Common Weight Loss Questions
Tell me about your program.
What will happen at the first visit?
During your first visit, Dr. Marlowe or Natasha Rudd will give you a full physical (focused on finding causes and complications of obesity) and review your current medications. The medications you currently take may be causing you to gain weight. You will be asked many questions about your past diets, failures and successes, your eating habits, and exercise routine. If you desire a medication for weight loss, your clinician will discuss one or more choices of weight loss medicines. If one of the medication options interests you, you will start the weight loss medication at the first appointment. Dr. Marlowe and Natasha are trained to discuss with you which medication would be safest, taking into account your medical conditions and other medications you take. If you are given one of the most commonly prescribed medications, one bottle is included with the visit at no extra charge. We will give you a diet to follow during the first month.
Between the first and second visit, Dr. Marlowe or Natasha will likely order bloodwork. At your second visit, your clinician will review the lab results with you, pointing out any abnormalities or deficiencies that are hindering your weight loss. Also, you will frequently be given a new diet that has been tailored to you from your bloodwork.
Each appointment after that, we will continue to monitor your vital signs, weight loss medication, food intake, and exercise regimen. We monitor vital signs like blood pressure, because as you lose weight, you may be able to come off of various medications (eg. diabetes medicines, blood pressure medications, cholesterol pills). If the weight loss medication is not working or has a side-effect, Dr. Marlowe or Natasha will discuss with you changing the medicine to one of the many other options.
What should I bring?
- Please know the medicines, herbs, and supplements you take. Or, you may bring a list.
- Lab results from your primary care physician, if you wish.
- A diary of food intake for the last week, if available.
What questions will be asked?
At the first appointment, we will need your complete medical history. You will be asked about your medicines, past medical conditions, previous surgeries, allergies to medicines, smoking/drinking habits, and medical conditions of relatives. Additionally, Dr. Marlowe or Natasha will ask you about what you eat and how you exercise. One of the most important questions is about previous weight loss attempts. The more detail you can provide, the better we will be able to determine what will work best for you in the future. Your previous failures at weight loss provide valuable information to your clinician, so don’t leave them out!
Will the doctor/PA need to do a physical exam, even if my primary care doctor just did one?
Absolutely! The North Carolina Medical Board requires every clinician to examine his/her patient at least once (even psychiatrists perform a “psychiatric exam”). Even if it were not required, our clinician would be sure to perform a full exam. Dr. Marlowe or Natasha Rudd will check for glaucoma, thyroid nodules, heart murmurs, liver enlargement, nail abnormalities, as well as many other physical findings which cause can obesity or are caused by obesity … and are not the focus of your primary care doctor. Every board-certified specialist performs an exam which is focused on his/her area of expertise. Beware any physician who never examines you.
Will I be given medicine at the office?
Yes. Unless you have a medical contraindication to receiving phentermine or phendimetrazine or Topamax. There are more than 30 different types of medicines which we prescribe for weight loss. For convenience, Dr. Marlowe will dispense to you at no additional cost the most common medicine (phentermine or phendimetrazine or Topamax), if it is the best choice for you. If you have a health condition which makes it an unsafe choice or if the clinician feels a different medicine would be more effective for you, they will discuss with you the reason for writing a prescription for a medicine available only at the pharmacy.
Will you order lab tests at the first visit?
Probably, but not always. Many patients have underlying vitamin deficiencies and endocrine abnormalities which contribute to weight problems. After asking extensive questions and carefully examining you, Dr. Marlowe or Natasha may not need blood tests to know what diet will be best for you. They may order medical tests which are appropriate for weight-related medical conditions. Since we only order tests when you have a medically necessary reason, the insurance companies cover the costs of the tests. We never order tests “just because”.
Will I be given a diet on the first visit?
Most patients will be given a general diet, a request to keep a food journal, and a blood test order. On the second visit, the results of the blood test will be used to determine the best dietary plan, which will be discussed in detail at the second visit. For some patients, the best dietary plan will be clear to Dr. Marlowe or Natasha, based upon their experience recognizing common patterns of patient health.
Do you treat childhood obesity?
Yes. We are one of the few weight loss programs in the United States that treats childhood obesity. Dr. Marlowe has ABFM board-certification which includes training in pediatric medical and behavioral issues. We note that children most often follow the example the parents set, so we at the Institute require parents to be patients before the children can become patients. If parents and siblings are thin, but only one child is obese, we recommend discussion with the primary pediatrician whether an evaluation by a pediatric endocrinologist specialist might be appropriate.
Do you do surgery? Prescribe bio-identical hormones? Give HCG?
No. This is a non-surgical medical weight loss clinic whose focus is medical weight loss. (Oh … did you know that the top 10 programs in the United States with the highest success rates don’t use HCG?)