This document provides information about the Allina Medical Weight Loss Program. It discusses the program's goals of assisting patients to lose 5-10% of their weight to improve health conditions. The program uses physicians, dietitians, exercise consultants, health coaches and behavioral modification. It treats obesity as a chronic disease. The program costs vary from $369 for 3 months to $519 for 12 months. Case studies show patients achieving weight loss of 10-15% along with improvements in medical parameters like blood sugar and lipid levels. Future plans include expanding the program to other Allina sites.

1. Medical Weight
Loss Program
Roxana Merz, MD
Medical Director,
Bariatrician
September 26th, 2015

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I have no conflicts of interest or relevant financial interests in
making this presentation
I will be discussing off-label use of phentermine
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Disclosure

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 Understand what the Allina Medical Weight Loss Program can
offer patients
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Learning Objectives

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A medically supervised, comprehensive, multidisciplinary program
Recognizes obesity as a chronic disease
Collaboration with the Penny George Institute for Health and
Healing/Livewell Fitness Center
Works in cooperation with the Allina Health weight loss surgery
program to provide a full spectrum for obesity treatment
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Allina Medical Weight Loss Program

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To assist patients in losing weight to improve their health
and weight related comorbid conditions, and to improve
their quality of life
To provide patients the tools for successful long-term
weight maintenance
Weight loss goals;
–5-10% of initial weight
–Additional goals thereafter, individualized to patient
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Goals of Treatment

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Physician supervised/use of medications
Registered dietitians
Exercise consultations and monitoring
Health coaches
Behavioral modification built into program
-Referral to behavioral health therapist as needed
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Program Components

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Treatment focused on weight loss
3-12 month duration
Visit Schedule:
MD and dietitian
 bi-weekly – first 4 weeks
 monthly–through month 6
 every 3 months-after month 6
Exercise staff and health coach
 Alternating visits throughout program
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Active Weight Loss Phase

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Follows Active Weight Loss Phase
Starts once patient has achieved weight loss goal
Assists patient in maintaining new lower weight
1-2 year duration
Visit Schedule:
 Every 3-6 months with MD, dietitian, exercise staff and health coach
 Return as needed with weight gain
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Maintenance Phase

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Criteria:
Age > 18
BMI > 30
Weight < 600 pounds
Aware of enrollment fee/self pay component
6 months post-partum, not breast feeding
No current psychological instability
No active chemical use
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Referral Information

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A mix of insurance and self-pay
Medical and dietitian visits covered by
insurance*
Exercise and wellness coaching costs covered by
package pricing/self-pay component
* Patients are counseled to verify insurance benefits prior to first clinic visit.
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Program Costs

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Length of Program Cost
3 months $369
6 months $469
12 months $519
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Medical Weight Loss Package Prices

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Length of Program Cost
3 months $249
6 months $349
12 months $399
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Medical Weight Loss Employee Package Prices

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Program 3 month cost
Seattle Sutton $1764
Jenny Craig $1638
Nutrisystem $957
Slimgenics varies
*Internet spring 2014
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Community Weight Loss Programs

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Annual financial savings:
 $1,092 if eliminate $3/day spent on junk food, fast food,
or alcohol
 $468 by splitting restaurant meals in half and bring
home to make additional meal
 $520 saved if reduce the # of meals eaten away from
home by 2 per week
Retrieved June 6, 2014 from http://njaes.rutgers.edu/healthfinance/health-behaviors.asp
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Potential Savings with Weight Loss

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Medication savings; average decreased cost:
Patients followed in medically supervised weight loss program who lost 44 pounds resulted in:
Patients with a Diagnosis of: Monthly Yearly
Diabetes $215 $2,579
Hyperlipidemia $124 $1,486
Hypertension $107 $1,287
GERD $81 $974
Retrieved June 6, 2014 from http://www.obesity.org/news-center/is-medically-supervised-weight-loss-for-obesity-
cost-effective.htm,Nov14,2013
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Potential Savings with Weight Loss

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75 patients enrolled
 91% female
 Average age 47 years
 Average initial BMI 40.41
32 patients had completed 12 weeks of program
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Results; First 6 months

