Common Questions


What is a Bariatrician?
Should you see a Bariatrician for weight loss?
What is a realistic expectation of my weight loss results?
Why see a medical specialist for weight loss?
Ultimately, what is the cost to me to complete your program?
What tests do you include in your initial examination?
How do you follow my progress?
Why should I choose your program over others?

 

What is a Bariatrician?

A bariatrician is a licensed physician (Doctor of Medicine [MD] or Doctor of Osteopathy [DO]) who, as a member of the American Society of Bariatric Physicians (ASBP), has received special training in bariatric medicine the medical treatment of overweight and obesity and its associated conditions. Bariatricians address the obese patient with a comprehensive program of diet and nutrition, exercise, lifestyle changes and, when indicated, the prescription of appetite suppressants and other appropriate medications. (The word bariatric stems from the Greek word barros, which translates as heavy or large.)

 

While any licensed physician can offer a medical weight loss program to patients, members of the ASBP have been exposed, through an extensive continuing medical education program, to specialized knowledge, tools and techniques to enable them to design specialized medical weight loss programs tailored to the needs of individual patients and modify the programs, if needed, as the treatment progresses. ASBP members are uniquely equipped to treat overweight and obesity and associated conditions.

 

A physician-supervised medical weight loss program may be the safest and wisest way to lose weight and maintain the loss. Overweight and obesity are frequently accompanied by other medical conditions, such as type 2 diabetes, hypertension, cancer and others. A bariatric physician is trained to detect and treat these conditions, which might go undetected and untreated in a non-medical weight loss program.

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Should you see a Bariatrician for weight loss?

The National Institute of Health (NIH) has clearly presented guidelines as to whom and how people should try to lose weight.  Their guidelines state the following:

 

A person should see a physician to lose weight if any of the following apply:

#1  You are trying to lose more that 15 – 20 pounds -and/or-

#2  You have any health conditions -and/or-

#3  You are taking any medications -and/or-

#4  You are planning to take medication to lose weight

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What is a realistic expectation of my weight loss results?

How do you compare grapefruits and zebras?  The question is fair but to try and answer it for every person is impossible.  Have you noticed all the weight loss advertisements that show a person losing 100 pounds the small print that says “results not typical”?  

 

Since beginning Idaho Weight Loss, Dr. Rader has tracked in a data base the average weight loss of all 9500 patients making at least three visits to the clinic.  He and his associates present the results in a series of presentations at local medical practices and at the National Weight Loss Physician programs.  His hope is by documenting the success of the program, insurances will begin to reimburse the medical expenses for patients.

 

As of August 2008, over eight years worth of patients, 97.4% of patients lost weight at the first visit.  The average weight loss the first month is:

 

Beginning

Weight (lbs)

Number of Patients # lost wt first month # that did not lose wt first month % losing weight
> 400 45 45 0 100%
375 - 399 48 47 1 97.9%
350 - 374 73 71 2 97.3%
325 – 349 144 140 4 97.2%
300 - 324 277 272 5 98.2%
275 – 299 580 566 14 97.6%
250 – 274 832 803 29 96.5%
225 – 249 1274 1240 34 97.3%
200 – 224 1845 1804 41 97.8%
175 – 199 2141 2084 57 97.3%
150 – 174 1592 1526 66 95.9%
< 150 376 353 23 93.9%
  9227 8951 276 97.0%

 

 

Longer term loss and maintenance is actually more important than first month loss.  The following chart shows the long term results that we've achieved with our patients.  All patients who made at least 3 visits to the clinic are included in the chart:

 

 

Over 80% of patients that make at least three visits lose enough to reduce the risk of diabetes 50%.

 

Most patients chose to enter our maintenance plan after losing more than 10% of their body weight.

 

Remember, how other persons did does not tell you anything about you, but these numbers are presented to give you some ideas and to let you know the success the program is having overall.

 

Overweight and obesity is a very complex medical disease.  Very often, unrecognized or undiagnosed medical conditions are associated with the weight gain.  These conditions may prevent weight loss or worse, be harmful to you if not recognized and treated.  A medical weight loss specialist knows these metabolic conditions and can test for them.

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Why see a medical weight loss specialist?

A medical weight loss specialist has done extra study, training, and testing to become board certified in weight loss medicine.  Also, to become board certified, the national board of Bariatric Medicine sent a previously board certified physician to Boise to investigate Dr. Rader’s and Dr. Freshwater’s practice and the physician reported back to a board of physician before certifying Dr. Rader’s qualifications.  Dr. Rader and Dr Freshwater are Idaho’s only MD’s to pass all three parts of the process and become board certified in weight loss medicine. 

