What Is Bariatrics?
What Is Bariatrics?
The root of the word bariatric derives from the Greek word barros meaning heavy or large. As such, the term has been applied to the branches of medicine and surgery dealing with the management of obesity. Most bariatric practitioners are licensed physicians that have specialized clinical experience and training in the nutritional, behavioral, and medical issues that pertain to the evaluation and treatment of overweight and eating disorders. To learn more about what bariatric physicians offer connect with www.asbp.org.
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What Is Obesity?
What Is Obesity?
Obesity is defined as an excess accumulation of total body fat. Accurate direct measurements of total body fat using various methods has limited application in clinical practice. Therefore, the simplest way to determine whether an individual is overweight is to make use of their height and weight measurements. The ratio of a person's weight in kilograms to height expressed in meters squared is referred to as the body mass index or BMI.
This figure is the standard used throughout hte world to define whether an individual is overweight or obese. As body mass index increases so too does the perecentage body fat of an individual. To calculate your own BMI you may link to http://www.nhlbisupport.com/bmi/bminojs.htm. In general terms, overweight is defined as being at least 10 pounds above the top limit of weight for your height. The corresponding BMI is greater than 25 and less than 30 for a person who is overweight. Obesity is recognized as a body mass index greater than 30 and is usually understood as being at least 30 pounds above the upper limit of weight considered normal for your height.
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Are There Other Simple Measurements That Help Assess Weight?
Are There Other Simple Measurements That Help Assess Weight?
Your waist measurement can indicate that you have excessive fat stores. Men with waist measurements above 40 inches and women with waist measurements above 35 inches are at significantly greater risk for heart disease and diabetes. This is due to the important hormonal and metabolic effects of fat deposited around vital organs.
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Why Is Obesity An Important Disease?
Why Is Obesity An Important Disease?
Fat had long been considered a dormant storage issue. However within the last decade it has been discovered that fat has a critical role not only in the commerce of energy throughout the body but in many of the hormonal and inflammatory processes leading to the common medical diseases. These processes play a critical role in the development of heart disease, diabetes, stroke, high cholesterol, high blood pressure, gallstones, arthritis, infertility, hepatitis and sleep apnea.
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Is Obesity A Disease?
Is Obesity A Disease?
This is a subject of great controversy. Obesity is not a single disease but may be better understood as a manifestation of multiple metabolic variants contained on several genes. The study of these genes forms the basis for some of the most promising scientific research to date. These interrelated metabolic subtypes share a common pathway leading to the accumulation of excess body fat under the appropriate environmental influences. Scientific research has yet to put the pieces of this puzzle together. Yet, in so far as high blood pressure and asthma are classified as diseases produced by a variety of causes, obesity too may be thought of as such.
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What Is The Cause Of Obesity?
What Is The Cause Of Obesity?
Obesity results from the interaction of an individual's genes and the environment. Your genes are important because they will determine the degree of adaptation you will require to maintain your weight despite today's overabundance of food options and labor saving technological advances. If you are obese, chances are that your body has a natural tendency to be in "energy saver mode" most of the time. We all can become overweight if we take in more energy than we use up. Nonetheless, in today's world some of us do not seem to have to try so hard in order to store a surplus of energy as body fat.
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Why Is The Treatment Overweight And Obesity Important?
Why Is The Treatment Overweight And Obesity Important?
There is a worldwide increasing trend in the number of children and adults that are obese. Studies matched for subjects age and gender demonstrate a rise in the prevalence of many of the most common medical problems affecting Americans as body weight increases. Death rates from all causes are associated with increased body weights. Thus, it is not surprising, that obesity is associated with more frequent visits to hospitals, longer hospital stays, increased needs for medications, and finally decreased productivity. And this doesn't touch the quality of life and psychosocial issues that pervade today's society.
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Why Should I Seek The Help Of A Physician To Manage My Weight?
Why Should I Seek The Help Of A Physician To Manage My Weight?
