By Jane Ehrhardt
For decades, weight loss programs have relied on a familiar formula: eat less, move more, track calories, repeat. Yet for many women, especially those navigating pregnancy, perimenopause, menopause, or metabolic disorders, that approach has delivered frustration rather than results. As obesity rates continue to rise, a growing body of evidence suggests that women-focused individualized weight loss programs that are supported by physicians are producing more consistent and sustainable outcomes than traditional plans.
At Birmingham OB/GYN, a physician-led weight loss program integrated directly into obstetric women’s health and gynecologic care now offers a model for why medical oversight matters—and where conventional weight-loss strategies often fall short.
Where Traditional Programs Go Wrong
Commercial diet plans and app-based programs often treat weight loss as a simplistic, universal equation, and success is framed as a matter of discipline. What those programs often overlook are the biological variables that disproportionately affect women.
Post-pregnancy hormonal shifts, perimenopause, insulin resistance, thyroid dysfunction, and leptin resistance metabolic disorders can all interfere with metabolism and appetite regulation. “Willpower alone doesn’t work unless you tailor treatment to also address these issues“, says Vineeta Estes, MD, who practices at Birmingham OB/GYN.
Many popular approaches also rely on short-term restrictions—such as juice cleanses, extreme calorie deficits, or rigid macro rules—that may lead to initial weight loss, but are rarely sustainable. Exercise-only strategies can temporarily shift the scale, but often fail to produce lasting metabolic changes. Exercise helps with weight maintenance, not weight loss. Supplements, despite their popularity, have shown no meaningful benefits. “There is no evidence that supplements will boost weight loss in a meaningful way, and are probably not worth the cost.” Estes says.
There are many diet recommendations out there: low-fat, low-carb, high protein, Mediterranean, etc. These recommendations by commercial programs and advertisements are constantly changing, making it difficult to choose which way to go. Ultimately all these diets can result in temporary weight loss and each can have some health benefits. But if you don’t sustain those diet patterns, the weight will drift back. “It doesn’t help to follow a particular diet plan for short periods of time if it isn’t something you can stick to long-term”, Estes says.
Treating Weight as a Medical Condition
Birmingham OB/GYN’s weight loss program is designed around the premise that treating weight management as a health issue. The program is physician-led and tailored for women, incorporating hormonal, metabolic, and reproductive health considerations into every treatment plan.
Each patient assessment begins with an in-depth medical evaluation, including a review of health history, current medications, lifestyle factors, and long-term goals. Baseline laboratory testing may include thyroid function, hemoglobin A1C, iron levels, vitamin D, and markers of insulin resistance, variables that frequently go unaddressed in nonmedical programs.
“That’s one of the key differences with physician oversight,” Estes says. “A weight loss plan is individualized based on all these other factors, and placed in the context of improving health.”
The program includes monthly 30-minute office visits with a board-certified OB/GYN. During these visits, physicians monitor progress, review lab data, adjust treatment, and address side effects or barriers. “Consistent follow-up and accountability are essential for success” Estes says.
Adding Modern Medications
There are several medications that are FDA approved for weight loss. Choosing which medication to add to the treatment plan is just one benefit of a physician guided program. While many of the other available treatment options can be successful, GLP-1 and GLP-1/GIP combination therapies, such as tirzepatide, have dramatically changed how weight loss is approached. These medications work more quickly and have a greater success rate for weight loss. “These newer therapies work on signals between the gut and the brain, taking away food noise and hunger,” Estes says. “They also have been shown to have a significant effect on long-term health. Dosing for medications is individualized and increased gradually to minimize side effects, which most commonly include transient nausea or fatigue.”
Support Beyond the Exam Room
Between visits, patients can utilize the Birmingham OB/GYN Wellness App to track nutrition, activity, and weight, sync wearable devices, and access physician-curated educational resources. The program also includes an InBody scale analysis, which tracks lean muscle mass and basal metabolic rate in addition to weight.
“We monitor closely to make sure our patients are maintaining muscle mass and improving health, not just losing weight,” Estes says. “We encourage our patients to take advantage of these tools which are included in the program. We want them to be active participants in their weight loss journey.”
Costs, Coverage, and Access
The program is structured as a six-month commitment. The initial consultation is $200, followed by a monthly fee of $125, plus the cost of medication. Program fees are generally eligible for HSA or FSA reimbursement. Laboratory testing may be billed to insurance when coverage allows, though medication coverage varies by plan. The program is not for pregnant women.
Outcomes That Extend Beyond the Scale
Most participants report noticeable changes within the first month, including decreased hunger in addition to weight loss. By six months, average weight loss ranges from 10 to 15 percent of starting body weight, with some patients exceeding 20 percent.
Just as important, physicians emphasize lasting weight maintenance. “Our goal is to help patients lose weight in the short-term and improve health in the long-term,” Estes says. “We want them to graduate from our program with the necessary tools to sustain that.”
