Packet - Dr. Fortino

Philadelphia & South Jersey’s Premier Weight Loss Physician, Dr. Robert Fortino
1913 South Broad Street Philadelphia, PA 19148 215.336.8000
129 Johnson Road A3 Turnersville, NJ 08012 856.318.4100
www.drfortino.com
Welcome, whether you want to lose weight or maintain your current weight, Dr.
Robert Fortino can help. Dr. Fortino’s accelerated results program advocates a
comprehensive, multi-faceted approach to the treatment of obesity that includes
medical assessment and monitoring, as well as behavioral and dietary counseling,
exercise, and at the physician’s discretion pharmacotherapy. Our goal is to guide
you on your way to a lifelong, healthier weight. We will work with each patient
individually to customize a program consisting of any or all of the following:
1. Appropriate eating guidelines – not a fad diet
2. Medication
3. Correct Vitamins and Supplements
4. Exercise recommendations according to your needs
5. Lab work, if necessary
6. Ongoing communications and monitoring
7. Success through Maintenance!
The weight reduction plans that we have found to be most successful are high in
protein, low in carbohydrates, and low in fat. A high protein diet will maintain lean
body mass (muscle, bone, organs). Preserving lean body mass will result in a higher
metabolic rate, which will enable you to burn fat more rapidly. Eating smaller meals
that are more frequent will replenish your body’s immediate energy needs
What’s Important Now: The key is to get started. Why not set your first goal to
be 10 pounds. Reward yourself (in a non-food way) when you meet those goals.
Reaching small goals along the way is much easier than struggling to meet the final
goal. After all, it is important to realize and accept early on in your weight loss
journey that few of us can meet and permanently maintain our ideal weight.
Instead, focus on improving your health and well-being. Reaching your healthy
weight will be a pleasant side effect.
When your body uses more calories than you consume, you will lose weight.
Exercise builds muscle and muscle burns more calories. Exercise also increases your
body’s metabolism, which allows you to burn stored body fat. Exercise during a
weight reduction program or maintenance program is necessary. However, when
you are overweight, it is more difficult to exercise. You do not want to do anything
that could cause injury to yourself. Therefore, I strongly recommend that you
exercise at your own comfort level. Aim to be physically active every day. Keep in
mind that exercise will improve your muscle tone and your cardiovascular system.
Regular exercise can lower your blood cholesterol and triglyceride levels, which will
reduce other risk factors for disease.
Water:
Maintaining a good fluid balance will help: support your weight loss and
reduce the risk of cramps or heat exhaustion, maintain a proper balance of
electrolytes, allow for proper digestion and help control appetite. Keep your body
well hydrated. Drink at least 8-10 glasses of water, club soda, or seltzer daily.
Remember, dehydration has an adverse effect on muscle strength, endurance and
coordination. Do not drink more than two (8-ounce) glasses of sugar free or caffeine
free sodas per day due to their high salt content. Decaffeinated beverages are
preferred. Avoid alcoholic beverages.
Preparing Foods: Steaming, baking, grilling, boiling, or poaching foods is
preferred. No cooking oils should be used except for light cooking sprays such as
PAM. No salt or salt substitutes; instead, try garlic powder, pepper, onion powder,
catsup (1tsp), horseradish, mustard, vinegar, low calorie mayonnaise, etc.
Philadelphia & South Jersey’s Premier Weight Loss Physician, Dr. Robert Fortino
1913 South Broad Street Philadelphia, PA 19148 215.336.8000
129 Johnson Road A3 Turnersville, NJ 08012 856.318.4100
www.drfortino.com
Aerobic Exercise: Begin by always using the stairs and walking outside or on a
treadmill for 10 or 15 minutes everyday. Remember to stretch before and after
walking to reduce injury. You should see a gradual improvement along with
increased stamina. Other types of aerobic exercise include swimming, jogging,
bicycling, stair stepper, rollerblading, and rowing. Remember to begin slowly and
gradually increase your pace and time.
Anaerobic Exercise: Ask us about a personal trainer/gym.
This type of exercise involves lifting lightweights to improve muscle tone. It is
important to use lightweights with frequent repetitions rather than heavy weight
lifting.
Use of Appetite Suppressants / Other Medications
Medication: The purpose of appetite suppressants is to reduce your hunger drive.
The reduction in hunger can help to resist physiological and psychological pressures
to eat. All appetite suppressants have side effects such as irritability, rapid heart
beat, insomnia, dry mouth and drowsiness. The proper selection of appetite
suppressants as well as the lowest dosage possible that will give good appetite
suppression will be given.
