Dear Patients, I am pleased to announce that we are now accepting new patients into our medically supervised weight loss program. My goal is to not only help individuals lose weight but to develop sustainable lifestyle changes through the use of medications, healthy nutrition, and exercise. Dr. Emrani's Medically Supervised Weight Loss Program* is tailored toward patients who have more than 25 pounds or more than 15% of their body weight to lose. This program is not meant to be for those who want to lose 5 or 10 pounds for an upcoming event, nor is it aimed at those who wish to have better aesthetics. Ours is a medically intensive weight loss program meant to be used in lieu of or in conjunction with bariatric surgery. Toward this goal, we use several FDA-approved medications backed by stringent science that have demonstrated success in individuals looking to lose a significant amount of weight. While these medications are effective, they are to be used in conjunction with proper lifestyle modifications. As part of this process, we obtain a full medical history and assess individual risks for diabetes, heart disease, stroke, sleep apnea, and arthritis. We obtain a full set of blood tests to ensure that we have a complete picture of your hormones, vitamins, cholesterol, insulin, and metabolic health. Through in-depth medical evaluations, we will look to identify any potential markers that are preventing you from losing weight, such as insulin resistance, inflammation, thyroid diseases, low estrogen or testosterone levels, polycystic ovary syndrome, menopause, etc…We obtain a history of your previous diet attempts to figure out your particular challenges, what worked, and what failed. We also probe potential psychosocial causes of your weight gain. After this process is complete, we tailor a medical regimen to be used for you and tweak it over time based on how your body responds. Based on your personal medical history, we plan to create an individualized, sustainable, long-term weight loss plan. With the understanding that there are many challenges to weight loss, we will work together to overcome such obstacles in a manner most fitting to your lifestyle. There is not a “one size fits all” approach to weight loss. We understand that weight is affected by many factors: genetics, environment, culture, behavior, and metabolism. Here are a few of the most commonly overlooked challenges to weight loss that we will help you monitor and address: Poor sleep hygiene. Not getting a proper amount of night's sleep disrupts the balance of hunger-related hormones in the body, as well as the body's ability to metabolize sugar, insulin, and fat. Untreated anxiety. Chronic stress can result in the release of the hormone cortisol, which helps the body hang onto stubborn fat. Individuals with anxiety often resort to unhealthy behaviors such as binge eating or eating when not hungry to soothe anxiety. Over-exercising. Too much exercise or the wrong kind of exercise can, unfortunately, be deleterious to your weight loss progress. Oftentimes, high levels of rigorous activity lead to a larger appetite and consuming excess calories. What you eat. You cannot lose weight if you eat a large watermelon every day or frequently eat at fast-food restaurants! When you eat. You cannot lose weight if you snack at midnight. How much do you eat? We will help you manage your appetite and control your portions so that you can reprogram your brain and your stomach. Water. Water breaks fat. You have to drink plenty of water. Hidden calories. You cannot drink calories! Alcohol. No alcohol. Sorry, but this is a big deal. You cannot lose weight if you drink alcohol. Throughout this journey, we hope to supervise the progress of your weight loss through periodic physician visits, telemedicine follow-ups, regular blood draws, and periodic EKG and body-fat composition tests. Dr. Emrani will be available to you via email as often as needed to support your progress toward health. At this time, I may help manage a number of patients in California via telemedicine only. But, I cannot take care of patients who are out of state. Over the years, many of my patients have lost 50- 100 pounds using the protocols that I have honed. We look forward to guiding you through this important chapter and journey in your life. Please contact our front office at (818) 996-4100 to make your appointment. Please read the message I shared with my social media followers: "Today, I received a call from a 38-year-old mother ecstatic that she lost 22 pounds since using my weight loss program. She had always been in great shape all her life. She exercised. Tried multiple diets. Since her third pregnancy, nothing worked for her. She was feeling desperate because she had gained about 40 lbs which she could not shake off. She did not want to do surgery- either a mommy makeover or bariatric surgery- although she had met with multiple surgeons. When I first met her, I told her that medications can have significant side effects and that she should really try lifestyle modification. She started crying, telling me that she had done everything I was suggesting and she did not want to end up like her mother who had died of a heart attack in her 50s when she started gaining massive weight. In further testing, the patient had insulin resistance but no evidence of heart disease- and with a combination of Trulicity, Metformin, and a couple of supplements- and minor lifestyle changes, she lost 22 lb in about 15 weeks. when I spoke to her, it was the first time she was hopeful and asked if she can get off her Prozac! We're looking to get her back to her baseline, with another 20 lbs to go and get her off all meds. I share this story for several reasons. 