Everything You Need To Know About Medical Weight Loss

Welcome to the Medical Weight Loss Summit 0:00

Hello and welcome to the DrTalks Medical Weight Loss Summit. I'm your host, Dr. Carolynn Francavilla I'm a family physician and obesity medicine specialist, and I've been helping people with Medical Weight Loss for more than a decade. I am so excited to share a huge toolbox of resources and experts with you on this Summit. And I want to take a moment to tell you a little bit more about Medical Weight Loss. So when I talk about Medical Weight Loss, I describe this as something I do to help people lose weight in order to live longer and live better.

I really like to focus on the health benefits, and I really think it's important to recognize everyone's experience with weight and how much weight they need to lose is individual. Let me tell you about two patients that came to see in my clinic.

Why Medical Weight Loss Is Personalized 1:01

The first patient we'll call Karen. She was about 40. Years old, and. She came in to me to see about losing weight. And I spent an hour with her, as I usually do with my patients. I got a very full history. We ordered some. Bloodwork, and. After regrouping, we decided that the best option. For her to reach her. Weight and health goals was going to be a low carbohydrate diet. And a medication called CONTRAVE. She was doing great. She was really happy with. Her results and her health goals. And so she recommended that her friend Diane, who.

Was her best friend and coworker. Come to see me because she was so impressed with the results she had. And Diane came in to see me, and I could tell she was a little bit skeptic. And as I was getting her history, Diane said, you know, I know you started Karen on a low carb diet, but I really don't think that's a good fit for me. And I don't know about that medication. You gave her. But she said, you're fabulous. I wanted to give you a try. So I got Diane's full history. Diane was a little bit older.

She was approaching 50, and she had very different health needs. I got all of that information in her history and of course got her bloodwork. And when we regrouped. the plan. For. Diane was very different. We focused on treating her perimenopause and menopausal symptoms, and we did use a, high protein plant based diet for her. And, actually started a different medication called phentermine. And she did well as well. And she was really pleased and a little surprised that she was getting something completely different than what her best friend was.

And what I want to highlight here is that comprehensive weight loss or comprehensive obesity care really looks different for every person. It truly is a medical specialty, and there is a whole menu of options that. Work for different people based on a large variety. Of things age.

How the Body Adapts During Weight Loss 2:56

Gender, how busy you are, your. Unique health needs, your risks, other medications that you're on, what you've tried in the past, your genetics, your gut microbiome. There's so many things. And my job as an expert in the experts you'll see on this summit as well, is. Really to make sure. We find something that's a good fit. For you. It's important to realize. That while we all have different struggles with our weight and our health when it comes to weight loss, there is one thing that almost all of us are going to struggle with, and that is the adaptations our body makes when it's trying to lose weight.

The two main things it does when you start a diet start to clean things up. Try to lose weight, restrict calories, restrict some sort of macro is that you are going to have two adaptations that occur. The first is a metabolic adaptation where your metabolic rate actually goes down as you start to diet and lose weight. That's why eventually whatever plan you're doing doesn't seem to work anymore. Even though you're doing the. Exact same thing, your metabolic rate is slowing down to adjust to the fact that you are losing weight.

Your body doesn't want to lose weight, and it fights it. We have really great data that shows this happens, particularly from The Biggest Loser study. The second thing that happens is appetite adaptation, which means that as you lose weight and you're cutting calories, or cutting some sort of macro, or changing your diet, exercising more, your appetite actually changes. This means that your hunger goes up, and your satiety or your feeling of being full and done goes down. And that's another reason why it's really hard to stick to your plan.

You're actually hungrier. It is not willpower. I can't emphasize that enough. You're just actually hungrier and your metabolic rate is going down. And that's why a nutrition strategy alone sometimes is not enough.

