Medical Weight Loss Options
Being overweight is a chronic disease. As such it requires different treatment modalities at different times in ones’ life. At times surgery is essential, and at other times, nutritional education, life style guidance, exercise interventions, behavioral-mindful eating technologies and trigger analysis is needed. At the NYU Weight Loss Management Program patients have an array of choices to choose from. Programs are customized to meet each individual’s needs.
Dr. Stiles offers Individual Programs as well as evidence based Behavioral-Nutritional Groups with Supervised Meal replacement technology.
At the NYU Weight Management Program we offer:
1. Medical evaluations of weight related conditions
2. Medications for weight loss
3. Review of medications which cause weight gain
4. Metabolic profiling and evaluation for malnutrition
5. Meal replacement alternatives
8. VLCD Group – Full meal replacement Very Low Calorie Diet
9. Behavioral training in weight control: mindful eating
12. Evaluation of exercise limitations: orthopedic and pain issues
13. Strategies for safe, pain-free and doable exercise you might even enjoy
15. Chronic disease management – it takes a lifetime!
1. Medical evaluations of weight related conditions
Many medical conditions worsen with increasing weight. Some are metabolic diseases like diabetes and some are mobility diseases as knee pain and osteoarthritis. The understanding and treatment of weight and coexisting diseases goes hand in hand.
2. Medications for weight loss
Hunger can be distracting and defeating. Medications can often help us gain control of our hunger while we also put other medical, surgical and lifestyle strategies into place. Medications are a tool and work best when used as part of a comprehensive weight management plan.
3. Review of medications which cause weight gain
Many medications used to treat common diseases as hypertension, diabetes, depression, seizures and arthritic conditions can contribute to weight gain. There may be alternative medications or ways to ameliorate the disease processes so as to utilize less medicine in general. Dr. Stiles works with your regular doctor to suggest helpful strategies.
4. Metabolic profiling and evaluation for malnutrition
One can be severely overweight and malnourished due to an overuse of carbohydrates, and fast foods. Patients who have had a weight loss surgery or for any other reason have taken in too few calories and vitamins or vomited frequently are also at risk of malnutrition. Fatigue, achiness, funny feeling extremities or confusion may be due to a weight related vitamin deficiency or a protein deficiency.
5. Meal replacement alternatives
Research shows that prepackaged nutritionally balanced low calorie food choices help to maintain weight loss and can be a mainstay of weight loss success. Over the counter or special medically supervised meal replacement products are used depending on individual patient needs. Dr. Stiles helps each individual patient figure out which meal replacement strategy might suit them at any one time. One option is our Quick 20 program designed for you to lose weight
conveniently, rapidly and comfortably without hunger, pills or shots,
safely under clinical supervision. Check out our Quick 20 Program.
6. Individual meal planning
Planning is key. Nutritional awareness is key. Self accountability is key. This can be done individually or in groups, often with daily homework in terms of food diaries. There are many ways to record what one eats from a simple breast pocket check list to a detailed excel spread sheet.
7. Weight loss groups
Just showing up at a group energizes patients to work to lose weight. Well structured informational groups where a sense of safe community develops can make the difference in success or failure both short or long term. Some groups will incorporate behavioral and nutritional strategies only. Some groups are centered around a “partial” / (Low Calorie Diet) meal replacement strategy where patients use meal replacement products for all but one meal a day. The total calorie consumption remains at 1200-1500 calories usually. Groups work best if they are weekly. Sometimes there is not enough time on your schedule for this so we utilize scheduled weekly telephone contact with Dr. Stiles.
8. VLCD Group – Full meal replacement Very Low Calorie Diet
These groups are a full medically supervised fast of approximately 800 calories per day. One’s weight loss can be 5-20 pounds a week. Thus regular medical monitoring is essential in order to monitor fluid shifts, medication effects and other metabolic parameters. The group is critical to understanding the nutritional and behavioral issues which all dieters will face when they come off the fast. Groups occur either before or after your individual appointment with Dr. Stiles.
9. Behavioral training in weight control: mindful eating
This is a cornerstone of all individual and/or group curriculums. Changing how one eats, understanding ones eating cues and understanding head hunger vs. metabolic needs is key. Diets all fail when life hits us sideways. It is important to learn how to manage inevitable stress and eat less, see it coming or get back on track as soon as you can. There are tools. We all need to practice and fine tune these tools to develop a kind and safe individual strategy.
10. Nutrition planning tools
Part of mindful eating is to learn to read labels, menus and general food composition while setting into motion how to utilize this knowledge into one’s busy life style and one’s family preferences as well. Holiday planning is important. Dr. Stiles utilizes the expertise of the Nutritionists at the NYU Program for Wellness and Surgical Weight Loss to provide meaningful weight loss strategies and goals.
11. Self monitoring tools
When do you need to weight yourself? How much of a diet history must you do? How many labels should you read? How do you know you are “safe”? There are many strategies. What works for one person may not work for another. But we do know that staying accountable to yourself helps weight loss and prevents weight regain. This should be done in the spirit of curiosity and not guilt or dread. There are ways.
12. Evaluation of exercise limitations: orthopedic and pain issues
Walking may be painful and even damage joint surfaces when there is extra weight to bear. There are many considerations on how to find a safe, comfortable, easy to do exercise program: sitting, water, reclining, pacing, frequency.
13. Strategies for safe, pain-free and doable exercise you might even enjoy
What is cardiovascular fitness when walking really hurts? What biomechanical factors can be addressed to find safe exercise? What about strength training? Who needs a stress test? What about supportive shoes? Do I need a trainer? How do I find a gym? I hate gyms, so what do I do? How do I use a gym? Why do I need to exercise anyway? Research shows that people who exercise doing something they love and especially if it is with someone they enjoy, these people are resistant to weight regain.
14. Special populations
Diabetics, patients with insulin resistance including women with PCOS (polycystic kidney disease) or with a history of gestational diabetes have unique vulnerabilities related to glucose (sugar) metabolism. Dr. Stiles works intensively with you to develop safe low calorie and very low carbohydrate meal plans which often seem to jump start and accelerate weight loss.
15. Chronic disease management – it takes a lifetime!
Practice and repetition. Dr. Stiles reminds us that overweight issues are a chronic disease process which reflect societal, genetic and individual vulnerability that usually needs to be addressed for the rest of one’s life. Life hits us sideways and issues crop up. Sometimes we may need different tools: surgery, medication, VLCD meal plans, group talking, or specialty referrals to many therapists (orthopedists, cardiologists, psychologists to name a few). If one has a Weight & Wellness Specialist which you see routinely (usually ever 4 weeks), new life issues, new insights and new medical concerns are addressed and strategies and instituted. This is the best obesity care possible for any disease. And you deserve it. There is hope when you know that there are solutions as long as you keep coming. It is not simple but you are not alone.
