A bariatrician is a licensed physician (Doctor of Medicine [MD] or Doctor of Osteopathy [DO]) who subspecializes in weight loss medicine. Often people hear the word “bariatrics” and think of weight loss surgery. This is because weight loss surgery is done by bariatric surgeons. However, bariatricians provide non surgical weight loss to patients (whether they have had weight loss surgery, are thinking about it, or have no desire for it.) Not all physicians who claim to be bariatricians have had appropriate training and board certification from the American Society of Bariatric Physicians (ASBP) and the American Board of Bariatric Medicine (ABBM). Appropriately trained Bariatricians, like Dr. Swindler and other physicians at MBL address the obese or overweight patient with a comprehensive program of 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.

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”?  

As of Aug 1 2007, 7896 patients have lost over -71,555 lbs lost in the first month

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.

Dr. Swindler wants to make her program available to everyone because she knows what weight loss can do for so many people on so many different budgets. Dr. Swindler and Rader’s electronic medical system can print out for patients a summary of the visit’s costs and diagnoses so that patients can submit this to their individual plans for reimbursement. Many patients are surprised to learn how much of the costs can be tax deducted too. Unfortunately, not all insurances reimburse for weight loss programs. This is way it is our goal to keep costs of a visit similar to a subspecialist’s copay and prescription co-pay.
 
The basic first visit at the office costs about $85. This includes:
· History and physical exam done by the Dr.
· Complete body composition analysis.
· Weight, measurements, and vital signs.
· Dr. Swindler also does a 45 minute presentation in a small group
· One on one with the physician to discuss your individual plan after the presentation
· Nutritional and possible medication instructions are included 
 
Blood tests are needed during the first visit to appropriately determine our individual needed. They can be done at our MBL office for about $70 or recent labs done in the past 3 months can be brought in for review. These cost about $200 in most other labs. The lab tests needed include blood chemistries, liver functions, kidney functions, fasting cholesterol panel, CBC (complete blood count) and two thyroid blood tests.
 
An EKG may need to be obtained. This depends on your medical history, your physical exam, and other factors. They are not done on everyone but only when indicated. Costing about $150 in most offices and more in the hospital, Dr. Swindler performs the EKGs and interprets the EKGs for $55.
 
Follow-up visits typically are monthly during active weight loss. Follow-up visits average about $75-$85 depending on if medications are needed and dispensed.  After completion of the active weight loss phase, patients are encouraged to enter our maintenance program. Hundreds of patients are active in our maintenance program. During this time, visits are spaced out to 2, 3, or 6 months apart depending on how the patient is doing. There is no added cost to the maintenance programs besides the regular visit cost.

Dr. Swindler does only the blood tests and EKGs that she feels absolutely necessary for appropriate medial care based on the patient’s current medical history/current medications/and current medical diseases. 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. By finding these and correcting these, patients are often able to do much better in their weight loss results.
 
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. Swindler has chosen to do initial basic screening profiles on every patient, and then only do the more expensive blood testing on patients that require it or who don't progress with weight loss like expected to find out if some other biochemical process is blocking the loss. This is always discussed with the patient in advance. Together Dr. Swindler and the patient try to determine the least expensive way to obtain the labs.
 
Blood tests are done for about $70. These cost about $200 in most labs. The lab tests needed include blood chemistries, liver functions, kidney functions, fasting cholesterol panel, CBC (complete blood count) and two thyroid blood tests.
 

Successful Results and Experience

Medical Bariatrics of American, associated with Medical Bariatrics of Lexington is now tracking over 8000 patients that have been treated in the program. Several thousand patients have been treated in Dr. Rader’s previous weight loss practice with similar results.  Bariatrak, the electronic medical record used by MBL, was designed by Dr. Rader in order to track the specific needs of the bariatric patient as well as to follow patient results.  This program documents any changes done in the program and the result in patients’ success to help improved patient care and design the best treatment protocol for you. Results have been so successful that Dr. Rader has been invited to train other physicians around the nation how to become successful weight loss physicians and how to appropriately follow their patients’ progress.
We know from our database tracking system, that 97.7% of patients in this program loss significant weight (on average 9.3 lbs) in their first month. 78% of patients loss enough weight in just 3 months to reduce their long-term risk of diabetes by greater than 50%. 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.
Patients have now lost over 71,555 combined pounds in just their first month in our program, and over 210,000 pounds total. Numerous physicians 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. Swindler has passed written and oral examinations by the American Board of Bariatric Medicine. The office is in compliance with all ASBP and DEA guidelines and laws. National Conferences are attended by Dr. Swindler and members of her staff twice a year to maintain current knowledge on advances in obesity.  Dr. Rader has passes these same exams and has been a lecturer at the national conferences since 2003.  Dr. Rader and Swindler constantly research all new information on weight loss.  They work with other physicians to help maintain the best patient care possible. Dr. Swindler has spoken to numerous physicians throughout Kentucky on current weight loss practices and has truly become Lexington’s weight loss expert just as Dr. Rader who mainly practices in Idaho has become Idaho’s weight loss expert.  They both have been published in the field of research and in patient care.
 

Compassion and Understanding

Upon a first visit to the clinic, Dr. Swindler shares how the disease of obesity has affected her and her family. She saw her grandfather die of heart disease and diabetes that could have been prevented with weight loss. She helped her father loss about 60lbs after realizing he was the oldest living male is his family as all others had died prematurely from heart disease. She also helped herself prior to entering the field of bariatrics to loss weight and to decrease her bad cholesterol from twice the normal amount (LDL of 197) to normal range (about 80). After years of training in family medicine and working in various emergency rooms treating chronic and acute obesity related diseases such as high blood pressure, diabetes, sleep apnea, high cholesterol, and heart disease, she realized how most of these conditions could have been cured or prevented if obesity was appropriately treated. She also saw how much weight loss training was lacking in the medical field along with necessary patient education time forcing patients to rely on programs not supervised by physicians and using medications and herbs obtained illegally or over the internet without regard to their current medical history. Dr. Swindler has therefore made Bariatric medicine her passion, and it is her goal to uphold expertise in this field, promote and reflect a healthy lifestyle, and provide safe and effective weight loss and maintenance to all who desire to combat or prevent this disease. Her experiences have allowed her to be empathetic and understanding towards both the emotional and physical well-being of her patients.
 

Prices that are affordable to most everyone.

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. Swindler is a bariatric (medical weight loss) specialist and is 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 confidential database and is tracking over 8000 weight loss patients’ results. These results are broken into subsets based on initial patient weight, age, sex and other factors. When a new patient is started into the program, the database results along with the new patient’s medical history, physical exam, and blood tests then helps Dr. Swindler to know how much weight loss to expect in the first month and beyond. If expected weight loss is not obtained, then she 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 her mentor, Dr. Rader, the 2007 bariatrician of the year, subspecialty training done at The Cleveland Clinic Foundation, 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.
 
Dr. Swindler establishes weight guidelines to help every patient be prepared for relapses in their weight.  All patients have a safety plan specific for their current weight and know when to return to the office.
 
Patients that fall out of the program for whatever 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.
 
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 improve 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 throughout the years.

Medical Bariatrics of Lexington is committed to provide to all of its patients the most medically appropriate, safe, and effective weight loss and maintenance programs currently available.

For further questions, call us at (859) 263-SLIM (7546). We’d love to here from you.