Ongoing condition
Obesity Treatment in Southlake, TX
Obesity treated as the metabolic disease it is, with a workup first and follow-up that does not stop.
We see patients age 16 and older.
Obesity is a chronic metabolic disease with a strong biological floor, and treating it as a character issue is why most attempts fail. At Magnolia we work up what is driving it, treat it with medication where that is appropriate, and stay involved long after the first prescription.
What we look for first
Before treating weight, we look for what is feeding it.
- Thyroid function, since untreated hypothyroidism adds weight and blunts progress. See thyroid disorders.
- A1c and fasting insulin, to see how much insulin resistance is in play. See prediabetes.
- Liver enzymes, because fatty liver is extremely common here and largely reversible.
- Sleep apnea screening, the most commonly missed contributor by a wide margin. See sleep apnea.
- Your full medication list. Several antidepressants, some antipsychotics, beta blockers, gabapentin, steroids and older diabetes drugs cause weight gain. Swapping one occasionally solves a large part of the problem.
Cortisol and testosterone get checked when the history points there. So does a conversation about binge eating, which is common, treatable, and rarely volunteered.
Treatment
GLP-1 receptor agonists including semaglutide and tirzepatide are the most effective medications we have had for this, and we prescribe them when criteria are met. Generally a BMI of 30 or more, or 27 with a weight-related condition.
We start low, increase on a schedule, and stay in contact through titration, because that is when nausea and constipation show up and when most people quit. We check benefits before you start rather than letting you discover the cost at the pharmacy counter.
Not everyone is a candidate. A personal or family history of medullary thyroid carcinoma or MEN2, a history of pancreatitis, and pregnancy all rule these drugs out, and we check for each.
Protecting muscle
Losing muscle alongside fat is a real risk on these medications, and it makes regain worse later because a smaller muscle mass burns less at rest.
We talk about protein and resistance training from the first visit as part of the prescription, not as a wellness aside. In older patients this is the difference between losing weight and losing independence.
The long view
These medications work while you take them. Stopping usually means regain, which is exactly what happens with blood pressure medication and nobody calls that a failure.
We plan for the long term from the start, including what happens if your coverage changes, which it frequently does.
What we do not do
No compounded GLP-1 products. No HCG protocols. No proprietary supplements, and we do not sell products of any kind. No very low calorie crash programs, which produce fast loss, muscle wasting and near-universal regain.
Weight and joints
Every pound off the body takes roughly four pounds of load off the knee with each step, which is why weight and knee and joint pain are managed together here rather than in separate appointments.
This is handled through our medical weight management program. See our primary care Southlake practice overview.
Questions about your own case?
These pages describe how we treat this generally. What matters is your history, your labs and your medications, and that takes a visit. We are taking new patients now and most major insurance is accepted.
Questions patients ask
Is BMI a fair way to define obesity?
It is a rough screening tool that misclassifies muscular people and works differently across ethnic groups. We use it as a starting point alongside waist circumference, labs and what your body is actually doing.
Why is keeping weight off so hard?
Because your body defends its highest weight. Losing weight lowers resting metabolic rate and raises hunger hormones, and those changes persist for years afterward. That is measured biology, not weak willpower.
Do I have to try diet and exercise before medication?
You have almost certainly already tried. We do not require a documented failure before treating a disease with an effective drug, though nutrition and activity remain part of the plan rather than an alternative to it.
Should I consider bariatric surgery?
It is worth discussing at a BMI of 40, or 35 with a related condition. Surgery still produces the largest and most durable results we have, and we will refer and co-manage if you want to explore it.
Will treating my weight fix my other conditions?
Often it improves them substantially. Blood pressure, A1c, triglycerides, liver enzymes, joint pain and sleep apnea severity all tend to move in the right direction, frequently before the scale shows what you hoped for.
Related care at Magnolia
2111 Kirkwood Blvd, Ste 110C, Southlake. Free parking directly in front.