Medical Weight Loss

Everything You Need To Know About Medical Weight Loss

Medical Weight Loss Summit

https://drive.google.com/file/d/1CE3uf95t0gX3PNPVAOVfFk-kaJVUs8Ne/view?usp=drive_link

<h6>Carolynn Francavilla, MD, FOMA, D-ABOM</h6>
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 over a decade. I am so excited to share a huge toolbox of resources and experts with you on this summit. I want to take a moment to tell you a little bit more about medical weight loss. When I talk about medical weight loss, I describe this as something I do to help people lose weight to live longer and live better. I like to focus on the health benefits, and I think it's important to recognize everyone's experience with weight and how much weight they need to lose individually. 

Let me tell you about two patients that came to see me in my clinic. The first patient we'll call is Karen. She was about 40. Years old, and. She came in to see about losing weight. I spent an hour with her, as I usually do with my patients. I have a very full history. We ordered some bloodwork, and after regrouping, we decided that was the best option for her to reach her. Weight and health goals were going to be a low-carbohydrate diet, a medication called Contrave. She was doing great. She was happy with her results and her health goals. She recommended that her friend Diane, her best friend and coworker come and see me because she was so impressed with the results she had. Diane came in to see me, and I could tell she was a little bit skeptical. As I was getting her history, Diane said, “I know you started Karen on a low-carb diet, but I don't think that's a good fit for me. I don't know about that medication. You gave her.” But she said, You're fabulous. I wanted to give you a try. 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 thenwe 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. Started a different medication called phentermine. She did well as well. She was pleased and a little surprised that she was getting something completely different than what her best friend was. What I want to highlight here is that comprehensive weight loss or comprehensive obesity care 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, 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 are so many things. 

My job as an expert in the experts you'll see on this summit as well is, to make sure we find something that's a good fit for you. It's important to realize that 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 are to clean things up. Try to lose weight, restrict calories, restrict some sort of macro that you are going to have two adaptations that occur. The first is a metabolic adaptation where your metabolic rate 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. 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 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 changes. This means that your hunger goes up, and your satiety, or your feeling of being full and done, goes down. That's another reason why it's hard to stick to your plan. You're hungrier. It is not willpower. I can't emphasize that enough. You're just hungrier, and your metabolic rate is going down. That's why a nutrition strategy alone sometimes is not enough. That's where we often need to layer on a supplement, a strategy like intermittent fasting or fast mimicking, a medication, and sometimes even surgery. We're going to explore all of those options are in this summit. If 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 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 medication, and layering on surgery. 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 what. You need to be your healthiest. If you lose 5% of your weight, you lose five or ten pounds, and you feel great, that may be enough. If your bloodwork looks good, and your joints feel better, then you may not need to lose more. If you have more significant health conditions like Type-2 diabetes, sleep apnea, or fatty liver disease, you may need to lose closer to 10 or 15%. 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. You're going to learn about a lot of tools that may be a good fit for you at this summit. When you come to see me in 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. 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, and what's important to you. What is going to make you feel like you are living better? Then we're going to come up with a personal plan incorporating your blood results, and your health risks into a nutrition plan that makes sense for you, and an exercise plan that makes sense for you. Working on key behaviors and stress that are impacting your health. 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 are. 

I've been using medications for more than a decade, which means I've been using medications since before medications like Wegovy and Zepbound. A lot of those, like phentermine and contrave 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, 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. If you want even more resources, you can check out my website, GLP Strong, where you can find exercise training that is targeted at people who are on medications. We'll go over that bound, but it can be utilized by anyone as well as a whole host of other tools supporting people on medications, like Wegovy and Zepbound. 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 like to focus on coaching not just your health but your mindset. 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 their 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. 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. We will not hide it from you. As doctors, we want you to experience the thing that's most important for your health. Sometimes that's a little bit of trial and error as well. 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. 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. Welcome to the summit, and I can't wait for you to learn so much.

https://d1tnc8rqovg0h0.cloudfront.net/2024+Summits/Medical+Weight+Loss+Summit/Transcripts/2024_MWLS_Mini+Talk+Day+1+Transcript+File.pdf

Carolynn Francavilla, MD, FOMA, D-ABOM is Board Certified in Family Medicine and a Diplomate of the American Board of Obesity Medicine. She owns and operates Green Mountain Partners for Health and Metabolic and More Colorado. Dr. Francavilla is a nationally recognized obesity expert, lecturing to clinicians on the topic of obesity as well as teaching through her platform HelpYourPatientsLoseWeight.com. She also hosts The Doctor Francavilla Show a podcast about weight and health. She serves on the Obesity Medicine Association Board of Trustees and was awarded the Dr. Vernon B. Astler Award for dedicated service and support of OMA in 2017. Dr. Francavilla is an Assistant Professor at Rocky Vista University and a Volunteer Faculty at the University of Colorado School of Medicine.

Everything You Need To Know About Medical Weight Loss

Carolynn Francavilla, MD, FOMA, D-ABOM

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Carolynn Francavilla, MD, FOMA, D-ABOM