Our 4 Pillar Approach to treatment

The AOTA 4-Pillar Approach is used by our medical center as the treatment protocols. The treatment is carried out by multi-disiplined staff of Medical Doctors, Registered Nurses, Behavior Physiologists, Nutritionists and Physical trainers.

The 4 pillars consist of Dietary Therapy developed for the patient’s metabolic needs by the nutritionist. The next pillar is Behavior therapy which is used to change the way the patient behaviors towards food. The Third Pillar is Physical Activity in which the patient is evaluated by a Physical trainer with experience in weight management. The fourth pillar is Natural Supplements or Drug Therapy. AOTA believes in first trying natural supplements which have less adverse effects and are generally less expensive. Only after medical observance notices that natural supplements are not have the desired effects on the patient will the patient start a drug therapy.

Dietary Therapy

• Dietary therapy involves instruction on how to adjust a diet to reduce the number of calories eaten.
• Reducing calories moderately is essential to achieve a slow but steady weight loss, which is also important for maintenance of weight loss.
• Strategies of dietary therapy include teaching about calorie content of different foods, food composition (fats, carbohydrates, and proteins), reading nutrition labels, types of foods to buy, and how to prepare foods.
• Some diets for weight loss include low-calorie, very-low calorie, and low-fat.

Behavior Therapy

• Behavior therapy involves changing diet and physical activity patterns and habits to new behaviors that promote weight loss.
• Behavioral therapy strategies for weight loss and maintenance include:
  • Recording diet and exercise patterns in a diary.
  • Identifying high-risk situations (such as having high-calorie foods in the house), and consciously avoiding them.
  • Rewarding specific actions, such as exercising for a longer time or eating less of a certain type of food.
  • Changing unrealistic goals and false beliefs about weight loss and body image to realistic and positive ones.
  • Developing a social support network (family, friends or colleagues) or joining a support group that can encourage weight loss in a positive and motivating manner.

Physical Activity

• A decrease in the amount of daily activity related to work, transportation and personal chores is believed to contribute to the high percentage of overweight and obesity today.
• Moderate physical activity, progressing to 30 minutes or more on most or preferably all days of the week is recommended for weight loss.
• Physical activity is reported to be a key part of maintaining weight loss.
• Abdominal fat, and in some cases waist circumference can be modestly reduced through physical activity.
• Strategies of physical activity include: the use of aerobic exercise (such as aerobic dancing, brisk walking, jogging, cycling, and swimming), beginning slowly and gradually increasing intensity, and selecting enjoyable activities that can be scheduled into a regular routine.

• Drug therapy is recommended as a treatment option for persons with: 1) a Body Mass Index (BMI) > 30 with no obesity-related conditions or 2) a BMI of > 27 with two or more obesity-related conditions.
• Drug treatment should be used with appropriate lifestyle modifications.
• Drug therapy may be used for weight loss and weight maintenance.
• Therapy using Bio-Slender a natural supplement which acts a appetite suppressant is first given to the patient.
• Patients should be regularly assessed to determine the effect and continuing safety of a Bio-Slender and if the expected results are not reached after a period of 2-3 months should the patient look at other drug therapies.
• Three weight loss drugs, approved by the US Food and Drug Administration (FDA) for treating obesity, are Orlistat (Xenical), Phentermine, and Sibutramine (Meridia).

1. Orlistat works by blocking about 30 percent of dietary fat from being absorbed, and is the most recently approved weight loss drug.
2. Phentermine, an appetite suppressant, has been available for many years. It is half of the “fen-phen” combination that remains available for use. The use of phentermine alone has not been associated with the adverse health effects of the fenfluramine-phentermine combination.
3. Sibutramine is approved for long-term use, and works to control eating by sending a signal of fullness (satiety) to the brain. But has recently be banned in Europe because of CV problems in patients. Other articles on the ban.

• A combination of a diet (with lower calories) and increased physical activity is reported to produce more weight loss than diet alone or physical activity alone.
• A combination of behavior therapy and drug therapy could prove to be an effective treatment for obesity.
• Drug therapy appears to assist in the adherence to dietary therapy (low-fat, low-calorie diet), and may improve maintenance of weight loss.