How long does each of the three phases of Medical Weight Loss last?
Phase 1 and 2 both last approximately six months and each include 14 or
more sessions. Phase 3 is about maintenance of your new lifestyle, and
usually lasts approximately 12 months with quarterly visits with your
What happens after I complete the program, but I “fall off the wagon?”
It is extremely common for patients to resort back to old habits,
especially when life throws you a curve ball. Obesity and overweight
are chronic health conditions and need to be treated as such. We
recommend you continue to follow up with your team every three to
six months after completion of the program. That way if life throws you a
curveball, we help you problem solve and get back on track.
How fast can I expect to see results?
Each patient and situation is different, and results may vary.
Average Memorial Wellness Center Medical Weight Loss Results:
Percentage of Total Body Weight Loss
- After 12 months: 8%
- After 18 months: 17%
- After 12 months: 3 point reduction
- After 18 months: 5 point reduction
- After 12 months: 4 inch reduction
- After 18 months: 7 inch reduction
What is Visceral Fat?
Visceral, or "deep" fat, wraps around the inner organs and spells
trouble for your health. Visceral fat drives up your risk for diabetes,
heart disease, stroke and even dementia. Visceral fat is thought to
play a large role in insulin resistance—which boosts risk of diabetes.
Studies have shown a link between visceral fat and dementia. In a study,
records of more than 6,500 members of Kaiser Permanente of Northern
California, a large health maintenance organization, were studied for an
average of 36 years, from the time subjects were in their 40s until
they were in their 70s. The records included details on height, weight
and belly diameter—a reflection of the amount of visceral fat. The
study concluded subjects with higher visceral fat had a higher risk of
dementia than those with less visceral fat. Possible speculation of the
trial is that substances such as leptin, a hormone released by the belly
fat, may have some adverse effects on the brain. Leptin plays a role in
appetite regulation but also in learning and memory. Normal visceral
fat values: Women: 9-10; Men: 12.
In regard to weight loss, what type of exercise is more beneficial: strengthening or cardio?
Both! Cardiovascular exercise is anything that gets your
heart rate up for a sustained period of time, makes you feel sweaty and
gets more oxygen pumping through your blood. Running, cycling and
aerobic classes, like Zumba, are all examples. Government guidelines
suggest adults should do 150 minutes (30 minutes, 5 times a week) of
moderately high intensity aerobic activity. Your heart and lungs will
benefit immensely from consistent cardiovascular exercise. It is
especially important for beginners, as it thickens the tendons and
ligaments in joints in preparation for higher intensity exercise. Health
benefits include improved circulation, increased bone density (to help
combat osteoporosis), improved sleep and reduced anxiety levels.
Moderately high intensity cardio also increases your energy levels. The
secret is to find an exercise you love, or something to do with friends.
It will help you stick to it, which is key to any type of exercise.
Strength training is any exercise that helps the different muscles in
your body become stronger and more powerful. It can include using
weights or even your own body weight like press-ups and squats. It can be
resistance-based, using different forms of resistance like elastic gym
bands or gym fit balls. Strength training helps tone muscles and
strengthens bones. It is also the key to losing weight. By doing
strength or weight training, you are looking at increasing your muscle
tissue. The more lean muscle tissue you have, the more calories you burn.
One kg of muscle burns 50 extra calories a day, whereas 1kg of fat
burns just three calories a day.
What is the best time of day to exercise?
The key is to exercise whenever you can—whether it's morning, afternoon
or evening. Your goal should be to move your body as much as possible.
But, by starting your morning with physical activity, you set the day's
pace. Starting your day with activity can help boost your physical
energy and mental alertness for the day ahead. Research shows morning
exercisers tend to stick with their exercise habits. By doing the bulk
of exercise first thing in the morning, you get your exercise in before
other distractions can intrude. Research suggests that morning exercise
improves sleep, a benefit that could also promote weight loss. A study
of overweight women between the ages of 50 to 75 showed that those who
engaged in consistent morning exercise (about four hours a week) slept
better than those who exercised later in the day. The evening exercisers
had more trouble falling asleep—even if they fit in the four hours a
week. How does sleep affect weight loss? Poor quality of sleep
influences certain hormones that control appetite. It is possible that
by exercising in the morning—instead of evening—the exercise affects the
body's circadian rhythm (your internal body clock) so you get
better-quality sleep. Good sleep helps control the hormonal balance that
helps control appetite. One way to think of your morning exercise is
schedule it like a business appointment—one you can't easily cancel. It
takes discipline, but consider the fact that exercise can be the highest
priority for your health.
If you know you can put the time aside to exercise regularly,
lunchtime exercise is a good option. You’ll be awake and alert and your
muscles will be warmed up so you might be less likely to injure
yourself. Plus, you can grab an exercise partner—a friend or
colleague—and this will help you commit to exercise regularly and make
it a lot more fun. Exercising in the middle of the day could help to
relieve daily stresses and boost blood flow to your brain so you are
sharper for your afternoon duties. Additionally, you might find that
exercising in the middle of the day makes you more mindful of what you
are eating for lunch and later in the day. On the down side, time
constraints might mean that you cannot get in a full workout.
Exercising later might be your best option if you want to gain muscle
mass. Studies have shown exercising in the evening is a good way to
gain strength which is why strength trainers, like weightlifters, train
in the evening. The reason: the muscles have warmed up by the afternoon
or evening and certain hormones that are necessary for muscle-resistance
work are optimal later of the day. Evening exercise might also help you
regulate the amount of food you feel like eating for dinner, which is
beneficial if you tend to eat big meals at night. It can also be a great
stress reliever after a busy day at work or home. On the downside, some
research suggests that vigorous activity just before bedtime isn’t a
good idea, so you’ll need to exercise approximately three hours before
you go to sleep. This is because exercise raises your body temperature
and increases hormone activity, which could interfere with sleep as
Shouldn’t I eat less and move more to lose weight?
