There are three general circumstances where this is NOT the case and when Dr. Holland will not be able to treat a patient with weight loss medications. These circumstances are outlined below and discussed in specific detail in the pages linked to the right.
The best way to understand the rules we use to determine eligibility for our medical weight loss program is through a risk-benefit analysis. It is essentially the same type of analysis that is used to make decisions for all medical conditions.
The first thing to understand is that medical treatment including medications, including weight loss medications have risks. The risks are extremely low but they are not zero.
Obesity poses some very serious risks to your health. If you are obese you face significantly increased risks for diseases like type 2 diabetes, hypertension and many, many others.
In medicine, a contraindication is a condition or factor that serves as a reason to withhold a certain medical treatment. The reasons are not trivial. In medical weight loss, there are a number of conditions that prevent the use of weight loss medications because of higher than acceptable risk. We carefully screen every one of our patients for these conditions, but if you already know that you have one, please understand in advance that we will likely not be able to treat you. You can find the list of contraindications to medical anorectic therapy here.
Patients with a body mass index slightly above "normal" (25-27) generally do not face significant health risks from their weight. Patients whose body mass index lies between 27 and 30 who lack a weight-related "co-morbidity" like type 2 diabetes are also not at high risk. On the other hand, patients in that weight range who DO have a co-morbidity often are.
Treatment is rational only when it is significantly more likely to help than harm you. That is the basis of all medical care and medical weight loss is no exception. From this basic consideration, we can conclude several important things.
If a person's weight does not place his health at risk then there is no reason to expose him the risk of a weight loss medication, even though the risk is very low. Very low risk outweighs zero benefit.
Even if a person's weight places her health at risk, it makes no sense to expose her to even greater risks to treat it. This is where contraindications matter and this is where the practice of careful and ethical medicine matters. It is sometimes very hard to tell people who are eager to lose weight that medications are not a good option for them, but unfortunately, sometimes that is the case.