Questions People Actually Ask

An obesity medicine physician is a doctor who has focused their training on the complex genetic, environmental, social, biologic and behavioral factors involved in the lifelong disease of obesity. They specialize in helping patients lose weight, maintain that loss, and treat the medical conditions that come with excess weight.

The approach is comprehensive: diet, physical activity, behavioral change and pharmacotherapy together, rather than any one of them alone. Obesity medicine physicians also provide pre- and post-surgical care for bariatric surgery patients, which is where much of the long-term value sits: preventing weight regain before it happens, and catching late post-surgical vitamin or nutrient deficiencies.

The two main national organizations in the field are the Obesity Medicine Association, for physicians, and The Obesity Society, a research organization that includes physicians, psychologists, registered dietitians, public health specialists and research scientists working in genetics, nutrition and behavior. Dr. Larimer is a member of both, and of the Obesity Action Coalition.

Any licensed physician, nurse practitioner, physician assistant, or chiropractor can advertise a “medical” weight loss program. Very little separates those programs from one another on the surface. Even some “spas” are now providing “GLP-⁠1s.”

What matters is depth of education and experience. A specialist has studied obesity as a disease and completed specialized training and testing to validate their knowledge. Also, years of caring for people who have complex forms of obesity and a wide range of special problems and issues give your obesity specialist a deep understanding of this disease and what each patient specifically needs.

Dr. Larimer has practiced obesity medicine for more than a decade. She became board-certified in Obesity Medicine in 2014 and, in 2016, founded GMOS Clinic, a practice dedicated entirely to obesity medicine.

That background is what makes the GMOS program tailored to you. This allows you to have excellent care and medications tailored to your needs.

Obesity is scientifically defined by three criteria, with BMI used most commonly:

• A BMI of 30 or greater.
• Body fat above 25% in men, or above 32% in women.
• Abdominal obesity: a waist circumference over 40 inches in men, or over 35 inches in women.

Obesity is a chronic disease with many causes. However, lack of willpower is not one of those causes. As the body carries more fat cells, it becomes less responsive to the signals that tell us we’re full. Over time, this can lead to joint damage, breathing problems, diabetes, heart attacks, and strokes.

For most people, obesity is a lifelong, relapsing condition. Weight regain is programmed into us. We must have that programming to survive being lost with no food, severe famine, and more. Stress can also increase appetite; this includes fatigue, pain, emotional, hormonal, and other stress situations. Genetics and epigenetics often affect how quickly and how much weight you regain.

“Obesity is defined as a chronic, relapsing, multi-factorial, neurobehavioral disease, wherein an increase in body fat promotes adipose tissue dysfunction and abnormal fat mass physical forces, resulting in adverse metabolic, biomechanical, and psychosocial health consequences.”Obesity Algorithm®, Obesity Medicine Association

At Gainesville Medical Obesity Specialty Clinic, we recommend a weight loss of about 1–2 lbs. per week, or ½ to 1% of your starting weight weekly. This gives us a goal of about 5% weight loss by 8 weeks, 10% by 16 weeks, and 13–14% by 6 months. Some patients on the newest medications, like Zepbound or Wegovy, lose a higher percentage. Our main goal is your health, so slower weight loss is better to minimize muscle loss.

Anti-obesity pharmacology is evolving rapidly, and we work with you to match the best available medication to your specific issues and needs.

We need to quiet your hunger, your thoughts of food, and your cravings for a snack. It is important to speed up how quickly your brain says, “I’m full.” Once those signals calm down, we can build on that with a specialized eating program, supplements, and behavior change. Adjusting these powerful, natural brain signals requires the right prescription medication.

Older, well-known appetite suppressants we use at GMOS Clinic include phentermine and diethylpropion. These are easy to use and affordable but must be individualized to each patient’s needs and risks. Other combinations can further reduce appetite, increase fullness, decrease cravings, or reduce binge eating. Again, we work closely with each patient to develop a treatment plan tailored to them.

GLP-⁠1 medications are the best-known and most effective. They are a fantastic addition to our medication options. They require more intense monitoring because of the risks of rapid weight loss causing greater muscle loss than with older medications. At GMOS Clinic, we were one of the first clinics to start prescribing these for our patients.

We see patients aged 16 to 65 and older.

Prior bariatric surgery does not change how we treat you or the results we see, but it does change your nutritional needs, which we discuss during your first one or two visits.

Current guidance is that once hunger returns after surgery and weight regain begins, patients should see an obesity medicine specialist to prevent or minimize rebound gain. Several of our patients came to us after regain following surgery, large and small, and have lost that weight again.

As with any medical condition, outcomes vary. No one can guarantee a specific amount of weight loss or a permanent resolution, in the same way no one can guarantee you will never have a heart attack.

Nearly every patient we see has fought the battle of weight loss and regain for years. Some have lost and regained hundreds of pounds over a lifetime. Weight regain is natural, and it is a strong instinctual mandate. Your fat cells, your bones, and even various protein chemical messengers and enzymes can push your weight back up.

We treat obesity no differently than any other chronic disease, such as diabetes, hypertension, or congestive heart failure. That means long-term medication therapy and continual adjustment of that therapy as the body changes are central to good care. Alongside this, there is enormous value in understanding how our psychological and social lives contribute to weight, and in steadily supporting each patient with eating and lifestyle changes that keep them in the healthiest condition possible.

No. GMOS Clinic is a direct-care membership practice. Not billing insurance is what lets us spend real time with every patient, instead of fitting care around what a plan will pay for.

You can pay with an FSA or HSA account, CareCredit, cash, check or any major credit card. See Membership for the programs and pricing.

No single number decides it. BMI is an imperfect measure of the health risks that come with weight: depending on your age, sex, history and ethnicity, you can have a “normal” or overweight BMI and still have metabolic disease.

That is why new patients start with a brief, free consult. We review your medical and weight history and help you choose the right program. We welcome anyone starting or continuing GLP-⁠1 therapy, and anyone who has regained weight after surgery or earlier treatment.

Yes, once you are started. Your first 2–3 visits are in the office for testing and training. After that, many visits can be virtual, unless you need testing or training on site. Maintenance members come in every 2–3 months.