Health Weight Management Center: Leading-Edge Programs for Weight Loss and Health Optimization

For more than 40 years, the MUSC Health Weight Management Center has offered leading-edge programs to help people lose weight and improve their quality of life. Tonya Turner, MPH, RDN, LDN, is the associate director for clinical services and a registered dietitian and nutrition specialist at the Weight Management Center. In this episode, she describes the range of programs and tools offered at the center to help people successfully lose weight.

“Most people who come to us, this is not their first time attempting weight change, and so most of us also know … eat less, exercise more. Well, that's only one piece of it. Really, with a lot of our programs, we like to look at it from a holistic approach.”
—Tonya F. Turner, MPH, RDN, LDN

Topics Covered in This Show

• The MUSC Health Weight Management Center offers a multidisciplinary approach to losing weight with a team of experts in diet, exercise and psychology. Programs are designed to fit the needs of all patients with intensive, longer-duration programs to some that are just a few weeks long.
• Changing behavior when it comes to diet and exercise is difficult. Tuner says the psychologists on staff are essential to people's success; They help patients tackle areas of their lives that need to be addressed so that they're able to sustain any weight loss success.
• Embracing the "ABCDs" of lifestyle change is critical to the success of any patient who comes to the center. ABCDs stands for Activity Changes, Behavioral Changes, Cognitive (Thinking) Changes, Dietary Changes and Support System.
• Programs are offered in-person and virtually and range from First Step, an eight-week lifestyle change program, to more intensive 15, 23, and 27-week programs that include some meal supplementation products.
• Turner says average weight loss in the 15-week program is about 10 percent of body weight, and in the 23-week and 27-week program, patients lose 40 to 60 or more pounds of weight.
• The shakes and the bars used by the center's programs are tools to assist with initial weight loss. Turner says there's scientific evidence showing such supplements can alleviate some of the stress of having to plan five or six meals a day. However, the goal is to help patients embrace a healthy eating style after weight loss that does not include meal supplements.
• While the center does not provide weight loss medication that has recently made a splash in the media, it does help patients on these medications with lifestyle modifications.
• In the nearly 20 years Turner has been with the center, she has seen many success stories of people who have lost weight and kept it off. Anyone interested in learning more about the programs and cost can contact the center for a free orientation.

Read the Transcript

[00:00:00] Erin Spain, MS: Welcome to Advance with MUSC Health. I'm your host, Erin Spain. This show's mission is to help you find ways to preserve and optimize your health and get the care you need to live well. Many people wanting to lose weight and keep it off benefit from working with professionals who understand the complexities of weight loss. The MUSC Health Weight Management Center offers the safest, most current and effective weight management interventions. Here with insight on the in-person and virtual programming offered at the center is Tonya Turner. She is the associate director of clinical services at the MUSC Health Weight Management Center and a registered dietician. Welcome to the show.

[00:00:49] Tonya Turner, MPH, RDN, LDN: So happy to be here.

[00:00:50] Erin Spain, MS: MUSC Health Weight Management Center has a long history of helping people lose weight. Tell me about the center and how unique it is to the Charleston area.

[00:01:00] Tonya Turner, MPH, RDN, LDN: We are by no means new to the Charleston area. MUSC Weight Management Center has actually been in place for over 40 years. And so we have a wide variety of different offerings ranging from things that are just a couple of weeks long to really, really intensive programs. I think the piece that makes us the most unique is that we are one of the very few centers, not only in Charleston, but actually across the country that is a multidisciplinary approach to weight loss where all the different disciplines are housed under one roof, including dietician, psychology, exercise. So we really are a unique group.

[00:01:36] Erin Spain, MS: Well, and tell me why is it important that your patients have access to all of these different professionals. The physicians, registered dieticians, psychologists, and exercise physiologists.

[00:01:46] Tonya Turner, MPH, RDN, LDN: Most people who come to us, this is not their first time attempting weight change, and so most of us also know that. You know, you hear, eat less, exercise more. Well, that's only one piece of it. Really with a lot of our programs, we like to look at it from a holistic approach. So we have the physicians on staff because we do monitor labs pre and post in a lot of our programs to be able to get more markers than just weight loss alone. Dieticians and exercise physiologists are in place because we're the ones that really help the clients get education on appropriate, safe and evidence-based tools for exercise and dietary approaches to weight management. But truth be told, the behavioralists, the psychologists are the nuts and bolts of the program. Everyone knows: eat less, exercise more. But how many of us are really able to apply that to our normal lifestyle? And that is the big piece. It's the behavior modification piece that really helps people implement it, not only for while they're in the program, but tackle some of those areas that maybe, you know, need to be looked at or addressed so that they're able to sustain the weight change off at the end.

