tldr: I'd like to have a consultation with one of the leading non-surgical bariatric physicians in America to do an especially thorough investigation of my weight issue and potentially discuss uncommon but evidence-based approaches to weight loss. I have seen several good bariatric surgeons in the past, and had successes, but after decades of efforts and issues am looking to go "up the ladder". I have a PPO and can travel. Money is an object but let's assume it isn't for the sake of argument. Who should I talk to?
Edit: Really looking specifically for recommendations for doctors or practices, not general weight-loss advice.
I'm a 52 year old male who has maintained a loss of ~100 pounds for over two decades. By normal weight loss standards, I'm a "pro" who has had "success". The problem is, I'm still morbidly obese after that loss, and there's another ~100 between where I am and a healthy weight. While I've been able to lose that additional weight (multiple times), it is remarkably, painfully hard to get and keep it off.
I've kept off the "top" hundred using approaches similar to what's in the FAQ. Nutrition, activity, the standard advice. I cook for myself, know that lean meats and vegetables and regular activity to maintain cardio health and muscle mass are the way to go. I don't want to see a doctor who refers me to a nutritionist, believes that this is related to mental health, or, god help me, tells me to use a smaller plate.
I've only been able to lose and maintain the loss on the "bottom" hundred doing fairly extreme portion control (under care of physicians) and enduring a great deal of hunger even in maintenance. Multiple combinations of macros and calories have been tried. I haven't found a combination that allows me to lose and keep off that weight without severe hunger. (Again, keeping the "top" 100 off using typical weight maintenance guidance is not a problem, so something seems to be going on here.)
I've tried all or most of the standard appetite suppressants over the years, including ones that have since been taken off of the market. While some have been helpful over short periods, none have proven effective over more than a year - either losing the appetite-suppression effects or creating serious side effects. This, unfortunately, includes the GLP-1s. I would gladly consider trying experimental appetite suppressants or hormonal approaches. I intend to try retatrutide when it is available, although I am concerned about side effects.
I've been regularly tested for thyroid issues and diabetes, which are not an issue. I do not have chronic health issues other than high blood pressure (under control with a typical medication) and arthritis, which has begun to affect my mobility and weight loss would greatly help with. My vitals are surprisingly good. My current and past doctors have not believed my weight and appetite issues are related to any typical illness or a medication side effect.
I will not consider a non-reversible surgical bariatric procedure. This is non-negotiable.
I've worked with many physicians in the cities I've lived in over the years, including several credentialed by the Obesity Medicine Association (or its earlier incarnation). This isn't about finding a good bariatric physician or a clinic - I've done that, many times. I'm looking for the physician who will go a step further, really go in depth, and look beyond the typical approaches.
Do you know who that might be? Many thanks.
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