Medically Supervised Weight Loss

Have you tried to lose weight but been unsuccessful?  Or have you been initially successful with weight loss, then regained the weight plus a few extra pounds? Dr. Twigg is a member of the Obesity Medicine Association, the largest organization of physicians and other healthcare providers working every day to improve the lives of patients affected by obesity.  Using a comprehensive, scientific, and individualized approach, she will help you achieve your health and weight loss goals.  Weight loss can be successful and sustainable with the proper techniques, knowledge, nutrition, exercise, and even approved medication-therapy, if needed.  You will be successful at maintaining your weight loss if you follow my steps and continue some basic rules for life.  This is based on eating real foods you prepare, not commercially prepared or "special" foods.  Nutrient-dense healthy foods for life are the goals to achieve and maintain your best weight and health.  What you put into your body and the exercise and activities you do each day are the most important aspects that directly affect your health or lack there of.

Questions and Answers:

What diet plans are available for weight loss?

There are multiple diet plans available:  

  • The Customizable Diet Plan: Dr. Twigg develops this plan specifically based on your current health status, body composition analyses including your body fat levels and other factors.  With this plan, she will design your plan for weight loss of ½ pound to 2 pounds per week.  This will be based on many factors.  With this plan, Dr. Twigg uses appropriate calories and macronutrients to get to lose weight more effectively while helping to maintain muscle mass. You choose your foods you eat and learn as you go, that way you can easily maintain your loss once you hit your goals.  Dr. Twigg may make adjustments to your diet as needed and as weight loss goals are met. 
  • The Twigg Plan: This customized diet provides you with the proper calories, proteins, complex carbohydrates, and fats in a simpler format.  You are provided with a list of proteins, carbohydrates, and fats to chose from eat day to check off your list.  You weigh your foods and pick what works for you that day. 
  • The Doubl-EE Plan: This easy and effective low calorie weight loss plan makes is a simple way to lose weight. This weight loss plan is simple and effective without a lot of counting.  If you don't want too many decisions to make, this is the plan for you, as it allows more limited foods to choose from while providing a healthy, nutrient-dense plan.  This eliminates certain foods, allowing proteins, fruits, vegetables, and some fat into the diet only.  You will be required to eat certain amounts of each macronutrient (proteins, complex carbohydrates, and fats) each day. 
  • The Evidence-Based Nutritional Ketogenic Diet:  Although this plan is not chosen by many, it is a nutritionally complete weight loss diet with emphasis on real food and protein.  This high-protein, low carbohydrate diet has been studied for many years in the medical community.  It is not what is on the internet!  This is not a high-fat diet!  This safe, effective diet, when done correctly, works for virtually everyone.  You can expect to see great weight loss with no calorie counting, improvement in blood pressure and hemoglobin A1c (diabetics may be reversed), a decrease in stroke risk, and improvements in your triglycerides and HDL cholesterol levels.  You will ultimately feel less hunger due to the effects of the foods you eat.  Less hunger means less calories consumed and weight loss.  This plan comes in 4 week and money-saving 20 week plans.

Do I need to exercise while on these weight loss diets?

Everyone, whether trying to lose weight or not, needs to exercise for health.  This is the perfect time to start and research shows those who lose weight will tend to keep it off if they are exercising.  Building muscle is a key component to maintaining metabolism.  If you are losing muscle, which we typically do as we age, then your metabolism is slowing down, you are burning less calories every minute, every hour, every day.  You don’t need a gym membership to exercise, but if you need this for motivation, then spend the money and go every morning before you start your day.  One hour or more is the goal.   However, if you can only manage 20 minutes, then please do 20 minutes.  I recommend doing 3-5 days of strength training exercises to build and maintain muscle with aerobic exercise the remainder of the days.  Make time for you.  You are important!  In addition, remember that non-exercise activities can add up:  park farther from entrances, take the stairs, walk as if you are late to a meeting, walk 15 minutes during your lunch-time quickly, etc.  

How often do I need to come in for best weight loss results?

During active weight loss, all plans include twice monthly visits with 2 body composition analysis, diet plan, nutrition counseling, and Uscriptives brand Multivitamin with Sugar Control, Weight Loss Formula, and Fat Loss Formula. The Ultimate Active plan includes 1 additional body composition analyses for you to check your own progress.  Medications may or may not be prescribed based on your particular needs and desires.  You may choose from 1-month, 3-month, and 6-month active weight loss plans.

Will I have to eat certain foods on this diet or buy specific foods you provide?