If you develop bother some side effects, another method of appetite control will be
considered. All patients who are taking appetite suppressants are monitored closely.
Consult with your doctor if you think you are pregnant or before breast-feeding.
Avoid stimulant drugs that may cause an increase in heart rate such as
decongestants or caffeine.
Notify the Physician of all medications that you are currently taking, both
prescribed by your family doctor and purchased over the counter.
Blood and urine screening studies: If necessary, these studies may be done at a
laboratory or medical office of your own choosing. In many instances, this fee may
be covered by your own medical insurance.
Jump Start Program
only…
$99.00
New Patient Examination/Consultation with Physician: The first visit begins
with a physician consultation, which will include your medical and weight history,
evaluation of your health and diet, and a thorough explanation of our program.
At each follow-up visit you will be weighed, blood pressure screened, food diary
reviewed, medication adjusted, and any medical or non-medical challenges that
you have encountered will be discussed and managed.
• Lipotropic plus B-12 Diet Injection
• 30 Multivitamins (1 month supply)
14 day supply Appetite Suppressant Medication
We apply only the safest and most effective prescription and non-prescription
appetite suppressants and dietary supplements available.
Purchase Medication only: One Week (7 day) supply medication $30
Two Week (14 day) supply medication $60
One Month (28 day) supply medication $120
Two Month(56 day) supply medication $240
Philadelphia & South Jersey’s Premier Weight Loss Physician, Dr. Robert Fortino
1913 South Broad Street Philadelphia, PA 19148 215.336.8000
129 Johnson Road A3 Turnersville, NJ 08012 856.318.4100
www.drfortino.com
Lipotropic Injection: The B12 Lipotropic Injections help boost your metabolism
and keep your energy high. The injections include the following naturally occurring
vitamins, amino acids and minerals:
•
Methionine – This is a sulfur-containing amino acid that increases your
metabolism and energy level, neutralizes free radicals, aids in breaking down
fat, removing heavy metals from the body, and helps with digestion. It is one
of the important amino acids that increase energy and lean muscle mass.
•
Inositol – A vitamin that is vital for metabolism of fat and cholesterol. It
prevents hardening of the arteries; it has also been shown to help in the
treatment of depression and anxiety.
•
Choline – Plays a major role in cardiovascular health, in addition to
minimizing excess fat in the liver through its fat and cholesterol metabolic
properties. It aids in hormone production.
•
Vitamin B12 – Important vitamin that helps in formation of red blood cells ,
utilization of iron, and also in preventing anemia. It is an important
component of the body because it is required for proper digestion, absorption
and synthesis of foods, protein synthesis, and the metabolism of
carbohydrates and fats. Vitamin B12 is also necessary for a healthy nervous
system.
Who is qualified to get the injections?
In order to receive B12 Lipotropic injections, you must be an established patient and
must have an initial visit with the doctor. If you have sulfur allergy, our physician will
give you B12 injection alone.
How often can I get the injections?
You can get the B12 Lipotropic injections as often as twice per week.
How much do the injections cost?
If you are already participating in one of our diet programs, then your injections will
cost $25 each.
How much weight will I lose while taking the Vitamin B12 Lipotropic
injections?
The injections will not cause weight loss alone. You must follow a healthy diet and
exercise program in order to see and feel the benefits of the injection. When our
patients follow our diet plans, they end up losing anywhere between one to 3 pounds
per week on the B12 Lipotropic injection program. It varies per patient.
Dr. Robert Fortino’s Lipotropic Slim & Oral Drops TM
“The Lipo Shot In Drop Form” Lipotropic nutrients are compounds that enhance liver
function and increase the flow of fats and bile from the liver and gallbladder. By
definition, a lipotropic substance decreases the deposit, or speeds up the removal of
fat (lipo=fat, tropic=stimulate) within the liver. Burn fat with lipotropic. Each 6 drops
contain essential vitamins and amino acids to enhance the fat burning / metabolism
process. Directions: Place 3 drops under the tongue, hold for 30 seconds and
repeat.
