Obesity is an epidemic in the United States. US data projections suggest that by the year 2025, obesity will affect 40-50% of the US population. Southwest Healthcare Services has a well established medical weight loss program to address the obesity epidemic in our area.
The program director is Dr. Forrest Lanchbury, who is specialty trained in Bariatric medicine and is a member of the American Society of Bariatric Physicians. Dr. Lanchbury established the Bariatric medical program in May of 2006 and since then the program has treated over 200 patients for weight loss from primarily North Dakota, but also patients from Montana and South Dakota. The program has been very successful in helping over weight patients lose weight. Treating obesity requires a long-term commitment on the part of the physician and patient. In respect to this, Dr. Lanchbury has developed programs for initial weight loss and maintenance. At Southwest Healthcare Services, we are committed to help you over the long term. We view obesity and being over weight as a chronic illness that does not just go away when the patient loses weight. Chronic illness requires long-term treatment and periodic re-evaluation of the treatment program effectiveness, and that is what we provide for our patients.
Affects of Obesity
Obesity is associated with several diseases and is behind many of the health problems we have today. These diseases include diabetes, coronary artery disease, high blood pressure, arthritis, sleep apnea, cancer of the breast, colon and other areas, menstrual irregularities and infertility problems in women, depression and chronic fatigue. The effective treatment of overweight patients involves addressing the conditions associated with being overweight and management of these conditions during active weight loss. Medications prescribed for diabetes, high blood pressure and cholesterol lowering are often decreased as weight loss occurs. In some cases, depending on the patient and other associated diseases, medications can be discontinued.
How to Begin Your Weight Loss Journey
When a patient chooses to begin the weight loss program, they will need to fill out a very complete history that is specific for weight loss. The patient is also asked to sign consent forms for the weight loss program and the use of appetite suppressants when they are prescribed. Laboratory studies are ordered to check for kidney and liver function, anemia, serum electrolytes and obesity associated conditions such as high cholesterol, diabetes, pre-diabetes, metabolic syndrome and thyroid disorders.
The initial appointment with Dr. Lanchbury and his staff involves a metabolism test to measure average daily calorie expenditure, review of the medical history, physical examination including an ECG, review of laboratory tests, education on metabolism, behavior modification, diet and supplements, exercise and medications. A specific diet and daily calorie intake is prescribed. Medications are prescribed as indicated to improve glucose metabolism and suppress appetite. Specific vitamins and supplements are prescribed for optimizing metabolism and protecting against deficiencies. Recommendations are also made for counseling and participation in weight loss groups when available. Some patients may require additional tests to evaluate metabolism problems, heart disease, hormonal imbalance of menopause or other problems that may influence medication, exercise and dietary prescriptions.
Follow up weights, vital signs and evaluation of any treatment side effects are scheduled weekly with a nurse and reviewed by Dr. Lanchbury. Follow up appointments with Dr. Lanchbury are usually scheduled on a monthly basis. Christine Peterson, Family Nurse Practitioner, has also received training in Bariatric medicine and is qualified to do follow up evaluations in consultation with Dr. Lanchbury. The follow up appointments include evaluation of progress, compliance with prescribed diet, exercise and medications. Further education on behavioral modification is usually emphasized. The need for medication dosage adjustments, continued need for medications and possible side effects are also addressed at these follow up appointments.
To Schedule an Appointment for Dr. Forrest Lanchbury’s Bariatric Program, contact: Southwest Medical Clinic (701) 523-3226.
Weight Loss Maintenance
When the patient has reached their weight loss goal, a maintenance program is prescribed. A calorie test is repeated at this time to evaluate calorie needs to maintain weight. A dietitian consult may be recommended. Initially the patient is asked to continue regular biweekly nurse follow ups for the first month and follow up with Dr. Lanchbury in one month. Recommendations will be made depending on the patient’s needs as to the frequency of future follow ups. Regular follow ups can be less frequent at this point but it will depend on remaining chronic medical problems and prescribed medications as to the frequency.
