Physician-led · assessment first
Medical weight management
A programme for people whose weight is affecting their health, built on an assessment by a physician, bloodwork, and a plan you can keep up. Medication can be part of it where it is appropriate. It is never the whole of it.
- Minute assessment
- 60
- Before any prescription
- Labs
- Follow-up
- Ongoing
What it is
Obesity is a chronic medical condition with biological, genetic and environmental causes. It is not a failure of willpower, and it rarely responds to willpower alone. It also matters for health — blood pressure, blood sugar, sleep apnoea, fatty liver and joint pain all tend to improve with a modest, sustained loss — which is why it is treated as a medical question here rather than a cosmetic one.
The programme at our North Vancouver clinic starts with an assessment: your weight history and what you have already tried, medications that can cause weight gain, sleep, mood and eating patterns, measurements and bloodwork. From that comes a plan built on eating, activity, sleep and the habits that make them stick. Where it is appropriate, prescription treatment is discussed as one part of the plan — its likely effects, its side effects and its costs — and it is never offered on its own.
We do not quote a target weight before the assessment, and we do not name or promote medications on this website. Follow-up is part of the programme rather than an extra: weight that comes off without a plan for keeping it off tends to come back.
Treated as health, not appearance
The question is what your weight is doing to your blood pressure, blood sugar, sleep and joints — and what would help.
The whole history first
What you have tried, what you take, how you sleep and how you eat, before anything is suggested.
Medication only as part of a plan
Where it is appropriate, with its side effects and costs explained. Never on its own, and never from a web form.
Follow-up built in
Regular reviews to adjust the plan, watch for side effects and prepare for what comes after.
What gets checked first
Some weight gain has a cause that can be found and treated. The assessment looks for it before a programme is designed.
- An underactive thyroid
- Medications that commonly cause weight gain, including some used for mood, diabetes, epilepsy and inflammation
- Sleep apnoea and short sleep
- Polycystic ovary syndrome, and the hormonal changes of menopause
- Binge eating and other eating disorders, which need their own care first
Usually a good fit
- A body mass index (BMI) of 30 or more, or of 27 or more with a weight-related condition such as high blood pressure, prediabetes or type 2 diabetes, sleep apnoea or fatty liver
- You have made structured changes to eating and activity, and the weight has not come off or has not stayed off
- You are ready for a programme with regular follow-up, not a single appointment
- You want a plan that looks at your health as a whole
Usually not
- Pregnancy, breastfeeding, or planning a pregnancy soon
- A current or recent eating disorder — that needs its own care first, and we will help you find it
- Your weight is already in a healthy range and the goal is appearance — a medical programme is the wrong tool
- You want medication without the rest of the programme
- A personal or family history that rules out certain medications, such as some thyroid cancers or pancreatitis — though the rest of the programme may still help
Before
- Write down your weight history, roughly — when it changed and what you tried
- Bring a list of every medication and supplement you take
- Bring recent bloodwork if you have it
- A few days of notes on what and when you eat is useful, but not required
- Wear something comfortable; weight, waist and blood pressure are measured at the visit
The assessment
- 01HistoryYour weight over the years, what you have tried, your medications, sleep, mood and eating patterns.
- 02MeasurementsWeight, waist and blood pressure — the starting point the programme is measured against.
- 03BloodworkBlood sugar, cholesterol, liver, kidney and thyroid tests, and others as your history suggests.
- 04A written planEating, activity, sleep and follow-up; whether prescription treatment is reasonable for you; and what each part would cost.
During the programme
- Regular follow-up — more often at the start — to review progress, side effects and the plan
- Repeat bloodwork at intervals, depending on your results and any treatment
- The plan changes as you do; if something is not working or not tolerable, it is changed
- A plan for maintenance before the active phase ends — this is where most regain happens
- If a lot of weight is lost, loose skin can follow; that is a separate conversation, and not one to have in advance
What can go wrong
The risks depend on what the plan includes. Changes to eating and activity carry few; prescription treatment carries more, and they are explained against your own history before anything is started.
