Weight Loss FAQ

Will you see my children, too?

(Do you treat pediatric obesity?)

Yes. We are one of the few weight loss programs in the United States that treats childhood obesity. Dr. Marlowe has ABFM board-certification which includes training in pediatric medical and behavioral issues. In addition to the standardized pediatric training which the ABFM requires, Dr. Marlowe sought specialized focus on nutrition for his pediatric patients. At the Riley Children's Hospital in Indianapolis, he took extra rotations in adolescent pediatrics to learn the behavioral aspects of eating disorders ranging from anorexia to bulimia to obesity. Instead of taking the summer off, he worked at Happy Hollow Summer Camp and learned the latest techniques for management of carbohydrates, calories, and insulin for children with type I diabetes. We note that children most often follow the example the parents set, so we at the Institute require parents to be patients before the children can become patients. If parents and siblings are thin, but only one child is obese, we recommend discussion with the primary pediatrician whether an evaluation by a pediatric endocrinologist specialist might be appropriate.

What should I bring?

• Please bring a list of medicines, herbs, and supplements you take.

• Lab results from your primary care physician, if you wish.

• A diary of food intake for the last week, if you wish.

What will you ask me?

At the first appointment, Dr. Marlowe will need your complete medical history. You will be asked about your medicines, past medical conditions, previous surgeries, allergies to medicines, smoking/drinking habits, and medical conditions of relatives. Additionally, Dr. Marlowe will ask you about what you eat and how you exercise. One of the most important questions we ask will be to tell us about previous weight loss attempts. The more detail you can provide, the better Dr. Marlowe will be able to determine what will work best for you in the future. Previous failures provide valuable information to Dr. Marlowe, so don't leave them out!

Will the doctor need to do a physical exam?

(Even if my primary care doctor just did one?)

Absolutely! The North Carolina Medical Board requires every physician to examine his/her patient at least once (even psychiatrists perform a "psychiatric exam"). Even if it were not required, Dr. Marlowe would be sure to perform a full exam. Dr. Marlowe will check for glaucoma, thyroid nodules, heart murmurs, liver enlargement, nail abnormalities, and many other physical findings which are not the focus of your primary care doctor. Every board-certified specialist performs an exam which is focused on his/her area of expertise. Beware any physician who never examines you.

Will I be given medicine at the office?

Yes. Unless you have a medical contraindication to receiving phentermine (eg. advanced arteriosclerosis, serious cardiovascular disease, uncontrolled hypertension, hyperthyroidism, hypersensitivity to sympathomimetic amines, glaucoma, taking MAO-inhibitors at the same time, or having a history of drug abuse). There are at least eight different types of medicines which Dr. Marlowe prescribes for weight loss. For convenience, Dr. Marlowe will dispense to you at no additional cost the most common medicine (phentermine), if it is the best choice for you. If you have a health condition which makes it an unsafe choice or if Dr. Marlowe feels a different medicine would be more effective for you, he will discuss with you his reason for writing a prescription for a medicine available only at the pharmacy.

Will Dr. Marlowe prescribe exercises at the first visit?

Yes. At each visit, Dr. Marlowe will review the exercise you have done since the previous visit. Tell him if you have any pain or difficulty exercising. At the end of the first visit, Dr. Marlowe will provide an "exercise prescription" which includes what type of exercise, how long, and recommended frequency. For patients who are new to exercise, the plan will begin very simple and may increase with each visit. For patients familiar with exercise, Dr. Marlowe will discuss intensity, frequency, and special techniques for increasing metabolic rate. If you're new to exercise, don't expect the complex program at the first visit.

Will Dr. Marlowe order lab tests at the first visit?

Probably, but not always. Many patients have underlying vitamin deficiencies and endocrine abnormalities which contribute to weight problems. For many years, Dr. Marlowe told his patients that they needed their Vitamin D level checked. Now it's old news and everyone checks this test. But, it's not the only vitamin level you need to have checked. After asking extensive questions and carefully examining you, Dr. Marlowe may not need blood tests to know what diet will be best for you. Dr. Marlowe may order medical tests which are appropriate for weight-related medical conditions (eg. Vitamin D levels for fibromyalgia, h. pylori for GERD, CBC for anemia, etc.). Since Dr. Marlowe only orders tests when he has a medically necessary reason, the insurance companies cover the costs of the tests. He never orders tests "just because".

Will I be given a diet on the first visit?

Most patients will be given a general diet, a request to keep a food journal, and a blood test order. On the second visit, the results of the blood test will be used to determine the absolute best dietary plan, which will be discussed in detail at the second visit. For some patients, the best dietary plan will be clear to Dr. Marlowe, based upon his experience recognizing common patterns of patient health.