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"Successful obesity management is not about having all the answers. It is about
asking your patient the right questions and taking the time to listen to their response"

- Obesity Medicine Association

Abnormal weight is a serious and growing global health concern, leading to various chronic diseases that reduce both healthspan and lifespan.
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Why is it so difficult to lose weight ?
Excessive body weight is a medical condition caused by numerous factors such as genetics, environment, nutrition, sedentary behavior, stress, poor sleep, brain injuries, and mood disorders.

Traditionally, nutrition treatment for weight loss is generally focused on reducing calories while maintaining nutritional needs. However, reducing total body fat mass is a complex process that combines important factors such as age, biological sex, energy expenditure, insulin resistance, hunger hormones, metabolic adaptation, visceral or subcutaneous fat, and mental and emotional well-being. 
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Our appetite is regulated by hormones, NOT willpower or conscious thought.

In some people, these hormones don't function properly, which can lead to hunger despite sufficient calories. Our brains are designed to protect us from starvation; so when we lose weight, hunger hormones increase, satiety hormones decrease and our brain reduces our metabolic rate to re-establish the starting weight.
This is where the emotional roller coaster truly takes off, a journey of restrictive dieting and binge eating, loss and gain, followed by the heavy weight of frustration, discouragement, and eventual surrender.
What weight loss is NOT about
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What weight loss IS about
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One-size-fits-all plans do not work - they need a structured medical approach.
How do we individualize obesity goals in our Clinical Practice?
Excess body fat cannot be determined by BMI alone. Excess body fat predominantly accumulates within the abdominal cavity or around the waist. Measuring waist circumference is a good clinical tool to assess and to monitor body fat.

At Choose Healthy, Dr. Casian is taking a detailed approach in exploring the root cause of the excess body fat by addressing the characteristics of two distinct clinical scenarios:
  • subclinical obesity - patients with abnormal body fat, but normal biological markers and no current health problems.
  • clinical obesity - patients with abnormal body fat that have evidence of metabolic dysfunction and coexistent weight related complications. 18 different adult organ systems can be impacted in terms of clinical obesity.
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A therapeutic decision making is essential!
Our structured approach to weight management
In-person 2 hour new patient weight loss consultation
In a compassionate and empathetic setting, Dr. Casian's initial focus is on:
  • Comprehensive assessment of past and currently medical history
  • Understanding patient's unique reality
  • Creating a personalized therapeutic plan
Our evidenced-based treatment options
  1. Intensive Lifestyle Interventions - expecting to achieve up to 5% weight loss
    • Structured food plans​
    • Individualized physical activity recommendations
    • Environmental restructuring (addressing stress, sleep, nighttime eating)​​
  2. Medical Management - expecting to achieve 10-20% weight loss
    • Treat abnormal weight with FDA-approved, highly effective pharmacotherapy when indicated​
    • Optimize management of other medical problems such as diabetes, hypertension, hyperlipidemia, obstructive sleep apnea, osteoarthritis​
Liraglutide / Semaglutide
GLP-1 receptor agonists
Tirzepatite
Dual glucose dependent insulinotropic polypeptide (GIP) and GLP-1 receptor agonist
In-person 1 hour follow-up visit (monthly)
  • Evaluate measurements (weight, waist circumference, body composition)
  • Review laboratory results
  • Assess adherence to medication and lifestyle recommendations
  • Evaluate medication efficacy and make dose adjustments as clinically indicated
  • Explore and identify personal barriers
  • Adjust nutrition and exercise to enhance fat burning and to minimize muscle mass loss 
Pharmacological therapy alone is NOT a treatment option.
Based on personal and professional experiences, Dr. Casian has a clear understanding of challenges behind forming new and sustainable health habits. However, she will not prescribe weight loss medication to patients that are not actively engaged in changing their lifestyle behaviors.

While she recognizes the benefits of medication, Dr. Casian is determined to empower her patients to take  small steps towards better health by applying lifestyle modifications as first line therapy.

At Choose Healthy, we choose to prioritize patient's medical needs. Through Dr. Casian's specialized training and experience, she is dedicated to guiding and supporting you on this challenging, yet achievable, and rewarding wellness journey.
Start here by scheduling your free 20-min weight loss consultation 

"Believe you can, and you're halfway there"

- Theodore Roosevelt

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