Now offering medical medical weight management consultations!
Now offering medical medical weight management consultations!
Dr. Ryan is a dually Board Certified Physician in Family Medicine and Obesity Medicine who has been in practice in the Madison area for the last 14 years. She has a passion for preventative medicine and weight health. She became board certified in Obesity Medicine in 2024 and is excited to announce openings in her practice focused solely
Dr. Ryan is a dually Board Certified Physician in Family Medicine and Obesity Medicine who has been in practice in the Madison area for the last 14 years. She has a passion for preventative medicine and weight health. She became board certified in Obesity Medicine in 2024 and is excited to announce openings in her practice focused solely on weight health. Her practice is focused on judgment free weight management. Weight is a deeply personal struggle for many and deserves a personalized care approach. Obesity is a complex disease state affected by environment, genetics, stress, sleep habits and hormones. It’s effects can extend into all aspects of life. Even modest weight loss can lead to substantial improvements in quality of life. Our goal is to work with you to tailor a plan specific to your lifestyle. This is an exciting time to treat obesity as there are new medications available that can be highly effective at aiding in weight loss. Engaging in regular follow up, creating healthy lifestyle changes and adjusting our treatment plan as your body changes, will help you to not only meet your health goals but to maintain them long term. We are excited to start this journey with you!
Your first appointment will be approximately an hour in length. We will review your medical and weight history, recent labs and current medications. We will discuss your goals and what has worked or not worked for you in the past. We will discuss options available and recommendations.
To prepare for your first appointment we ask that you register as a new patient on our patient portal and complete all of the Forms/Questionnaires under Weight Health.
Link to portal: harmonymedical.md-hq.com
Prior to your visit consider contacting your insurance to see if you have coverage for anti-obesity medications.
No. Medication for weight loss can be a powerful tool to aid in sustained weight loss, however they are not for everyone. They are indicated for use in those with a BMI >30, or a BMI of 27 or above with a risk factor (such as diabetes or cardiovascular disease). If you are planning to start on a medication for weight loss it is likely that you will need to be on the medication long term to maintain your weight.
Remember that anything that helps you lose weight, likely needs to be continued long term to keep weight off. This is true of medications as well. As long as they are safe, not causing side effects, and working to help you lose weight or maintain the weight lost from the medication, they should be continued long term- otherwise you are likely to regain weight. Medications will have best results when they are used with healthy diets and movement
Phentermine
Diethylpropion
Qsymia- (Phentermine/Topiramate ER combination)
Contrave- (Naltrexone/Bupropion Combination)
Saxenda- Liraglutide
Wegovy- Semaglutide
Zepbound- Tirzepatide
Orlistat
Vyvanse- Lisdexamfetamine
Metformin
Starting a GLP1 or GIP/ GLP1 Injectable
Victoza or Saxenda (liraglutide)
Ozempic or Wegovy (semaglutide)
Mounjaro or Zepbound (tirzepatide)
GLP1 and GIP/GLP1 agonists are a type of medication that work by increasing incretin, a hormone found in the gut. Incretins help to produce more insulin when needed and reduce how much blood sugar is produced when it’s not needed. These medications improve our physiologic response to food. They also affect how quickly food travels through the digestive system, which can lead to feeling fuller faster and more satisfied in-between meals. Many people find they think less about food because of this.
Side Effects?
Because these medications affect your gut hormones, you may experience side effects anywhere along the
digestive tract. Common symptoms include:
• Constipation
• Diarrhea
• Bloating
• Excessive burping, Sulfur burps
• Nausea
• Heartburn
Most side effects are temporary and tend to improve as you continue the medication. To lessen these effects, the medication is started low and gradually increased. Depending on the medication you start, expect to be at the same dose for 1-4 weeks before a dose increase.
Some people do continue to experience side effects regardless of how long they’ve been on the medication. Our goal is to keep these side effects at a minimum and not significantly impact day-to-day life.
In multiple studies, less than 5% of individuals stop their medication due to side effects!
Methods to reduce side effects
- Eat slowly. These medications slow down digestion. By eating meals slowly and with intention, we
can better recognize our satiety cues. You can practice this by using your non-dominant hand or
setting your utensil down between every 1-2 bites. Some people even prefer using smaller sized
utensils (think kid sizes).
