Obesity is a common problem that can cause fatigue, diabetes, fatty liver disease, and sleep problems, and raise the risk of many cancers. It reduces energy, and can take the pleasure out of many aspects of life. Extra weight also places stress on vital organs, including the heart, liver, and kidneys, as well as joints and the reproductive system. Although organs can work under this extra stress for a number of years, eventually they are likely to fail. Most organs lose about 80% of their capacity before symptoms are evident, and by that time, it is often too late to return them to normal function. The conditions associated with obesity are: Cancer Cardiovascular disease Diabetes Liver disease Obstructive sleep apnea Losing weight can help improve and sometimes cure many of these conditions, as well as fertility issues. Losing weight can also lead to a life with fewer medications, lower health expenses, and overall greater enjoyment. At the Yale Metabolic Health and Weight Loss Program, we offer all nonsurgical weight-loss interventions in one location. Our philosophy is to focus on health, rather than specific disease, and to tailor our care to each patient’s specific needs and goals. The first step in our care is to determine weight-loss goals. Patients may need to lose 5 to 10% of their body weight to help in the treatment of a disease. We will help patients choose from interventions that include intensive meal-replacement programs, a range of medications, or endoscopic (nonsurgical procedure) options. Sometimes, there are additional medical necessities, such as an upcoming surgery, that require a specific weight-loss goal. We will explain the advantages and disadvantages of the various options, but the choice will depend primarily on what feels right to the patient. We provide therapies under the medical supervision of obesity experts. Patients can choose from the full range of tested interventions: Lifestyle changes: Nutrition counseling goes hand-in-hand with medical management of metabolic health. Care will include a personal visit with a registered dietitian with advanced training in weight management. OPTIFAST® program: OPTIFAST® is a medically monitored weight management program that allows patients, under the supervision of a physician, to consume a low-calorie diet and receive comprehensive lifestyle education. The OPTIFAST program provides full meal replacement for 12 weeks and transitions to self-prepared “everyday” meals in conjunction with comprehensive patient education and support, to help patients achieve long-term weight loss. Medications: All medications are used as part of a comprehensive program that includes proper nutrition and a healthy lifestyle. Contrave® is a single pill that contains two medications (naltrexone and bupropion) and is taken twice a day. It will reduce appetite and can produce weight loss in the 5 to 10% range. Phentermine is taken once in the morning, and is prescribed for a few weeks.

Our highly skilled cardiologists expertly treat and diagnose heart failure—a chronic, progressive condition in which the heart muscle can’t pump enough blood to meet the body's needs. In addition to caring for cardiac patients at Yale New Haven Hospital, we provide treatment to the rapidly growing number of outpatients living with heart failure in the community. We treat each patient with a personalized plan, carefully monitoring medications on an ongoing basis while minding other issues that affect cardiac health. We also educate patients and their families about lifestyle changes, prescribe and oversee exercise rehabilitation programs, and facilitate communication between the many professionals involved in outpatient care. Our physicians work as part of a multidisciplinary team to offer patients comprehensive care with the goal of prolonging their life and improving its quality. Treatment options may include medications, short- or long-term mechanical support, or heart transplant. Before treatment begins, we perform cardiac diagnostic procedures, such as stress tests, catheterization, and biopsies. We collaborate with cardiac-trained radiologists to provide noninvasive imaging studies including positron emission tomography (PET), computed tomography (CT), magnetic resonance imaging (MRI), and 2D and 3D electrocardiography. At the Center for Advanced Heart Failure at Yale New Haven Hospital, we treat the full continuum of heart failure and offer a variety of medical and surgical treatment options. The center cares for patients with an LVAD (left ventricular assist device), a battery-operated mechanical pump that is surgically implanted and helps maintain the heart’s pumping ability when it can’t work effectively on its own. This is the only long-term mechanical circulatory support for patients otherwise ineligible for heart transplant. Our surgeons regularly perform heart transplants and LVAD implantations, and our heart transplant survival and post-LVAD rates are among the best in the region.

The Preventive Cardiovascular Health Program at Yale (PCHPY) brings a personalized approach to cardiovascular disease prevention. Patients referred to the program meet with one of our cardiologists for an in-depth consultation that takes into account their biology and biography, along with information from advanced diagnostic testing. This approach leads to a more personalized, evidence-based approach to cardiovascular risk assessment. Using this information, and in partnership with patients, we design tailored programs to reduce cardiovascular risk and improve well-being. PCHPY brings together experts in cardiovascular disease prevention, including cardiologists, nutritionists, exercise physiologists and health psychologists. We also work together with Digital Technology Solutions (Information Technology) and digital health companies to offer high-tech/low-burden approaches to cardiovascular care. Our team is highly attuned to the challenges of maintaining a healthy lifestyle and taking medication, and understands that a one-size-fits all approach often falls short. Instead, we strive to understand and integrate each person’ priorities, preferences and goals into the care plan. This program is particularly focused on people who are: At increased risk for cardiovascular disease, including people with: Severe hypercholesterolemia or familial hypercholesterolemia or elevated Lp(a) Family history of premature coronary artery disease (before the age of 60) Poorly controlled hypertension Underlying inflammatory condition (e.g., rheumatoid arthritis, HIV) A diagnosis of ischemic heart disease or coronary artery disease Women with cardiovascular disease Individuals seeking a more personalized approach to cardiovascular health PCHPY additionally works with communities to identify and address barriers to cardiovascular health, focusing on environmental and social factors that contribute to disparities in health outcomes.