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Adult Weight Management

Our Approach

Seger | MD’s approach to achieving weight loss goals and healthy weight maintenance for our patients is holistic and comprehensive. Our program focuses on utilizing prescribed nutrition and lifestyle plans in addition to medications and surgical interventions – when appropriate. Not every patient requires medication to lose weight, but for those who do, it is important to work with someone with the knowledge and expertise to guide them safely through the entire process.

At the first visit, our providers strive to get to know the patient and understand as much as they can about how he/she got to this point in life. In collaboration with the Seger | MD team, the patient will begin setting goals, which can be either weight loss or other health-related goals and are broken down into short-term (daily-weekly), intermediate (monthly), and long-term (yearly/annually). We typically recommend a beginning weight-loss goal of 5-10% of your starting weight, which typically occurs within the first 3 months.

We believe in planting the seed for what it takes to sustain meaningful weight loss long-term starting on day 1. This is so important because weight loss maintenance is challenging, some say even more so than active weight loss, especially if the patient doesn’t have proper guidance and support.

Patients need to understand the importance of continuing the changes they have made lifelong if they want their results to stick. Everyone will hit some bumps in the road and we will be there to help navigate the road ahead.

In some cases, patients may not be able to achieve their weight loss goals with medical weight management and weight loss surgery may be the best option. At Seger | MD we have you covered no matter which weight loss solution works best for you. Visit Weight Loss Surgery to learn more about our surgical program. 

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Getting Started

Duration: first 6-12 weeks

  • Initial Visit: Patient to outline/define their WHY – reason for reaching out to us
  • Comprehensive history and physical exam, including vitals, impedance body composition analysis, DEXA body composition analysis, EKG
  • Appropriate labs and other diagnostic testing are ordered
  • Collection of data on patient’s sleep, stress, physical activity, hormonal status and eating habits
  • Initial dietitian visit (usually within 2 weeks after 1st visit)
  • Follow-up visit with provider to go over labs and check in on what’s working/what’s not
  • Additional follow-up visits with provider and/or dietitian every 2-4 weeks, based on patient preference and need
  • If patient is on track, visits will continue every 4 weeks; once everything is running smoothly, these visits can be spaced out to every 6-8 weeks depending on the patient
  • Focus for first 4-12 weeks is all about optimizing nutrition – getting the patient into a realistic and consistent eating pattern
Phase 2 continues while the patient is actively losing weight and reversing disease. That means “as long as it takes”—weight gain didn’t happen overnight, so we don’t want to be in a hurry or worry about a timeline for weight loss as long as we are making progress.

ACTIVE WEIGHT LOSS

Duration: as long as it takes

  • Ongoing monthly follow-up visits with provider and/or dietitian
  • Assessment of active weight loss
  • Loss of 1-2 pounds per week is about average
  • Monitoring what’s working/what’s not—fine-tuning plan and goals
  • Evaluation and adjustment of medications, including weight loss meds, but also DEPRESCRIBING (YES! We get to take people OFF of meds!)
  • Follow-up labs as needed
  • Other follow-up testing as needed (sleep study, cardiac tests, etc.)
  • Ensuring patient is making progress in ALL of the 8 ELEMENTS
  • Follow-up visit with provider every 4 weeks
  • Continue working with the dietitian as needed-goal is to find an affordable, accessible, sustainable approach to eating
  • Optimization of nutritional approach, supplements, medications, begin to focus more on managing the mind and getting more physical activity
  • If patient is on track, visits will continue every 4 weeks ; once everything is running smoothly, these visits can be spaced out to every 6-8 weeks depending on the patient
Visits can be done either in office or virtually; however, we will need to monitor body composition and vital signs as often as every 8 weeks. If a patient lives outside of a reasonable travel radius, we can work to coordinate with the patient’s PCP/local clinic.

Maintenance (& Living Well!)

Duration: months, years, a lifetime …

  • Follow-up visits every every 3-4 months AT FIRST, then bi-annually or annually (arranged based on the patient’s needs)
  • More attention to all aspects of wellness (the 8 ELEMENTS)
  • Patients follow their customized plan – including “reset” tools when needed
  • “Maintenance” doesn’t mean doing nothing! Self-monitoring, healthy habits, autocorrect skills, and safety zones are key
  • “Keeping it off” can be challenging- we partner with the patient to determine a “safety zone” where he/she feels well emotionally/physically — patient experiences persistent decline in energy, increase in weight, need to move up a clothing size…it’s time to reconnect, sooner rather than later
  • We instill skills for patients to autocorrect without increasing the frequency or intensity of intervention, but if after 2-4 weeks (not 3-6 months!), the patient isn’t able to reset, they reach out to us to get back on track
  • Labs and body composition analyses repeated 1-2 times/year
  • Ongoing medical advice and support. Patients ALWAYS have convenient, confidential access to our team—via phone, text, email and the website.

UNDERSTANDING LOW-CARB EATING

So, it is true that if patients are insulin sensitive, and have NO signs of insulin resistance, he/she may not need to reduce dietary carbohydrates as much as the rest of us, in order to lose weight. The fact is that about 80% of US adults have insulin resistance and many have no idea.

