"You're just going to stand still,” explains a nutritionist at Renown’s Medical Weight Management office on the South Meadows campus. The patient steps onto the scale, grasps a handle bar on each side and patiently awaits the numbers that will help determine her strategy for better health moving forward. Then it is time to measure her waist circumference. "So we go to the belly button," she explains as she wraps a measuring tape around her stomach. For men, doctors encourage a reading of less than 40-inches and less than 35-inches for women. "If their waist circumference is too large that could be a problem because a lot of the visceral fat that sits in the middle of the belly is the inflammatory fat that can lead to heart disease,” says Dr. Kirsten Frederiksen who is Renown Health’s Medical Weight Management Program Director.

Dr. Frederiksen has a large toolbox of ways to help a patient’s metabolic health. The reason she focuses on metabolic health is because there are many people who appear thin but their body mass index and body fat percentage show they are technically obese. Dr. Frederiksen and a team of trained nutritionists work to help people lose weight to improve their overall health. They closely monitor the medical conditions of each individual patient. “For example,” she explains, “If someone has diabetes related to being overweight, they may be on insulin, so we can help tailor their medications to their weight loss." Along with calculating a patient’s daily energy expenditure – or how many calories are needed for daily function – they also consider weight, height, BMI, body fat percentage, muscle mass and water intake to formulate a weight-loss plan.

"So this has all the nutrients that are required for the day," Dr. Frederiksen says as she shows us boxes of drink packets, soups and energy bars. Her office is stocked with a meal replacement options – all high-protein and low-carb. "It is not as if they'll be on them forever, but enough time to maybe re-program, get counseling and learn to eat healthier." She says ways to eat healthier include cutting out refined carbohydrates like processed/packaged foods and sweetened drinks. "Whether it is juice, soda, even diet soda; it triggers your brain into thinking you're drinking something sweet and it changes the hormones into thinking that they need more sweet foods." She encourages patients to stick with lean meats, fish, some dairy, vegetables and berries. "Tropical fruits have a lot of sugar, so we have people avoid those in this program."

Although this program is only about six months old, it is already proving to be successful. "We have had several patients who've lost over 50 pounds in several months." She says educated nutrition - combined with exercise, possibly medication, counseling and the accountability of consistent weigh-ins - is a good recipe to help people lose weight. However, for Dr. Frederiksen, success means more than just a lower number on the scale. "I've been in internal medicine for 20 years and I've usually been prescribing medications and saying you need to take this and that test and so on... and now I'm getting people off medications."

The Medical Weight Management program is designed for people with one or more of the following:

-A BMI of 27 or higher and a health risk such as Type 2 diabetes, obstructive sleep apnea, cardiovascular disease, stroke, gout, osteoarthritis, infertility or polycystic ovarian syndrome.

-A BMI of 30 and higher without one of the previously mentioned conditions.

-A metabolic problem such as Type 2 diabetes, fatty liver or cardiovascular disease, which is not responding to regular medical care. This may not be the result of being overweight in pounds, but may require loss of fat mass or waist circumference to get healthier.

Referrals are necessary to make an appointment. Call (775) 982-5073.