General Information: Please note that we do not accept insurance and all fees must be paid up front.

Contraindications to Medical Weight Loss:

Pregnancy or the attempting to become pregnant

Routine alcohol use more than 2 drinks per day

Breast feeding

Medical conditions: such as type 1 Diabetes (unsafe to enter ketosis with Ideal Protein), congestive heart failure, uncontrolled hypertension, epilepsy

Certain medications may be a relative contraindication (especially if you have diabetes- may need to do adjustments before starting)

Any serious life illness-may need to discuss with doctor

Some of the Causes Leading to the Obesity Epidemic

  • Genetic factors (twin studies)
  • Socioeconomic conditions
  • Poor eating habits with incorrect choices
  • Incorrect guidelines supported by the food industry
  • Medications
  • Poor sleep
  • Lack of good facilities/environment conducive to weight loss
  • Medical conditions predisposing to obesity (such as insulin resistance/thyroid)
  • Excessive hunger caused by poor eating habits
  • Behavior, emotional, and psychiatric illness possibly caused by chemical imbalances
  • Hormonal changes

In the last couple decades there has been much research into the complicated causes, associations, and treatments of obesity. Now more than ever, you have a good chance of finally overcoming, or at least manage this pernicious condition we know as obesity.

Today what is known is that over 70% of the USA population is considered overweight. Based on BMI guidelines ( BMI > 30), around 40% of the population is obese. With that comes common conditions as listed below:

  • Prediabetes/Diabetes
  • Coronary Artery Disease
  • Increase risk of many cancers
  • Arthritic conditions
  • Non-alcoholic fatty liver disease and cirrhosis (the new epidemic)
  • Emotional problems such as depression, anxiety, and sleep disorders
  • Obstructive Sleep apnea
  • Hypertension
  • High cholesterol

Obesity is now the second leading cause of preventable deaths in America. Although many factors can contribute to becoming overweight, there is just one generally accepted, effective approach to weight control. Bariatric physicians understand that overweight conditions are medical problems and should be treated with methods of weight control that are both practical and effective.


We use a commercial weight loss program called Ideal Protein. It has been studied (Tulane Study) against the low-fat low cholesterol diet and after 3 months, the average weight loss was 17.8 pounds vs 3.5 pounds. What makes this a highly effective program is the flexibility and structure it provides with the use of an IP app that makes it very easy to journal your intake. There are several food options available tailored to your taste. And the price is similar to what you would normally pay at home. You will be provided a coach who meets with you on a routine basis to take many measurements including bio-impedance measurements, evaluate your progress, and give you evidenced based advice and encouragement.

Although medications are frequently prescribed by weight loss doctors, the ideal protein protocol does not cause much increase in appetite and therefore medications are usually not necessary.

This weight loss plan is particularly effective for people with prediabetes or diabetes as it is a low carbohydrate diet. In fact, if you have prediabetes or diabetes, weight loss with a low carbohydrate diet may be the ONLY effective way to manage your prediabetes or diabetes. For diabetes, it is not a "cure" because if you regain the weight, the condition will inexorably return.

Ideal Protein - Ideal Living Program at Avera Medical Group Integrative Medicine

With Prolon 5 day Fasting Mimicking Diet:

Join the health trend of fasting with food™.

Consultation with Dr. Guy

With or without the use of ideal protein

A consultation with the doctor is highly recommended. Although as long as the health profile is filled out correctly, you do not need to see the doctor if you choose to go the Ideal Protein program. if the coach has any questions, she will bring it to the doctor's attention. If it is of a medical opinion that you are not a candidate for Ideal Protein, or if you are having any undo trouble or complications, the doctor may decide to Cancel the Ideal Protein Program. In that case, if you wished to continue to have medical assisted weight loss, you would need a consult with the physician.

Dr Guy believes that each element in his four-pronged, multidisciplinary approach (behavioral modification, nutritional counseling, medicine, and exercise) is necessary for successful weight loss and weight loss maintenance.

On your first visit, in addition to a comprehensive medical exam and thorough behavioral assessment, Dr. Guy may perform an EKG, order laboratory if not already done, and perform anthropometric measurements to determine how much weight you should lose and how quickly you should lose it, based on a specific, calorically controlled diet. He then discusses a plan that includes a food-based diet, partial meal replacements, or full meal replacements.

He uses medications that are approved by the FDA and the American Board of Obesity medicine. Part of the plan may include a consultation with a cardiologist, endocrinologist, bariatric surgeon, nutritionist, exercise therapist, psychologist, eating disorder specialist, and more. If you have an eating disorder, there are medications that are useful.

Treating Behavior

Treating the behavioral element that compels the eating is critical. Research shows that past childhood events often form the psychological foundation that drives an individual's present eating patterns. Many obese and overweight individuals have a history of different forms of abuse, which leads to unhealthy coping methods through food. Some are binge eaters, night eaters, and some purge. Many are depressed.

As Dr. Guy explains, these issues must be handled delicately on a one-to-one basis. "We provide each patient with the emotional respect and support they deserve. I can treat their depression with medications that may not be conducive to weight gain, for example. My staff can then work with them to develop strategies to modify their bad habits."

Finding Medical Causes

Most of Dr Guy's patients have medical causes behind their obesity or overweight condition. Metabolic syndrome, Polycystic Ovary syndrome, insulin resistance, and occasionally hypothyroidism are a few of the diseases she sees in her office that frequently go undiagnosed and often contribute to weight gain.

Sometimes, weight gain is related to medications. "It is unfortunate that many medications used to treat depression, hypertension, diabetes and menstrual irregularities can cause weight gain. Instead of treating the problem, we are contributing and worsening it," he commented. "There are, however, safe, effective and very useful alternatives that should be considered."