Serotonin imbalance linked to depression, anxiety, bipolar, panic attacks, migraine headaches, IBS, eating disorders carbohydrate cravings.

1. Robert Posner, M.D., Founder,
Serotonin-Plus Weight Loss Program
The Obesity Epidemic In America:
Our Role as Physicians

2. Disclosure Statement
• Robert Posner, M.D., is the Founder and Owner of the
Serotonin-Plus, Inc. a “For Profit” S-Corporation The
clinical mission of this company is to enhance the
wellness of Americans by providing effective and safe
weight loss. The business mission of this company is
to increase shareholder value
• A patented serotonin supplement (US Patent No.
6,017,946) will be referred to in the slides explaining
the Serotonin-Plus Weight Loss Program. Dietary
supplements are categorized under the Dietary
Supplement Health Education and Safety Act of 1994.
The FDA has not evaluated the safety and efficacy of
this supplement.

3. Dinosaurs

4. • 68% of Americans Overweight
• 38% Obese
• 88% of African American Females
Overweight
• Over 300,000 deaths a year
related to obesity
The Obesity Epidemic

5. • Americans spending over 343 BILLION
dollars a year on obesity related health
conditions
• Estimated by the year 2030, 35% of the
American population will have diabetes
mellitus
• For the first time ever, the life expectancy
of the younger generation is less than that
of their parents
The Obesity Epidemic

6. • Diabetes Mellitus
• Heart Disease
• Colon, Gastric, Breast, Pancreatic Cancer
• Arthritis
• Sleep Apnea
• Hyperlipidemia
• Hyperlipidemia
• GERD
• Neuropathy
• Low Self-Esteem and Confidence
The Co-Morbidities
of Obesity

7. • Recruitment Issues
• Retention Issues
• Costs
Obesity and the Military

9. • High sucrose food sources
• Growth of fast food restaurants
• Less exercise
• Inflation/Cost of calories
• Dual working parents
• The Internet generation
• Lack of insurance company involvement
• Lack of effective government involvement
• LACK OF PHYSICIAN INVOLVEMENT
How/Why Did This Happen?

10. • Lack of formal training in medical
school and residency training
• Lack of time with patients
• Insurance companies not
providing reimbursement
Why PhysiciansWhy Physicians
Are Not InvolvedAre Not Involved

11. ““If It Was Easy, Everyone Would DoIf It Was Easy, Everyone Would Do
ItIt””……Tom Hanks inTom Hanks in League of TheirLeague of Their
OwnOwn
• “Eat Less and Exercise More”
• Psychological Factors
• Stress Eating
• PEOPLE NEED HELP IN LOSING
WEIGHT

12. Why DonWhy Don’t we Just’t we Just ““Eat Less and ExerciseEat Less and Exercise
More?More?””
• Instinctual part of the human brain: taste of foods,
reward systems, metabolism decreases,
social/family/cultural issues, human nature factors
• Intellectual part of the
brain: health awareness,
vanity issues, clothes
issues, energy factors

13. Where/Who Are PeopleWhere/Who Are People
Turning To For Help?Turning To For Help?
• Americans are spending over 60 BILLION dollars a year on
weight loss efforts
• Commercial weight loss programs based on prepackaged
foods
• Supplements
• Weight loss clinics
• Nutritionists
• Personal Trainers

14. The Chemical Contribution to ObesityThe Chemical Contribution to Obesity
• Leptin
• Ghrelins
• Other Neuropeptides
• Serotonin

15. • 5-HT made inside the brain from the amino acid
tryptophan
• Total body content 10mg, most of which is present
in the GI tract
• Metabolized by monoamine oxidase and aldehyde
dehydrogenase
• 4 classes of serotonin receptors and different
subclasses of each receptor
• Serotonin imbalance linked to depression, anxiety,
bipolar, panic attacks, migraine headaches, IBS,
eating disorders carbohydrate cravings
SerotoninSerotonin

16. Serotonin and Eating DisordersSerotonin and Eating Disorders
• Serotonin1-A receptor sites: Anorexia
Nervosa and Bulimia
• Serotonin 2-C and 1-B receptor sites:
Carbohydrate cravings and the sensation
of satiety

17. Oral Serotonin DeliveryOral Serotonin Delivery
• Patented (U.S. Patent Number 6,017,946)
in 2000
• Formulation issues
• Animal toxicology study
• Human clinical study
• Clinical experience: October, 2002
through February, 2011

18. The Serotonin-Plus
Weight Loss Program
• Patented oral serotonin supplement reduces
carbohydrate cravings
• Dietary plan based on “real food”-high protein-high
vegetables/low carboydrate-low fat
• Weekly visits for behavioral modification
• Most patients also take an FDA-approved anorectic
medication, prescribed and monitored weekly

19. The SP Program: Results
• Over 12,000 patients placed through the
program since October, 2002
• Average weight loss in 12-week protocol is 30
pounds for women and 40 pounds for men
• If more than 30-40 pounds of weight loss
needed, patients can stay for more than one 12-
week session
• No significant adverse events, hospitalizations,
lawsuits

20. Success!

21. Helping Patients Rediscover Wellness

22. Weight Loss and Diabetes
Prevention
Tethys Labs 7-Panel test:
•Glucose
•Hemoglobin A1C
•Insulin
•CRP
•Ferritin
•Adenopectin
•Interleukin 2 receptor alpha

23. Weight Loss and Diabetes
Prevention

24. Weight Loss and Diabetes
Prevention-Interim Results
• Diabetes Risk dropped from 6.66% to 3.51% (47.3%
decrease)
• Risk dropped from 2.43 X general population risk to
1.0236 X general population risk (57.91% decrease)
• By the end of the 12-weeks, the risk of diabetes was the
same as the general population

25. Weight Loss and Diabetes
Prevention: Case Study
• 58 year old Caucasian male, 69 inches, 238 pounds, 42% body fat
• Medical issues: Diabetes, hypertension, hypercholesterolemia,
GERD
• Meds: Lisinopril 20mg, Lipitor 40mg, Lantus insulin 40 units hs,
Glucophage XR 2000mg, Prevacid 30mg, Norvasc 5mg
• After 8 weeks of the SP Program, weight 209 pounds, 38% body fat
• Med changes: Lantus was discontinued, Norvasc was
discontinued, Glucophage XR reduced to 1500mg Prevacid
discontinued

26. The Role of Health
Care Providers
• You must discuss with your patients the
relationship of their weight issues and the medical
co-morbidities for which you are treating them.
• If you cannot offer them a comprehensive solution,
refer them to other specialists for a
multidisciplinary approach.
• BECOME PROACTIVE in CREATING HEALTH
and not just treating disease

27. Conclusion
• The obesity epidemic is contributing to increasing
medical costs and increasing morbidity/mortality of
Americans
• The Military is losing people that they have invested
millions of dollars in.
• Recruitment is challenged by the obesity epidemic in the
general population.
• Americans are spending billions of dollars on weight loss
efforts that are often not safe and not effective in the long
term
• We, as health care providers and patient advocates,
MUST become more involved.