Southcoast Weight Loss Center

Southcoast Weight Loss CenterMedical 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 ProgramF Fits with your lifestyleR Real FoodE EnergyS SupportH Healthier You Focuses on Therapeutic Carbohydrate Reduction (TCR) as a way to improvemetabolic 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 carbohydrateper day. Multidisciplinary program that supports you with guidance from: PhysiciansNurse PractitionersDietitiansBehavioral Health Specialists Offers Nutrition Education and Support Groups3

Benefits of TCRConditions that improve:ObesityInsulin ResistanceType 2 DiabetesHypertriglyceridemia (High Triglycerides)Fatty LiverHypertension (High Blood Pressure)Mood DisordersMigrainesPCOSIrritable Bowel Syndrome (IBS)Binge Eating DisorderMild Chronic Kidney Disease 4Conditions that make TCR more difficult (but not impossible): Type 1 Diabetes, prior Cholecystectomy,Developmental Delays (unless there is a support system), Severe psychiatric conditions (uncontrolledBipolar, Schizophrenia, etc).

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 BehavioralHealth Specialist) Step 5: Nutrition Class (optional) Step 6: Support Groups (ongoing)5

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 refinedgrains/sugars. Encourage protein, healthy fats and non-starchyvegetables at meal times Create a framework for a style of eating that you are agreeable to6

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 whostruggle with: Specific eating behaviors such as eating disorders, emotionaleating, 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 9depending on treatment planLabs (if needed)Troubleshooting/Predicting roadblocksDeprescribingCommunication with healthcare teamSupport groupsLiberalizing the diet once goal is reached.

Program Rules We don’t make people eat anything they don’t like or that makesthem sick We respect your ethical choicesWe can work within your budget. We are just taking out the food-likesubstances that don’t serve your body well We treat everyone as an individual and make individualizedrecommendations Nutrition Class and Support Groups are optional but very muchencouraged!10

Indications for Weight Loss Medications Difficulty achieving healthy weight with lifestyle alone. Patient and prescriber agree that potential benefits outweighrisks. BMI greater than 30, OR BMI greater than 27 with at least one comorbid condition suchas: Diabetes type 2, impaired fasting glucose/prediabetes,hypertension, hyperlipidemia, obstructive sleep apnea, fattyliver disease, coronary artery disease, polycystic ovariansyndrome or any of the less-frequently identified conditions associatedwith 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 agespectrum)12

Please watch video onWeight Loss MedicationBy: Dr. Jessica Inwoodhttps://www.youtube.com/watch?v LpNFOvNtMuk&feature youtu.be

Weight Loss Surgery

Types of Surgeries Performed atSouthcoastRoux-en-Y gastric BypassSleeve 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 ineffective16

Weight Loss SurgeryFOR OUR PROGRAM Weight less than 450 pounds Medical weight loss for higher weights (400-450 lbs) thensurgery AGE 18 or older Nonsmoker Non-negotiable Drug and Alcohol dependence free No uncontrolled psychological conditions Patient agreeable to lifestyle changes17

Educational SeminarSurgical Evaluation3-6 WorkshopsNursing educationSurgery18Lab work andTesting Medicalclearance

Insurance CoverageInsurance will likely cover: Physical and medical workup Weight loss Surgery Consultation with Physician Consultation with Dietitian Medicare only covers nutrition visits if you have adiagnosis of Diabetes or Renal Disease**Please check with your insurance plan regarding yourspecific coverage for medical weight loss treatments orweight 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 508-973-1850ORSubmit an interest form and our staff will contact you

Thank You!

- Weight Loss Medication - Weight Loss Surgery. Weight Management Treatment Options at our Center. 3 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 . Liberalizing the diet once goal is reached.