While we believe that good health can be achieved at a large variety of sizes, there are some medical truths about excess body fat – particularly visceral fat – that cannot be denied. Unlike subcutaneous fat, visceral fat is hormonally active and pro-inflammatory, and larger-then-normal amounts of it contribute greatly to your risk for high blood pressure, heart disease, stroke, Type 2 Diabetes (T2D), Alzheimers, and various types of cancer.
Chronically high circulating levels of blood glucose and blood triglycerides (from an excess of energy consumed daily, relative to your metabolism) also increase all of these same risks. Bringing your energy consumption into alignment with your body’s energy needs is crucial to your overall health. Fortunately, there are a variety of ways to achieve this.
We work with you to achieve sustainable fat loss and gain strength.
Our team can work with you to achieve sustainable fat loss and body recomposition changes in whichever way works best for you, your means, and your goals, be that through diet and exercise alone, or with the help of medications, including, but not limited to, GLP-1 Receptor Agonists such as:
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Ozempic
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Wegovy
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Mounjaro
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Zepbound
At this time our office is not prescribing GLP-1s to compounding pharmacies, nor are we prescribing them for clients who don’t have the conditions for which each drug is FDA-approved (e.g. Mounjaro for Type 2 Diabetes, Zepbound for obesity, etc). These drugs are a powerful game-changer in the treatment of obesity and T2D, and the positive health effects that their use can bring to those who need them are impressive. That being said, though, the decision to go on GLP-1 medications should not be taken lightly. Studies have shown that nearly every person who discontinues GLP-1 use (if that was the only intervention or change they made) will regain all the weight they lost within one year of ceasing use, thus reversing most or all of the health gains and/or improvement of chronic conditions that they experienced as a result of the weight loss. For this reason, it is our approach to combine these powerful medications with lifestyle changes to preserve and grow muscle mass and adopt sustainable and healthful dietary patterns, to arm our clients with the ability (and new habits!) to preserve the health benefits that accompany their fat loss over the long term, with or without the medications.
For this same reason, we do not offer these drugs to clients who aren’t seeking them, or who do not meet the medical criteria for their approved use. Carrying some extra weight in subcutaneous fat, while it might be displeasing to you aesthetically, is not in and of itself a health risk. Our emphasis here at this practice is on cardiovascular and metabolic health, mental health, and muskuloskeletal health (strong bones and muscles!), as opposed to appearances. “Skinny” is not the goal here. Skinny does not always equal healthy, as many low-BMI but sedentary people can also have unhealthy levels of visceral fat and a lower amount of lean body mass than is optimal. Our goal is to help each client understand their unique risks for conditions that could cut their life short or lower their quality of life in their later years, such as heart disease, T2D, cancer, and osteoporosis, and then to take all the steps they can take to manage the risk factors that are within their control.
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In addition to follow-ups with our FNP to track progress and side effects of medications, clients working with our office specifically for weight loss and/or metabolic health are required to meet with our Registered Dietician to – at a minimum – learn the ways in which you may need to change your eating habits to prevent undue muscle loss, and to mitigate common side effects and prevent gut motility issues that GLP-1s can frequently cause. We encourage more engagement with the RD than that, however, to overhaul dietary patterns and habits to ensure long term sustainability of your medication-aided weight loss. We also strongly encourage our clients to work with either one of our PTs or a personal trainer to adopt a sustainable exercise regimen that includes both aerobic exercise and
In concrete terms, you would likely benefit from, and appreciate our approach to GLP-1-aided fat loss if you are:
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Between the ages of 16 and 64, and qualify for the use of FDA-approved medications for either T2D, obesity (BMI > 30, with body fat percentage over 30%)
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Wanting to make lifestyle changes in the areas of diet and physical activity in order to really lock in the health benefits of losing some excess body fat, and protect against the rapid regain of the weight after ceasing the medication
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Wanting to meet with our in-house RD to learn strategies for healthful dietary patterns and ways to nourish your body and preserve your lean mass while experiencing the appetite suppression and reduced gut motility that comes with GLP-1 use
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Wanting to learn how to lift weights or do other resistance training and weight-bearing exercise that strengthen bones and muscles, and preserves muscle mass during weight loss. While visits with a PT just to learn weightlifting technique wouldn’t be covered by insurance, anyone suffering from back pain, hip or other joint pain, muscle weaknesses impairing their quality of life or movement, or stress urinary incontinence, can benefit from visits with our in-house pelvic floor PTs, which can include treatment plans that encompass learning how to do various compound lifts safely, or learning how to do a full-body resistance band workout, for example.
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Interested in learning about your body, investing some resources in testing like a DEXA scan, to ascertain your total body fat percentage, visceral fat percentage, and lean mass, as well as your bone density. Knowing your lean mass percentage is helpful in calculating your body’s daily energy needs, and knowing your starting body fat percentage can help you track progress toward your goals. Knowing your resting metabolic rate (RMR) through testing is also tremendously helpful in understanding how much energy your body needs on a daily basis. We also routinely order blood labs to assess various biomarkers of health, which can also be used to track your progress toward your health goals.