[00:02:52] Erin Spain, MS: A big focus of the center, you mentioned this behavioral approach and also lifestyle change. And the center is focused on what you call the ABCD of lifestyle change. Walk me through those.

[00:03:05] Tonya Turner, MPH, RDN, LDN: That's really kind of, you know, really what we are. So the ABCDs of lifestyle change are essentially activity. So obviously, you need to be active and we want you to be active not only while losing weight, but also to sustain long-term weight loss. Behavioral approaches is really approaching your thoughts and your lifestyle around diet and exercise so that you're, again, able to be successful for the long term. The C is just. The cognitive or the thought processes behind it. How you think about food, how you relate to food, your behaviors around food again. The dietary part, obviously anytime you're trying to lose weight, the dietary part is a big aspect to get that calorie deficit. And then the SS is a support. And so we really need you to have support throughout the program. And so we provide that by providing weekly accountability in most of the cases, but also we want you to have support within your community, whether it's your family or friends, your coworkers. So we really encourage that as well.

[00:04:01] Erin Spain, MS: You mentioned the programs. There are different programs and these are tried and true for your patients, and some are just a month long and others can go six months or longer. Explain some of those options. Options to me and what someone may be offered if they come to the center.

[00:04:16] Tonya Turner, MPH, RDN, LDN: So we have programs that range from varying different links because people are coming to us with different goals in mind. Some people maybe only wanna lose 10 to 15 pounds. They want to see some health changes, but they don't have a tremendous amount of weight to lose. Whereas other people may be coming to us with 60, 75, a hundred plus pounds that they're looking at wanting to lose. So we have those different offerings for that reason. Kind of our least intensive program is The First Step. And that is our eight-week-long program, which is really just a kind of a traditional approach to weight loss. So you meet with a dietician, you get a meal plan that is based on a calorie deficit, focused on structured eating macronutrients, getting the right amount of carbs, proteins, fats, making sure you're getting meals structured throughout the day. And then you have the exercise visit, which is more prescriptive in nature, where they're getting kind of a plan for how are you gonna get to the amount of cardiovascular and the amount of resistance that we want you to be at so that you're seeing weight change and then able to sustain it after. And then the behavioral piece is, like I said, kind of bringing those pieces together, but also working on, you know, helping people. Life happens, there's gonna be a wedding, there's gonna be a trip. So how can you still follow those exercise and dietary goals within the structure of the program?

[00:05:33] Erin Spain, MS: What is the amount of cardiovascular and weight training or resistance that you're asking people to do in a program like that?

[00:05:40] Tonya Turner, MPH, RDN, LDN: From an exercise standpoint, research just really shows for weight loss and weight maintenance being between at least 200 to 300 minutes of cardiovascular per week. That sounds kind of daunting, but it can be broken up into different increments throughout the day. It could be, you know, a 15-minute walk in the morning, a 30-minute walk after work, doing that five to six days a week and you've gotten your 200 minutes. From a resistance standpoint, recommendations are really for sustaining lean mass and making sure that while you're losing weight, you're building muscle and sustaining it as well. It's about two to three days per week of resistance training. So just some goals that the exercise physiologist goes over and tries to help people implement. But we also know some people are coming to us with no exercise, and so building up to that slowly and gradually is really important too.

00:06:31] Erin Spain, MS: OK. So that's The First Step Program. Tell me about the others.

[00:06:34] Tonya Turner, MPH, RDN, LDN: The focus programs are more intensive. They range anywhere from 15, 23 or 27 weeks in duration. Really the idea behind them is that they're obviously longer, they're double the duration of The First Step at the least, all the way up to 27 weeks. And one of the biggest differences with that program is whereas The First Step Program is an all-food-based plan, just a calorie deficit, the focus is a partial supplementation. It is where people are doing shakes, bars, and one food-based meal for the first basic two phases of it, and then gradually transition back onto an all-food diet ending the last six weeks of any of those programs on an all-food-based plan, similar to The First Step. They're really promoting more change, more weight loss. Average weight loss with the 15-week-long program is usually about 10 percent, and then the 23 and the 27, we're generally promoting that to patients or clients who are looking at more like 40 to 50 or 65 plus pounds lost.

[00:07:37] Erin Spain, MS: Tell me about that use of meal supplements, shakes, and bars. Why is that approach so effective for some?

