Medical Weight Loss

Madison Surgical Associates offers patients a different way to achieve their weight loss. Instead of only offering surgical solutions, we offer a weight management program supervised medically and monitored closely for the patient’s success. In this program, we assess your progress along the way and help you have both better well-being emotionally and better health. This program uses a high-protein plan and meal replacements that, over time, become everyday meals that patients can prepare themselves along with continued support and patient education. It is available to both teens and adults, plus it’s personalized for exactly how much weight you want to lose.

We want to give patients access to knowledgeable resources to think about their lifestyles and modify them as needed along with their meal decisions.

You may be struggling to lose weight, and might not qualify for bariatric surgery or not interested in a surgical solution. Instead, if you want a medically supervised and structured program to help you make changes that allow you to reach your weight goal. If you’re interested, call our office and make an appointment with a dietician to begin today.

With this weight loss program, supervised by a physician, we consider your health and personal well-being to be much more than the number shown on the scale.  Your weight and overall health will be assessed, and we will track your progress- and not just the number of lost pounds. 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 take the time to assess every patient and create a personal program that is just right for their needs. If you have any concerns, we address them with you. There is enough flexibility in the program that we can change the program if it is ever necessary.

We do not have just one weight loss program for everyone. Instead, we use several different weight loss tools. We want every person’s weight loss plan to be unique and use the tools best for each patient. We never presume that everyone needs the same method of weight loss. We have plenty of options available, including consultations about your diet, meal replacements, psychological support, and medication when needed. We strive to create a personal weight loss method with discussions with our patients and a complete assessment.

Weight Gain

As people gain weight, they tend toward continuing to do so. When a person is obese, it tends to lead to more obesity, making obesity a progressive disease. When a person gains weight, it causes many changes to the body, including molecular, metabolic, and hormonal changes, leading to even more fat accumulation. These physical changes can make it harder for the body to burn fat to use for energy. They also increase the carbohydrate conversion into fat and make the body better able to store fat. When this occurs, more of the calories taken in will become fat. Even worse, being obese can affect some of the appetite regulators that can make you hungrier to eat more often and eat larger meals. When you gain weight, biological changes to your body will make it easier for you to put on weight and become obese.

Obesity-Related Conditions

Other medical conditions come with obesity, which makes the situation worse. An obese person has reduced mobility, and they will burn off fewer calories by engaging in physical activity. Being overweight can cause emotional stress, causing more hormonal changes that lead to even more weight gain by making you hungrier and increasing the amount of fat you put on.

When a person has gained weight, they don’t sleep as long because of several conditions that make it harder to sleep. These can include pain in various points around the body, breathing problems like sleep apnea, needing to urinate during the night, some required medications, and altered body temperature regulation. When you sleep less, your body will again produce hormones that make you hungrier and increase the amount your food converts to fat.

When you gain weight, you are also contributing to other diseases developing. These include diabetes, osteoarthritis, hypertension, depression, and heart disease, and treating these conditions often requires medications that cause even more weight gain. Once someone is obese, they become trapped in a vicious cycle of weight gain.


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, and the body results in storing more. Weight loss through dieting results in less fat being burned for fuel and allows more fat that isn’t being stored. This leads to a steady fat increase even if the person isn’t overeating.

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.