New Fitter Me program at UH offers a tailor-made plan for a healthier lifestyle
UH Clinical Update - July 2018
For many if not most people, diets don’t work – or at least not for long. Permanent behavioral change does.
University Hospitals is offering a new program to help motivated patients who want to lose weight, one that emphasizes changes in behavior and lifestyle first. It is called Fitter Me, and it does also offer medical options to patients who want to lose pounds and have struggled to do so in the past – or who are not candidates for bariatric surgery.
The Fitter Me program is under the leadership of Goutham Rao, MD, FAHA, who is the Chair of the UH Department of Family Medicine and Community Health and the Director of the UH Office of Provider Wellness. Dr. Rao was among the first physicians certified in the U.S. in obesity medicine.
“We are offering this program because there is a lot of interest among clinicians at UH in medical obesity management,” Dr. Rao said. “And the timing is right because for a long time we didn’t have medical options for patients – there was a big lull in medicine for a few years.”
Now, he says, there are five medications that can be used to help patients with weight loss. Four are new: Belviq, Qsymia, Contrave and Saxenda. And Phentermine is another one, though it has been around since 1959.
However, patients enrolled in Fitter Me do not get any medication at first, Dr. Rao explains. The initial approach is to get them to make one habit change, and experience success. Then, another habit change.
“I come from a background in public health, and what we know works is starting with essential goals,” he says. “Everyone is different, and we work with them as individual, which is very different from a commercial weight loss program.
“So we find out what their habits are and which one might be the first to approach for them to change.”
That habit might be drinking sugary soft drinks, not eating breakfast or eating a meal too late at night, among others. Each patient also will meet with a registered dietitian for guidance.
Patients do have to be motivated to participate in the program, which is covered by insurance. (Some of the medications, however, are not covered by some insurance companies.) Follow-up appointments are arranged monthly, or according to individual patient’s needs or progress.
Fitter Me will also offer another method to spur weight loss for some patients: Obalon, a balloon temporarily inserted in the stomach. (Obalon is not covered by insurance.)
“Balloons have been around for 30 years, but because of side effects, they weren’t popular,” Dr. Rao says. “People could feel them inside, and they suffered from nausea or vomiting. The new balloons – a series of three in varying sizes, one month apart – have minimal side effects.” The new balloons were approved for use in patients in January 2017. They are only used for six months.
The biggest motivation for creating Fitter Me, say Dr. Rao, was that “we were not serving part of population who have specific needs. Some people with high BMIs are not candidates for bariatric surgery, for example – perhaps they aren’t heavy enough, or they have unstable heart disease, which creates a high surgical risk.
“We want patients who have some degree of self-motivation – a patient who tells his or her physician that they want to achieve a healthier weight. That’s the person we want to see.” The program is especially designed for candidates with a BMI from 25 to 40.