 

Not only is Dr. Rader a treatment specialist, he is an instructor teaching other physicians in his weight loss medicine methods.  He has been a presenter and lecturer at the national conferences in 2003 though 2008. He has other physicians train in his office.  Local physicians are referring patients to his office, but a MD referral is not necessary.

 

Dr Rader has lectured in the following cities over the past several years including Tampa FL. Phoenix AZ  Las Vegas, NV,  San Diego, CA Louisville, KY Chicago, IL and St Louis.

 

As a specialist, weight loss with a Bariatrician is a total program, not just weight loss but also in weight maintenance.  Bariatricians are experienced in helping overweight patients in the personal highs and lows during a weight loss program.  They are experienced in the roadblocks to becoming successful in controlling the disease called overweight and obesity.

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Ultimately, what is the cost to me to complete your program?

Money is and should be an issue when considering any weight loss program.  In developing his program and deciding on fees, Dr. Rader considered many options. One program in Philadelphia advertised $2000 for the first visit. When asked who takes care of school teachers and bus drivers, the doctors said “I'll let someone else do that.” Another weight loss program locally tries to get the patient to commit to hundreds of dollars of food purchases on the first visit. Another local program is $350 first visit. Another offers half off the first visit to get you started the sell you hundreds of dollars of other supplements and materials.

 

Dr. Rader and Dr Freshwater want to make this program available to everyone.  They know what weight loss did for their life and they want to help you do the same or better.

 

Our doctors are the  only board certified medical doctors in weight loss medicine in the state of Idaho. The cost of the first visit at the Boise is extremely reasonable and includes:

  • History and physical exam done by the Dr. Rader or associate physician
  • Infrared body composition determination.
  • Weight, measurements, and vital signs.
  • Dr. Rader or associate physician also does a 45 minute presentation in a small group
  • Dr. Rader or associate physician talks with each patient again individually
  • Medications and nutritional instructions are included 

 

Contact the clinic with specific questions on first visit procedures and pricing.  At the first visit, the physician may order certain blood tests.  These tests include blood chemistries, liver functions, kidney functions, serum triglycerides, total cholesterol, good cholesterol, bad cholesterol, CBC (white and red blood cell counts) and two thyroid blood tests

 

EKGs are often obtained. This depends on your medical history here physical and other factors. They are not done on everyone but only when indicated.

 

Follow-up visits typically are monthly.  After completion of the active weight loss phase, patients are encouraged to enter our maintenance program. A thousand or more of our patients are active in our maintenance program. Some see us on a quarterly basis and others just communicate their weigth by phone or email.  These patients understand this is a life long disease and have been instructed at what weight they may need to return to the clinic.

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What tests do you include in your initial examination?

Dr. Rader or associate physician does only the blood test and EKGs that they feels absolutely necessary... There are multiple causes of overweight and obesity that may be identified in some screening labs.  Also, many consequences of overweight and obesity may cause abnormalities in blood testing. These must all be identified prior to beginning a weight loss program. 

 

Most biochemical causes of being overweight and obese are fairly common. These can usually be identified with some basic lab testing. However a few causes of being overweight obesity are identified only with very unique and often very expensive lab testing. Many offices will do hundreds of dollars of blood testing on every patient to try to find the one patient with the very rare biochemical causes of obesity. This means in some offices patients spend hundreds of dollars on blood testing that wasn't necessary.

 

Dr. Rader or associate physician chose to only do a basic profile on every patient, and then do the more expensive blood testing only on patients that don't progress with weight loss like expected. This is always discussed with the patient in advance. Together the doctor and the patient try to determine the least expensive way to obtain the labs.

 

Blood tests are done for about $60 These cost about over$200 in most labs These tests include blood chemistries, liver functions, kidney functions, serum triglycerides, total cholesterol, good cholesterol, bad cholesterol, CBC (white and red blood cell counts) and two thyroid blood tests.

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Why should I choose your program over others?

Successful results Experience Scientific Knowledge
Professionalism Compassion Understanding
...all at prices that are affordable to most everyone.

 

Successful Results and Experience

Dr. Rader or associate physicians are now tracking over 9000 patients they have treated in the program in Boise, Twin Falls and Fruitland ID. Also these numbers are compared to other clinics across the country to ensure we are continuing to be in the best programs compared to others across the country. Several thousand patients had been treated in his previous weight loss practice.  Computer software programs were designed by Dr. Rader in order to follow patient results.  This program documents that changes in the program have improved patient care. Results have been so successful that he has been invited to train other physicians around the nation how to become successful weight loss physicians.

Four out of five patients that enter our weight loss programs for just three visits lose enough weight to reduce their long-term risk of diabetes over 50 percent. Patients that lose weight in the program have improvements in their lipid profile (cholesterol and triglycerides) equal to or better than commonly used cholesterol medicines. Many patients are able to come off blood pressure medicines, lipid medicines and antidepressant medicines.

