talk to your doctor

How to talk about weight with your doctor 

 Always consult a physician before starting any fitness or nutrition programs. Be sure to tell your doctor about new weight loss programs, medications, herbs, supplements, or online products that you are taking.

So, you’ve decided that it is time to start a weight loss journey and before exercising or making dramatic dietary changes you want to talk to your doctor. If you are like most patients, you may be a little nervous about discussing your weight. This is normal.

We hope that after reading this article you will feel more confident about discussing your weight with a medical professional.

Bariatricians are weight loss doctor who specialize in weight management

Many patients are unaware that doctors exist who specialize in obesity, nutrition and weight management. A bariatrician or medical weight loss doctor (also called an obesity specialist) is a medical doctor experienced in non-surgical weight loss methods.  These doctors have completed medical school, a residency program, and board certification in a primary medical discipline such as Internal Medicine or Family Medicine and have also completed additional certification in Obesity Medicine. Speaking with a professional who understands weight management makes the discussion much easier. Patients can visit a bariatrician through a referral from a doctor such as a Primary Care Doctor or by calling the clinic directly to schedule an appointment. Bariatricians tend to be less judgmental regarding weight and open to various treatment modalities such as FDA approved weight loss medications, meal replacement programs, nutrition, and exercise plans. In addition to weight management, bariatricians also diagnose and treat co-morbidities related to excess weight such as diabetes, high blood pressure, and sleep apnea.

charlotte bariatrician

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Be Prepared

Most individuals seeking to discuss weight with a medical professional will begin with their personal doctor or a Primary Care Provider (PCP). The more organized you are for this visit, the better. It is important to maximize the appointment time and ensure that all of your concerns are organized so that they can be easily addressed.

Start by reflecting on your weight history

  • When did you start gaining weight?
  • What events in your life have affected your current weight?
  • Have you successfully lost weight in the past and if so, how?

A Weight History Chart is a great tool to help prepare for this discussion (download a free copy of our weight history chart). Providing your PCP with a weight history chart serves as a powerful visual that quickly provides a summary of trends in your weight.

How to complete the weight history chart.

Step 1:

On the bottom line or x-axis add your age (use increments that work for you). For example, if you are 50 years old you may want to apply your age in increments of 10. On the other hand, if you did not gain weight until adulthood you may want to skip from 0 to 20 or the age where weight gain began.

Step 2:

On the vertical or y axis plot your weight, again use increments that work for you.

Step 3:

Chart your weight and identify important life events that impacted your weight.

weight history chart

Be Honest

In addition to your weight history, be prepared to discuss what you eat and drink along with physical activity. If you don’t eat healthy this is the time to be honest with yourself and your doctor. Nutrition is paramount to weight loss so knowing exactly what you eat is necessary, don’t rely on memory, write it down. Prior to the doctor’s visit use an electronic food diary like MyfitnessPal or a paper food diary.

As you reflect on your food intake be prepared to discuss your weaknesses. Do you overeat? Do you have cravings or food triggers? Do you eat healthy throughout the week just to blow it all on the weekend? Eating habits are essential and will help provide insight for your doctor to make recommendations to facilitate weight loss.

Be clear when discussing your concerns with the doctor

The Primary Cweight loss clinic in charlotte ncare Doctor will evaluate weight, Body Mass Index (BMI), medical history, medications, and bloodwork while providing a preliminary plan for weight loss. The PCP is a great place to start since this doctor knows you best. When approaching your PCP be open and honest and clearly state your needs. Do you desire weight loss, nutrition education, accountability, a weight loss referral to a specialist, or simply a discussion about your concerns? If you are uncomfortable discussing your weight with your primary doctor either find a doctor that you are comfortable with or let your guard down so that you can receive the help that you need.

Be Open to Weight Loss Referrals

Your Primary Care Doctor may refer you to additional specialists in order to maximize the time, tools, and resources needed for weight management, counseling, nutrition, exercise, and accountability. These professionals are intended to enhance your weight loss success.