[00:07:44] Tonya Turner, MPH, RDN, LDN: The shakes and the bars are in place and there's honestly a good amount of research behind using shakes and bars, especially as a tool to assist with initial weight loss. It's not something that we want people doing five supplements a day for the rest of their life, but it's a way to, basically, alleviate some of the stress of having to meal plan five or six meals a day, help with caloric adherence because there's just less room for error if you're using shakes and bars. And within that focus program, we're still doing one food-based meal, so they're not doing entirely shakes and bars. But it's a great way for somebody who has a busy schedule or who's running around all over the place and being able to still eat every couple of hours, knowing that they're getting good, solid nutrition that they need. And also seeing the scale move because we know if the scale's moving and they're putting in all this work that's motivating, that's a drive to continue. So that's why we use them and that's why the evidence behind them kind of shows that they're helpful.

[00:08:41] Erin Spain, MS: And how do they taste?

[00:08:43] Tonya Turner, MPH, RDN, LDN: I'm partial, I love our shakes and bars. Honestly, we have a lot of clients that do our programs and then continue using the supplements in some way, shape or form, even when they're done with the program, at a much lesser capacity. But we've got about 13 different flavors of bars, chocolate and vanilla shakes, and lactose-free and regular, and in all honesty, ours in comparison with some of the flavors that are on the market just at like Amazon or Target, I think ours are quite tasty.

[00:09:10] Erin Spain, MS: And you mentioned, people are still in touch once they complete these programs, and some people may even come back to do some maintenance. Just tell me about those ongoing relationships you have with patients.

[00:09:22] Tonya Turner, MPH, RDN, LDN: With any of our programs after the consecutive weekly visits, whether it's The First Step or the focus 15, 23 or 27, we have built-in contract sessions so that they're still seeing us on a monthly basis for at least two, if not three months. At the end of that, we have a number of clients who then continue with us in a contract fashion where they're still seeing us once a month and kind of checking in. Whether they're looking at continuing their weight change or they're looking at maintaining what they have off. And we have clients too that maybe leave for six months and then say, you know what? Life's gotten a little bit more challenging. I don't necessarily need to do the big program all over again, but I'd still like to touch base with somebody on a monthly basis to just make sure that I'm still doing the things and continuing the habits that made me successful in the first place.

[00:10:11] Erin Spain, MS: What does the research say about accountability and having professionals there who are keeping you on track?

[00:10:17] Tonya Turner, MPH, RDN, LDN: There's not very many centers like us, but most of the research trials that have looked at weight loss, the accountability piece of it is huge. And so whether it's, you know, having a one-on-one session with a professional, having a group session or a check-in or a follow-up. Having that support and kind of somebody to check in with and to look over your shoulder, make sure you're achieving those goals is always very, very helpful.

[00:10:42] Erin Spain, MS: Something that's been in the news a lot lately are these new weight loss medications. Do you incorporate weight loss medications in any of your programs?

[00:10:51] Tonya Turner, MPH, RDN, LDN: In our clinical programs, we do not incorporate the weight loss medications. I will say that in the past, that was a part of our clinical programs. And we also have research that we've done with these weight loss medications for years, on our research side of the Weight Management Center. The medications that they've come out with are, hands down, amazing at this point. They really do promote great weight change effects as well as help people deal with cravings and hunger. So, they're quite miraculous in all honesty. One of the things, though, is we are not currently able to prescribe those medications. However, we can be a partner with the clients who are using them. So if they're meeting with their primary care physician or their, you know, OB/GYN or whoever is making that prescription recommendation to them. We can still be the lifestyle approach that they're doing in conjunction with it. The research behind all those medications was done with the medication, while also following a lower calorie diet and being physically active, and that's the key for even the medications to be long-term successful.

[00:11:55] Erin Spain, MS:

[00:11:55] Tonya Turner, MPH, RDN, LDN: The one that is getting the most media at the moment is the Wegovy, which is basically a semaglutide. And so what that's doing is it's decreasing hunger, decreasing cravings and slowing digestion, which in turn just causes people to be able to see a more successful weight change.

[00:12:13] Erin Spain, MS: So, are you currently working with clients who are using your programming as their lifestyle modification?

[00:12:19] Tonya Turner, MPH, RDN, LDN: I have a couple of clients who are still in the contract aspect, so seeing us once a month and still working with us on the diet, the exercise, and the behavior modification while in conjunction doing the medication.

[00:12:30] Erin Spain, MS: Now you offer a free program orientation for folks who just want to learn more, but it's important to note that most insurance plans don't cover weight loss programs. So what is the typical out-of-pocket cost to your patients?

[00:12:44] Tonya Turner, MPH, RDN, LDN: That's a question that we do get obviously all the time. So our programs are fee-for-service. The First Step Program, which is our eight-week duration program, is $950. The focus programs are anywhere from $1975, all the way up to $3,200. One of the things I will say with the cost of those programs is that, that is a hundred percent inclusive, so that includes all of their visits, their labs, pre and post, as well as in the case of the focus programs, all of their shakes and bars. We also, because they are pricey and we know that they're pricey, we offer options for payments. So you don't have to pay it all upfront. You're able to pay it in monthly installments. For MUSC employees, they're actually able to pay for the programs over the course of a year, which is a great benefit.

