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