#1 Dietician:

A registered dietician (RD) is a professional who provides food recommendations, nutrient intake, grocery lists, meal plans, and even recipes to help with healthy eating. Dieticians are great accountability partners and will focus on structuring the eating plan and routine.

#2 Bariatrician

A bariatrician is a doctor who specializes in weight loss. These doctors provide nutrition along with a comprehensive treatment plan for weight management. In addition to structuring food intake they may also provide advanced nutrition testing such as food sensitivities or comprehensive nutrition labs for nutrient deficiencies. Bariatricians measure body fat, body composition, may order labs, EKGs, or other studies in order to diagnose or treat conditions related to excess weight. Bariatricians may also prescribe FDA approved weight loss medications to aid in weight loss.

#3 Psychiatrist and Psychologist

The bariatric doctor may request that a psychologist or psychiatrist work with a patient regarding certain behaviors, emotions, or psychiatric conditions related to weight. Psychiatrists are consulted to work with weight loss patients regarding eating disorders such as binge eating, bulimia or body image disorders such as body dysmorphia. A psychiatrist will also be consulted to treat severe depression and anxiety or to clear a patient for bariatric surgery, if applicable. A psychologist or counselor may be asked to provide intense counseling for weight loss behaviors, habits, trauma, and emotions.

#4 Bariatric Surgeon

A bariatric surgeon specializes in weight loss surgery techniques ranging from lap band, vertical sleeve gastrectomy, to gastric bypass. The bariatrician may refer a patient to a bariatric surgeon if they need more intense intervention beyond medical weight loss. In addition, a bariatrician often starts the required medical weight management process to qualify for surgery by most insurance programs.

#5 Gastroenterologist

Gastroenterologists and bariatric surgeons both perform the weight loss balloon system or Orbera procedure. A gastroenterologist may be consulted by your bariatric doctor to provide this weight loss method if it is considered to be suitable for you.

#6 Plastic Surgeon

A plastic surgeon can be helpful if the issue is related to cosmesis such as loose skin or diastasis recti or excess tissue needing reduction or augmentation such as a breast reduction. Your bariatric or primary care doctor may refer you to a plastic surgeon for cosmetic surgery in this case.

#7 Physical Therapist or Exercise Physiologist:

A bariatric doctor may refer a patient to a physical therapist or exercise physiologist for education, fitness assessment, and weight loss routines.  A physical therapist is often preferred over a fitness trainer for patients who have severe obesity, osteoporosis or joint pain, or certain medical conditions that require professional modifications.

#8 Massage Therapist

A massage therapist is a great adjunct for soothing tight muscles and improving circulation and flexibility. A bariatric doctor may refer a patient to a massage therapist for muscle pain related to physical activity. Massage therapy is great for improving tension related headaches.

weight loss specialist in charlotte nc

Treating your weight may cure other medical problems

 Often excess weight is the underlying cause of other medical conditions and chronic diseases. Weight loss provides several health benefits including less fat around visceral organs, less inflammation, improved oxygenation and blood circulation. For these reasons weight loss improves the following medical conditions:

  • Diabetes
  • High Blood Pressure
  • Reflux Disease
  • Sleep Apnea
  • Polycystic Ovarian Disease (PCOS) and Infertility
  • Joint pain and osteoporosis
  • Chronic Pain
  • Autoimmune Diseases

Be Aggressive

Obesity is related to the top causes of death in the United States, therefore, it is not to be taken lightly. Obesity increases the risks of heart disease, stroke, and certain cancers such as breast and colon cancer. The longer individuals carry excess weight the harder it becomes to lose weight due to brain and hormonal changes.

It is imperative that you become aggressive regarding your weight loss efforts. Although a BMI over 30 is categorized as obese, it is recommended to seek professional weight management for a BMI over 25 (overweight category). Patients who have rapidly gained weight for unknown reasons should also consult a doctor. Patients with more than 15 pounds to lose, more than 1 medical condition, or more than 1 medication are recommended to consult a doctor for weight loss.

