“I’ve tried every diet in the book. I’m a regular at the gym. But no matter what I do, I just can’t seem to lose weight.”
We hear this all of the time at the Cotton O’Neil Weight Management Center. The majority of our patients come to us having already tried to lose weight, but haven’t been successful.
At the Weight Management Center, we provide patients with the tools they need to lose weight: from diet and exercise plans, to medication therapy, to counseling for bariatric surgery. We encourage patients to build relationships with us so that we are always ready to help them along their personal weight-loss journey.
Since we know that there is no one-size-fits-all approach to weight loss, our program is highly individualized. When you come to the Weight Management Center, we will work on developing the plan that is best for you, and providing you with the support and motivation you need to meet you goals.
We treat patients who are overweight or obese. This is determined by each patient’s Body Mass Index (BMI).
What is a Body Mass Index?
BMI is a ratio that compares body weight to height in order to get an estimate of overall body fat. Then, we look at a chart to see your weight status (underweight, normal/healthy weight, overweight, or obese)
The standard BMI and weight status categories include:
|BMI||Weight Status Category|
|18.5 – 24.9||Normal or Healthy Weight|
|25.0 – 29.9||Overweight|
|30.0 and above||Obese|
A higher BMI means you have an increased risk for heart disease, type 2 diabetes, high blood pressure, breathing problems, gallstones, sleep apnea, osteoarthritis and certain types of cancer (e.g., colon, breast, or endometrial).
High BMIs can also complicate other medical conditions. For example, if you have cancer, a high BMI can decrease quality of life or increase the chance of cancer coming back.
What is My BMI?
Your BMI is your weight in kilograms divided by the square of your height in meters.
But don’t worry — you don’t need to know your weight in kilograms or your height in meters to figure out your BMI.
There are plenty of online calculators where you plug in your weight in pounds, and height in feet and inches. With the click of a button, you will find out your BMI without having to do any math.
Try this BMI calculator from the Centers for Disease Control and Prevention (CDC).
Is BMI a Good Measure of Health?
There are a few limitations of BMI. For example, it doesn’t distinguish between lean and fat tissue. That means that if you have a high BMI because you are very muscular, you may technically be considered overweight — but you may be fit, and perfectly healthy. BMI might also underestimate body fat in older patients or patients who have lost muscle (e.g., from diseases such as muscular dystrophy).
But even with these limitations, BMI has been shown to be a good indicator of body fat. It is a great screening tool to alert patients and providers to potential weight problems so that these problems can be addressed before they have serious medical consequences.
Am I Eligible for the Stormont Vail Weight Management Program?
We have specific criteria for patients who can enter our program. Any patient with a BMI over 30 is a candidate for our program. We also take patients with a BMI over 27 who also have other conditions related to their weight, such as high blood pressure or high cholesterol.
Treatments & Services
Diet and Nutrition CounselingWe have developed a high-protein, moderate carbohydrate diet. We focus on helping you get the right amount of calories and macronutrients (protein, carbohydrates, and fats).
Our plan is all about moderation, and making healthy eating part of your lifestyle. That means you don’t have to give up your favorite sweets — we’ll teach you how to incorporate them into your diet in a healthy way.
Everyone’s needs and preferences are different, so we will work with you to make sure you’re finding the foods and moving at the pace that is best for you. If you can’t make drastic changes right away, that’s OK. You may be able to focus on individual parts of the diet, such as increasing protein or water intake, during the first month. Then, you can add on the next piece, such as limiting carbohydrates, the following month.
As part of this individualization, we will also have you start a food diary where you log the type of food you’re consuming, as well as the time you’re eating it. If the diary shows that eating at a certain time of day or having certain foods just isn’t sitting well with you, we can tweak your diet plan.
EducationLosing weight can be a challenge, especially if you don’t know how to do it. Our goal is to provide you with the education you need to become your own weight loss expert. Even if you stop coming to the Weight Management Center, we want to make sure that you have the tools you need for lifelong success.
That’s why we don’t just tell you to eat better and exercise more — we teach you why and how to adopt a healthy diet and exercise regimen and give you support along the way. We send you to gyms, health food stores, and grocery stores to learn which exercises to try and the best foods to buy.
At our clinic, we offer group and individual, one-on-one classes every other month.
Group classes have monthly topics, such as emotional eating, getting enough fiber, eating to prevent hunger so you don’t have cravings, avoiding the urge to overeat, and tips for eating at restaurants. These classes usually have about four to six people and are called shared medical appointments.
The one-on-one classes have a more individualized focus. For example, we may discuss ways to cope with stress or we may prescribe an antidepressant.
While we do sometimes prescribe appetite suppressants, we do not recommend or encourage the use of other diet supplements — we want to help you lose weight by educating you on making the correct nutritional choices.
Bariatric SurgeryBariatric surgery is a weight loss procedure. It’s not cosmetic, like a tummy-tuck — it’s a medical approach to losing weight.
At Stormont Vail Health, we offer two types of bariatric surgery: sleeve gastrectomy (“the sleeve”) and gastric bypass. Both surgeries make your stomach smaller, reducing the amount of food you can eat. The gastric bypass also reduces the amount of food you can absorb. And both surgeries are minimally invasive, which means we make small incisions rather than large cuts.
In order to have either surgery, you must meet certain requirements for your body mass index (BMI) — a measure of your weight in relation to your height. You must have a BMI of 40 or above, or a BMI of 35 or above plus another chronic condition, such as high blood pressure, sleep apnea, arthritis, or diabetes.
Here at Stormont Vail, bariatric surgery is a team effort. You will regularly meet with a team of experts, including your surgeon, bariatric nurse practitioner, dietician, pharmacist, anesthesiologist, behavioral health specialist, and endocrinologist (specialist who handles metabolism issues).
We will be with you throughout every step, from preparing for surgery, to recovery, to maintaining healthy diet and exercise habits for years to come.
We see patients about three to six months before their operation. We help them with nutrition, dieting, and medical therapy. The goal is to have them lose some weight prior to the surgery.
Medical TherapyWhen diet and exercise changes aren’t enough, we may recommend that you begin medication to help you along through your weight loss efforts.
The main types of medication we use are appetite suppressants. They do not cause weight loss themselves — they decrease hunger, so you are less likely to overeat.
Appetite suppression medications can be either stimulants or non-stimulants.
Stimulants increase activity in the brain. The most common stimulants we prescribe for decreasing appetite include:
- Phentermine (Adipex-P, Suprenza)
- Phendimetrazine (Bontril, Bontril PDM, Bontril Slow-Release, Melifiat, Obezine, Phendiet, Phendiet-105, Prelu-2)
- Diethylpropion (Tenuate)
Non-stimulants we commonly prescribe include:
- Liraglutide (Saxenda)
- Naltrexone and bupropion extended-release (Contrave)
- Phentermine and topiramate extended-release (Qsymia)
- Lorcaserin (Belviq)