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TREATMENT EVALUATION PROCESS

THE INFORMATION BELOW IS INTENDED FOR CASE MANAGERS AT COMMERCIAL INSURANCE CARRIERS OR FOR CLAIMS EXAMINERS AT WORKERS COMPENSATION CARRIERS.

Michael D. Myers, M.D., Inc. offers a comprehensive approach to treating obesity that incorporates a low-calorie structured diet with medical supervision, professionally directed behavioral modification, and guidance in increasing physical activity. Dr. Myers first gives patients a comprehensive initial history and physical exam. This examination lasts about three hours with about 60 to 90 minutes of direct physician time. Upon completing this exam, Dr. Myers submits a detailed initial report to the primary treating physician with a copy to the case manager or other appropriate individual. The initial report includes recommendations, including whether or not the patient is an appropriate candidate for obesity management. If the patient is a candidate, Dr. Myers will recommend appropriate obesity treatment modalities and anticipated length of active obesity treatment (assuming reasonable compliance).

OBESITY TREATMENT PROGRAMS

For significantly overweight individuals, Dr. Myers generally prescribes a low-calorie diet, frequently incorporating Optifast for meal replacement. Optifast is a high-protein, low-calorie product that is an ideal source of complete nutrition. Optifast is taken in lieu of meals. Programs may include a medically supervised modified fasting protocol with two main dietary options:

• Optifast as a soul source of nutrition (a minimum of 800 calories per day in the nutritional supplement).
  
• Food plus Optifast (1000–1400 calories per day in the nutritional supplement and balanced food servings of protein, fruits, and vegetables).

Published, peer-reviewed clinical studies show that giving people fewer food choices facilitates decreased daily calorie consumption. By eliminating the selection and preparation of foods, people tend to have less anxiety about making food choices and thus, often find it easier to comply with the dietary protocol. By using portion- and calorie-controlled Optifast dietary supplements, patients (given compliance) can consistently lose weight (generally two to four pounds weekly), while simultaneously meeting all of their nutritional needs (calories excepted).

If authorized for obesity treatment, patients attend a weekly behavioral group facilitated by a licensed clinician. Behavior modification (lifestyle change) is the key to successful weight loss. In these sessions, patients learn to change their undesirable eating habits and inactive lifestyles and to recognize and overcome the factors that have contributed to their weight conditions.

Patients also receive nutritional and exercise guidance from our staff dietician/exercise physiologist. Dr. Myers sees each patient weekly and performs periodic laboratory testing to help ensure safe weight loss. If a patient is diabetic or has other medically significant complications, Dr. Myers will usually see that patient two to three times per week during the first two to three weeks of treatment to ensure that the patient’s medical conditions are adequately controlled while adjusting and reducing medications. For example, Type 2 diabetics are usually able to taper off their insulin at the start of the program and generally do not need further insulin treatment. If needed, Dr. Myers can also institute various pharmacologic interventions that can improve a patient’s overall sense of well-being, pain tolerance, and binge-eating patterns (seen in about 40% of obese patients). These interventions result in better compliance and overall progress. Dr. Myers sets what he believes is a reasonable goal weight for each patient.

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