do I know if I’m overweight or obese?
The World Health Organization uses the Body Mass Index (BMI) as a measure of what is a healthy weight. It is a simple calculation the divides weight by height (click here to use the BMI calculator). The advantages of using BMI are its simplicity and reproducibility. Most research uses BMI to stratify patients. The disadvantages are that it does not take into account muscle mass (a body builder will have a high BMI), distribution of weight (healthier to have less abdominal fat), and ethnic differences.
A BMI table oversimplifies the diagnosis of overweight or obesity. Our physicians utilize far more medical data when evaluating our patients.
10. Why see a Board-Certified Weight Loss Specialist?
The American Board of Obesity Medicine is a specialty board that oversees the education and testing of physicians who desire board certification in bariatric medicine. Physicians are required to complete 60 hours of medical education, attend conferences, and pass a rigorous written exam. Board Certified doctors must continue their education and retest every 10 years. Dr. Mackey maintains her board certifications in both Obstetrics and Gynecology and Obesity Medicine and stays up to date on the latest research through conferences and continuing medical education.
According to the National Institutes of Health (NIH) and the US Preventative Services Task Force (USPSTF), patients with medical conditions or those needing to lose more than 15 pounds should seek physician treatment. These organizations use medical evidence to support their recommendations that treatment should include reduced calorie diets, increased physical activity, and intensive behavioral therapy. They also suggest the use of weight loss medications in the appropriate setting. The American Academy of Family Physicians agrees and the American Congress of Obstetricians and Gynecologists recommends referral for treatment to an Obesity Specialist when the patient’s BMI is greater than 40, the patient’s BMI is greater than 35 with health problems, or when the patient has not succeeded with other interventions. Any patient with a BMI over 25 is appropriate for intervention. Our comprehensive program at Salvéo offers these skilled services to meet each patient’s needs.
Because of their specialized training, the physicians will focus on ensuring that your weight loss is healthy. They can ensure that you preserve lean body weight (muscle), and provide a plan for weight loss maintenance. The Salvéo physicians and staff will identify any medical or psychological barriers to weight loss, treat plateaus and identify medical conditions that often accompany excess weight.
11. Why is it important to treat obesity?
Carrying excess weight can be uncomfortable, inconvenient and socially stigmatized. However, the most important reasons to treat obesity are not cosmetic. Obesity and overweight are associated with significant health risks including diabetes, heart disease, high blood pressure, high cholesterol, heart attack, sleep apnea, kidney disease, fatty liver, asthma, arthritis, gallstones, gout, depression, infertility and many cancers. These health problems cause financial burdens due to necessary medical care and prescriptions as well as lost productivity at work. It is estimated the U.S. health care expenditures for obesity exceed $270 billion! (Society of Actuaries, 2010)
And $50 billion is spent annually on weight loss products in the United States!
So why do we continue to gain weight? The answer is complex and involves genetic, environmental, political and financial components. However, there is good news! There are many organizations like the ABOM, OMA , OAC (Obesity Action Coalition), AMA (American Medical Association), ADA (American Diabetes Association, AHA (American Heart Association) and many others that are actively researching and advocating for improved treatment options. Their advancements are directly communicated to your bariatrician so we can better treat each individual patient.
There is very clear medical evidence that shows that weight loss of just 10% can significantly reduce your risk of these medical complications of excess weight.
Benjamin Franklin was right when he said, “An ounce of prevention is worth a pound of cure.”
12. What is BMI/BMR?
BMI, or Body Mass Index, is a simple math equation of weight (kilograms) divided by height (meters). The World Health Organization categorizes BMI as:
- Normal: 18-25
- Overweight: 25-30
- Obese I: 30-35
- Obese II: 35-40
- Obese III: 40 and above
There are drawbacks to using BMI as a measure of health, however. It does not take into account fat mass versus lean mass. For example, consider: Body weight=fat free mass + fat mass
Fat mass is a more useful tool for predicting health and maintaining a healthy body fat percentage is important. This can be measured using a body composition analyzer, like the Seca scale in our office.
BMI also does not take into distribution of body fat. An android, or apple, shape has more fat deposited around the waist. This is less healthy than the so called “pear-shape”. Body measurements help to evaluate where fat is deposited. Ethnic differences also exist for BMI.
Know your numbers! During weight loss, it is important to see the number on the scale moving in the right direction. But it is more important to see improvements in body fat percentage or in laboratory results.