- Nausea, constipation, diarrhoea and reflux with some medications, most common when a dose is started or increased
- Rarely, inflammation of the pancreas or gallbladder problems — which is why new abdominal pain is always reported
- Loss of muscle as well as fat, if protein intake and activity are not kept up
- Weight regain after medication is stopped, which is common and is planned for rather than ignored
- Cost: prescription treatment is often not covered by public plans, and coverage by extended health plans varies
Questions we get
How much weight will I lose?
We do not quote a figure before the assessment, and we do not promise one after it. How much changes depends on your starting point, your health, the plan you agree to and how well it fits your life. What we can do is set expectations that are realistic for you and revisit them at every follow-up.
Will I be prescribed an injection?
Not necessarily. Some people are prescribed medication as part of the programme — some of it by injection — where it is appropriate for them. Whether that applies to you, and which option, is decided at the assessment. We do not name or promote specific medications on this website.
What happens when I stop the medication?
Weight often returns after weight-loss medication is stopped. The programme plans for that from the start: the habits built along the way, and a maintenance plan, decide how much stays off.
Is this the same as body contouring?
No. Contouring changes the shape of a small area in someone already near a stable weight; it does not change weight. If overall weight is the question, contouring is the wrong tool — and if one pocket of fat is the question, this programme is the wrong tool.
I have tried everything. Why would this be different?
It may not be, and if that is the case we will say so. What differs is the starting point: a medical assessment that looks for causes, a plan built around your life, and follow-up that adjusts it — rather than another diet.
Is it covered by MSP or insurance?
The programme here is self-pay; this clinic does not bill MSP. Prescription costs are separate — some extended health plans cover part of them, particularly where there is a diagnosis such as type 2 diabetes. Check your plan before you start.
Request an assessment
Request an assessmentWho does this
Assessment, prescribing and follow-up for these programmes are by a licensed physician in British Columbia, at the Lonsdale Avenue clinic in North Vancouver. Nothing is prescribed without an assessment. Who the physician is, and who else you will meet, is on the team page.
Other programmes here
Everything listed here is offered at the Lonsdale Avenue address in North Vancouver. Names, durations and prices come from the clinic’s live schedule rather than from this page, so what you see is what is bookable today.
- Hormone Replacement Therapy (HRT) ConsultationPhysician assessment first
- Testosterone Replacement Therapy (TRT) ConsultationPhysician assessment first
Other places people start
These are sorted by what is bothering you rather than by treatment name. Each page says what actually helps, what does not, and when the honest answer is that nothing here is needed.
- Loose Skin After Weight LossLosing the weight is the hard part and you have done it. What is left is usually a skin problem rather than a fat problem, and those have completely different answers.
- Fatigue & Low EnergyThis is the concern where we are least likely to sell you anything, and we would rather say that at the top of the page than at the end of a consultation.
- Dullness & Uneven ToneDullness and dehydration are a texture problem, not a shape problem. That distinction decides which half of the menu is even relevant.
- Volume Loss & HollowsVolume loss is the change people describe as looking tired or gaunt without being able to name a line. It is also the one where over-treatment is most visible from across a room.
- Forehead & Frown LinesForehead and frown lines are muscle before they are skin. The question that decides your result is not the dose — it is whether the line is still only there when you move.
- Hooded Upper LidsThe line where this stops being an injectable question and becomes a surgical one is unusually clear, and you are entitled to be told which side of it you are on.
- Jawline & Contour LossThe most common reason people book here, and the one where the honest answer changes most with age. In your forties a device usually does it. In your sixties it usually does not.
- Nasolabial FoldsNasolabial folds are usually a symptom. Filling the fold itself is the most common way to end up looking heavy in the lower face.
- Stubborn Body FatA pocket that stays the same size while the rest of you changes. Usually the flanks, the lower abdomen, or under the chin. The useful question is not which machine to use — it is whether what you are looking at is fat at all.
- Under-Eye Hollows & ShadowsThe most common request here, and the one where the answer is most often no. Under-eye shadow has at least four causes and filler helps exactly one of them.