Earlier this month, the first class of pioneering soon-to-be weight management experts gathered for the inaugural Clinical Weight Management Certification Program in Scottsdale, Arizona. This immersive experience was filled with insightful lectures, thought-provoking discussions, and engaging collaborative learning opportunities that left participants empowered and equipped with the critical knowledge and skills needed to navigate the complex weight management landscape. Amid the current obesity epidemic and craze surrounding Ozempic and similar “miracle” weight loss drugs, acquiring expertise in this field has become increasingly vital for healthcare providers across disciplines.

Renowned faculty members took the stage — including specialty leaders Ben Gonzaléz, MD, Gordon Crozier, DO, and James LaValle, RPh, CCN, MT — sharing their wealth of knowledge and presenting a practical, integrative approach to weight management. Drawing from their extensive experience as leaders in the functional and integrative weight management revolution, they provided attendees with easily applicable tools and protocols designed to achieve sustainable, long-term results for their patients.

Newly minted certification holders raved about the Clinical Weight Management Certification Program, citing its timeliness, relevance, esteemed faculty, and comprehensive scope as the primary reasons for their satisfaction. They praised the course’s ability to bridge the gap between the latest research and clinical application, providing a solid foundation for success in the ever-evolving field of weight management.

For those unable to attend, we’re delighted to offer a sneak peek into the transformative education this certification provides — before its second iteration occurs October 24-25 in Boston, MA.

In the following sections, we’ll reveal some of the key takeaways and innovative interventions redefining the field of clinical weight management, as captured in our detailed lecture notes.

Takeaways From The First-Ever Clinical Weight Management Certification Program

From precision diagnostic tools to personalized treatment protocols, the course prepares healthcare providers to deliver the most effective, evidence-based care to patients struggling with weight-related issues. It features an all-encompassing curriculum of essential education for guiding patients toward long-term effective, sustainable, and health-optimized weight outcomes, as well as actionable strategies for ensuring success in the clinical setting. Explore some of the leading-edge learnings from the Clinical Weight Management Certification Program below.

“Managing Cortisol and Thyroid Hormones” presented by Gordon Crozier, DO

Gordon Crozier, DO, a recognized leader in integrative medicine and a pioneer in genetics-based medicine, shared his endocrinology expertise with course participants during his presentation, “Managing Cortisol and Thyroid Hormones.” Dr. Crozier emphasized the impact of chronic stress on cortisol levels, explaining how prolonged elevation of cortisol can lead to weight gain and other health issues. He highlighted the need for a multi-dimensional approach to stress support, including supplements, medications, and lifestyle interventions. These strategies aim to balance and optimize the adrenal glands and thyroid function, two crucial components of the endocrine system that play a significant role in regulating metabolism and overall wellbeing. Dr. Crozier’s lecture underscored the importance of addressing stress and hormonal imbalances to achieve sustainable weight management and improved health outcomes.

Lecture Notes

Systems Biology Approach and Systems Theory 

• Emphasis on the importance of understanding the interconnectedness of bodily, such as the thyroid, adrenal glands, and pancreas, for a whole-patient approach to healthcare.

• It is essential to recognize the relevance of systems theory in medical practice, offering a comprehensive framework for analyzing and treating systemic health issues like obesity from an interdisciplinary perspective. 

• GLP-1 effects: GLP-1 (Glucagon-like peptide-1) is closely intertwined with the thyroid, adrenal glands, and pancreas, emphasizing the hormone’s role in managing conditions related to these organs.

Impact of Circadian Rhythm and Hormonal Imbalance

• Imbalances in hormones, specifically with an increase in cortisol (a stress hormone) and a decrease in DHEA (a hormone involved in producing sex hormones), can lead to various health issues: thyroid dysfunction, altered immune function, increased fat deposition, muscle wasting, and increased cardiovascular risk factors.

• Circadian rhythm plays a significant but often understated role in weight management interventions. 

• Healthcare providers should consider the timing of biological processes when developing treatment plans for maximum efficacy.

The Dangers of High Cortisol  

• Chronic elevation of cortisol is illustrated to have numerous adverse effects, including immune dysfunction, hypothyroidism due to adrenal exhaustion, memory loss, emotional instability, bone and mineral loss,

• Managing stress and cortisol levels is critical for overall health and improving patient outcomes. This is especially important in the case of metabolic dysregulation. 

• Prolonged periods of elevated cortisol can result in metabolic consequences such as increased insulin secretion, fat deposition, and an increased risk for cardiovascular diseases.

HPA Axis Adaptability

• The adaptability of the HPA (hypothalamic-pituitary-adrenal) axis to stressors and environmental changes has profound implications for health and maintaining balance within the body. Imbalances in this system greatly heighten the risk of disease.

• Imbalances in the body — whether hormonal, metabolic, circadian, or related to other systems — can lead to the development of various diseases, emphasizing the significance of homeostasis for optimal health.

“GLP-1 Natural Alternative Amarasate and Its Use to Wean Off Injectable GLP-1s” presented by Ben González, MD 

Renowned integrative medicine expert and one of the leading authorities in metabolic and obesity medicine, Ben González, MD, delivered enlightening lectures on the connection between sex hormones and weight loss and the GLP-1 natural alternative, Amarasate. During his session on this natural compound, Dr. González provided a comprehensive overview of the benefits and mechanisms of Amarasate, a bitter hops extract that aids in weight loss by triggering the release of GLP-1, which regulates appetite and glucose metabolism. Dr. González emphasized the importance of whole-person approaches to metabolic health, stressing the significance of adjunct therapies like GLP-1 receptor agonists and dietary modifications in achieving sustainable weight loss and improved overall health. He highlighted the potential of Amarasate as a natural alternative to injectable GLP-1s, offering a promising option for patients seeking to wean off these medications. Throughout his lecture, he reiterated the importance of an educated, measured, and comprehensive clinical approach to obesity and metabolic health, leveraging both pharmacological and non-pharmacological strategies for effective patient management.

