By Michael C. Luciano, D.O.
Welcome Dr. Michael C. Luciano and Healthy Solutions as one of our new contributors!
As a Board-Certified Family Medicine Physician, I have been educated to care for most medical conditions. In over 10 years of private practice, I consistently see how changes in lifestyle, mainly nutrition, improve health status. If most physicians were able to dedicate their time and effort to discussing lifestyle modification, there would be much less disease, lower health care costs, less medication prescribed, and happier and healthier individuals.
Over the last 30 years, the U.S. has seen an obesity increase of epidemic proportions, with rates doubling from 15-30%; currently, 65% of Americans are overweight. Unfortunately, during medical school, most clinicians receive little or no training in nutritional matters or the management of obesity. Therefore, I actively pursued additional training in obesity medicine and applied for board certification in this important subspecialty. It has become a passion of mine to assist patients in this complex issue, which was previously viewed as a lack of willpower and oversimplified obesity treatment as the need to eat less and exercise more. Further validation is the recent recognition by the American Medical Association of obesity as a disease state.
The causes of obesity are complex; therefore, individualized tailored treatment is essential. No single diet works for everyone. We are learning more and more about the complex interplay of gut hormones and neuropeptides. Understanding the obese individual involves pinpointing obesity’s potential causes, including environmental, psychological, socioeconomic, medical, genetic, medication-related, and many others. This information is the key to developing an effective treatment strategy.
There are many possible weight-reduction strategies. The right method is the one best suited for the individual patient, accounting for medical issues, exam findings, lifestyle, and sustainability. Most of my patients have tried and failed multiple diets during their lives, sometimes with short-term success because they regained the weight shortly afterward. Structure and accountability coupled with impressive short-term results fuel long-term compliance. These are the keys to success in my patients. I utilize my clinical skills, education, and compassion to empower patients to take control of their health.
My initial goal is to help patients have less hunger and cravings, feel less bloated, and be more energetic with improved mood and sleep and an overall improvement in quality of life. It takes 4 weeks to create a new habit but a year to make it stick. Therefore, follow-up and maintenance are imperative. As the patient loses weight, the metabolic rate naturally slows, which creates a plateau or even a gain even if the patient follows the diet. This is when many people regain, get frustrated, and give up. It is important to change treatment plan direction at this time. This usually requires an exercise routine coupled with a change in nutritional intake, using creative ways to get the body burning calories more efficiently.
Most people want weight loss to be quick and dramatic. However, calorie reduction is not a simple process. My job is to make it simple, take out the thinking, give patients a structure, and make it sustainable. I utilize modern- day bariatric medicine, which may include lipotropic injections, medical-grade protein supplements, pharmaceutical intervention, vitamins, and hormone therapy combined with the right proportion of macronutrients and total calories. Essentially, I want the patient to lose the most weight in a safe manner by losing fat and preserving muscle. In my experience, the first four weeks are critical to gain patients’ trust by showing them results and empowering them for success going forward. This is where the complexity of weight management becomes easier, since the accountability factor is now inherent in patients who feel better than ever before.
I begin each weight-management consult with a detailed history and exam. I gain a good understanding of the individual and his or her health status and goals before making a nutritional recommendation. Putting the pieces of the puzzle together may include further workup such as laboratory assessment or electrocardiogram. My office is equipped with the latest technology including metabolic testing and body composition analysis. With metabolic testing, I can show patients the amount of calories their body requires for weight loss and maintenance by using oxygen expenditure to calculate their metabolic rate. With body composition testing, I show patients the breakdown of their weight by calculating the distribution of body fat, muscle, and water, which is useful in tracking their progress.
My recommendation after each initial consultation is customized for the patient and is expected to yield the most-effective weight loss. It includes a transition and maintenance strategy for long-term sustainability. I understand how difficult and emotional the subject of weight management is for most patients, and I am honored and privileged to be in a position of changing their lives for the better. I always tell patients that this is the fun part of my practice. Preventing and reversing disease by using nutritional and lifestyle modification is a simple but powerful concept that has incredible health benefits. Set up an initial consult and see how to improve your everyday future—your body will thank you!
Dr. Luciano is Board Certified in Family Medicine. He earned his degree in Osteopathic Medicine from Western University of Health Sciences in California. Dr. Luciano is an active member of the American Academy of Family Practice, American Osteopathic Association, and the American Society of Bariatric Physicians. He is the current Family Medicine Chairman at St. Mary Medical Center in Langhorne, PA. Dr. Luciano has his primary care office in Ivyland, PA and a satellite office in Horsham, PA.
Healthy Solutions by Dr. Luciano
400 Horsham Rd.
Horsham, PA 19044
At the Horsham Athletic Club
Services offered at Horsham:
Weight Loss, Body Contouring, Skin Tightening, Cellulite Reduction, Micro-Needling, Chemical Peels, IPL Photo Rejuvenation, Laser Hair Removal, BOTOX & Fillers.
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