Philadelphia & South Jersey’s Premier Weight Loss Physician, Dr. Robert Fortino
1913 South Broad Street Philadelphia, PA 19148 215.336.8000
129 Johnson Road A3 Turnersville, NJ 08012 856.318.4100
www.drfortino.com
Hormone Therapies
Sermorelin:
Sermorelin is an alternative to Human Growth Hormone, (HGH). It is a shortened
analog of growth hormone releasing hormone, (GHRH), consisting of the first 29
amino acids of natural GHRH. It is also known as Growth Hormone Releasing Factor,
GHF 1-29NH2. Sermorelin stimulates the pituitary gland to produce and secrete its
own HGH without the effects of overstimulation that can occur with HGH
administration. Sermorelin provides the benefits of HGH on body composition with a
decrease in fat mass and an increase in lean body mass. It can also help sustain
pituitary health and opposes the loss of activity of the endocrine system that
normally occurs during aging. Sermorelin is given at bedtime as sublingual drops or
by subcutaneous injection. There are minimal side effects due to the very short halflife of the supplement. Recommended doses range from 200 micrograms to 500
micrograms at nighttime.
HCG:
Human Chorionic Gonadotropin is a hormone produce by the components of a
fertilized egg, the syncytiotrophoblast. This develops into the placenta during
pregnancy. Luteinizing Hormone, (LH), is the “cousin” hormone of HCG. It is
produced by both males and females in the pituitary gland. In females, HCG
promotes the maintenance of the “corpus luteum” which develops from an ovarian
follicle in the early part of the menstrual cycle. It makes the hormones
progesterone, estradiol, and Inhibin A hormones. The corpus luteum is needed to
maintain pregnancy. When fertilization does not occur, the corpus luteum stops
secreting progesterone and decays. The natural menstrual cycle follows. Since HCG
and LH are very similar in structure, HCG will aid in the maintenance of pregnancy,
with more secretion of Progesterone to give the developing fetus the proper nutrients
for further growth and maturation. HCG can also be used to induce puberty in
children who may have delayed development, induce ovulation in women, and to
increase testosterone production in men who may have low testosterone levels and
fertility issues. With the resurgence of HCG recently, with its promotion in weight
loss, there are no studies to date that have shown that it causes changes in body fat
tissue. The side effects that have been reported in the literature include testicular
tumors, ovarian hyper stimulation, ovarian enlargement, acites, pleural effusions,
rupture of ovarian cysts, multiple births, and thromboembolism. The general dose
associated with these side effects probably varied. The dosing used in the popular
“HCG Diet” is about 125-250 International Units daily. This dosing regimen is very
small compared to the dosing regimen required for treating infertility and delayed
puberty.
Growth Hormone:
Human Growth Hormone, (HGH), is produced by the pituitary gland through
stimulation of the hypothalamus. The hypothalamus signals the pituitary to secrete
HGH via GHRH. There are many different hormone stimulants for growth hormone.
One hormone is called “Ghrelin”. This is made in the stomach, and is an important
nutritional regulator of HGH. It acts to maintain blood sugar levels during starvation
periods. Insulin-like Growth Factor- 1, IGF-1, is responsible for the peripheral
actions of HGH. Growth Hormone secretion is stimulated by fasting and high protein
meals. High blood sugars inhibit HGH secretion. Estrogen, Dopamine, and certain
drugs like alpha-adrenergic agonists, like clonidine, beta-adrenergic antagonists, and
niacin, (Vitamin B3), also are a stimulus of HGH. There is a substantial decline in
Philadelphia & South Jersey’s Premier Weight Loss Physician, Dr. Robert Fortino
1913 South Broad Street Philadelphia, PA 19148 215.336.8000
129 Johnson Road A3 Turnersville, NJ 08012 856.318.4100
www.drfortino.com
HGH production with the natural aging process. By age 55 years, GH declines to
about one sixth the amount from puberty. Growth Hormone is secreted in a pulsatile
manner throughout the day. There are about ten pulses throughout the day. The
nighttime levels are about twice as much as the morning. Growth Hormone is lower
overall in the elderly and obese. Peak Growth Hormone secretion occurs within an
hour after the onset of deep sleep. Other factors that increase Growth Hormone
secretion are exercise and physical activity. Growth Hormone causes an increase in
lipolysis and lipid oxidation, protein synthesis, antagonism of insulin’s actions, and
phosphate, water and sodium retention through IGF-1 secretion. GH is responsible
for cell growth and regeneration. It is important for bone strength, increasing lean
muscle mass, and promoting the loss of fat in the body. Growth Hormone is used to
treat children with short stature that have GH deficiency. It is given to enhance
vitality and is known as the “Anti-Aging Hormone”. There are several ways to
increase GH secretion. These include adhering to a high protein diet, physical
exercise, and of course, pharmacologic therapy. Growth Hormone is now made
through recombinant technology, and is taken by injection on a daily basis. There
are also homeopathic forms that come in the form of a sublingual spray that
stimulate Growth Hormone release.
