When a health checkup finally makes up your mind

What follows combines several patients' visits into one composite story. It is not about any one person, and anything that could identify someone has been removed.

What we often hear

• "My health checkup flagged something, so here I am."
• "Seeing the numbers, I feel like I really have to do something now."
• "I manage to lose the weight, but I've lost count of how many times."

How do patients usually come to us?

Patients who had been coming in for back or shoulder pain bring up their weight first after getting their checkup results. These are people who used to say, "I'll get to it someday."

Having a trigger isn't a bad thing. But the more urgent people feel, the more often they reach for extreme methods first, so we talk about that first.

Do we treat blood sugar?

No. Your blood sugar and medications should continue to be managed by the clinic that diagnosed you. What we look at is your weight and overall condition, and only as far as that helps.

Fat built up around the belly can make blood sugar harder to control. So the two go in the same direction. But from the start, we make it clear that we are not taking over your blood sugar care.

What do we look at?

We look at body composition first. Rather than just your weight, we look separately at where fat has built up and how much, and how much muscle you have.

Then we look at what you actually eat. Many people say, "I don't eat much, but I keep gaining," and usually it's because it's hard to keep track of what you eat on your own.

How do we treat it?

We start by making what you eat visible. We suggest putting each meal on one plate and taking a photo of it.

It's a hassle. But the difference between people who do this and people who don't is big. Once you can see it for yourself, late-night eating and snacking go down naturally.

Herbal medicine is added on top of that. It's meant to restore your body's ability to use energy and to support you so you don't wear out while cutting back.

For diet, a staff member with a dietitian's license works with you one-on-one.

How did things go?

The first thing people say is that their body feels lighter. Checkup numbers are confirmed at your next test, and that's for the clinic that diagnosed you to review.

While you're losing weight, we compare body composition side by side to make sure you're not losing muscle too. A lower number alone doesn't mean it went well.

What are the limits of this approach?

We do not adjust your blood sugar or your medications. Please don't stop taking your medication on your own.

If you feel dizzy, your hands or feet shake, or you break into a cold sweat, tell the clinic that diagnosed you right away. If how much you eat changes, your treatment there may need adjusting.

To people with the same worry

1. Your blood sugar and medications should continue to be managed by the clinic that diagnosed you.
2. Reducing belly fat goes in the same direction as that care.
3. We start by making what you eat visible.
4. If you lose muscle too, it didn't go well.
5. Please don't stop taking your medication on your own.

We don't look only at the number on the scale. Why the weight went up differs from person to person, so we start by finding the reason.

If you keep losing weight and gaining it back, come see us once. Before the number on the scale, we look for why it went up. It's different for everyone.

There are many possible causes, so the same treatment can lead to different courses for each person.