Weight Management Program - Obesity

What is it

Obesity is defined as a body weight greater than 100% over the ideal weight.

IDEAL WEIGHT FOR MEN
Height
(Ft/In)
Small
Frame
Medium
Frame
Large
Frame
5' 2" 128-134 131-141 138-150
5' 3" 130-136 133-143 140-153
5' 4" 132-138 135-145 142-156
5' 5" 134-140 137-148 144-160
5' 6" 136-142 139-151 146-164
5' 7" 138-145 142-154 149-168
5' 8" 140-148 145-157 152-172
5' 9" 142-151 148-160 155-176
5' 10" 144-154 151-163 158-180
5' 11" 146-157 154-166 161-184
6' 0' 149-160 157-170 164-188
6' 1" 152-164 160-174 168-192
6' 2" 155-168 164-178 172-197
6' 3" 158-172 167-182 176-202
6' 4" 162-176 171-187 181-207
IDEAL WEIGHT FOR WOMEN
Height
(Ft/In)
Small
Frame
Medium
Frame
Large
Frame
4' 10" 102-111 109-121 118-131
4' 11" 103-113 111-123 120-134
5' 0" 104-115 113-126 122-137
5' 1" 106-118 115-129 125-140
5' 2" 108-121 118-132 128-143
5' 3" 111-124 121-135 131-147
5' 4" 114-127 124-138 134-151
5' 5" 117-130 127-141 137-155
5' 6" 120-133 130-144 140-159
5' 7" 123-136 133-147 143-163
5' 8" 126-139 136-150 146-167
5' 9" 129-142 139-153 149-170
5' 10" 132-145 142-156 152-173
5" 11" 135-148 145-159 155-176
6' 0" 138-151 148-162 158-179

An easy way to determine your frame size is to circle one wrist with the middle finger and thumb of your other hand. If the fingers just touch you are medium frame, if they overlap you are a small frame, and if they can't reach you are a large frame.

It Kills

It is a serious medical problem with greatly increased risks of heart attack, stroke, pulmonary embolus, hypertension, diabetes and others.

Its Not Your Fault

It is a chronic disease with a strong genetic component. If one of your parents is obese, your risk are >50% of being obese. If both of your parents are obese, your risk of being obese is greater than 80%.

It is treatable

There are many treatment options now. These consist of three components, diet, exercise, and medication.

Diet

Most important is diet. We recommend a low fat diet, typically 20-30 fat grams a day for women, and 30-40 fat grams a day for men. If you don't want to read labels and count fat gram, there are many prepackaged health food items to choose from.

Exercise

To lose weight, you must do aerobic exercise. Aerobic exercise is continuous exercise that gets your heart rate up. For a healthy heart you should exercise a minimum of one half hour three times a week. To lose weight, the more the better. Examples are walking, jogging, swimming, treadmill, and stair climber machines.

Enter in your weight and how many miles you jog or run then click on the calculate button to see how many calories are consumed.

Your
Weight
Miles
Run
Calories
Burned
Just a Comment

Isometric exercise helps to tone muscle. Examples of isometric exercise are weight lifting and weight machines.

It takes a lot of exercise to burn off calories. The following table shows the number of calories burned per hour for various activities.

Walking 278
Jogging 863
Running 1130
Aerobics 1054
Swimming 382
Dancing 460
Basketball 556
Racquetball 1092
Cycling 402

Medication

Research by Dr. Michael Weintraub changed the thinking on diet medication. He tested the combination of phentermine with fenfluramine, commonly known as "phen-fen". He showed that diet medication could be used up to three years with continued and maintained weight loss. Perhaps more importantly, he stressed that obesity is a chronic medical problem like diabetes or high blood pressure, and may require treatment for life. It is not a character defect or moral weakness. Weight Loss Rx

Phentermine (Adipex P, Fastin, Ionamin)

Phentermine is the most effective, safest, least expensive diet medication. On it most of our patient lose five to ten pounds a month. It is taken once a day in the morning, and is time released to suppress your appetite all day long. Side effects are usually minor, including dry mouth, constipation, rapid heart rate, and nervousness. Some people find they have more energy and use this to exercise more. It is not associated with the rare but fatal lung disease of PPH (primary pulmonary hypertension). It can not be taken by patients with heart disease (angina or heart attack), and some kinds of glaucoma. In Dr. Weintraub's research it was as effective as alone as the combination of "phen-fen".

HCG (Human Chorionic Gonadotropin)

Is the pregnancy hormone. It's use to treat obesity in conjunction with a 500 calorie diet was first described by A. T. W. Simeons in his book "Pounds & Inches, A New Aproach to Obesity". It is available as an injection, or an oral solution. Click here for more information on our HCG diet program.

Diethylpropion (Tenuate, Tepanil)

Diethylpropion is similar to phentermine, but tends to have less but similar side effects, and is available in once daily doses of 75 mg, or 25 mg three times a day.

Rimonabant (Accomplia)

Accomplia brand name of generic Rimonabant has been released by Sanofi-Adventis. It is the first drug in a new class of weight loss drugs known as selective CB1 endocannabinoid receptors. It promises to not only to help lose weight, but also to stop smoking and drug addictions. Accomplia has been called the “Anti-Marijuana” because where Marijuana gives people the munchies, Accomplia decreases apetite by blocking instead of stimulating the CB1 receptors.