 

Idaho Weight Loss Results vs. Diet Studies

The A to Z weight loss study

from Journal American Medical Association and IWL computer records

 

  Atkins Zone LEARN Ornish IWLRader
# Patients 77 79 73 76 8951
Avg wt begin 189 184 187 189 216
Avg wt loss 10.3 3.5 5.7 4.8 30.0
% wt loss 1 year 5.4% 1.9% 3.0% 2.5% 13.9%

 

Numerous MD’s, DO’s, and nurses are patients in the program.

 

Professionalism

The American society of bariatric physicians has a set of 15 criteria “principles of excellence” that all bariatricians are encouraged to follow. These include always putting patients’ welfare above all, avoiding value judgments concerning a patient’s behavior, complying with all state and federal laws, providing adequate and truthful information to the patient about their disease, and cooperating fully with other physicians in providing medical care to every patient.

 

Scientific Knowledge

As a specialist in weight loss medicine, Dr. Rader and Dr Freshwater have passed written and oral examinations. The office has also passed and on-site examination by the American Bariatric society.  National Conferences are attended by Dr. Rader and members of his staff twice a year to maintain current knowledge on advances in obesity.  Dr. Rader has been a lecturer at the past seven national conferences.  Dr. Rader constantly researches all new information on weight loss.  He also works with other physicians, and has spoken to various physicians around Idaho.  He has been published in the field of research and in patient care. He currently is writing a textbook chapter for publication on the Pathophysiology of obesity.  Another  article was recently published in a medical Journal.

 

Compassion and Understanding

Upon a first visit to the clinic, Dr. Rader discusses that he too shares the disease of obesity.  There was a time in his life that he would wear the same pair of pants two times in one week because none of his other suits fit.  All the while he was working 12-hour shifts in the ER (and chairing in his department), coaching his sons Little League team, being a dedicated Scout Master with his youngest, presiding over two companies and staying actively involved in his church.  Despite this busy lifestyle his weight continued to rise.  Dr. Rader then made the life changing decision of devoting his time to helping those like him, and became dedicated to living and promoting a healthier lifestyle.  With over 15% of his initial body weight and 90% of his excess body weight lost, he has been pioneering this healthy lifestyle for himself and thousands of patients for over 8 years.  Obesity is a disease; Dr. Rader has experienced flare-ups, but has remained dedicated in his attempts to control the disease.  His struggles with this allow him to be empathetic and understanding towards both the emotional and physical well-being of his patients.

 

Dr. Freshwater brings the same compassion to her Bariatric Practice. She also shares her struggles with obesity. She started Dr Rader’s program as a patient. She shares in her classes the weight she lost weight as a patients’ in the program.  

 

 

Prices that are affordable to most everyone.

For more information on costs, see question 'What is the Cost to Complete Your Program'.

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How do you follow my progress?

Monitoring a patient active in a weight loss program is essential. The rate of weight loss, the amount of weight loss, vital signs, percent body fat and percent lean tissue, emotional stability, and biochemical health must all be considered as a patient is losing weight.

 

Dr. Rader and Dr. Freshwater are bariatric (medical weight loss) specialists and are specifically trained to know how and when to follow-up with patients.  Several programs are available.  Most patients are monitored monthly with visits in the office.  Sometimes a person needs more frequent visits for closer observation, training, and motivation.

 

The clinic maintains a database and is tracking over 8500 weight loss patients. Based on experience with other patients, after a patient history, physical exam, blood tests, and the first month weight loss, Dr. Rader is able to predict what expected weight losses should be following that first follow-up visit.  If expected weight loss is not obtained, then he knows the questions to ask, tests that might be necessary and changes in medication that might help pull the patient up to the expected weight loss.

 

Training patients for weight loss maintenance begins on the very first visit. Information from national weight loss conferences, experiences from patients, experiences from his own weight loss maintenance, and information from the national health-care weight loss registry of 10,000 weight loss patients who have lost 30 or more pounds is used to help determine an appropriate maintenance plan for every patient.

 

He establishes with the patient, weight guidelines to help every patient be prepared for relapses in their weight.  All patients have a safety plan and know when to return to the office.

 

Patients that fall out of the program for what ever reason are contacted by the office on a reasonable basis for encouragement in maintaining their weight loss or are invited to return to the office for additional bariatric care.

 

Over his eight years in Boise, patients that do not to stay active in the program have been contacted for information as to why they did not stay active in the program and information obtained from these questionnaires are used to steadily improved the program. This can be proven because the percentage follow-up each year has steadily increased and the average weight loss in every weight category has improved.

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