Obesity is a common problem that can cause fatigue, diabetes, fatty liver disease, and sleep problems, and raise the risk of many cancers. It reduces energy, and can take the pleasure out of many aspects of life.
Extra weight also places stress on vital organs, including the heart, liver, and kidneys, as well as joints and the reproductive system. Although organs can work under this extra stress for a number of years, eventually they are likely to fail. Most organs lose about 80% of their capacity before symptoms are evident, and by that time, it is often too late to return them to normal function.
The conditions associated with obesity are:
Obstructive sleep apnea
Losing weight can help improve and sometimes cure many of these conditions, as well as fertility issues. Losing weight can also lead to a life with fewer medications, lower health expenses, and overall greater enjoyment.
At the Yale Metabolic Health and Weight Loss Program, we offer all nonsurgical weight-loss interventions in one location. Our philosophy is to focus on health, rather than specific disease, and to tailor our care to each patient’s specific needs and goals.
The first step in our care is to determine weight-loss goals. Patients may need to lose 5 to 10% of their body weight to help in the treatment of a disease. We will help patients choose from interventions that include intensive meal-replacement programs, a range of medications, or endoscopic (nonsurgical procedure) options. Sometimes, there are additional medical necessities, such as an upcoming surgery, that require a specific weight-loss goal.
We will explain the advantages and disadvantages of the various options, but the choice will depend primarily on what feels right to the patient.
We provide therapies under the medical supervision of obesity experts. Patients can choose from the full range of tested interventions:
Lifestyle changes: Nutrition counseling goes hand-in-hand with medical management of metabolic health. Care will include a personal visit with a registered dietitian with advanced training in weight management.
OPTIFAST® program: OPTIFAST® is a medically monitored weight management program that allows patients, under the supervision of a physician, to consume a low-calorie diet and receive comprehensive lifestyle education.
The OPTIFAST program provides full meal replacement for 12 weeks and transitions to self-prepared “everyday” meals in conjunction with comprehensive patient education and support, to help patients achieve long-term weight loss.
Medications: All medications are used as part of a comprehensive program that includes proper nutrition and a healthy lifestyle.
Belviq® is taken twice daily and can produce weight loss in the 5 to 10% range after about six months of use. Its main effect is to decrease appetite.
Contrave® is a single pill that contains two medications (naltrexone and bupropion) and is taken twice a day. It will reduce appetite and can produce weight loss in the 5 to 10% range.
Phentermine is taken once in the morning, and is prescribed for a few weeks. It causes appetite suppression and weight loss.
Qysmia® is a single pill that contains two medications (phentermine and topiramate), and is taken once a day in the morning. It will reduce appetite and can produce weight loss in the 10 to 15 % range.
Xenical® reduces absorption of fat and is taken three times a day around meal times.
Individual counseling: In addition to the medical management of weight loss, improved health, and well-being, our program offers support through individual counseling.
Group sessions: Patients may attend monthly weight management classes that will teach good nutrition practices, providing patients the information they need to make lifestyle changes that will help them lose weight.
Endoscopic interventions: Endoscopy is the use of instruments to examine the esophagus and stomach. It is usually a 20- to 30-minute outpatient procedure that does not involve incisions. Many interventions that previously required regular surgery can now be done endoscopically.