Topamax (Topiramate)

Topamax brand name of generic Topiramate is used for various medical problems including migraine headaches, seizures, and behavior problems in children. As a side effect it was noticed that people taking the drug lost typically twenty pounds. It is used off label as a weight loss medication. Our patinets report that it makes sweets taste funny and helps with the craving for carbs. One patient said it made Coke taste like acid.

Phendimetrazine (Bontril, Plegine)

Phendimetrazine is similar to phentermine, but is in a stronger strength category.  Some people finds it works better than phentermine, others find it doesn’t work as well.  It is available in once daily doses of 105 mg, or 35 mg three times a day.

 Symlin (pramlindite), Byetta (exenatide) and Victoza/Saxenda (liraglutide)

 Symlin (pramlintide), Byetta (exenatide) and Victoza/Saxenda (liraglutide) are medications used to treat diabetes that cause weight loss.  They work in the brain to decrease hunger, and cause a feeling of prolonged fullness after eating by delaying emptying of the stomach.  They also stabilize glucose levels.  Saxenda was voted in favor of FDA approval as a weight loss medication on September 11, 2014

Qsymia

 Qsymia (formerly Qnexa) from Vivus is a combination of phentermine and Topamax in a single pill.  In one study patients lost 37 pounds in 56 weeks. It was approved by the FDA on July 17,2012. It became available on September 18, 2012. The individual components are available in less expensive generics and can be taken as two seperate pills. Qsymia has a proprietary time release mechanism that minimizes side effects. Click here to read the full prescribing information.

Belviq (lorcaserin)

 Belviq (lorcaserin) from Arena Pharmaceuticals helps lose weight by creating a feeling of fullness.  In one study patients lost 35 pounds in one year. It was approved by the FDA on June 28,2012, and is the first new diet pill in over ten years. It is essentially an improved safe Phen-Fen and may have the same spectacular results. Our patients taking this combination report losing 10-20 pounds or more without being hungry at all. They say they had to force themselves to eat, and that even their favourite foods would make them nauseous, as if they were sick. Click here to read the preliminary prescribing information.

 Contrave

 Contrave from Orixigen is a combination of bupropion and Naltrexone.  Bupropion is an antidepressant also used for smoking cessation that is chemically similar to diethylpropion.  Naltrexone is a narcotic antagonist used for the treatment of alcohol addiction. It was FDA approved on September 11, 2014. The individual components are available now and can be taken as two seperate pills.  In one study patients lost 9.3% of their body weight in 1 year.

Orlistat (Xenical)

Orlistat is a fat blocker that keeps up to 30% of dietary fat from being absorbed into the body. Dosage is 120 mg up to 3 times a day taken ˝ hour before meals containing fat. Common side effects include cramping, diarrhea, gas, and uncontrollable oily leakage.

Sibutramine (Meridia)

Sibutramine is an appetite suppressant chemically similar to antidepressants with side effects similar to them, most commonly dry mouth, insomnia, nausea, and headache. Daily doses of 5, 10 and 15 mg are available. It was withdrawn in 2010.

Fenfluramine (Pondamin) withdrawn from market 9/23/97

By itself, fenfluramine is a relatively mild appetite suppressant. It has just the opposite side effects of phentermine. It makes some people sleepy, and can cause diarrhea. By using them together, the side effects of both can be reduced. It has been associated with PPH, and heart valve damage .

Dex-fenfluramine (Redux) withdrawn from market 9/23/97

Dexfenfluramine is a relatively new diet medication. It is the chemical mirror image of fenfluramine, and has similar action and side effects, including the risk of PPH and heart valve damage.

Buying Diet Medication on the Internet

It is illegal to buy or sell prescription drugs on the internet. We have had patients aproached by customs and other law enforcement agencies. If you buy these medications on the internet, you are buying from criminals. While you may receive the real medication you may just recieve sinus or sugar pills or worse. The cost is often higher than seeing a board certified bariatric physician and a licensed pharmacist. We have many patients hounded by these criminals for months wanting to sell them more.

Prescription Diet Pills

Some prescription diet pills (phentermine, phendimetrazine, and diethylpropion) are recommended to be used only in people who are dangerously overweight, according to the following chart.

If you fall in the red region, you fall in the dangerously overweight category, and are eligible for these medications. If you are in the yellow region, you are eligible only if you have hypertension or diabetes or other medical conditions. If you are in the green region you are not eligible for these medications, but you may take any of the other medications listed above. We have something to help everyone.

Body Mass Index (BMI), kg/m2
Weight
Pounds
Height (feet, inches)
5' 0" 5' 3" 5' 6" 5' 9" 6' 0" 6' 3"
140 27 25 23 21 19 18
150 29 27 24 22 20 19
160 31 28 26 24 22 20
170 33 30 28 25 23 21
180 35 32 29 27 25 23
190 37 34 31 28 26 24
200 39 36 32 30 27 25
210 41 37 34 31 29 26
220 43 39 36 33 30 28
230 45 41 37 34 31 29
240 47 43 39 36 33 30
250 49 44 40 37 34 31

 

What Our Patients are saying...


"I thought losing weight had to be hard, boy was I wrong"
"Thank you Dr. Stege, my daughter is a new person!"
"Fear was keeping me from losing weight, don't let it keep you from being thinner."
"They helped me realize being heavy was not my fault."

"I did it for me, but the fact that everyone else noticed isn't bad either ."
"I lost the weight but I didn't have to do it alone."

 

 



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