Helen Dandurand (Host): Welcome back to the Well Within Reach podcast, brought to you by Riverside Healthcare. I'm your host, Helen Dandurand, and today I am here with Dr. Rachel Shell Riverside Endocrinologist, and Nicole Potts, a Registered Dietician who are going to give us a little bit of insight into Riverside's Weigh to Healthy Living Program.

Thank you guys for being here.

Nicole Potts, MS, RD, LDN, CDCES: Thank you.

Rachel Shell, MD: Thank you for having us.

Helen Dandurand (Host): Of course.

Alright, so to get started, I'll ask you, Nicole, what is Weigh to Healthy Living and what does the program commitment entail?

Nicole Potts, MS, RD, LDN, CDCES: Sure. So the Weigh to Healthy Living Program is a six-month medically supervised lifestyle and weight management program designed to help people build sustainable and healthy habits rather than focusing just on the number of the scale. The program will look at overall health, including nutrition, physical activity, medical factors, and behavior change.

Participants work with a care team, including an endocrinologist, a registered dietician and fitness professional. Each month, patient's meet with a physician to review medical history, medications and progress, followed by visits with a dietician who helps create individualized meal plans on preferences, lifestyle, and goals.

 The program also includes a fitness component, with guided exercise support to help patient's safely increase their activity. Overall, the goal of the Weigh to Healthy Living Program is to help patient's develop long-term habits that improve health and quality of life.

Host: Awesome. So what does Healthy Living kind of mean in this context beyond weight loss, and how does Weigh to Healthy Living differ from other weight loss programs people might have tried?

Nicole Potts, MS, RD, LDN, CDCES: Sure. So Healthy Living really goes far beyond the number on the scale and the Weigh to Healthy Living Program, it really means improving energy, strength, mobility, but also labs like blood sugar and cholesterol. It's about building healthy habits that support both the physical and mental health, not focusing just on the weight loss.

What makes the Healthy Living Program different from many other weight loss programs is it's medically guided and individualized, instead of a one-size-fits-all diet or quick fix. Patients work with a full care team that look at the whole patient.

Host: That's really great to be able to have that kind of all encompassing picture of what your health looks like and how it's improving. From an endocrinology perspective, for Dr. Shell, what kinds of medical issues or risks does the program aim to address or prevent?

Rachel Shell, MD: So obesity puts patient's at-risk for insulin resistance, Type 2 diabetes, hypertension, high inflammatory states, you know, hyperlipidemia, and even things like reproductive complications of infertility.

Also, overall poor mental health, low energy, poor mood, and can increase social anxiety for patients. What the WHL program aims to do is to correct or mitigate these hormonal and metabolic dysregulations that drive their disease risk.

Host: Great. So weight management can be sensitive or emotionally challenging at times. How does the program team approach this delicately to avoid maybe stigma or shame, or account for just emotional eating?

Rachel Shell, MD: So weight management is deeply personal and often emotionally charged. The WHL program recognizes obesity though, as a chronic, biologically influenced disease and not just a moral failing of patients.

So turning the barge on this population biased opinion is difficult in this American society that places a lot of focus on personal blame and cosmetic appearances to define a person's health. Our team emphasizes the biology of the disease process versus the willpower, and does not label or define participants by their medical diseases.

We are sensitive to these topics surrounding a patient's weight loss journey and focus on health gains versus the number on the scale as, Nicole already alluded to. We sent collaborative, individualized goals and avoid setting expectations that aren't really realistic. Our emphasis is on our long-term changes for the patient's and providing behavioral tools and solutions that can be continued beyond the six month program.

Host: That's really awesome. Yeah, definitely the longevity of it all and not setting unrealistic expectations is something I feel like when you're doing it yourself, that's easy to do. So I think that's a really great to have that kind of steering compass. We are going to take a quick break to talk about primary care at Riverside.

At Riverside, our primary care providers are right here in your community offering personalized care for you and your family close to home, and connected to the specialists and services you may need. Having a primary care provider means having someone who knows you, listens to you, and helps you stay well through every stage of life. From annual checkups and preventative screenings to managing everyday concerns when they pop up, because remarkable care should never be out of reach. Remarkable care right where you live. To find a primary care provider who's right for you and your family, visit myrhc.net/acceptingnew.

And we are back. And Nicole, I'm going to turn it to you a little bit here. How do you design these individualized nutrition and education plans for participants, kind of incorporating things like mindful eating, portion control, and dealing with cravings?

Nicole Potts, MS, RD, LDN, CDCES: Sure. So we design meal plans by starting with the patient, not just a template. Education is provided through a combination of in-person visits, but also virtual learning through MyChart, allowing patients to access education resources and guidance that fits their schedule. We really focus on mindful eating, practical portion control and understanding cravings rather than restrictions.

So everything always fits in moderation.

Host: How does that program then address the role of physical activity and how it plays into this sustainable weight management while balancing that with diet and medical concern?

Nicole Potts, MS, RD, LDN, CDCES: Sure. So we look at physical activity treated as an essential part of long-term health. A required component of the program is completion of the MyFit RX program, which is an eight week structured exercise program at the Riverside Health Fitness Center. During MyFit Rx, patients will meet with an exercise professional who creates a personalized exercise plan for them that's safe, realistic, and tailored to their ability, schedule, and goals.

Physical activity is balanced with nutrition and when appropriate, medication management as well. We make sure that patients are fueling their bodies appropriately as they exercise.

Helen Dandurand (Host): That is so nice to have that guidance. I think that's another area where there's always a lot of questions, what should I be doing? How do I get active? So it's great to have that. Dr. Shell, how do you address barriers to healthy habits such as financial constraints, physical limitations, or conditions like diabetes or sleep apnea?

Rachel Shell, MD: So first, I mean, health should not depend on income. Our dieticians do provide strategies on optimizing the grocery list with budget neutral ways to swap out and prioritize getting low cost, high impact foods like eggs, beans, frozen veggies, canned tuna, et cetera. We also have the patients work with fitness specialists to design a program that is safe for the patient considering their current physical limitations. Providers will work with the insurances to get medical therapies approved, and sometimes give alternatives to more cost effective options if medications that are directed towards obesity treatment are not covered. We address barriers by identifying them first. We cannot, come up with different excuses and overcome all those, but we do try to help remove obstacles, adapt expectations, and, really just meet the patient where they are.

Host: Definitely. So then after the program kind of ends, what kind of follow-up or support is available to help maintain these healthy habits and prevent weight regain?

Rachel Shell, MD: So once the patients have completed the six-month program, they will be given a certificate of completion. This is basically documentation for any future insurance requirements that may say that they have to have completed a program in order to get approval for therapy plans like medications or even bariatric surgery.

But our team is available to continue to see them in follow-up visits, after completion for support. The frequency of those visits are determined by the provider and the patient. The follow-up plan will vary patient to patient. It partially depends on whether or not the patient is on medical therapy for weight loss and or whether their insurance will cover more visits, especially with the dietician. The program is not intended to be the end of their weight loss journey, but rather the beginning. It builds a foundation of lifestyle changes that are sustainable and will lead to long-term healthy habits and success in changing their overall health status.

Host: Great. Yeah, you can't expect anything to be the end when you've just started with four to six weeks, but that sounds like a really good, basis and a lot of great information, to get started with.

So I really appreciate you guys being on today. Thank you so much and thank you listeners again for tuning into the Well Within Reach podcast brought to you by Riverside Healthcare. To learn more about the Weigh to Healthy Living Program, visit myrhc.net/weightohealthyliving or call Riverside Endocrinology Specialists at (815) 936-8909.