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What does “SLIM TLC” stand for?

SLIM TLC has two meanings.  Most importantly, it represents becoming SLIM through Therapeutic Lifestyle Changes (outlined below).  The program is designed to be very flexible to meet your specific needs, and can be done in several ways.  First, you may decide to implement the program all by itself, independent of other strategies, as it is highly effective as a stand-alone health and weight loss program.  However, if you already have a specific eating preference or are making other efforts that aren’t working, simply add SLIM TLC (mold what you are doing to SLIM TLC principles), and you will significantly increase your chances of long-term success.

Your next step is to decide if you want to do the program alone, with a friend (or friends), or with the help of your doctor (you can always change your mind later).  The latter options can provide additional support, accountability, and troubleshooting.  The least expensive way to do the program is on your own or with a friend (or friends).  If you choose to do it through your doctor, group sessions may also be an option.  For those who feel they need it, and if your health care provider is willing to prescribe it, SLIM is also an acronym for Short-term, Low-dose, Intermittent, Mid-day appetite suppressant (specifically, phentermine), i.e., the (optional) use of low-dose phentermine (18.75 mg/day), given short-term (<1 year), intermittently (20 doses per month), in the middle of the day, and prescribed as long as lifestyle changes are made and continued.  This “SLIM TLC” approach utilizes phentermine in several beneficial ways, while reducing the likelihood of side effects.  It may ensure the highest chance of turning your weight loss efforts into long-term success, but must not distract from the primary goal of making crucial therapeutic lifestyle changes.

Why short-term?

Phentermine is only FDA-approved for short-term use.  Its benefits tend to wear off after several weeks, it is potentially addicting, and it is a stimulant medicine with possible side effects of dry mouth, elevated blood pressure, insomnia, rapid heart rate, tremor, dizziness, irritability, headache, and stomach upset.  It is contraindicated in agitated states, high blood pressure, hyperthyroidism, glaucoma, significant heart disease, and a history of drug abuse.  This is why many physicians are very hesitant (or refuse) to prescribe it.  However, even though it is only used short-term, if you combine it with the SLIM TLC program (which facilitates long-term lifestyle changes), the benefits can last a lifetime.

Why low-dose?

1) It decreases the chances of side effects (including insomnia) and dependence; 2) you feel less of a difference when not taking the medicine; and 3) you must not rely solely on medicine to help you make wise decisions.  We do not want to suppress your appetite too much – it is imperative to learn to pay attention to your internal hunger signals and eat when you are truly hungry.  The low-dose phentermine helps you make smarter choices by making it easier to say “No!” to the less-healthy foods to which most Americans are addicted (unhealthy meats, dairy products, fats, sweets, and other processed goods), and the goal is for these choices to become a habit.

Why intermittent?

As mentioned above, phentermine loses its efficacy after a few weeks, can be habit-forming, and has potential side effects. Intermittent use largely overcomes these issues.  It also helps patients learn how to make the necessary lifestyle changes on days the prescription is not used, thus building self-sufficiency and self-confidence.

Why mid-day?

Most patients struggle with their hunger during the last half of the day, far more than the first half.  The most damage to their waistlines usually begins in the early afternoon.  Taking phentermine around the middle of the day (it is taken on an empty stomach, recommended 15-30 minutes before lunch, but some may find it more helpful to take it 1-2 hours afterwards) assists many patients in making better eating choices, and may give them a little extra energy, when they need the most help.  Taking phentermine in the morning, on the other hand, encourages poor eating habits.  It causes many to skip or eat an inadequate breakfast and eat too little during the first half of the day.  This may leave them more hungry at night and lead to worse night-time bingeing.

Why phentermine?

Phentermine is an inexpensive and effective prescription appetite suppressant.  It may also provide some extra energy to help you exercise.  As such, many folks feel it is the closest thing we have to a magic pill.  However, because of its downsides and the fact that its efficacy wears off after a few weeks, it is only approved for short-term use.  Therefore, as traditionally prescribed and recommended, it leads only to short-term weight loss, and sometimes may encourage poor eating habits as described above.  SLIM TLC uses phentermine differently, in a revolutionary way that truly can be magical, by encouraging healthy lifestyle changes and helping you learn how to manage your weight long-term.  If done as prescribed: 1) It serves as an incentive to make necessary lifestyle changes (refills are only given if other aspects of the program are followed); 2) It suppresses your appetite and may give you more energy to exercise (when you need it the most); and 3) It teaches you to pay more attention to your true hunger level (if you’ve taken phentermine that day, you automatically stop before eating and ask yourself if you are truly hungry – something we call “Checking Your Fuel Gauge,” or CYFG).

Why therapeutic lifestyle changes?

Without making permanent lifestyle changes, any weight loss effort, including the use of phentermine, results in only temporary weight loss.  After your first prescription of phentermine, refills should only be provided if important lifestyle changes are made.  Long-term lifestyle changes, which include following The 4:1 Rule and exercising regularly, are the keys to long-term health.  These lifestyle changes and the long-term weight loss they provide, along with not smoking, will prevent most cases of heart disease, cancer, stroke, and diabetes (the first, second, fourth, and seventh most common causes of death, respectively, along with a host of other diseases and ailments).  As such, they will likely save both your life and our health care system.