You will need to buy all your own selections from a regular grocery store or online store as long as they fall within your specific diet/food plan.  There are no preset meals to purchase.  You will want a wide selection of  foods on any diet.  Dr. Twigg will provide you with a list of foods to choose from as a guide, but you will decide each day’s meals.

I need to lose 50 lbs.  How long will that take?

This is a difficult question to answer.  Men tend to lose weight more quickly than women because of a higher metabolic rate due to higher muscle mass.  Much of weight loss is accuracy in calories and what specifically you are eating.  Most people think they eat 40% less calories than they actually do.  Our aim is for a steady progression of weight loss of an average of about 1-2 lbs per week after the first 4 weeks.  Some will have a more rapid loss in the first 4 weeks, mostly due to some water weight loss initially.  Too rapid of a progression of weight loss can result in muscle wasting.  We do monitor your muscle mass using our body composition at each visit, however, utilizing proper weight training techniques and adequate protein intake can help minimize this loss.

I don’t want a fad diet, but I do want to lose weight quickly.  Can you still help me?

None of the diets or weight loss plans are “fad” diets and are truly healthy eating plans that you can continue throughout your lifetime.  Each of these meal plans are real foods that you prepare and make yourself so you can continue to do so and learn to eat for your entire life so that you can maintain your weight loss after you have gotten to your goals.  These plans are all very healthy, high protein, low fat and low carbohydrate food plans that teach you meal planning to eat lean proteins and complex carbohydrates in the correct amounts to keep your energy levels high, burn more calories, and feel great doing it.  

You can expect to lose anywhere from 0.5 – 2 pounds per week on average with any of these weight loss plans.  Some may lose more in the first few weeks, but this will begin to level out after the first couple of months for a slow, steady weight loss.    

I have trouble with my appetite control when I diet. Can you help with this?

Dr. Twigg will review your history and past weight loss patterns, perform a physical examination, then discuss options for appetite control or anti-obesity medications, if needed. Supplements that come with each program can aid with this.  But many different medications may help with appetite suppression and weight loss, if needed.  Some patients may not need this at all once the diet is adjusted.    Oftentimes, correcting the macronutrients in someone’s diet improves appetite significantly.  In other words, the proportions of protein, fat, and carbohydrate have to be corrected.   In addition, the carbohydrates most of us eat are not the good ones.  When we talk about carbohydrates to most people, everyone pictures potatoes, rice, corn chips, cake, etc.  Yes, these are carbohydrates, but not a great choice to choose on a regular basis.  These are the ones we need to eat very little of if at all.  The carbohydrates that need to come to mind and be eaten are a variety of vegetables, fruits, (berries are the best ones to choose but many others too) and limited grains.  Minimal fats should be consumed.  Bake and grill foods. Add in natural fresh herbs for flavor, not heavy sauces.  

I am interested in a weight loss medication.  Can I get one of those?  What about if it is too expensive?  Will my insurance cover it?  Do you prescribe compounded medications?

Many can benefit from weight loss or anti-obesity medications and studies support the use of these medications to both aid weight loss and help maintain weight loss.  You current health examination and laboratory studies will be necessary prior to consideration of medication use.  You may or may not need this at all.  However, those who have struggled in the past to maintain a healthy weight or also have other health issues certainly may benefit from adding one or more of these medications.  Some may use them temporarily, others may benefit from long-term use.  

Some insurance companies cover anti-obesity medications while others do not.  You can check this yourself.  Many of the oral medications are quite affordable, even if you have to pay out-of-pocket for them.  The injectable medications, such as Wegovy and Zepbound can be more expensive on a monthly basis, but have shown some of the best weight loss projections overall. 

I do not and will not prescribe compounded weight-loss medications, as it is not recommended by the FDA nor the Obesity Medicine Association due to the inability to assure the same safety, efficacy, and purity of the manufactured products we have available.  I highly discourage the use of obtaining these medications from other providers at this time as hundreds of adverse events using these agents from compounding pharmacies, some being very serious requiring hospitalization and death have occurred. 

I have kids and a spouse.  I’ll have to cook two different meals to lose weight.

Dr. Twigg gets this question all the time.  Why cook differently for your family? You want them to be healthy too, so cook them healthy meals.  OK, so maybe add a couple extra special things for them.  But, really, why should they be eating junk?  We’ve gotten programmed to think we need box meals or take-out food.  If you prepare healthy food, then that’s what they will crave and desire and expect.  Healthy food can and should taste really good.

Do I really have time to lose weight?  

Yes, you do.  You are worth it.  You are worth taking 15 minutes to prepare food in the morning.  You are worth making time to food prep, exercise 1 hour, and making your health and wellness a priority.  Make the time each day for just you.   If you don't, than who will.  Make the time! 

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