[00:13:31] Erin Spain, MS: And you don't have to come in person to Charleston either. Explain the virtual aspects.

[00:13:37] Tonya Turner, MPH, RDN, LDN: This is something actually we've been even doing pre-COVID but we got really good at it during COVID. People can do the program whether they live in Charleston or not. So we are currently located in Mount Pleasant, so you have the option of coming into clinic and seeing us physically in person one-on-one. You also have the option of doing all of your visits a hundred percent virtually via basically a Zoom platform in our Healthy app. All of the supplies can be shipped directly to your home. And then we also have people that do a hybrid. So they maybe wanna come in for their initial visit or on a monthly basis, but weekly is way too often to come into the office. So they'll do kind of a half-and-half or a hybrid. And so any way, shape or form is absolutely fine.

[00:14:19] Erin Spain, MS: And this is for people across the state.

[00:14:21] Tonya Turner, MPH, RDN, LDN: Yes, across the state of South Carolina.

[00:14:23] Erin Spain, MS: Share some success stories.

[00:14:25] Tonya Turner, MPH, RDN, LDN: So I've been with the Weight Management Center for about 19 years, so I've seen a lot of people do really, really well. Our focus program, the 15, we actually did research behind it, and the average patient loses about 10% of their body weight, which, you know, is actually a great change in 15 weeks. It's, you know, pretty tremendous. I've seen a lot of people do really amazing things not only from the scale standpoint, but just from an activity standpoint, feeling better, having more energy. Seeing improvements in their health, doing things that they never thought that they would be able to do. And I think at the end of the day, that's really like, I can't pinpoint one particular person who did the best, 'cause there's been so many of 'em. But it really makes it fun to work with the clients that we do.

[00:15:07] Erin Spain, MS: That 10 percent reduction in body weight, what can that do for people who have chronic diseases such as high blood pressure or diabetes?

[00:15:15] Tonya Turner, MPH, RDN, LDN: Research really shows that a 5 percent weight change is kind of the first marker for seeing improvements in blood glucose, blood lipids, blood pressure. So anything above and beyond that 5 percent is really just a bonus and you're gonna probably see even better success. And like I said, that 10% is what we typically see in our 15 week. For our longer programs, we're really looking at hopefully seeing 15, 20 percent so people can really make a dramatic improvement, not only with the number on the scale, but also within their health aspects.

[00:15:48] Erin Spain, MS: So we know that there's no magic bullet when it comes to weight loss, and these programs do take work, but this is why there's support built around them. For people listening who are considering making this type of lifestyle change and includes losing weight, what is the good first step?

[00:16:03] Tonya Turner, MPH, RDN, LDN: I think the big thing is, knowing that this is gonna be something that is gonna take some commitment. One of the things is, is that you have a lot of accountability and partners within our program, so you're gonna be working on changing your diet, eating less, hopefully exercising more. But I think the other piece of it is knowing that we don't expect every day to be cookie-cutter perfect. This is a lifestyle change. It has to work within your lifestyle. If you're somebody who travels, if you've got, you know, little kids, you have to make the changes that are gonna be sustainable for you for the long term.

[00:16:38] Erin Spain, MS: What do you do to optimize your health and live well?

[00:16:41] Tonya Turner, MPH, RDN, LDN: Because I've worked here for so long and I promote these things so often, I try to do a lot of the things that I ask our patients to do. So, you know, I do try to track my weight on a regular basis. I, as a dietician, track my calories. I try to be as active as I possibly can. Am I gonna tell you that I don't love sweets? No, but I mean, I think that, again, it has to all be within moderation, and I do try to do a lot of what I ask my clients to do.

[00:17:09] Erin Spain, MS: Thank you so much, Tonya Turner for coming on the show and explaining everything that is offered at the MUSC Health Weight Management Center. If people want more information, how can they find you?

[00:17:20] Tonya Turner, MPH, RDN, LDN: They can visit our website and they can also call 792-CARE, which is 2273. And they can sign up for a free program orientation where really we go through all of our different programs and services and they can kind of determine if we're a good fit.

[00:17:34] Erin Spain, MS: Thank you so much.

[00:17:35] Tonya Turner, MPH, RDN, LDN: Thank you.

[00:17:36] Erin Spain, MS: For more information on this podcast, check out advance.muschealth.org.

Learn more about the MUSC Health Weight Management Center’s leading-edge programs that help people lose weight, optimize their health and improve their quality of life.