There are certain risks associated with weight loss. Rapid weight loss may cause serious health problems when misguided. These complications may include gallstones, abrupt changes in blood pressure, abnormal heart beats and excessive loss of nutrients and water required for vital bodily functions. Furthermore, consideration of your baseline health and medication usage is paramount before undertaking any efforts at weight reduction. Often times the treatment and goals of therapy must be modified to accommodate individual factors. Furthermore, the appropriate addition of mediciation to a program of healthy eating and lifestyle changes may considerably enhance your odds of attaining a healthier weight and staying there over time.
Many of our patients have tried self-guided and popular diet programs with varied degrees of success. Others are taking medications for problems often times related to their weight. Sometimes these medications may be tapered in consultation with your primary care doctor after there has been a sustained modest reduction in your weight. Individuals that need to lose greater than 30 pounds or have medical problems are best managed by a physician.
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What Do You Offer At DOCTORS WEIGHT MANAGEMENT?
What Do You Offer At DOCTORS WEIGHT MANAGEMENT?
We offer a realistic approach to weight management in an exclusive confidential medical office setting where the care is individually specialized by a qualified board certified internist.
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What Is Done During The Initial Office Visit?
What Is Done During The Initial Office Visit?
The new patient evaluation is usually one hour but may be up to an hour and a half. During this time, a medical interview and exam is conducted by Dr. Padial. This session includes a baseline body fat percentage measurement, an estimation of your baseline metabolic rate, an electrocardiogram and collection of blood samples for routine test. The nutrition plan is discussed and realistic goals for therapy are constructed.
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What Is The Typical Course Of Therapy Following The Initial Visit?
What Is The Typical Course Of Therapy Following The Initial Visit?
You are seen by the doctor on every visit at weekly intervals in most cases. Each visit involves monitoring of weight and blood pressure. Each session usually emphasizes some form of problem oriented education. Review of food record and adjustments of medications is carried out at each session. These follow-up sessions are usually 15-20 minutes in length.
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How Much Weight Can I Expect To Lose On An Average?
How Much Weight Can I Expect To Lose On An Average?
An acceptable rate of weight loss in most medically supervised practices is about 1% of your initial body weight per week after the initial loss of body water that occurs with caloric restriction. Therefore, if you are 250 pounds you can lose up to 2.5 pounds per week. And if you are 200 pounds the expected decrease in weight can be as much as 2 pounds per week and so on.
After about six months the rate of weight loss may plateau. At this time, the objectives of therapy may change accordingly. The rate of weight loss may vary on an individual basis. Weight loss may differ according to individual factors such as gender, menstrual cycle changes, medication usage, water intake, dietary consumption and physical activity habits.
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Are More Rapid Rates Of Rate Loss Achievable?
Are More Rapid Rates Of Rate Loss Achievable?
Yes, yet this often involves the use of a low calorie diet which employs the use of low calorie protein enriched formulas in the form of shakes, puddings, hot and cold drinks, soups and bars which may be purchased at a cost additional to the customary program fees. The use of this type of diet may be advantageous and effective in select individuals. This option is available in our practice. For more information about this program, please consult Dr. Padial at the time of the initial visit.
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Will Medications Prescribed As Part Of The Weight Management Program Be Covered By My Health Benefits Plan?
Will Medications Prescribed As Part Of The Weight Management Program Be Covered By My Health Benefits Plan?
Restrictions pertaining to weight loss medications vary depending on your pharmacy benefits plan charter. Several plans require prior authorization for certain anti-obesity medications. Depending on the circumstances, we may be able to assist you in obtaining prior authorization for the medication prescribed. The usual co-payments and duration of authorized coverage may differ between various benefit plans. In many cases, we have battled successfully on behalf of our patients.
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Is There Any Magic Diet To Follow?
Is There Any Magic Diet To Follow?
