Lifestyle and metabolic medicine

Our care team is passionate about helping patients lose weight and make critical health improvements. Our doctors are board certified in obesity medicine. Our nutritionists have advanced training and certifications in nutrition and functional medicine. 

Obesity means having too much body fat. It is not a character flaw or lack of will power. It is a complex medical disease that increases the chances of getting other diseases and health problems. These include heart disease, diabetes and certain cancers. 

Metabolic disorders mean that the body’s ability to turn food into energy doesn’t work correctly. Disorders include diabetes, prediabetes, metabolic syndrome and dyslipidemia (high levels of cholesterol and other fats in the blood).

The Primal Pathway Program is the focal point of lifestyle and metabolic medicine. It is located at The Polyclinic Broadway. 

Primal Pathway is designed for patients with a body mass index (BMI) of 30 or more. It can also help those with high blood pressure, type 2 diabetes, hyperlipidemia (too many fats in the blood), fatty liver and women with polycystic ovary syndrome. Calculate your BMI.

The program’s curriculum was developed by the doctor who directs the program and our nutritionist. It follows the model of intensive behavioral therapy. 

The program includes a mix of individual visits with a member of our care team as well as group classes. You can expect:

• One initial visit with a doctor or nutritionist  
• Four group classes (one per week) led by the nutritionist; you may schedule as many educational follow-up visits with her as needed  
• One or more medical follow-up visits with a doctor, depending on your participation in the program and/or if you take certain medications

Group classes are offered several times a week:

• Group classes are held every weekday with morning, afternoon and evening options.

Class topics include:

• Program outline
• Introductions and basic program overview
• Carbohydrates
• Dietary fats
• Protein
• Goal setting, behavior change and strategies for success
• Stress and emotional eating
• Physical activity #1 — The truth about exercise and how to get started
• Physical activity #2 — Best types of exercise and making exercise a part of your life
• Dining out — How to maintain your new healthy lifestyle without deprivation
• Meal timing and intermittent fasting
• Too much screen time and sleep/walk rhythms
• What now? — Recap, feedback and continuing with the program

We chose Primal Pathway because it focuses on getting to the root causes of weight gain and metabolic problems.

“Primal” means returning to eating habits of our primal ancestors. They ate whole, unprocessed foods. We hope to reawaken patients’ inner primal strength and empower them to take control of their health. 

“Pathway” refers to the lifestyle changes our program teaches. These changes are a journey, not a destination. We believe long-term success comes from making changes that you can maintain throughout your life — not by a set start or end date.

The Primal Pathway Program includes different types of office visits. Insurance coverage varies:

• The initiation consultation and any medical-related follow-up visits are subject to standard office visit copays and deductibles.
• Group classes or individual nutrition sessions are part of a preventive service benefit called Intensive Behavioral Therapy for Obesity. If you have a BMI of 30 or higher, these sessions are covered by most commercial insurance plans. There is no copay or deductible. 
• If you have a BMI of 25 to 30 (meaning you are overweight but not clinically obese), insurance coverage varies.

All patients pay a one-time, out-of-pocket fee of $299 for the first year of service, regardless of insurance coverage. This fee is non-refundable and covers: 

• All course materials
• MyChart online patient portal messages
• Access to a private Facebook support group
• Shopping guides
• Meal planning resources
• Savings on local 5k and 10k walking/running events
• Savings on meal delivery services
• Access to monthly support group visits for up to one year from sign-up date once visits covered by insurance have expired
• Use of our medical-grade body composition scale, which measures fat, muscle, fluid and more

We try not to use the term “diet.” Instead, we encourage patients to make nutritional changes to improve health. We also believe there is no “one-size-fits-all” plan when it comes to nutrition. 

We strongly encourage patients to:

• Remove processed foods and oils, excess sugar and refined carbohydrates, like white bread
• Eat nutrient-rich, whole foods, including natural dietary fats

Most patients want to lose weight fast and we understand that. But we believe that lasting results come from more consistent, sustainable changes. 

That said, patients who limit their sugar and refined carbohydrate intake often lose a significant amount of weight early. That slows to a gradual, steady rate of weight loss over time.

Our program isn’t about quick fixes and short-term dietary changes. It’s a complete lifestyle transformation. We don’t ask you to count calories, “starve” yourself or do physical activities that are difficult and hard to maintain. 

We’ll help you learn to eat in ways that give your body the nutrients it truly wants and needs. This means choosing foods closer to their natural state, including:

• Grass-fed meats
• Wild-caught fish
• Organic eggs
• Vegetables
• Full-fat dairy
• Nuts and seeds
• High-fiber fruits
• High-quality oils like olive, avocado and coconut

Contrary to popular belief, exercise is not an effective way to lose weight. Weight-loss success is almost always due to making needed nutritional changes. That said, we encourage patients to exercise regularly because it offers many health benefits.

Exercise benefits every system in the body by:

• Helping you manage stress
• Promoting sleep
• Preventing depression
• Helping digestion
• Improving heart health
• Increasing lean muscle mass
• Helping maintain weight loss from dietary changes

Our program focuses on eating whole foods. This includes high-quality proteins such as grass-fed beef, free-range poultry and wild-caught fish. Because of this, strict vegans will have a hard time following our program and meeting protein needs.

Lacto-ovo vegetarians (who eat eggs and dairy) or pescatarians (who eat fish) may find the program a little challenging in the beginning. But we’ve had great success helping patients who eat this way and can offer useful strategies to help you succeed.  

Not eating dairy or grains with gluten is not a problem. In fact, we urge patients to avoid most grains, particularly those that contain wheat. And some of our patients find that not eating dairy leads to even better results.

Our program focuses on making lasting, realistic changes in how you think and live. We review every patient’s current medications and medical conditions. 

If you’re taking medications now that could make losing weight more difficult, we suggest more natural alternatives. Or we suggest options that might enhance weight loss. 

For some patients, prescription anti-obesity medications can help make starting nutritional and behavioral changes easier. However, medications alone offer little to no benefit unless you also make basic changes to how you eat. 

If you’re interested in prescription anti-obesity medications, you must first sign up for the Primal Pathway Program.

As with any weight management program, results vary and no guarantees can be made. However, most of our patients have good results. The vast majority lose 15 to 20 or more pounds, and some lose 30 to 50 or more pounds. 

We’ve even had patients lose 100 pounds making nutritional changes only. No medications were involved.

Call our patient scheduling line at 1-206-860-5499.