COVID-19 Update:

Medical Weight Loss

Madison Surgical Associates offers patients a different way to achieve their weight loss. At MSA we consider your health and personal well-being to be much more than a number shown on a scale. Therefore, we not only offer endoscopic and surgical solutions for weight loss, but we also offer a weight management program to help address your weight-loss journey. This program is available to all patients, post-weight loss surgery patients, and patients that don’t contemplate surgery to manage their weight loss.  The program can be tailored to the amount of weight you want or need to lose. This weight management program is medically supervised and closely monitored by our onsite registered dietitian to ensure your success.

Our weight management program uses a high protein plan and meal replacement plans that, over time, become everyday meals that you can prepare yourself. We also provide continuing support and education: this includes access to knowledgeable resources to help you think about your lifestyle and meal choices so you can modify them if needed.

With our medically supervised weight management program, we not only provide a meal plan, but we also assess our patient’s overall well-being and health. We track their progress as a whole and not just the number of lost pounds on the scale. We want to help you make the changes you need to be healthier for the rest of your life so that the weight comes off and stays off. We do not run any group sessions and we do not have the same weight loss program for everyone. Instead, we use several different weight loss tools tailored to your own needs.  We strive for every person’s weight loss plan to be unique and we use the best tools available including but not limited to consultation about your diet, psychological support, medication when needed, etc. All of this allows us to take the time to assess you individually and create a personal program that is just right for you. Any concerns that may arise at any given time are addressed directly with you. We can assure you there is enough flexibility in the program that allows us to adapt to your individual needs if ever there is a need for it.  

This program is available for both teens and adults.

Weight Gain

Weight gain leads to more weight gain. In other words, we can say that weight gain is a risk factor to gain more weight, making obesity a progressive disease. Obesity is known to promote molecular, metabolic, and hormonal changes in our bodies. These changes are responsible for altering the metabolism of carbohydrates and fats: “carbohydrates are converted to fat easier and faster”. At the same time, this fat is more difficult to burn by the body as a source of energy. In addition, obesity affects the regulation of appetite and hunger, making you even hungrier and making you prone to eating bigger meals and eating more frequently.

Obesity-Related Conditions

Obesity leads to other health issues that contribute to the progression of obesity.

A decrease in mobility and daily activity decreases the number of calories spent by the body and leads to a positive energy balance and therefore obesity.

Emotional and psychological distress producing a hormonal imbalance leading to the stimulation of appetite leading also to a positive energy balance and therefore obesity.

Sleep deprivation caused by sleep apnea, frequent urination, joint pain, certain medications, and inability to regulate body temperature correctly,  etc. Sleep deprivation leads to hormonal imbalance that stimulates appetite and increases the mobilization of fat to fat storage.

Underlying chronic diseases directly related to obesity are hypertension, diabetes, heart disease, osteoarthritis, and depression. Medications administered to treat these diseases can cause obesity also.

All in all, weight gain leads to obesity which leads to underlying health issues that lead to obesity which ultimately leads to more obesity. 

Obesity is a chronic and progressive disease but it is reversible.

If you are worried about your weight please call us to learn more about obesity and how to treat it.


A diet that is low in calories is the primary way to treat excess weight, but being on a diet can also contribute to the progression of obesity. When you use your diet to lose weight, there are specific ways that the body responds that stay with you for a long time and can make it easier to gain weight. One bodily response to weight loss is your balance of energy. When someone loses weight, their body begins to believe they are starving, and it reduces the amount of energy you have to conserve how many calories you burn. When energy reduces, the person on a diet has to take even fewer calories than if they were the same size and have never dieted. It’s hard to eat less after a diet due to the changes that happen to the appetite regulators that make you hungrier and allow you to eat more at each meal. These changes that come from dieting are trying to cause the dieter to gain weight. Because these changes continue for a long time, the dieter will generally regain their weight and add more to it.

There is another bodily response that happens when being on a diet causes changes to the body. The body’s fat metabolism reduces so that it cannot burn fat as well, and it allows for more fat to be stored. With weight loss from dieting, the body will only burn about half of the dietary fat that it did before. Dieting also causes the body to burn less fat when you do smaller physical tasks like cooking, cleaning, or walking. Meaning, that you burn less fat, and therefore more can be stored.

Weight Loss Medications

Which drugs have been approved for weight loss in the U.S.?

The U.S. Food and Drug Administration has approved four medications for use in weight loss long term. These include Orlistat (Xenical), Bupropion-Naltrexone (Contrave), Phentermine-Topiramate (Qsymia), and Liraglutide (Saxenda).

Most of the approved drugs for weight loss decrease the patient’s appetite or make them feel more full, and some drugs do both of these. Orlistat is the exception, as it interferes with the body’s ability to absorb fat.

Bupropion-naltrexone is a drug that is a combination of two drugs. Naltrexone treats opioid dependence as well as alcoholism. Bupropion is used as an aid to quit smoking as well as an antidepressant. It comes with a warning that it may increase suicide risk, as many antidepressants do. Bupropion-naltrexone requires you to be monitored for a while as you’re taking it, as it can cause elevated blood pressure. There are a few other side effects commonly felt, including headaches, nausea, and constipation.

Liraglutide is a drug used in diabetes management. While other drugs for weight loss are administered by mouth, this one is an injection. It is common to have nausea with this drug, and it can cause vomiting.

Orlistat can cause a host of annoying gastrointestinal side effects. These can include loose stools and flatulence. When you take this drug, it’s essential to eat a diet low in fat. It is also available over the counter, called Alli, in a lower strength. There have been liver injury cases reported rarely, but there has not been a cause and effect reaction proven.

Phentermine-topiramate combines topiramate, and anticonvulsant, and phentermine, a drug for weight loss. Phentermine has effects, much like amphetamine, so that users can abuse it. A handful of side effects are possible, including higher blood pressure, a higher heart rate, constipation, insomnia, and anxiety. It also comes with a higher risk of birth defects.

Phentermine can also be taken by itself for losing weight. It is approved only for the short term. It has to be taken for less than three months because it can be abused and has many side effects.

The Bottom Line

Drugs for weight loss don’t present an easy way to lose weight, but they are one tool that can be used as you make changes and adopt a healthier lifestyle that will allow you to lose weight and be in better health.

We Are Open!