If you would like to visit

Abundant Health & Vitality Associates for medical weight loss

Please call 704-997-9661 to schedule a new patient appointment

Medical insurance is not required or accepted (all patients receive super bills for insurance reimbursement)

 We accept cash, credit, HSA, FSA, and Care Credit for payment

charlotte weight loss center

How to Choose a Weight Loss Doctor

It’s no secret that the weight loss industry is a $60 billion a year industry but did you know that less than half of the products and services in the weight loss arena are effective or safe? Unfortunately, most of the weight loss programs and supplements advertised as weight loss solutions are fake with exaggerated claims. Exploiters of the industry know that individuals suffering with weight are desperate to lose weight quickly at any cost. The World Health Organization (WHO) recommends that individuals consult a doctor for weight loss if they have more than 15 pounds to lose, 1 or more weight related diseases, or taking 1 or more medications.

If you want to lose weight the safe and effective way, consulting a weight loss doctor is the best and most reliable option.

# 1: Ensure that your weight loss doctor is indeed a weight loss doctor

weight loss doctor in charlotte nc

A weight loss doctor or bariatrician (sometimes called an obesity specialist) is a medical doctor who specializes in overweight, obesity, and the diseases associated with excess weight. These doctors are licensed and board certified and often well versed in nutrition, behavioral health (related to weight and eating disorders), chronic medical conditions, and pre and post bariatric surgery. The majority of bariatricians are internal medicine doctors followed by family medicine, gynecology, and endocrinology, but any licensed medical doctor can complete additional training to practice obesity medicine.

When researching a potential weight loss doctor be sure to Check the “about the doctor” section of the website for credentials, experience, and medical training.

Red Flags:

  • Unable to find the doctor or their information on the clinic website
  • Credentials and training are vague, or licenses are from illegitimate or unknown organizations
  • Non-medical professional providing clinical services illegally
  • Unable to find the doctor outside of the website (i.e. Healthgrades or WebMD)
  • Website is a “carbon copy” or identical to several other websites as part of a national chain or franchise
  • Staff members listed on the website change constantly due to high turnover
  • Website with no contact information

It’s important to note, that a bariatrician is more likely to use effective, safe, and evidence-based methods for weight loss. If the  weight loss solutions are not FDA approved such as HCG shots, lipotrophic injections, or non-FDA approved medications, the office may be more interested in making money than your health.

Some weight loss clinics are supervised by a physician who is not physically present in the office or actively seeing patients, it is important to know this beforehand. When scheduling the appointment be sure to clarify whether the doctor will be on-site and an active part of your care.

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#2 Ensure that the weight loss program is personalized

It is true that there are various weight loss options ranging from multiple diets, fitness programs, and weight loss medications but the only weight loss program that matters is the one that is especially suited for you! A weight loss program with only one treatment option is not personalized. For example, Weight Watchers works for a lot of people but not everyone just like the FDA approved weight loss medication phentermine works for a lot of patients but not everyone. A weight loss clinic with only one method for weight loss increases the chances of failure.

#3 Weight Management is a Priority or Significant Part of the Clinic

There’s nothing worse than being a low priority customer. What is the real focus of the business? Is it a gynecology office that has agreed to see you on the side for weight loss or a spa that specializes in facials and massages with a sliver of space for weight loss patients?  The true intent of the business will be obvious in the name, the services offered, lobby paraphernalia, the wait time, and the type of professionals working in the business. If the business specializes in skin and hair, obviously weight loss is not their real forte. Does the clinic have the proper accommodations for overweight or obese patients (appropriately sized furniture, weight related reading material, and a proper body composition scale that can measure fat mass and extremes in obesity)? Many businesses add weight loss services for additional income, and they have no interest in treating patients with obesity or the related medical conditions. Don’t allow businesses to exploit you! If you are serious about losing weight only invest in weight loss programs that fully invest in you.