Testosterone:
Testosterone supplementation is effective in treating males with hypogonadism. This
is the clinical condition in which low levels of testosterone are found in association
with a few specific signs and symptoms. Typically, a man with hypogonadism may
complain about diminished libido, erectile dysfunction, sexual difficulties, decrease in
muscle mass with an increase in fat mass. Also, there could be associated
depression or mood change, fatigue, difficulty concentrating, sleep disruption,
anemia, reduced bone mass and a decreased sense of vitality. This can be part of
the natural aging process. Hypogonadism affects an estimated 2 to 4 million men in
the United States and it generally increases with age. It is estimated that only 5
percent of men currently receive treatment. Testosterone treatment can be
controversial due to the issue of risks that are thought to be associated with
testosterone therapy. Testosterone therapy has been proven to show benefits in
hypogonadism, and most men show significant improvement in the quality of life
with therapy. With the proper lifestyle and diet most men undergoing testosterone
replacement show significant improvement in sexual performance, weight
management and overall well being. Risks of testosterone replacement have been
studied over many years. Studies have shown that testosterone therapy in the
hypogonadal male does not pose a risk to coronary artery disease, higher cholesterol
profiles, or liver disease. With proper follow-up and monitoring, testosterone
therapy is safe and effective. Testosterone therapy would contra-indicated in any
male with prostate cancer, and initial evaluation should include a PSA level before
initiation of therapy. Typical forms of replacement therapy are intramuscular
injections of testosterone, transdermal patches, gels and creams. The intramuscular
injection is the most cost effective form of treatment. It is generally given once a
week at a dose of 100mg. Peak serum levels occur in 2 to 5 days and generally
return to baseline in 10 to 14 days. Levels of hormones are generally checked within
2 months of starting therapy. Treatment can be tapered to blood levels and patient’s
clinical improvement
Philadelphia & South Jersey’s Premier Weight Loss Physician, Dr. Robert Fortino
1913 South Broad Street Philadelphia, PA 19148 215.336.8000
129 Johnson Road A3 Turnersville, NJ 08012 856.318.4100
www.drfortino.com
Dr. Robert Fortino is proud to offer the newest LIPO SCULPTING LASER,
ILLUMIWAVE 635 for optimal non invasive body slimming and
contouring. Our office offers a no charge consultation to discuss your
individual questions regarding the ILLUMIWAVE 635 TREATMENT.
Please call our office 215 336 8000 to schedule your
evaluation/consultation.
Many individuals hesitate to contour and sculpt their bodies with conventional methods. The
illumiWave635 lipo contour head offers a painless and non-invasive laser treatment
solution to contour and sculpt individual trouble areas anywhere on the body, reduce
cellulite, and improve overall appearance. Results are quickly noticeable and
measurable with no strict regimen.
IllumiWave 635 Benefits
• Non-invasive procedure, painless, no down-time
• No bruising or scarring, little risk of tissue damage
• 89 red line collimated laser diodes, 635nm wavelengths
• Targets stubborn areas of body fat
• Contours the body and reduces cellulite
• Patients can see measurable results after only 1-2 treatments
• Patients can expect a standard loss of 3-4 inches during 4-6 weeks of
treatments and can treat TWO BODY areas in one session!
• No adverse side effects
• After one treatment, ultrasound images show up to 30% reduction in
the fat layer depth
Illumiwave 635 LipoContour Laser treatments are 20 to 40
minutes long and the protocol is three treatments per week for 4
weeks. Results are noticeable after only one to two treatments and
you can expect a standard loss of three to four inches overall after four
to six weeks. In short, give us 40 minutes three times a week and lose
3-4 inches in 4 weeks. A total of 12 treatment sessions is all that you
need! We will customize your treatment plan to fit your schedule.
Overview of Adipose Tissue:
Fat, or adipose tissue, can be found in several places in the body. Typically, areas in
need of body contouring are different between men and women, due to the
hormones estrogen and testosterone. Men typically carry excess body mass in the
chest, abdomen, and buttocks. Women typically carry excess body mass in the
breasts, hips, waist, and buttocks.
Philadelphia & South Jersey’s Premier Weight Loss Physician, Dr. Robert Fortino
1913 South Broad Street Philadelphia, PA 19148 215.336.8000
129 Johnson Road A3 Turnersville, NJ 08012 856.318.4100
www.drfortino.com