© Jose Luis Pelaez Inc The term “weight loss clinic” can mean almost anything. Here’s what obesity experts say to look for to lose weight safely, and avoid getting scammed.
Losing weight is easy for no one, and there is zero shame in deciding you need help.
The problem is, between commercial plans, storefront medi-spas, fad diets, wellness influencers hawking unproven supplements, and other kinds of get-thin-quick schemes (some with doctors associated with them), it’s hard to know where to begin.
And for a country as populous as ours—with more than 70% of U.S. adults considered overweight or obese, according to the Centers for Disease Control and Prevention—there are relatively few stand-alone, one-stop shopping clinics that allow you to get the multi-disciplinary approach to healthy weight loss that works the best, says Rehka Kumar, M.D., medical director of the American Board of Obesity Medicine (ABOM) and an assistant professor at Weill Cornell Medical College in New York City.
Why do you want a team? Because carrying too much body weight can lead to or worsen other health issues, so depending on your complicating factors, your pit crew might include a cardiologist, a gastroenterologist, a nutritionist, an exercise physiologist and a behavioral therapist, she says. “If we are all working on different things related to a patient’s weight together, that’s a more comprehensive approach,” says Dr. Kumar, who is also an endocrinologist at the Comprehensive Weight Control Center, part of Weill Cornell Medicine.
Major universities like Cornell often have full-service weight loss programs—Boston University, New York University, and UCLA are just a few—so a university-affiliated research hospital in the nearby city is a good place to start. Geisinger Weight Loss and Bariatric Surgery in Danville, Pa., was mentioned by a few of Prevention’s experts, as was The UT Center for Obesity Medicine and Metabolic Performance in Austin; The Vanderbilt Weight Loss Center in Nashville; The Emory Bariatric Center in Atlanta, and others. The Obesity Medicine Fellowship Council also has a list of universities around the country that offer fellowship programs, which indicates the institution has physicians experienced enough in treating obesity that they are training others.
But if you don’t live close to one of those, you may need to piece it together on your own. Here’s how to get started:
Look for a board-certified obesity medicine specialist.
Your primary care physician is a great person to ask, says Dr. Kumar. Your doc may be certified already (there are currently around 3,000 diplomates in obesity medicine) or able to refer you to someone who is. You can also try the provider locator at the Obesity Medicine Association. “This site will specifically mention doctors that are board-certified in obesity medicine, which means they passed an example and have some minimal competency in this field,” she says.
Obesity Action, an advocacy group that raises awareness about and improves access to the prevention and treatment of obesity, also has a locator for screened providers, and includes input from ABOM and other professional organizations such as the American Society for Metabolic and Bariatric Surgery and the Obesity Society, says James Zervios, the group’s VP of marketing and communications. While only physicians can be board-certified, this listing features nurse practitioners, dietitians, and mental health pros as well.
If a certified doctor does not have a team in her practice, she will likely have other providers to refer you to, say, an endocrinologist or physical therapist if your weight has caused arthritis or if your hormones are out of balance. They can then communicate to make sure you’re getting a personalized approach.
Pop by for a free consultation.
“A good facility should sit you down for free in a low-pressure setting and explain their approach,” says Craig Primack, M.D., ABOM’s board president and co-founder of the Scottsdale Weight Loss Center in Scottsdale, Ariz.. That conversation should cover what kinds of diets they put together for patients, what sort of exercise counseling they offer, behavior modification (classes or individual nutritional counseling), and what medications they have seen success with. You should expect to be charged for a medical consultation, says Dr. Primack, but not to walk in the door. If you feel like you’re being given a hard sales pitch, you’re likely in the wrong place.
If you don’t live near an academic center or a comprehensive facility, making an initial visit to one, and then doing your follow-up remotely with a doctor near you is an option. “There are parts of the Midwest where you may not have people within 100 to 200 miles,” says Dr. Kumar. Telemedicine uses computer and video technology to allow access to specialists when none are nearby.
Make sure they’re practicing evidence-based medicine.
“Just because the sign says ‘medical weight loss’ doesn’t mean they’re practicing medicine,” says Dr. Primack. Dr. Kumar advises asking if what you’re getting is an FDA-approved treatment or medication. Another sign of a reputable place: they accept and bill insurance. Some doctors, of course, are out of network, but insurance tends to cover therapies that are approved for the treatment of obesity.
Consider your own comfort.
Does the waiting room have furniture that’s designed for bigger people? Is the staff sensitive and nonjudgmental? Is this a place where you feel safe talking about your body? “You might have a very attractive weight loss clinic, but it might not actually be comfortable for patients of a certain size,” says Dr. Kumar.
Check out the equipment.
All weight loss facilities are for people who want to lose a weight, but they’re not all equipped to treat major obesity. Dr. Primack says some of his patients are there to lose a relatively little weight, and some a lot more. “Do they have a scale that goes up to at least 600 pounds?” he asks. And they should have the current technology to measure body fat composition, not a simple scale.
Ask for stats.
“You want to know what the odds are you’re going to benefit from a program,” says Steve Heymsfield, M.D., president of the Obesity Society and a professor at the Pennington Biomedical Research Center in New Orleans. ”Good programs offer real information.” That’s not the same as promising a specific amount of weight loss, he emphasizes. “Be wary of promises, like a guarantee to lose 30 pounds in a month,” says Dr. Kumar. “Not everyone responds the same way to treatment.”
Make sure there’s a solid follow-up plan.
Even if you’re doing well on your program, you want to be in regular touch with your doctors, says Dr. Primack. “Are they continuing to monitor your body fat composition, and are they doing blood work to make sure what you’re doing isn’t harming you?” he asks. Some of his patients come in every month or two, whereas some longer-term patients come in every six months. “Obesity is not cured—it’s treated,” he says. “It’s better to know you have a place that you can go back to.”
Heed these red flags:
- HCG injections or pills: If a facility offers HCG for weight loss (it stands for human chorionic gonadotropin, a hormone women produce when they’re pregnant), walk out the door, say Drs. Kumar and Primack. The HCG Diet, a very low-calorie plan that involves taking HCG supplements, was all the rage a few crazes ago. But there is no FDA-approved over-the-counter HCG drug for weight loss, and the prescription form is meant for fertility issues, and is not effective for weight loss.
- Claims of miracle results: If anyone says, “I’m going to cure you of your weight problem—that’s a deal breaker,” says. Dr. Primack.
- Mandatory supplements. “That could be a way some of these borderline places make money, by offering various weeds that you’re going to eat,” says Dr. Heymsfield. “None of them have any efficacy to speak of.” Dr. Kumar agrees. “I’m not saying that there’s no good medicine being practiced there, but it’s important to make sure what they’re doing is evidence-based.”
- A heavy emphasis on appearance. Of course we all want to look good, and if you feel losing weight will help, that may be one of your motivations. But the focus in a quality facility will be on your health, not on the aesthetic, says Dr. Kumar. “If there’s an emphasis on the cosmetic, that’s a different kind of practice,” she says.
By Stephanie Dolgoff and Prevention Magazine