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Initial Visit
(N=75)
4 week visit
(N=70)
8 week visit
(N=48)
12 week visit
(N=32)
Weight Loss (lbs)
Average 6.32 10.49 14.39
% of initial weight (average) 2.5% 4.2% 5.7%
5% weight loss (or more) 4 patients
6%
21 patients
44%
19 patients
59%
10% weight loss (or more) 0 patients 0 patients 5 patients
16%
PAVS (Physical activity vital
sign)
Minutes per week 63 126 159 212
% increase 221%
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Allina MWL Program Results;
First 6 months

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Demographics
-38 year old
-female
-obesity related co-morbid conditions: type 2 diabetes, PCOS,
hypercholesterolemia
Program
-completed 3 month package
-phentermine 37.5 mg daily
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Case Study #1

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Measure Initial visit 3 month Total Change
Weight 276.5 lbs 259.9 lbs -28.7 lbs
% Weight loss ---- ---- -10.4 %
BMI 43.4 38.89 -4.51
Waist measure 52.75” 48.75” -4”
Hip measure 58” 53.25” -4.75”
PAVS (# of minutes of
exercise/week)
225 630 +405
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Case Study #1; Results
Type of Medication Initial visit Final visit
Oral Type 2 DM agents 2 2
Cholesterol lowering agents 1 1**
Antihypertensives 0 0
** Advised patient to discuss decreasing med with PCP

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Lab Initial 3 month
Hgb A1c 7.1 5.9
Fasting glucose 108 NA
Fasting lipid panel
Total cholesterol 286 154
Triglycerides 275 171
HDL 33 28
LDL 198 92
Non-HDL 253 126
Ratio 8.67 5.5
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Case Study #1; Results

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Demographics
– 39 year old
– female
–obesity related co-morbid condition: low back pain
Program
– completed 6 months of a 12 month package
– phentermine 37.5 mg
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Case Study #2

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Measure Initial visit 6 month Total Change
Weight 279.8 lbs 236.6 lbs -43.2 lbs
% Weight loss ---- ---- -15.4 %
BMI 48.46 40.98 -7.48
Waist measure 57” 47” -10”
Hip measure 56.25” 52.5” -3.75”
Waist to hip ratio 1.01 0.90 -0.11
PAVS (# of minutes of
exercise/week)
40 120 +80 also focused on
intensity of exercise
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Case Study #2; Results

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Lab Initial 6 month
Fasting lipid panel
Total cholesterol 214 176
Triglycerides 173 85
HDL 55 50
LDL 124 109
Non-HDL 159 126
Ratio 3.89 3.52
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Case Study #2; Results

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Demographics
– 44 year old
– female
–obesity related co-morbid condition: low back pain/sciatica(lumbar
disk herniation)
– found to have metabolic syndrome, elevated triglycerides
Program
– completed 6 months of 12 month package
– phentermine 37.5 mg, metformin
– reports significantly less back pain
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Case Study #3

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Measure Initial visit 6 month Total Change
Weight 182.4 lbs 153 lbs -29.4 lbs
% Weight loss ---- ---- -16.1 %
BMI 32.38 27.16 -5.22
Waist measure 42.0” 37.75” -4.25”
Hip measure 45.0” 38.5” -6.5”
PAVS (# of minutes of
exercise/week)
0 180 (month 5 at 420) +180
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Case Study #3; Results

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Body Comp Study* Initial visit 6 month Total Change
Percentage of Body Fat (%) 48.9 40.6 -8.3
Body Fat Mass 89.3 62.2 lbs -27.1 lbs
Skeletal Muscle Mass 50.9 49.4 lbs -1.5 lb
Basal Metabolic Rate 1282 kcal 1261 kcal -21 kcal
*In-Body 230
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Case Study #3; Results

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Program Details
 Location:
– ANW Bariatric Center, Piper Building Suite 401
– Future;
 United Hospital, West Health and Unity Hospital
 Long range potential for “hubs” at AHC sites
 Future Offerings:
– Low calorie diets/meal replacement products
– Support Groups

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ANW Medical Weight Loss Clinic
Immediate appointments available…
ANW Bariatric Center
Piper Building, Suite 401
913 E. 26th Street
Minneapolis, MN 55407
612-863-7501

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Thank you!
Please contact me for questions:
Roxana Merz, MD
Bariatrician
Medical Director, Medical Weight Loss Clinic
612-863-1217
(Staff only please)