Physician-run weight loss clinics are the latest craze in America's $58 billion dieting industry. Doctors are prescribing drugs, "fat-dissolving" injections, and severe diets to help patients lose weight. Fran Smith reports on the trend—the good, the bad, and the dangerous.
Love handles. Rose Katz, 43, an attorney, wanted to lose hers. Even though she worked out five times a week and watched what she ate, she just couldn't smooth those bulges. Katz had read that injections of something called Lipodissolve might help. An Internet search led her to the Center for Medical Weight Loss near her home on Long Island, New York—a place founded and staffed by doctors. She figured she'd be in good hands and that she could get some quick shots and be done.

At the center, Andre Giannakopoulos, MD, gave the 147-pound, 5'5" mother of three a physical, an EKG, and blood tests. He found that the dose of medication she was taking for her underactive thyroid was dangerously high and wrote her a new prescription. When she told him she wanted to get rid of her flabby pooches along with 20 pounds before her son's bar mitzvah, just a few weeks away, he scheduled the injections and also recommended an 800-calorie diet based on meal-replacement shakes and bars. Five weeks later, when Katz found herself struggling to stick to the plan, Giannakopoulos wrote a prescription for the appetite suppressant phentermine. The 800-calorie diet isn't recommended for minor weight problems, and phentermine isn't indicated for cases like hers—but then, the so-called fat-dissolving shots that brought her to the center aren't even FDA approved. Katz had no qualms, though. She trimmed 2.5 inches from her waistline, dropped 9 pounds in six weeks, and wore a size 6 dress to the bar mitzvah. After two months, Katz was holding steady at her new weight; if she starts to regain, she can go back to the clinic for more help.

Katz's experience encapsulates the promise and potential pitfalls of physician-run weight loss clinics, which are sprouting up in medical office buildings and strip malls coast-to-coast. Yes, many customers lose weight fast. And they typically get a thorough exam, something too many people ordinarily neglect. "I don't normally go to doctors. I should be seeing an endocrinologist for my thyroid every six months, but I haven't gone in years," Katz says. But the clinics offer a bewildering assortment of treatments that range from sensible to highly questionable, and the doctor in charge may have little experience in dealing with weight loss—many physicians open up shop after attending a brief seminar, if they get any special training at all. "Practitioners are seeing a business opportunity," says David L. Katz (no relation), MD, director of the Yale-Griffin Prevention Research Center and O's nutrition columnist. "Frankly, many clinics are making up their approaches as they go."


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