Doctor Launches Lifestyle and Weight Loss Program
Board certified in internal medicine, pediatrics and lifestyle medicine, Lisa Pathak found a way past "pills for ills." Social connection is key, she says.
After graduating from Icahn School of Medicine at Mt. Sinai in 1998, with board certification in internal and pediatric medicine, Lisa Pathak launched her practice in 2002, which is now at Dingman’s Medical Center. She also joined the Air National Guard and had two medical deployments, in Ecuador and El Salvador.
More recently, the pandemic prompted a period of re-examination of her work.
“I felt we were giving pills for ills, and it was frustrating,” she said. “We were just fixing problems with medicines and seeing poor outcomes—stroke, heart attack, arthritis. And I was feeling the effects of getting older.”
Many of these maladies resulted from lifestyle and being overweight, Pathak found, so she pursued lifestyle medicine certification from the American Board of Lifestyle Medicine. The program educated her about guiding patients to make lifestyle changes on several fronts: nutrition, exercise, social connection, sleep and toxin avoidance. She was certified in the fall of 2020 by the American College of Lifestyle Medicine, a program for doctors.
“Every year they hold an educational symposium,” said Pathak. “With lifestyle changes, people reduced or eliminated medication for blood pressure, cholesterol and diabetes. They were excited about their results. But practicing so long, I’ve seen weight loss as a problem many patients struggle with. They lose a little, 2-5%, but not much, not quick. Every week a patient says, ‘I don’t know what to eat.’ So I looked at new programs. I heard about obesity medications with big upgrades.”
She explored drugs such as semaglutide, under the brand name Ozempic, made famous by celebrities such as Kim Kardashian, though it was originally used for diabetes. Various weight loss drugs work in different ways, whether expanding in the stomach or suppressing appetite in the brain, Pathak said. The intention is to eventually stop using the medication when excess weight is lost and then sustain the loss with lifestyle habits. Pathak plans to begin promoting the program this month. She already has a two-page list of patients who are interested.
“Other places do weight loss programs for cash payment. We work with insurance,” she said. “The office visit costs $150, and the initial month’s medication is $200. People can get off it if they change their lifestyle, once they’re at a healthy weight and reset to a different baseline weight. But the American Board of Obesity Medicine says it’s okay to stay on it. It’s case by case.”
Her program entails monthly visits to her office for three months, half an hour each time, then every three months, along with obesity drugs. Although not much time in the doctor’s office is involved, the program could be demanding.
Her start-with-where-you-are regimen emphasizes social connection as well as exercise, sleep and nutrition—the fruit, vegetable, whole grains and nuts focused Mediterranean diet.
“The number one pillar of longevity is how socially connected you are,” she said. “Loneliness is the number one killer in the U.S. Not taking your relationships for granted is important. It’s a heavy topic, often involving hurt and pain. Social lunches are important. Get a community going. Meet for lunch. Put in the effort.”
She sees the consequences for people who don’t talk to parents or children.
“Do therapy. Write letters. Drop in on people. Text them. It can be difficult, but make the effort,” she said.
But how was loneliness quantified to determine its impact? Loneliness doesn’t appear as cause of death on death certificates.
“Essays in end of life years recap what’s important. It’ not money. What people regret most is failed relationships,” said Pathak. “Emotional wellness affects the nervous system, hormones and immunity. The nervous system affects everything, but people don’t think loneliness is a health issue.”
She encourages meditation to “manage thoughts,” as well as yoga, reading and gardening.
“Sleep hygiene” is another key element of Pathak’s lifestyle program. She notes the myth that four hours can suffice.
“You need to follow your body’s circadian rhythm for optimal sleep and nap time,” she said.
She recommends her “4-3-2-1” rules. For four hours before bed, no caffeine. For three hours ahead of bed, no alcohol. For two hours before bed, avoid television, blue lights and blue light glasses. An hour before bed calming exercises can help.
“Darken the bedroom, do yoga, read a book and relax your mind,” she said.
Avoiding toxins of various kinds is also another dimension of the lifestyle program. Addictions of all kinds are targeted—alcohol, tobacco and drugs, including marijuana; phone and social media use and gambling.
“Be aware of how it affects you, what it takes from your life. With social media, people compare themselves to others, and it affects their self-worth. Go outside. Be with friends. What you concentrate on benefits or detracts from your health.”
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how does someone who is interested in this weight loss program get started