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                         Have you ever told yourself that you needed to lose weight, but then did nothing about it, not knowing how or where to begin? 
                              Did you do something about your undesired weight, but found it was too hard to continue and gave up?
                                                                                                                                                                                                                                                            
                                             Did you stick with your plan and lose the weight, only to find that you gained it back again?

 

If any of these situations seem familiar to you, you are in the right place. Dr. Mandell has the training and expertise to help you get started and keep you going, by breaking down those barriers that are preventing you from being successful in your weight challenge.  She will help you begin, and lead you through ,the journey of weight loss and weight maintenance, to an emotionally happier and physically healthier life.     

As a psychiatrist, as well as an oncologist, with decades of medical training and practice, Dr. Mandell has observed the existence of a powerful interrelationship between the mind, i.e., emotions and thoughts about self, others and the world, and eating behaviors and living styles. She has seen individuals struggle with weight, but then unable to take the desired steps to lose weight, not necessarily because of a lack of will power, but more so from a lack of motivation and guided direction. She has seen weight successfully lost, only to be regained, and all too often as a result of re-emerging maladaptive and self-sabotaging emotional and binge eating behaviors. She has been witness to individuals suffering through repetitive cycles of weight loss and a sense of emotional and physical wellbeing  alternating with periods of weight regain and return of depression, isolating behaviors, and anxiety and worsening  of physical conditions (such as hypertension, diabetes, joint pains, migraines, and asthma). With each failed attempt at achieving sustained weight loss, Dr. Mandell has seen an increase in feelings of hopelessness and helplessness, shame and sense of a failure, anger and frustration, sadness and apathy, resulting, in turn, in longer and more sustained down periods of ill health.

Weight loss is often achieved when there is good patient adherence to structured diet programs. Evidence based studies have shown that adherence is markedly improved in those programs, when motivational techniques and educational counseling are incorporated and provided. Yet, weight loss is just one part of the equation along the weight management journey. Weight maintenance is the second part of the journey, and has proven to be the more difficult to achieve. Keeping the weight off may,infact, require a deeper understanding with analysis and intensive psychotherapy, in addition to motivational and supportive guidance and education.

It is important to recognize that, in almost every instance, weight management has both physical and emotional aspects. While weight loss will likely improve the physical appearance and also be beneficial with regard to a variety of physical illnesses, such as diabetes, heart conditions, etc., it does not necessarily solve the emotional ones that may also exist and be of long standing. In Dr. Mandell's professional experience, the emotional effects of a long term weight problem on self-esteem, image, emotional wellbeing and ability to cope with life in an adaptive and healthy way, is profound. Treating the weight problem and  achieving weight loss does not make those long standing distressful thoughts and feelings go away. They need to be attended to concurrently and addressed professionally to be able take the weight off and keep it off.

                                                                                       Weight Management Program

  • The goal and mission of Dr. Mandell's medical weight management program, which she has coined, "Mind-Weight Balance Therapy", is to strengthen the underlying psychological foundation upon which sits the “weight” of weight , along with its building blocks, to make them stronger and more adaptive to be able to sustain stable and healthy long term weight control.

     

  • She will be prescribing plans tailored to the individualized needs of each patient. A keystone to her approach will be a delivery of care, provided with compassion and empathy, recognizing  that "one shoe does not fit all", and that this journey to well-being, may be overwhelming and difficult, with obstacles to overcome along the way.

     

  • As with all weight management programs, diet, exercise, sleep and stress management will be addressed in Dr. Mandell's treatment planning. Where her approach may differ from that of other weight management professionals, will be in the depth and breadth of medical attention that will be given to the psychological, i.e., the cognitive, emotional, and behavioral aspects of the weight struggle. Such psychotherapeutic techniques as Cognitive Behavioral Therapy and insight-oriented psycho-dynamic therapies, will be employed to delve deeper into long standing psychological issues that might be interfering with weight loss and its maintenance. Identifying and addressing these root emotional and behavioral issues should allow for an easier adherence to healthier lifestyle habits learned during weight loss for more successful longer term control over weight re-gain.

     

  • List of Services Provided (Services outlined below may be given in conjunction with services or programs being provided by other facilities or professionals, or through a comprehensive weight management program that she will manage and oversee):

I.   Psychiatric Consultation only, at the request of a referral from a treating medical weight loss/management facility or provider for prescreening and clearance purposes and/or during treatment for improved protocol compliance referral only from.  The goal would be to evaluate pre- treatment, before commencing a weight loss program or before bariatric surgery to assess for any underlying psychiatric issues which might interfere with a successful result and would need specialized attention and treatment and to recommend a course of treatment, when applicable, including  weight neutral psychotropic medication regimens. 

II.  Full Psychiatric Services as an adjunct to an already determined/prescribed outside medical or bariatric surgical weight management program. The goal would be to not only assess, evaluate and diagnosis, but to provide the full array of psychiatric services, including ongoing psychotherapy as well as psychotropic medication management as clinically indicated, while working closely in tandem, in a multidisciplinary approach, with the other treating medical professionals. Weight neutral medications will be a emphasized in all psychotropic regimens.

III. Medical and Psychiatric Consultation and Assessment ,as an initial step prior to deciding on or beginning a weight loss program. The goal would be to help the patient gain an understanding of the many options available in the "weight loss/maintenance space" and offer specific recommendations based on the results of the office consultation and including information from the pre-screening questionnaire ) and the medical work up. 

IV.  A Comprehensive Weight Management Program, which Dr. Mandell would  recommend and oversee. The program would address both the physical and emotional issues, in tandem, throughout.  The goal would be to provide tailored recommendations customized to each patient's individual overall health needs and life styles through: 

                a. Body Composition testing which provide valuable information , beyond the number of weight  seen on a scale by distinguishing  the number of pounds that exist in the body as fat from those of  lean body mass. The baseline test  will provide valuable  body values of mass, fat, muscle and water as well as their body distribution, percentage of visceral fat and Basal metabolic rates(calories burned at rest without any activity), to aid in the development of  a weight management plan for each patient , targeted to meet  desired needs and goals. Ongoing testing will offer progress monitoring.

                 b. Diet recommendations * for healthy weight loss and maintenance.

                 c. Exercise Regimens* (aerobic, resistance, walking/step schedules, etc.) for improved baseline physical activity and muscle strength and maintenance.

                 d. Sleep Hygiene therapy* for adequate sleep quantity and quality.

                 e. Stress management therapy with mindfulness and problem-solving techniques and skills learning for better coping mechanisms to emotional distress and stressors.   

                 f. Cognitive Behavioral Therapy(CBT) and Insight-Oriented Psychodynamic Psychotherapy services to address any barriers that may be affecting motivation and ability to adhere to the program.

 

                 g. Medication management ,when clinically appropriate, for promoting further weight loss(weight plateau) and for emotional stabilization.

 

                 h. Bariatric surgical referrals, when appropriate, with explanation of, and rationale for, each of the several different currently available procedures.

      

              *Referrals to outside services during the course of the program will be made when/if clinically warranted.