Choosing the Right Strategy and Health Goals 4:46

That's where we often need to layer on a supplement, a strategy like intermittent fasting or fast mimicking or a medication and sometimes even surgery. And we're going to explore. All of those options in this summit. So with what you've done in the past. Didn't work, or if what you're. Doing now that worked in the past isn't working for you, the second time or third time, you try it, or you're just not getting the results that you need. For your health. We may need to step things up, which means layering on a more aggressive nutrition plan, layering on a supplement, layering on a medication, layering on surgery.

And the way we decide what makes sense for you is by looking to see how much weight you need to lose. We see that many health conditions improve with a 5% weight loss, and the gold standard in my clinic to improve health has always been a 10% weight loss. However, with more aggressive strategies, we can often get a 15 or 20% or even more weight loss. But it's really what. You need to be your healthiest. So if you lose 5% of your weight, you lose 5 or 10 pounds and you feel great, that may be enough.

If your. Bloodwork looks. Good, your joints. Feel better, then. You may not need to. Lose more. If you have more significant health conditions like type two diabetes or sleep apnea fatty liver disease, you may need to lose closer to 10 or 15%. And of course, if your weight is keeping you from comfortably doing activities like riding a roller. Coaster or. Sitting in an airplane seat, then you may need to lose. More to be able to reach. Your individual health goals. But I always come back to my mission here, which is to help you live longer and live better.

What to Expect in Dr. Francavilla's Clinic 6:29

And I think you're going to learn about a lot of tools that may be a good fit for you in this summit. When you come to see me and my clinic, we're going to spend more than an hour getting your intake together. This is after you've already filled out extensive paperwork, and I'm going to learn about. Your health, your goals, your. Past experiences, your stress, your sleep, your substance use. Your. Relationship with food, your family. Support, your. Relationships. What's important to you? What is going to make you feel like you are living better?

And then we're going. To come up with a personal plan incorporating. Your blood results, your health. Risks into a nutrition plan that makes sense for you, and exercise plan that makes sense for you. Working on key behaviors and stress that are impacting your health. And we're going to layer on medications when those make sense, and figure out what medication makes the most sense for you based on the other medications you might be on. Your health risks. and what your goals and needs really. Are.

I've been using medications for more than a decade, which means I've been using medications since before medications like what wegovy and zepbound were around. And a lot of those, like phentermine and contrary. Are wonderful. Tools that can be layered together with your nutrition plans or layered together in combinations with other medications and strategies to help you reach a successful goal. If, after this summit, you still have more questions, you can check out my free podcast, The Dr. Francavilla Show Show, where we talk about all things health and weight.

You're also going to have the opportunity to join me for a masterclass where it's going to be me one on one, and we're going to dive a lot deeper into my approach and different things that you might want to utilize. And if you want even more resources, you can check out my website, GLP Strong, where you can find exercise training that are targeted.

Resources, Support, and Final Takeaways 8:20

For people who are on. Medications. Like wegovy and zepbound, but it can be utilized by anyone as well as a whole host of other tools supporting people on medications, like wegovy and zepbound. And finally, if you want to work one on one with me, you'll have the opportunity to join a waitlist to work with me in my clinic, where we can dive deep into all of this. I really like to focus on coaching not just your health, but your mindset. And I think the biggest thing that people experience when they work with me is this giant weight that comes off of their.

Shoulders because. They realize. What the real. Health goals are, and they get rid of all the bias and stigma around their weight and focus on what they need to live their best life. Thank you so much for joining me on this Summit. I can't wait for you to explore the many different things that you're going to hear about in this Summit. And I think it's important to realize that all of these things work for some people. But if there was one perfect solution to weight and health, we would tell. You, right?

We were not hiding for it. You from from. It for you. As doctors, we want you to experience, the thing that's most important for your health. And sometimes that's a little bit of trial and error as well. So if you've tried something that didn't work in the past, you may just need to try a new approach. The thing that works for your best friend or your sister may not work for you. And it's important to realize there is a whole host of strategies, and that everyone's goal around weight and their health needs are different.

All right, well, welcome to the Summit and I can't wait for you to learn so much.