We recognize it is impossible to ALWAYS make the best choices, but if you strive to be MORE consistent with putting goodness in your body whenever you can, while leveraging protein, you’ll optimize weight loss, diminish unhealthy internal fat that you can’t see (called “visceral fat”), and begin experiencing a life with less disease and inflammation.

Working with our professional dietitians, you’ll learn to look for and enjoy foods in their more natural state, with less processing, fewer added sugars, and less refined ingredients and chemicals—while still allowing yourself the opportunity for “exception” foods and meals on occasion.

Our approach is not about a “diet” but about learning more about how foods affect your body and learning to incorporate more of the beneficial foods, while limiting those of low to no nutritional value.

We believe in optimizing satiety (sense of fullness/satisfaction) while achieving a more steady state of normal blood sugars and insulin levels.

Getting Started

Duration: first 6-12 weeks

  • Initial Visit: Patient to outline/define their WHY – reason for reaching out to us
  • Comprehensive history and physical exam, including vitals, impedance body composition analysis, DEXA body composition analysis, EKG
  • Appropriate labs and other diagnostic testing are ordered
  • Collection of data on patient’s sleep, stress, physical activity, hormonal status and eating habits
  • Initial dietitian visit (usually within 2 weeks after 1st visit)
  • Follow-up visit with provider to go over labs and check in on what’s working/what’s not
  • Additional follow-up visits with provider and/or dietitian every 2-4 weeks, based on patient preference and need
  • If patient is on track, visits will continue every 4 weeks; once everything is running smoothly, these visits can be spaced out to every 6-8 weeks depending on the patient
  • Focus for first 4-12 weeks is all about optimizing nutrition – getting the patient into a realistic and consistent eating pattern

ACTIVE WEIGHT LOSS

Duration: as long as it takes

  • Follow-up visit with provider every 4 weeks
  • Continue working with the dietitian as needed-goal is to find an affordable, accessible, sustainable approach to eating
  • Optimization of nutritional approach, supplements, medications, begin to focus more on managing the mind and getting more physical activity
  • If patient is on track, visits will then be spaced out to every 6-8 weeks, while actively losing weight
Phase 2 continues while the patient is actively losing weight and reversing disease. That means “as long as it takes”—weight gain didn’t happen overnight, so we don’t want to be in a hurry or worry about a timeline for weight loss as long as we are making progress.

Maintenance (& Living Well!)

Duration: months, years, a lifetime …

  • Follow-up visits every 3-4 months AT FIRST, then bi-annually or annually (arranged based on the patient’s needs)
  • More attention to all aspects of wellness (the 8 ELEMENTS)
  • Patients follow their customized plan – including “reset” tools when needed
  • “Maintenance” doesn’t mean doing nothing! Self-monitoring, healthy habits, autocorrect skills, and safety zones are key
  • “Keeping it off” can be challenging- we partner with the patient to determine a “safety zone” where he/she feels well emotionally/physically — patient experiences persistent decline in energy, increase in weight, need to move up a clothing size…it’s time to reconnect, sooner rather than later
  • We instill skills for patients to autocorrect without increasing the frequency or intensity of intervention, but if after 2-4 weeks (not 3-6 months!), the patient isn’t able to reset, they reach out to us to get back on track
  • Labs and body composition analyses repeated 1-2 times/year
  • Ongoing medical advice and support. Patients ALWAYS have convenient, confidential access to our team—via phone, text, email, this website, or our custom app
Visits can be done either in office or virtually; however, we will need to monitor body composition and vital signs as often as every 8 weeks. If a patient lives outside of a reasonable travel radius, we can work to coordinate with the patient’s PCP/local clinic.

UNDERSTANDING LOW-CARB EATING

So, it is true that if patients are insulin sensitive, and have NO signs of insulin resistance, he/she may not need to reduce dietary carbohydrates as much as the rest of us, in order to lose weight. The fact is that about 80 % of US adults have insulin resistance and many have no idea.
We recognize it is impossible to ALWAYS make the best choices, but if you strive to be MORE consistent with putting goodness in your body whenever you can, while leveraging protein, you’ll optimize weight loss, diminish unhealthy internal fat that you can’t see (called “visceral fat”), and begin experiencing a life with less disease and inflammation.
Working with our professional dietitians, you’ll learn to look for and enjoy foods in their more natural state, with less processing, fewer added sugars, and less refined ingredients and chemicals—while still allowing yourself the opportunity for “exception” foods and meals on occasion.
Our approach is not about a “diet” but about learning more about how foods affect your body and learning to incorporate more of the beneficial foods, while limiting those of low to no nutritional value.
We believe in optimizing satiety (sense of fullness/satisfaction) while achieving a more steady state of normal blood sugars and insulin levels.
Visits can be done either in office or virtually; however, we will need to monitor body composition and vital signs as often as every 8 weeks. If a patient lives outside of a reasonable travel radius, we can work to coordinate with the patient’s PCP/local clinic.

Ready to Become a Healthier You?

Your path to weight loss is singularly yours, and at Seger | MD, we’re committed to supporting you through every phase of your journey.
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Seger | MD is a member of the Metabolic & Bariatric Affiliates – A Collaboration of the Leading, Experienced, and High Quality Bariatric and Metabolic Surgeons in Texas.
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