Medical Weight Loss - Frequently Asked Questions

Q: Do I need to decide which By Design program I want to join prior to my first clinic visit?

A: Your first clinic visit will run more smoothly if you have an idea about which medial weight loss program you would like to join; however, you should come to this visit with the mindset that your program choice may change, depending upon the conversation you have with the doctor or nurse practitioner.  Our goal is to find the right medical weight loss program for you and tailor its components to your resting metabolic rate, goals, behavioral habits, and medical needs to maximize your potential for long-term success with weight loss and maintenance.

Q: If I initiate one program, can I switch to a different medical weight loss program

A: Yes, you may switch to a different program after initiating one program.  During your first clinic visit, the By Design team will work with you in-depth to determine which medical weight loss program would best suit your individual medical needs and personal circumstance.  However, individuals may begin one By Design program and find that they would be better served by the structure and components of another By Design program.  To switch medical weight loss programs, you must first schedule an appointment to discuss options with Dr. Ard or a By Design program coordinator.

Learn more by signing up for our free Medical Weight Managment seminar online.

Q: I travel frequently.  How might this affect my weight loss plan?

A: Many participants travel throughout their time in either By Design program.  When joining a By Design program, though, it is important to consider both your time commitments and priorities related to weight loss.  Both By Design medical weight loss programs require a significant time commitment and personal engagement to help you develop appropriate behaviors and tools for long-term success.  Continuing to remain adherent to your weight loss plan is important to ensure you are developing these behaviors and skills that lead to long-term weight loss maintenance success.  If you are using OptiFast product while traveling via airline, the clinic can provide you with a special letter for traveling with your medically-prescribed OptiFast product.

Q: May I drink coffee or caffeinated beverages on my weight loss plan?

A: Yes, you may consume caffeine as a part of your weight loss plan; however, the amount should be limited.  Maintaining appropriate fluid balance is a vital part of weight loss.  Caffeine is a diuretic, which means it causes your body to lose water.  When participating in a By Design program, you should limit caffeine consumption to 300 mg per day (about 2 cups of coffee).

Q: Can I drink alcohol on my weight loss plan?

A: No, it is best to avoid drinking alcohol while attempting weight loss.  Alcohol provides unnecessary calories and may slow down your rate of weight loss.  When you have reached your weight goal, a meal plan including moderate alcohol intake can be discussed as part of your weight loss plan.

Q: May I use meal replacements (e.g., protein shakes, protein bars) in the By Design Essentials weight loss plan

A: Meal replacements may be used in the Essentials program weight loss plan; however, utilizing a full meal replacement plan is not allowed.  A full meal replacement meal plan facilitates rapid weight loss and requires much more frequent medical monitoring than what is provided by the By Design Essentials program.  Participants in the By Design Essentials program can utilize up to 3 meal replacements per day in their meal plans to help meet nutritional goals.  If interested, By Design Essentials participants may use OptiFast products with their weight loss plans.

Q: How much does OptiFast product cost?

A: Weekly purchases of OptiFast product vary depending upon your individual meal plan and stage within the medical weight loss program.  They are not included in your total program cost.  For individuals on a full meal replacement By Design OptiFast plan, weekly product purchases range from $110-150 per week, depending upon the type of product selected and number of products used daily in your weight loss plan.  As you progress though the program and begin utilizing more food in your meal planning, the number of OptiFast products purchased decreases.  Individual product costs can be found on our OptiFast Ordering Form.

Q: Can I use my flexible spending account to pay for OptiFast product?

A: No, flexible spending accounts cannot be used in the Nutrition Shop to purchase product in our medical weight loss programs.  Exercise trainer packages, health behaviorist visit packages, and program extension plans also cannot be purchased using flexible spending accounts.  Flexible spending accounts can be used toward payment of the program.

Q: May I add anything to the OptiFast products?

A: If modification of the product is needed for better palatability, choose herbs and spices or flavor extracts that do not contain calories.  Chewing sugar-free gum or drinking flavored waters is allowed, but “extra” daily calories should total 20 or fewer.  Take note, sugar-free gum and some flavored waters typically contain about 5 calories.

Q: How do the By Design medical weight loss programs handle eating disorders or maladaptive eating behaviors, like binge eating?

A: All patients are screened for eating behaviors using a Binge Eating Scale prior to beginning a By Design medical weight loss program.  The tool is helpful in assessing and evaluating binge eating and serves to provide parameters for treatment outcomes.  Meal plans that use calorie restriction, like the By Design programs, have the potential to temporarily increase binge eating behaviors.  Programs at the Weight Management Center are not designed or intended to treat binge eating disorder.  Therefore, patients meeting certain criteria for binge eating may be required to participate in counseling with a licensed counselor who specializes in treatment of binge eating behaviors prior to participating in our By Design programs or starting a weight loss plan.

Quick Reference

Weight Management Center


Mon - Fri, 8:30 to 4:30

Find us at:
Medical Plaza - Country Club
4614 Country Club Road
Winston-Salem, NC 27104

Medical Plaza - North Elm
3903 North Elm Street
Greensboro, NC 27455

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Last Updated: 10-03-2016
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Disclaimer: The information on this website is for general informational purposes only and SHOULD NOT be relied upon as a substitute for sound professional medical advice, evaluation or care from your physician or other qualified health care provider.