In medicine, we refer to this as an elevated Body Mass Index (BMI). A BMI is a calculation determined by your height and weight. A normal BMI is less than 25.

An increased Body Mass Index has been proven to dramatically increase your risk of developing many diseases such as:

This testing may be done in our office, or if it is more convenient for you to return to your primary care physician, we will give you a prescription to bring with you to their office so that you may obtain the necessary tests. Our physicians always include physical exams when they initially consult with you. 

Our goal at our office is to initiate treatment as quickly as possible in order to lower a person's risk factors for multiple diseases as well as work towards cures and significantly reduce the amount of medications a person is taking.

In order to achieve this goal we will have to medically clear each individual as stated above, but we will work with each one of you on an individual basis in order to make it easier for you and less costly.

Initial Office Visit:

The first step in this process is to set up an appointment with one of our physicians, and as noted above, to please bring with you whatever medical records you can get your hands on. From that point on, the physician will determine what will be necessary to medically clear you and begin treatment. (Most of you will need minimal testing. If you already know that you have medical problems then you may require extra tests if you have not already had them.)

Return Office Visits and Costs:

It is important to remember that these office visits are medical consultations and not just visits to a "Weight Loss Clinic". When we consult and examine our patients we treat not just their weight, but we will be monitoring and treating your co-existing medical problems. 

It is often very rewarding when you begin to see that your medications are usually very quickly lowered in dosage and eventually discontinued because they are now unnecessary after reaching a normal weight.

If you already have a Primary Care Physician we will stay in contact with him or her through regular consultation notes. After we have achieved an appropriate weight for you, we will refer you back to your primary care physician while scheduling occasional follow-up exams with us in order to prevent regaining your weight through maintenance therapy. 

It is important to remember that obesity is a medical disease and will usually require maintenance therapy for the rest of your life. Why this is necessary will be explained thoroughly during each consultation. 

You must remember that the risk of any medication that we use to reduce or maintain a normal body weight is miniscule compared to the risk of all the diseases that are caused by an elevated body weight.

This is a much safer and more beneficial approach than taking a whole host of medications for the rest of your life to treat all the medical problems associated with being overweight and never even lose the weight.

Medical studies have consistently shown that overweight individuals who go on repeated weight loss programs and yo-yo with their weight have an increased mortality rate compared with those who maintain themselves at one constant weight. 

Obviously, maintaining your weight at a normal Body Mass Index will significantly reduce your risk of mortality from all the numerous diseases as listed above. This reduction is seen when we continually treat you on an ongoing basis to maintain your normal Body Mass Index.

New consultations will be scheduled for at least an hour visit on the first day, occasionally requiring more than one hour. Obviously the number of medical problems an individual has, will often determine the length of the first consultation. Sometimes, these consults could actually take two hours split up into two days. 

Cost of initial visit is based on medical sub-specialty consultation fees. Most often insurance companies do not pay for preventive medical care but, on occasion, if an individual calls their insurance they may find that they will be reimbursed due to their medical necessity.

Some insurance companies will reimburse the cost of weight loss medications but not the physician visits. If an individual finds it impossible to pay for the initial consultation at the time of the visit, a payment plan can be worked out with our business manager.

Follow-up visits usually are required approximately once a month, although during the first month an extra visit may be needed. These visits are usually scheduled for 15 to 30 minutes, but on occasion this may vary.

If you compare the cost of this comprehensive medical care, in one year from the time you start to work with us, you will have likely spent 1/2 to 2/3 the cost of what you would have paid if you had joined just a typical weight loss program. 

Again, we emphasize that this is not a weight loss clinic. We provide medical consultations to review and treat all diseases that are caused or worsened by being overweight or obese. 

Individuals who want to be seen for cosmetic purposes only, having a normal Body Mass Index with no medical risk factors will not be seen or treated for these purposes.

Questions About How We Medically Treat:

There will always be numerous questions from each individual about how we treat medically and what occurs during our consultation. This information is extremely technical and will be completely answered during each visit with the physician. 

The underlying philosophy of our treatment has already been described above. The medications that we use intercede with the neurophysiology and neuroendocrinology of the receptors in your brain that controls your appetite, satiety (the feeling of being full) and numerous endocrine reflexes from other areas of your body that affect your metabolic rate as well as appetite. 

During the consultations, we deal with every organ system in your body enabling us to manage any other medical problem that may coexist. Medications that are used will be explained in their entirety and are extremely safe. Many of these have been used for the last 50 years, even in children, but were never used properly in order to achieve significant weight reduction and maintenance. 

In addition to this, we follow the NIH guidelines and have put together numerous medical research studies which all consistently show that the only way a person can lose weight is to significantly reduce their caloric intake, but this will be regained within four years if not medically treated to prevent this.

How to Set up an Appointment:

Consultations will be scheduled with either Dr. Robin Levy-Miller, or Dr. James Rorig. Our physician assistants will be available during these hours to help answer questions that may arise, as well as to help follow your vital signs, and progress.

When you call our office, please identify that you are interested in a weight management consultation. Remember, if you already have an Internist you will need to bring with you, during your first consultation, copies of all your medical records, most importantly your previous complete history; including all of your labs, any EKG, as well as any important tests you have previously undergone (stress test, echocardiogram, chest x-ray, or any other medical evaluations). If you do not have a physician or have not had a previous medical physical, this can be performed through our office

Most individuals begin weight loss treatment following their first visit. If you have several medical problems, the initial consultation may require more than one visit, especially if you need additional testing or treatment in order to control your current medical condition. For example; an individual who has undiagnosed hypertension along with an elevated BMI will have their treatment initiated with antihypertensive medication. If an individual is found to have early diabetes, their treatment will be initiated with weight loss medication since this may cure the diabetes without the need for insulin or diabetic medication.

We offer state-of-the-art care in Internal Medicine that is generally not available elsewhere and usually not covered by medical insurance, yet recommended as necessary by the National Institute of Health.