1- I've been treating significant obesity for years and now that we have many safe and effective medications, I have opened my practice to helping such patients. 2- As soon as I posted about this service, I got two types of nasty responses: a) that I am a legal drug pusher; b) that I should be encouraging diet and exercise if I were a real doctor. Most such comments come from either of two groups of people: a) those who have never struggled with weight loss because it comes naturally to them, most of them thin and so it's easy for them to judge others, and b) those who don't realize that I only take patients who have significant obesity and who have already gone through many other attempts at weight loss and dieting! 3- Many people don't realize that true obesity is NOT a cosmetic issue but a medical problem! Obesity reduces the length of life. Obesity leads to diabetes, heart disease, stroke, sleep apnea, arrhythmias, cancers, mental illness, insomnia, major musculoskeletal pains, and disability... 4- I don't treat cosmetics. I treat a medical condition. 5- I take this program as seriously as I do when taking care of a person after open heart surgery. Obesity kills. Obesity is a chronic medical condition. The risk of not doing something is enormous. 6- When I use medications, I know too well that all medications have potential risks and this is precisely why I follow patients with blood tests and make sure that the benefits outweigh the risks. 7- Before you write nasty comments- think to yourself that I really care about patients and that I am doing this to help and that I have done my homework and that there are vulnerable patients reading this and that your comments will hurt them and set them back. Thank you." The cost of the program: There is a $1200 fee that must be paid for the program upfront. What it covers: Our first evaluation, discussion, body-fat composition, future emails, and communications, answering questions, concerns, side effects, addressing labs, etc. Support from my staff to get your meds covered as allowed by your insurance. There is a lot of work that we do on your behalf that is not seen by you. What it does not cover: Office visits, blood tests, diagnostic tests that may come up such as ECG, ultrasound, etc. Cost of medications. We will try to run these through your insurance, but if you have deductibles or copays, you will be responsible for those just like any doctor's visits. *** Please note: We will make a good faith attempt to help guide you through your weight loss journey but by no means do we guarantee results. Much of this will depend on you, your commitment, and your discipline to follow instructions. *** Thank you for your trust and looking forward to being part of your healthcare. Here's one of many success stories with #Ozempic: A 58-year-old real estate investor came to see me from San Diego as a last resort prior to having gastric bypass surgery. He had been struggling with his weight all his life. He had tried years of trainers, and dietitians, and had tried fasting, as well as various diets including plant-based. He was extremely frustrated as each time he would lose 20-30 lbs and would gain back 30-40 lbs. He had become diabetic and under the care of an endocrinologist was on 100 units of Insulin. I started him on a combination of Ozempic, Metformin, and time restricted eating. I switched out most of his diabetes and blood pressure medications. In 3 months, he lost 30 lbs, and in 6 months he lost 60 lbs. He is now down over 80lb and is off of Insulin and off of all blood pressure medications. He is only on Metformin and Ozempic now. And I'm slowly weaning those down to the lowest dose for maintenance. He is no longer hungry. He is no longer anxious about food. This journey was easy for him. He simply stopped thinking about food. I have no doubt that this regiment has added 20 years to his life- ten for his weight loss and another ten for being off of Insulin. Listen to my interview https://mailchi.mp/f699af6945ac/ozempic?e=eeac61efe7 Best Regards, Afshine Ash Emrani, M.D., F.A.C.C. Assistant Clinical Professor, U.C.L.A. David Geffen School of Medicine www.laheartspecialists.com Sign up for my medical newsletter. 18370 Burbank Blvd., Suite #401 Tarzana, CA 91356 Tel# 818-996-4100 Fax# 818-996-0842 This communication contains confidential information belonging to the sender which is protected by physician-patient privilege. Nothing contained in this communication and any attachments thereto is intended to waive any privileges or rights of confidentiality. 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