Weight Management Helps Patient Get Back in the Saddle

Amanda Rosen has loved horseback riding since she was a kid. But a combination of factors, including quitting smoking a couple of years ago, led to Amanda becoming almost 100 pounds heavier than her ideal body weight, limiting her ability to ride.

“I got to a point where I had to get rid of the extra weight,” says Amanda. “At a doctor’s appointment, I mentioned going the surgical route. The doctor suggested I consider medical weight management instead.”

Amanda was referred to Karen Cooper, DO, who specializes in obesity medicine at Cleveland Clinic. At an initial appointment, Dr. Cooper talked to Amanda about a ketogenic or high protein diet for effective weight loss.

“I got tears in my eyes,” says Amanda. “I’ve had so many doctors tell me to lose weight. All I could think was, ‘great, just another diet.’ Dr. Cooper sat face-to-face with me and told me it would not be easy, but if I stuck with this diet, it would work.”

A ketogenic diet is high in protein and low in carbohydrates. Because our bodies prefer carbohydrates as a primary source of fuel, when it is not provided in the quantity needed, a secondary form of fuel, such as stored fat, is utilized.

“I got tears in my eyes. I’ve had so many doctors tell me to lose weight. All I could think was, ‘great, just another diet.’ Dr. Cooper sat face-to-face with me and told me it would not be easy, but if I stuck with this diet, it would work.”

“Because this type of diet can lower important electrolytes such as potassium and sodium, it must be medically supervised. The patient is prescribed a potassium supplement to be taken only while following the diet plan, and nutritionists provide education on salt intake and other dietary information,” says Dr. Cooper. “Additional supplements include magnesium, calcium and a multivitamin. Diagnostic blood work is performed before starting and routinely during the course of the diet.”

After just a couple of weeks, Amanda noticed the weight coming off and her energy level increasing. “The first few days were the worst. But just like when I quit smoking, I knew I had to stick with it, because there was no way I wanted to go through those days again,” says Amanda.

Dr. Cooper credits Amanda’s success to her increased motivation once she experienced the initial weight loss, and her goal of getting back to horseback riding.

“When I first met with Amanda, from her obvious dismay at having to go on a diet, I wasn’t sure she’d be successful. As a provider, it can be difficult to help patients who aren’t fully convinced this approach will be effective. It helps when the patient can identify that one thing that will help them to follow through,” says Dr. Cooper.

In Amanda’s case, it was her love of horses and strong desire to get back to riding.

Amanda stuck with the diet, and lost 90 pounds in nine months. She now has her pick of any horse in the stable, and spends some time teaching others to ride. She vows never to let her weight get out of control again.

Dr. Cooper now offers shared medical appointments online for weight loss. Patients see her in-person for an initial visit, with a series of online visits for several weeks, then a final in-person visit to complete the program. Dr. Cooper is assisted by Cleveland Clinic nutritionists and a nurse manager.

Pictured: Amanda Rosen before beginning a weight management program (left) and with Dr. Cooper after losing 90 pounds (right).

Related Institutes: Digestive Disease & Surgery Institute
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