#4 The weight loss professional offers support not judgement

You’ve decided that you not only need to lose weight but are open to help. You are excited and nervous and vulnerable. You discuss your concerns only to be told that your weight is your fault and you should move more and eat less. What a waste!

Obesity is one of the only diseases where patients are blamed for the disease. Yes, individuals may overeat or dislike exercising; however, weight is much more complicated than mere eating and drinking and partnering with a weight loss doctor who understands this is essential. If you feel guilty or uncomfortable during the weight loss process, you are in the wrong place! If you are unable to receive weight loss treatment from your primary care doctor, ask for a referral to a bariatrician (a non-surgical weight loss doctor) or skip the referral and request an appointment on your own.

comprehensive weight loss program in charlotte

#5 The Approach to Weight Loss is Comprehensive

Obesity is a chronic disease that can be successfully treated but this does not mean there won’t be relapses, plateaus, and other challenges along the way. Weight is complex and multifactorial; it combines genetics, physiology, behavior and habits, emotions, education, nutrition, and environment. If a weight loss program fails to explore these facets of weight management, it is likely due to ignorance or lack of resources. A one-dimensional view of weight loss may impede long term success so be sure to join a program that addresses the entire patient and not just how much one eats or drinks.

#6 The weight loss doctor listens to you and addresses your concerns

how to choose a weight loss doctor

The most important resource that a doctor will use in her career is the ability to listen. Weight management is not just about weight loss, it’s about the journey. It’s the struggle, growth, the learning experiences, the ups and downs, setbacks and triumphs. Weight loss is personal and should be done with a medically competent and supportive doctor who understands the science of weight loss and how to execute a plan to get the results you desire and deserve.

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Make a New Year Resolution the Right Way

The RIGHT Way to Make a New Year Weight Loss Resolution

A resolution is a “firm decision to do or not do something”, it’s a promise but unlike most promises it is made to oneself. Many people set a new year resolution but sadly year after year the same goals are simply copy and pasted onto a new list.

This year, let’s make a weight loss resolution that sticks.

Be sure to download our free New Year Resolution Worksheet to help you apply these tips and stay on track.

Write it down

This goes without saying, unless it is written it does not exist. The resolution deserves an official record. Putting pen to paper also makes it easier to check off each goal once completed.  

Be Specific and Make Goals as “I” Statements

Make goals specific and always state “I will” or the present tense of the resolution as if it already exists. 

Examples of “I” Statements:

“I will reach my goal weight of 130 pounds by (enter specific date including year)”

“I will walk daily from 6 -7 pm for 1 hour 5 days a week”

“I will meal prep every Sunday and Wednesday for breakfast, lunch, dinner, and 2 snacks daily”

“I exercise 60 minutes a day 5 times a week”

Start with no more than 3 weight loss goals

Keep it Simple.

Less goals are more attainable and achieving simple goals builds confidence. This will require prioritizing what is most important.

Examples of simple weight loss goals (Choose no more than 3):

  • Lose 1-2 pounds a week
  • Weigh in Weekly
  • Track foods in daily food diary
  • Walk 30 minutes to 1 hour daily
  • 10,000 Fitbit steps a day
  • Drink 64 ounces of water daily
  • Eat lean protein and healthy fat at every meal
  • Stick to daily goal macronutrient balance
  • Cut back from 3 alcoholic beverages a week to 1
  • Strength train twice a week
  • Pack daily lunch for work
  • Eat out at a restaurant twice a month
  • Cut out sugary beverages
  • Remove added sugar from diet by cutting out baked goods and packaged sweets

Don’t forget these goals still include the first step, make “I” statement and be as specific as possible.

A goal without a deadline is just a dream

Setting an end date makes the goal real. Deadlines create accountability, require monitoring, and ensure step wise progression toward measurable success.

An example of a specific resolution with an end date would be “I will lose 20 pounds to reach a healthy goal weight of 140 pounds by April 15, 2019”.