Although the marketplace is continually flooded with "fad diets" and weight loss schemes that would have you believe weight loss is easy, the truth remains that there are no easy short cuts that provide effective long term weight management. There are certain essential ingredients to a healthy diet which may vary according to your medical history and preferences. However, diets provide the structured eating that is often necessary to produce weight loss. We strive to provide long term results without sacrificing your safety and well being.
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Are The Commercial Herbal Products And Nutraceuticals Effective?
Are The Commercial Herbal Products And Nutraceuticals Effective?
Certain products, especially those containing ephedra and caffeine, appear to be effective in small clinical trials. We all know someone that has experienced results with one or another of these compounds. However, the production standards and quality assurance measures that regulate the preparation of these products are not standardized. Moreover, some of these products are capable of causing profound changes in blood pressure, heart rate and personality that are no different than those produced by potent prescription drugs. The fact remains that their unsupervised use is potentially dangerous. Remember that weight loss is often a temporary outcome. There are some safe ways and some foolish ways to achieve any goal. Weight management is a lifestyle that has no endpoint. The foundation of effective weight management is built on the balanced integration of sound nutrition, regular physical activity and healthy attitudes. Medication or any other tool will not produce significant long-term results unless the key elements are practiced.
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What Are Some Of The Attributes Of Successful Weight Managers?
What Are Some Of The Attributes Of Successful Weight Managers?
Over the years I have observed the behavior of hundreds of my own patients. I have learned from their victories and their failures. I will share these qualities with you in the section that follows. For a more complete discussion of these you may refer to THIN FOR LIFE by Anne M. Fletcher, M.S., R.D.
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How Much Does The Program Cost?
How Much Does The Program Cost?
The cost of the initial evaluation is $140. We collect payment every 4 weeks for 4 consecutive weekly follow-up visits with the physician in the amount of $160. This billing cycle starts at the time of your first follow-up visit. If you have achieved an acceptable treatment outcome (as determined by the medical doctor) or have experienced a long plateau in your pattern of weight loss, you may be advised by the medical director to to enter the maintenance phase of the program.
At this point the visits are prolonged to every two weeks. In this phase, payment is collected at the start of each 4 week billing cycle, in the amount of $80 for the two consecutive visits. This fee is applicable as long as you have kept within 6 pounds of your weight at the time of entry into the maintenance phase and have not been absent from the clinic for more than 6 consecutive weeks. These fees do not include the cost of laboratory tests, medications or nutritional supplements utilized for your care.
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Should I Use Medications?
Should I Use Medications?
This is an individual decision to be discussed with Dr. Padial and your own primary care physician. Medications are no substitute for proper eating habits and positve lifestyle modifications. Over the years diet medications have been the subject of a great deal of controversy. There are certain risks and benefits of their use. When subjects are enrolled voluntarily in a weight loss study they are usually given similar diet and activity routines to follow. Some subjects are given a diet medication and others are given sugar pills. Many of these studies were conducted for periods ranging from several months to periods of up to two years, and have shown superior weight loss results and more sustained weight loss in individuals that took study medications. Different studies have produced varied results but most demonstrate that on average, medications produce at least a 10% reduction in initial body weight. For more information on specific medications which may be part of a weight management program visit www.4meridia.com and www.xenicare.com.
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Will My Health Insurance Plan Cover My Treatment?
Will My Health Insurance Plan Cover My Treatment?
There are literally hundred of insurance plans each having a different set of charter services. The majority of these do not reimburse for the costs of weight management programs. You may be eligible to receive reimbursement for a portion of the physician fees related to your care. This is usually possible if you have established medical diagnosis related to being overweight. If you do qualify for insurance coverage you may have provided with a bill that you can submit to your third party payer on a monthly basis. We do not prepare claims to be submitted to Medicare or Medicaid. We also do not submit directly to insurance carriers. In many cases the physician fees may be applied to your annual insurance deductible. Last year the IRS made medically supervised weight loss treatments tax deductible. See www.obesity.org for more on this subject.
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