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Scott Isaacs Part 1, Best Practices for Using Meal Replacements

In part 1 of this Exclusive Interview, Scott Isaacs talks with Diabetes in Control Medical Editor Joy Pape about effectiveness of meal replacements and ongoing strategies for maintaining weight loss.

Scott Isaacs, MD, FACP, FACE is the medical director for the HMR Program for Weight Management at Atlanta Endocrine Associates and a faculty member at Emory University School of Medicine.


Transcript of this video segment: 

Pape: I’m Joy Pape with Diabetes in Control. And we’re here in Boston at AACE’s 2018 Meeting. And I have the pleasure of speaking with my colleague and friend, Scott Isaacs, specializing in obesity medicine and he’s an endocrinologist, so endocrine problems. So, Dr. Isaacs, you presented yesterday on best practices for using meal replacements in weight management. What do you consider best practices?  

Isaacs: Well, when people are using meal replacements they can be losing weight rapidly and so they require close medical supervision. There’s great successes using meal replacements and patients lose a lot of weight but they can get into trouble. And so, we want to do a comprehensive history in physical and we want to do labs, and we want to have periodic medical appointments where we’re specifically monitoring for the types of complications that they can get from rapid weight loss.

Pape: So, I think what you’re saying is it may not be the best idea for people to just go online, find out a place where they can’t be in a medical supervision, and just start doing this on their own.

Isaacs: Well, for safety and also just because we want something to work.

Pape: Exactly.

Isaacs: And what I’ve seen is that when someone needs to lose a lot of weight, it’s hard to do it on your own and you really need the support of a physician that’s specializing in obesity medicine and a whole team of professionals; dietitians, exercise physiologists, psychologists, everybody that can work together to help you accomplish that goal because it’s not easy. And so, you need all the support you can get.

Pape: Which takes me to a question I was going to ask you later but I’ll get back to. Needing the support. But a lot of the question too about this rapid weight loss and using meal replacements, is the weight regained, or how do you get back into the real world?

Isaacs: So, those are great questions and that’s the biggest concern, really with any way that you’re losing weight: is weight regained? And when patients lose a lot of weight, they certainly have that risk. And so, the number one thing we can do to prevent weight regain is get into a good behavioral modification program that goes on for a long time. A lot of people when they get their goal weight they start feeling confident, they think they can do it on their own, but the disease of obesity is still there. Even if their body mass index is out of the obesity range, they still have a constant hormonal drive and metabolic drive to regain that weight and that can go on for a really long time. And so, if you can work with somebody that can help you keep that weight off, it makes a big difference. The other thing is that there’s been research looking on how to maintain weight loss after very low calorie diets or low calorie diets using meal replacements. And there are certain strategies that work better than others but the three that seem to work the best are ongoing use of meal replacements, weight loss medications, and high protein diets. Those seems to be the most effective for weight maintenance strategies.


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