The goal must be realistic

Your goals are as realistic as you want them to be so this part of the exercise requires honesty. A disciplined person may be able to lose 20 pounds in a month with a well personalized plan, precise execution, and the perfect schedule; however, a busy executive with limited time, poor sleep habits, and a team of employees working long hours may find reaching an aggressive weight loss goal difficult.

When setting resolutions ask yourself, “what am I willing to give in order to achieve the outcome?”. Anything worth achieving requires sacrifice. The sacrifice may be time, dedication, discipline, discomfort, or disappointment. If you are unwilling to sacrifice, then find a new resolution.

Learn something worthwhile in the process

Weight loss is more about the journey than the destination. On the road toward long lasting weight loss results ask yourself the following:

  • How will I grow?
  • What will be added to my life?
  • What do I need to learn about myself?
  • What will I accomplish that will change my life forever?

Identify the Obstacles and Crush Them

There are guaranteed to be obstacles along the way! However, with proper planning most obstacles can be anticipated and what you can anticipate you can plan a strategy for. On the Resolution Worksheet next to every resolution identify a barrier and write out how you plan to overcome it.

Long term successful weight loss is just as much about diet and exercise as is it about strategy, planning, and execution.

Build Accountability

Accountability is paramount. On the journey to crushing obstacles and achieving goals your brain will play tricks on you. These “tricks” come in the form of resistance, self-doubt, and negative self talk. An accountability partner serves as a force outside of yourself to provide support, encouragement, and honesty.

The accountability partner is unique in that they lend a helping hand while upholding the promise you’ve made to yourself.

Examples of Accountability Partners:

  • Family member (spouse, sibling, child, parent)
  • Friend
  • Co-worker
  • Physician
  • Fitness trainer
  • Dietitian
  • Health Coach  

Build the maintenance plan into each goal

In the case of weight loss, achieving the resolution is only the beginning. The next step will be maintaining it. The best way to maintain a weight loss resolution is to build the maintenance plan into the original goal.

Celebrate Your Success and then Raise the Bar

Once you’ve completed the resolution then it is time to celebrate!

Reward yourself for a job well done but don’t stop there… after celebrating, raise the bar.

The brain needs constant challenges so although you’ve reached a goal it will be essential to continue making new and exciting resolutions year after year. Each year that you achieve a new resolution will provide the momentum needed for future resolutions.

Happy resolution making!

Hypothyroid and weight gain

How Hypothyroidism Causes Weight Gain

Anyone diagnosed with hypothyroidism (or under functioning or under-active thyroid gland) understands the frustration of watching their body change without permission. Weight gain occurs despite reduced appetite along with fatigue, dry hair and skin, constipation, cold temperature sensitivity, and depression. Hypothyroidism is most common in women and the chances of developing hypothyroidism increases with age and family history of thyroid or autoimmune disease. For the 20 million Americans diagnosed with hypothyroidism there is nothing that they have done to cause this disease and there is nothing they could have done to prevent it. It just happens.

What do thyroid hormones do?

Thyroid hormone is a requirement for a healthy normally functioning body because thyroid hormones have so many essential functions. These potent chemicals are released from a butterfly shaped organ located in the middle of the neck called the thyroid gland and have functions that span from brain and nerve maturation, temperature regulation, mood, memory, and metabolism.

Hypothyroid Symptoms

  • Gеnеrаl mаlаіѕе оr not feeling well
  • Fatigue
  • Cold Intolerance 
  • Constipation
  • Poor appetite
  • Dерrеѕѕіоn
  • Irritability
  • Brittle and dry or coarse hair
  • Weak and easily cracked or broken nails
  • Dry skin
  • Slow heart beat
  • Mental “Fogginess” and difficulty with memory

 

