Metabolic Health & Weight Loss ProgramObesity 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: Cancer Cardiovascular disease Diabetes Liver disease 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 d
Pediatric Weight Solutions ProgramWe help children who are overweight or obese improve their health through a variety of strategies, including behavior and lifestyle modification. We understand that many factors can contribute to obesity, including genetics, diet, physical activity level, psychological issues, and adverse family events. Our team includes board-certified pediatric endocrinologists, advanced practice registered nurses, physician assistants, a registered dietitian, a bariatric surgeon, and an endocrinologist who specializes in diabetes and obesity management for adults and children. We work together to tailor treatment to each child and his or her family. Seventeen percent of children ages 2 to 19 in the United States are obese, according to the Centers for Disease Control and Prevention. While there is no cure for obesity, our caregivers work with children to prevent serious health complications that can accompany it, including: Prediabetes and type 2 diabetes Polycystic Ovary Syndrome (PCOS) High cholesterol Fatty liver disease When a child is referred to us—typically from a pediatrician—our first step is to do a full medical examination and check for obesity-related diseases and complications. We offer a traditional approach to weight loss through lifestyle changes, and incorporate the whole family into the process. We refer many children to Yale School of Medicine’s Bright Bodies Program in New Haven, which teaches children and their families about nutrition and encourages them to exercise. If lifestyle and behavioral modifications are not successful, medications are a potential option for children 16 and older. Our last step, if necessary, would be bariatric surgery, also for children 16 and up. There are rigid protocols for the surgery, as well as pre- and post-surgical care. Once patients turn 21, we can seamlessly transition them into an adult program for weight management.
Post-Bariatric Body Contouring ProgramWe offer state-of-the-art body contouring for patients who have lost a significant amount of weight, and now have extra skin and fat. Body contouring may include arm lift, breast lift/reshaping or reduction, tummy tuck, thigh lifts, and liposuction. We collaborate with the Yale Bariatric & Minimally Invasive Surgery Program to manage all aspects of treatment. Our multidisciplinary team of surgeons, nurses, nutritionists, and exercise specialists all help to ensure successful long-term results. Support programs are also available to help patients achieve their personal weight-loss, dietary, and stress management goals. Our team understands that living with the extra skin or fat after significant weight loss can present challenges, and we want to help patients meet those challenges by exploring what they mean in their daily life. We focus on education and making patients their own best advocate, and work closely with them so they can choose the contouring procedures that will help them feel confident about their body.
Center for Weight ManagementWeight management is a complex and multi-faceted challenge that can involve a wide range of health issues, with solutions that are different for every person. The Center for Weight Management, part of Yale New Haven Health (YNHH) and Yale School of Medicine, is a multidisciplinary practice offering a comprehensive range of services for patients needing help to achieve their target weight. The center provides assistance with weight and weight-related health conditions from many different perspectives, with personally tailored solutions based on each patient’s specific needs and goals. Weight management is a lifelong journey, and we are here to help. The center brings together renowned experts in both the medical and surgical treatment of obesity, as well as in such fields as psychology, nutrition, exercise physiology, orthopaedics, endocrinology, cardiology, liver disease, and more. The center doesn’t just focus on weight management, but also on the many health outcomes associated with excess weight, such as diabetes, fatty liver disease, heart disease, joint problems, and cancer. Successful weight management can significantly improve these conditions and reduce the chance of developing them in the first place. In short, the center provides services across the entire continuum of care for weight management, including everything from dietary advice to psychological counseling, medications, endoscopic interventions, and surgery. Having all of those services under one umbrella gives us the unique ability to care for any patient with weight management needs, regardless of size or treatment options. The center also has an alliance with the YNHH Department of Pediatrics, and since obesity tends to run in families, center administrators are planning an intergenerational clinic where the entire family can receive care. Currently, the center is situated at several different locations within the health system; in 2022, all of the components of the center are scheduled to move to a single location at 8 Devine St. in North Haven. Consultations are also available via telehealth. The Center for Weight Management has three physician-directors: John Morton, MD, MPH, medical director of bariatric surgery for the Yale New Haven Health System; Wajahat Mehal, MD, PhD, director of the Yale Weight Loss Program and an expert in obesity medicine and endobariatrics; and Ania Jastreboff, MD, PhD, an adult and pediatric endocrinologist with expertise in obesity medicine and weight management. The center has a fully integrated medical and surgical team. We have approximately 20 physicians, including 12 bariatric surgeons, who together have performed about 10,000 successful surgeries (Dr. Morton alone has performed about 4,000 successful bariatric surgeries). Other members of the team include nurses, dieticians, psychologists, social workers, and an exercise physiologist, as well as the many experts on weight-related health conditions who partner with the center.