Sara Joseph, Women's Health Care Nurse Practitioner
The G Spa
See additional services offered by Dr. Kathleen Griffin at www.thegspa.org, a medical spa within her office. The G Spa offers non-Invasive skin care for men and women. Treatments include, skin tightening, improving skin elasticity & texture, microdermabrasion, cellulite reduction, Botox & fillers, and laser hair removal.
Weight Loss Program
WEIGHT LOSS PROGRAM BASICS
What does the treatment consist of?
The program involves taking two medications, phentermine and topiramate, which work together to produce an enhanced effect to decrease appetite and give one a sense of fullness when the appropriate amount has been eaten. This allows for rather easy maintenance of an 800-1200 calorie daily intake, which generally results in a weight loss of approximately 1-2 pounds per week. No special "diet" is involved; just eating healthy foods and 50% protein.
Exercising regularly and taking nutritional supplements are also important and essential components of this program. Motivation is a key factor as well.
Detailed instructions and information on how to take the medications, how to avoid side effects, diet and exercise guidelines, and which vitamin and supplements to take will be given to you during your first visit.
Are there side effects?
Each medication has side effects, but most side effects are reduced by using the medications together. Other precautions that will be discussed at your first visit are also used to reduce side effects.
Phentermine has been approved by the FDA for use as an appetite suppressant to treat obesity since 1959, and topiramate has been approved for use to treat seizures since 1996 and to prevent migraines since 2004. Using topiramate for its appetite suppressant effect is a legal, but "off-label" use.
Patients have increased energy, often sleep better than usual, and have lower blood pressure than normal, as topiramate is a mild diuretic, or water pill.
What weight loss should you expect?
As long as you follow the program, you can expect to continue gradual weight loss for up to 24 months on medication. The weight loss should exceed 15% of your starting weight. Thus, if you weigh 200 pounds, you might expect to lose at least 30 pounds in a period of 12-18 months. A recent trial showed an average weight loss of 10% of body weight in 6 months in 200 patients with an average weight of 230 lbs., eating 1500 calories.
What prevents regaining weight?
A weight loss maintenance phase is instituted once the desired weight loss has been achieved.
Who is eligible?
This weight loss program is offered for patients with a BMI (Body Mass Index) over 27 or roughly those who are greater than 20% over ideal body weight. To calculate your BMI go to http://nhlbisupport.com/bmi/bmicalc.htm
What are the medical supervision costs?
Initial Consultation 45 min. $225.00 Follow-up visits every 4 weeks 15 min. $90.00 Complex / other health issues 20-40 minutes $125.00
*Please note that a follow-up visit is required every 4 weeks in order to obtain prescription refills and to monitor for the development of side effects. Regular visits also increase the consistency of continued weight loss.
What are the medication costs? (Approximate cost as of 04/09)
If you have health insurance which covers prescriptions, Topamax is generally covered, although some companies will only cover Topamax if it is being used for migraines or seizures. Almost all companies will not cover "diet pills," such as phentermine.
Who developed this program and are there studies to show that it works?
This weight loss program was developed by Dr. Thomas Najarian, a Harvard-trained obesity specialist. You may read more at his web site: www.najariancenter.com. The Vivus pharmaceutical company is developing "Qnexa," a combination tablet of phentermine and topiramate and is currently in phase 3 trials, which are described under "News Releases" at www.vivus.com.
