Frequently Asked Questions

What is Obesity Medicine?

Obesity Medicine is a specialty of medicine to understand and treat the metabolic condition of excess body fat.  At Rainier Medical Weight Loss, & Wellness, our programs are based on guidelines written by the Obesity Medicine Association, the Endocrine Society, and the American College of Cardiology and American Heart Association.  You can have confidence that your program is not only effective, but researched and evidence based.  Even if you do not choose our program, be sure that any program you consider can say the same.

Is a Very Low Calorie Diet program safe?

Not all of our clients are on a very low calorie diet and not all of them use meal replacements. We offer all variety of programs. But, if you are wondering, here is a guidelines statement from the American Heart Association, America College of Cardiology, and The Obesity Society:

2013 AHA/ACC/TOS Guideline for the Management of Overweight and Obesity in Adults Efficacy/Effectiveness of Very–Low-Calorie Diets as Used as Part of a Comprehensive Lifestyle Intervention:
"A Comprehensive, high-intensity, on-site lifestyle interventions that include a medically supervised very–low-calorie diet (often defined as <800 kcal/d), as provided by complete meal replacement products, produce total weight loss of approximately 14.2 kg to 21.0 kg over 11 to 14 weeks, which is larger than that produced by no intervention or usual care (i.e., advice and education only)."

•Strength of Evidence: High

Will I use meal replacements?
We recommend beginning with a complete meal replacement program for women who have 30 pounds or more to lose and men who have 40 pounds or more to lose. We do offer modified plans with one grocery meal per day if a person can not do the full protocol for medical reasons or for those who can not tolerate the full meal replacement protocol for any reason. If you have less than 30 pounds to lose, we have the option of one meal replacement and one medical food snack per day. Weight loss will be half the pace and take twice as long.


Do you offer all grocery meal programs?
We have a limited number of openings for all grocery meal programs. They require individual, more extended visits for nutrition counseling, complete and accurate food diaries, regular body composition testing, resting metabolic rate testing, and exercise assessment and coaching. Applications are subject to approval by our chief medical officer.

How much weight will I lose?
Our programs are intended to result in loss of 60-80% of excess body weight if all components are followed. If there are medical conditions or medications that affect metabolism or limitations on exercise, it may be less.


How fast will I lose weight?
Our “gold standard” full meal replacement protocol typically results in weight loss of 3-7 pounds per week. A modified plan with one grocery meal per day typically results in weight loss of 2-4 pounds per week. A plan with more than one grocery meal per day typically results in 1-2 pounds weight loss per week.

How long will I be on meal replacements?
That depends on how strictly you follow the protocol. If you follow it strictly, you can take the total excess body weight, multiply by 0.8, divide by 3 for women and 4 for men, and get an estimate.

How often do I need to come in? You need to come in every week as long as any of the following applies:

- You are in the first 4 weeks of a weight loss program
- You are on 800 calories a day or less
- You have diabetes and are on insulin or your blood sugars are not at goal
- You are on a water pill, have congestive heart failure or kidney disease and are in active weight loss
- Any other time the chief medical officer believes it is medically necessary.
If none of the above applies, it is still recommended you come in every week while in active weight loss. However, every 2 weeks is allowed as long as results are progressing as expected.

What Insurances do you accept?

We currently accept Aetna, Cigna, First Choice, Group Health, Medicare, Regence and Premera but contact us if you have different insurance as the list is expanding and we can provide you with the documentation to obtain reimbursement directly as well. We are a part of Multicare Connected Care as well. 

How much does it cost?
Our professional services are billed to you health insurance, if applicable. However, as with all medical care, you should expect some portion of covered services to fall under “patient responsibility.”

These typically come from:
- Deductible
- Copays
- Coinsurance
- Denied claims (many reasons insurance may deny a claim, such as: exclusion on policy, medical necessity, not covered for that diagnosis, etc). Out of pocket costs that are not covered by insurance but may fall under FLEX spending or HSA or unreimbursed medical expenses on tax returns are:
- Enrollment fee 
- Monthly body composition analysis 
- Monthly supplements in active weight loss 
- Medical foods 
- Most anti-obesity pharmaceuticals 

What labs do I need to get and how often? We require complete blood work within 30 days of starting and basic blood tests monthly while on a meal replacement program, or more often if medically necessary.

Do you have weekend and evening appointments?
No, we do not have weekend and evening appointments. We have some 7 am appointments and some 4:30 or 5 pm appointments. We can complete FMLA paperwork if you need to miss work. We offer a variety of online resources as well. But, you still need to follow the guidelines above for how often you need to come in during active weight loss. The minimum you can get to is every 2 weeks after the first month on a modified program. In
maintenance, you can order meal replacements online.

Do I have to do the same program as my friend who has participated?

No, you do not have to do the same program as everyone else.  There are many different ways to reach a healthier weight, and since we have a physician and registered dietician, we can tailor a program that works for you. So, if you know someone who has lost weight at our clinic but do not think their program is best for you, a program can be tailored during your physician consultation.

Can I purchase meal replacements online?

Yes, if you are part of our program.