How hard is it to make the lifestyle changes?

Permanent lifestyle changes are never easy – if they were, we’d all be slim.  However, those required by the SLIM TLC program are simpler than most programs require, and may be facilitated by using phentermine.  SLIM TLC encourages realistic, maintainable changes in your eating and exercise habits, founded on medically sound principles, along with significant recent advances in the field of nutrition science.  Participants follow a livable, rational exercise regimen, and strive to follow “The 4:1 Rule” of healthy eating and snacking, which is a mostly plant-based diet (see Where’s Your PS²? for more information) that does not prohibit other foods you enjoy.  Eating mostly plant foods, which have a low caloric density and require more energy for your body to convert to fat (not to mention the sheer nutritious value and high fiber content), allows you to eat to your satisfaction without gaining weight.  Changes are made as quickly as you feel comfortable.  These changes are sustainable and lead to long-term weight loss success.

How does my provider know I’m making the lifestyle changes?

They are tracked short-term through logs and progress reports, then long-term through a unique goal-setting and tracking system called the “SLIM TLC Map” (all of which can be followed on your own or with a friend if you choose not to utilize the services of a health care provider).

How do I make the lifestyle changes on the days I don’t take phentermine?

To have long-term success, you must not rely solely on the boost that phentermine provides to make the necessary lifestyle changes.  We will provide you with the education and teach you the necessary skills to make these changes permanent, without requiring daily phentermine.  Most experts agree that it takes a few weeks to develop a habit, and the goal is to develop healthy and sustainable patterns of diet and exercise, even before the end of your first prescription, which should then become a permanent part of your life.

When and how is phentermine prescribed, and is it required?

Weight loss occurs when lifestyle changes are made, which are facilitated by “attending” TLC University.  You can choose to make the journey without phentermine, or to delay its use.  We can help you succeed with or without it.  If you desire a prescription, you must find a provider who is willing to prescribe it (providers who prefer not to prescribe it may change their mind once they become familiar with the program).  For those who desire a prescription, you may receive it at the initial visit with your health care provider (20 doses).  Optional refills may then be provided monthly thereafter, as long as the program is followed (and efforts are made to continue the lifestyle changes), for a maximum of one year.  Many will learn how to have success on their own after only a few prescriptions, and be able to discontinue their visits.

How do I continue to have success after I stop taking phentermine?

Simply follow the SLIM TLC principles you have learned.

How do I get started, and what is the timeline for visits?

If you choose to do the program on your own or with a friend, simply join SLIM TLC Online.  If you would like to do it through your health care provider, you may join first or download the SLIM TLC Initial Patient Packet (found on the Providers page) first and read through it.  Then call your physician (or other provider) and set up an appointment at least one week in advance.  Tell the scheduler that the purpose of the visit is specifically to discuss the possibility of starting the SLIM TLC program (please do not try to discuss other issues).  If they have not heard of the program, please refer them to www.slimtlc.com/providers.  Then, fill out the first page of the packet and read through the third page (without signing it).  One week in advance of your appointment, make seven copies of, and start keeping, the SLIM TLC Food and Exercise Log (page 2) for your physician to review at your first visit.  You should visit with your health care provider twice during the first month, then monthly thereafter (or more often if needed) – visits may be one-on-one or in a group setting, or alternate as needed, depending on how your provider decides to conduct the program (feel free to express your preference).  You will also “attend” TLC University during your weight loss journey, and you should take the SLIM TLC Program Materials (available upon joining SLIM TLC Online) with you to each office visit.  There is no minimum required amount of office visits to the physician; however, at least the first 2-3 months are strongly encouraged to increase your chances of success.  Remember, refills of phentermine should only be provided as long as you follow the program as outlined.

Does insurance pay for SLIM TLC, and how much does it cost?

If you decide to do the program on your own or with a friend, only #3 below applies.  We are hoping that health savings accounts will reimburse SLIM TLC costs.  Some insurance companies will cover office visits dedicated to weight loss, especially when you have medical conditions that are worsened by obesity (especially diabetes).  Fewer cover specific weight loss programs, and even fewer cover group visits.  Medicare currently covers four weight loss visits per year if you have medical conditions worsened by the excess weight.  We are quite confident that over time more and more insurers will cover treatment, especially when they see the improved outcomes.  We recommend you contact them to find out for sure.  The potential costs of SLIM TLC are broken down as follows:

  1. If your insurance company does not cover your weight loss visits, we recommend that providers charge about $75 for each visit; however, your provider may charge a different amount, and may charge less if it is part of a group visit.  Be prepared to pay the amount charged, out-of-pocket, at each visit.
  2. Phentermine prescription costs (if you choose this option – these should be quite low, since phentermine is generic and you receive only 10 tablets/month)
  3. SLIM TLC Online subscription (currently only $19.99 for a lifetime membership!)

There are no other costs (e.g., special food or supplements) associated with SLIM TLC.