Fad diets are not the best way to lose weight and keep it off. These
diets often promise quick weight loss if you drastically reduce what you
eat, or avoid some types of foods. Some of these diets may help you
lose weight at first. But these diets are hard to follow. Most people
quickly get tired of them and regain any lost weight. Fad diets may be
unhealthy. They may not provide all of the nutrients your body needs.
Also, losing more than 3 pounds a week after the first few weeks may
increase your chances of developing gallstones (solid matter in the
gallbladder that can cause pain). Being on a very restricted calorie
diet for a long time may be a health risk which could lead to serious
heart problems. Research suggests that safe weight loss involves
combining a balanced plate, scheduled meals and snacks with physical
activity to lose 1/2 to 2 pounds a week (after the first few weeks of
weight loss). The key is a balance of making healthy food choices and
building exercise into your daily life. Combined, these habits are a
healthy way to lose weight and keep it off. These habits may also lower
your chances of developing heart disease, high blood pressure, and Type 2
What is my biological or physiological age? How does it affect my health?
Biological, or physiological, age is a measure of how well or poorly
your body is functioning relative to your actual calendar age. For
example, you may have a calendar or chronological age of 65, but because
of a healthy and active lifestyle (avoiding longevity threats like
tobacco and obesity), your body is physiologically more similar to
someone with a chronological age of 55. Your biological age would
therefore be 55. While not an exact science, the concept of biological
age can incorporate objective measures like resting heart rate, blood
pressure and visual acuity, as well as more subjective criteria like
ease of performing daily tasks, muscle strength and general mobility.
Will I develop a lot of excess skin folds as I lose weight, and if so, is there anything I can do to get rid of them?
With dramatic weight loss of 100 pounds or more, excess skin can be
problematic. Excess skin is most pronounced in people with pre-operative
morbid obesity who have the greatest weight loss and who are older at
the time of surgery. Common problems are abdominal skin folds and skin
folds at the buttock which can lead to discomfort when sitting and
bending over. In addition, excess skin at the upper arms, thighs and
breast area can develop infections leading to rashes and unpleasant
Exercise and muscle toning help with firming, but with significant
weight loss, plastic surgery is the most advantageous means of excess
skin removal and body contouring. Studies have shown that patients who
have plastic surgery after bariatric surgery have improved quality of
life scores and more successful weight maintenance.
Sometimes, excess skin depends on a person’s body shape before weight
loss. If someone has an even distribution of body weight, they may have
very little excess skin folds even with a 50-60 pound weight loss.
People with more central weight mass (apple shapes) with very thin legs
tend to have more abdominal skin folds even with modest weight loss.
People with pear shapes tend to have more skin folds in the thigh area
after modest to significant weight loss.
Non-surgical means of tightening skin include maintaining or
increasing muscle tissue. Muscle tissue is the key to minimizing loose
skin. If muscle mass is lost in addition to fat, it creates an even
larger void under your skin's surface. Increasing lean muscle tissue
fills the area underneath the skin, which helps to keep the skin taut. A
strength-training and muscle-building regimen with progressive
resistance training may yield better results over one that optimizes
endurance. Strength training specializes in increasing the overall size
and volume of your muscles, allowing your skin to cling tighter to the
underlying muscle tissue.
Is there a way to reduce my waist circumference? Will sit-ups do this?
Waist circumference is not affected by performing hundreds of crunches
or sit-ups. In order to decrease stomach girth, you have to focus on
lifestyle changes. Lifestyle changes include proper nutrition,
intensified exercise and increased activity throughout the day.
Nutritional changes which include healthy food choices, balanced plates,
scheduled meals and snacks and food logging, as well as decreasing
daily calorie intake, are keys to weight loss and especially a decrease
in waist circumference.
Increasing moderate-intensity cardiovascular exercise to 30-60
minutes (150-250 minutes per week), 6 days a week assist with weight
loss. Adding interval training to cardiovascular program can help target
belly fat. Strength training helps burn calories more efficiently.
Increasing physical activity throughout the day (taking the stairs,
parking farther away from the door, walking on breaks) helps, but is not
a replacement for purposeful cardiovascular and strengthening
How does exercise change as I get closer to my goal weight?
Exercising to maintain your weight loss isn’t much different than
working out to lose weight, get fit or stay fit. People who struggle
with their weight usually have metabolisms that naturally want to store
extra energy as fat instead of burning it off. That’s not going to
change just because you lost weight. You’ll have to work out just as
hard to keep your metabolism in high gear and keep the weight off.
Exercise and other lifestyle activities are essential to doing that.
Make sure your exercise program for maintenance includes these three elements:
- At least 30-45 minutes of moderate-intensity cardio exercise, 5-6
days a week. This helps your body use more energy (especially stored
fat) even when you’re not exercising, which will aid you in maintaining
your weight loss. Increasing exercise intensity so you are working in
the upper 2/3 of your target heart rate zone is also essential.
- Strength training: building and maintaining lean muscle mass will
keep your metabolism elevated so that you burn calories more
efficiently, even at rest. Muscle confusion is also essential. Doing the
same exercise routine every day and every week allows the body to
become accustomed to the exercise and benefits of strength and cardio
- Extra lifestyle activity: every little bit of activity you do
throughout the day can make a big difference. However, lifestyle
activity is an enhancement, not a replacement, for purposeful exercise.