- Eat smaller meals. Remember the old adage: your eyes are bigger than your stomach! With the
medication, this is especially true. Start by putting less on your plate that you think you’re hungry for.
Most patients feel fuller with even 50-75% of their average meal. Having less food available can
reduce the urge to over eat or finish our plate. Consider even using smaller plates/ bowls to practice.- Drink plenty of water! Increasing water intake can improve gut health, help break down foods, and prevent dehydration. Consider different temperature of fluids – ex. warmer (soups, tea, etc.) or colder (ice-cold water, sugar-free popsicles, etc.), especially if you’re struggling to stay hydrated.
- Regular meals with protein. Protein is essential for weight loss and maintenance. Getting enough
protein means we are less hungry in-between meals. Some people even find adding in addition 10-20g of protein the days before injection can help reducing side effects throughout the week.
- Don’t eat close to bedtime. Because your body is taking longer to digest foods, lying flat slow things
down even further. Consider waiting 1-2 hours between your last meal and falling asleep.
- Avoid eating/ drinking at the same time. Some people find that drinking & eating together causes
feeling of over-fullness and bloating. If you’re experiencing any discomfort, consider waiting 10-20
minutes after eating to start drinking water.
- Limit digestive irritants, such as caffeine/ coffee, acidic or citrus foods (tomatoes, oranges, lemons,
spicy, etc.), alcohol, carbonation, dairy products, and fatty/ fried foods. Tums can also help, just don’t take more than a few times a week.
- Increase fiber intake. Focus on plant-based products like chia seeds, flaxseeds, non-starch
vegetables, complex carbohydrates/ whole grains, beans, lentils, etc. or Over-the-Counter powders,
like Metamucil, Citrucel, and Benefiber. *Note – Increase fiber slowly. Too much, too quickly can cause
temporary upset stomach and bloating. Instead, aim to gradually increase fiber intake and be sure to
drink plenty of water. General fiber goals: 20-25g daily for women, 30-35g daily for men.
-Drink electrolytes. These can help with fatigue, headaches and muscle aches. Consider a low sugar or sugar free option.
- Add probiotics. Probiotics are live healthy bacteria, typically found in fermented foods, or in capsule
or liquid form as supplements. Probiotics improve and maintain the gut microbiome, which has benefit
in additional weight loss. When starting a probiotic, look for at least 1 billion CFU containing
Lactobacillus, Bifidobacterium or Saccharomyces strains. Popular brands are Seed, Culturelle, and
Align. Fermented foods include sauerkraut, kimchi, yogurt, kombucha.
- Add a stool softener. Stool softeners do just that – they soften the stool by increasing how much
water & fat you absorb so you can have an easier time stooling. Look for the active ingredient:
docusate sodium.
- Reduce sugar intake and ultra-processed foods. These foods don’t always align with health goals
and can often cause upset stomach or irritating symptoms while on their injectable medication.
Interestingly, many people are less interested in these foods anyway, especially the longer they use
the medication.
- Change the time of day you are injecting. If you have been taking the medication in the morning,
consider trying an evening dose instead, and vice versa.
- Try a different injection site. Some people find that injecting into a different area of the body (upper
arm, abdomen, thigh) can significantly improve side effects.
- Start a multivitamin. Not only does this ensure you are meeting vitamin and mineral goals, but even improve feeling fatigued when losing weight.
Not all bodies respond the same way. If you’re struggling to manage symptoms, don’t hesitate to contact your
prescriber to discuss further.
Initial consultation $350. Follow up visits $200. As weight management is an ongoing process that requires frequent follow up we offer membership for $175/month. This includes subsequent office visits and access to our patient portal for messaging and remote management of care. In the initial phase of your care we recommend that you have a visit every month. As we move from active initiation of care, typically 9-12 months after starting treatment, to more maintenance care we require visits every 3 month for follow up. Medication cost is not included in this price. We do not accept insurance at this time.
We're located in the heart of downtown Verona
271 S. Main Street, Verona, WI 53593
Ready to schedule your appointment? Book online or give us a call. We look forward to helping you achieve your weight health goals!
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