Hypothyroid and weight gain

Despite the assumption that all weight gain is due to overeating and sedentary behavior, patients with hypothyroidism rarely gain weight due to eating too many calories or foods high in sugar. Individuals with hypothyroidism tend to eat less due to a reduced appetite. On the contrary, individuals with hyperthyroidism – or an over functioning thyroid (the opposite of hypothyroidism) lose weight despite eating more calories due to constant hunger and increases in appetite. So how does weight gain occur in hypothyroidism? One cause is slow metabolism. Metabolism is the workhorse of the body. It is a huge part of how the body goes about doing its daily business. Metabolic actions range from converting cellular building blocks into a full product, breaking down substances, and converting calories and food (or fat stores) into fuel and energy. Because thyroid hormones aid in directing overall metabolism even the basal metabolic rate or metabolism at rest is lowered. Therefore the number of calories burned in a day is lower for someone with hypothyroidism in comparison to someone with normal thyroid function. A lower metabolism coupled with lack of energy, brain fog, feeling sluggish, and depressed makes weight gain inevitable. To counteract the unpleasant weight gain, sufferers of hypothyroidism often work harder to lose weight and this serves to only cause more weight gain. Continuing to fail at weight loss leads to more frustration and feelings of defeat. To add, attempts to cut caloric intake further reduce metabolic rate, exercise results in even lower energy and more fatigue, and any weight that is lost just leads to even lower metabolism. As weight continues to pile on it is most dramatic for individuals who were already overweight or obese prior to hypothyroidism.  The average amount of weight gain varies but it is common to see as much as a 20 pounds in only 1 to 2 months. Many medical blogs, articles, and even doctors will erroneously diminish the weight gained from hypothyroidism as only a few vanity pounds but that is not always true. Hypothyroidism not only causes weight gain but can make it extremely difficult to lose weight. It is not an excuse or crutch, it’s just a fact. So now what ?

Losing weight with hypothyroidism

The first steps toward weight loss are knowledge, understanding, and patience. Hypothyroidism causes weight gain and it is no one’s fault, it is unfortunately a normal physiological response to the absence of key metabolic hormones. The next step is to work with a physician to restore thyroid hormone. This is extremely important as it is impossible to live without thyroid hormone. The complete lack of thyroid hormone leads to coma, breathing issues, and ultimately death. The most common treatment for hypothyroidism is synthetic thyroxine or T4. A doctor will measure the level of these hormones along with thyroid stimulating hormone (TSH), a hormone from the brain that tells the thyroid gland to produce and release thyroid hormone. Once these hormones are restored symptoms of hypothyroidism will slowly start to fade, constipation is cured, slow heart rate normalizes, mental fogginess, and fatigue go away. Understand that some hypothyroid symptoms may linger despite normal hormone levels, such as fatigue, but over time all symptoms should continue to improve. Weight gain will unfortunately not go away overnight but it will make weight loss easier to obtain once thyroid hormones normalize.

What NOT to do to lose weight with hypothyroidism

During the time that thyroid levels are still abnormally low it is important to avoid strict dieting and caloric restriction because this will not work and will only make matters worse. It is also important to avoid rigorous exercise as this will not significantly impact basal metabolic rate and will only lead to more fatigue and frustration. The quality of exercise will be poor until other symptoms are optimized. While avoiding rigorous exercise, it is okay to work on building consistency with daily walking, light jogging, swimming, or biking. Strict dieting is not recommended, however, since gaining weight will be easier during this period, it is important to avoid large portions, excess calories, unnecessary calories from sugary beverages and alcohol, and foods with excess sugar and carbohydrates. Also avoid skipping meals. Meals should be well balanced, high in protein, low in sugar, and portion controlled. This will be a good time to use a calorie and macronutrient counter such as MyFitnessPal to keep track of food intake.

Will weight loss medication aid in weight loss for hypothyroidism ?

The answer is that it depends. It depends on the severity of thyroid disease, thyroid hormone levels, the weight loss medication utilized, and of course the patient. Weight loss medications can be effective by counteracting low metabolism and poor energy. However, weight loss medication is not a substitute for correcting thyroid hormone and should be considered secondary to proper thyroid management. It is important to work work with a weight loss doctor early in the process of hypothyroidism because the longer excess weight stays on the body the more difficult it will be to lose.