Lecture Notes

Insulin Resistance as a Root Cause

• Recognizing the central role of insulin resistance in non-infectious diseases emphasizes the need for healthcare providers to identify and address it early. This involves understanding the pathophysiology of insulin resistance and its contribution to conditions such as type 2 diabetes, cardiovascular disease, and obesity. Strategies include lifestyle interventions like diet and exercise modifications.

Importance of GLP-1 Receptor Agonists (RAs) 

• Given that the class of GLP-1 RAs is becoming increasingly popular for managing conditions like diabetes and obesity, providers must understand their mechanism, benefits, and how to responsibly integrate them into treatment plans. This also involves recognizing situations where their use might not be appropriate and managing expectations regarding outcomes.

• GLP-1 RAs, including preparations from bitter hops extract (Amarasate), play a significant role in managing metabolic issues, but they must be used judiciously and in combination with lifestyle modifications.

• It is important to stay current on emerging research on how bitter receptors influence appetite, digestion, and metabolic health.

Amarasate: The Natural GLP-1 Alternative 

• Amarasate, a natural GLP-1 activator, holds significant potential in the realm of innovative integrated treatment strategies for weight management and metabolic health. Its role in stimulating GLP-1 activation has garnered attention in clinical settings, offering a promising alternative to injectable GLP-1s.

• Currently, one of its key applications is in assisting the transition of patients away from injectable GLP-1 RA therapy. 

Transitioning Patients From GLP-1 RAs to Amarasate 

• The process begins with assessing the patient’s metabolic status, including a complete metabolic evaluation of hormones, insulin resistance, and inflammatory markers.

• Once this is completed and the patient is already on GLP-1 RA therapy, the next step is administering Amarasate. The process includes starting Amarasate while the patient is still on GLP-1 RA therapy and then gradually tapering off the GLP-1 RA.

• Alongside the medication shift, lifestyle and dietary changes play a crucial role in the success of this transition. Patients should be encouraged to clean their fridges and pantries to avoid diet or prescription rebound behavior, setting the stage for healthier dietary practices. 

• Important: The transition from GLP-1 RA to Amarasate must be accompanied by continuous monitoring, goal setting, and identifying and addressing any factors that could sabotage progress. 

• By providing ongoing support and guidance, healthcare providers can ensure a smooth transition to GLP-1 RA therapy and help patients achieve sustained weight management and metabolic health improvements.

“Sleep and The Reprogramming of the Master Slave Clock” presented by Marisol Duque, MD

Marisol Duque, MD, a prominent medical surgeon specializing in integrative and bio-regenerative medicine, delivered presentations on strategies for managing skin elasticity and the importance of sleep optimization on patient health outcomes. With a strong emphasis on patient awareness and healthy habits, Dr. Duque delved into the significance of circadian rhythms, the body’s internal 24-hour clock that regulates various biological processes. She explained how disruptions to the circadian rhythm, often caused by poor sleep habits, can have far-reaching effects on health, including impaired cognitive function, metabolic disorders, and even accelerated aging. By emphasizing the centrality of sleep and the circadian rhythm to overall health, she provided attendees with a multifaceted approach to sleep support that can be seamlessly integrated into patient care.

Lecture Notes

Understanding and Promoting Circadian Rhythm Synchronization

• The circadian clock dictates the best time for everything we need to do throughout the day, a proper hour for everything that happens in our body. The circadian timing system synchronizes the body’s internal clocks to adapt and optimize physiology to environmental changes. Circadian misalignment leads to negative health and behavioral outcomes. 

Importance of Quality Sleep

• Detrimental effects of sleep disturbances include disruptions in circadian rhythms, growth hormone release, inflammation, insulin resistance, and weight gain. Practitioners must prioritize interventions that improve sleep quality as part of a comprehensive weight management treatment plan.

Recommendations for Healthy Sleep Practices

• Key strategies include ensuring adequate sleep timing (8 hours), delaying eating in the morning, engaging in intermittent fasting or Time-Restricted Eating (TRE) (ranging from 8 to 12 hours), spending time outdoors (>30 minutes of daylight), daily exercise preferably in the afternoon, avoiding bright lights and caloric intake 2-3 hours before bedtime, meditation, and maintaining consistency in sleep patterns.

Melatonin’s Role in Sleep Support

• Melatonin is a critical sleep-regulating hormone that decreases with age and may be affected by various medications and lifestyle factors.

• Melatonin supplementation should be considered cautiously, including 3-20 mg one hour before bedtime dosages and monitoring for paradoxical effects, especially in patients taking medications that may deplete melatonin levels.

Glycine for Sleep and Stress Reduction

• Glycine’s potential anxiolytic effects suggest it could be beneficial for improving sleep quality and reducing stress. By modulating neurotransmitter activity, the compound may help patients reach a calm state that is more conducive to sleep and help patients struggling with sleep disorders.

Melatonin Depletion Caused by Medications

• Several common medications can reduce melatonin levels and adversely impact sleep. These include beta-blockers, calcium channel blockers, benzodiazepines, estrogen-containing medications, hydralazine, antidepressants, and NSAIDs.

“Gut-Immune-Brain Connection” presented by James LaValle RPh, CCN, MT

James LaValle, RPh, CCN, MT, the newly appointed Chief Science Officer of Life Time Fitness, brought a wealth of weight management wisdom to the course participants, drawing from his decades of experience as an internationally recognized clinical pharmacist, nutritionist, and integrative and precision medicine expert. As an invaluable resource for attendees, LaValle shared his extensive knowledge on a wide range of topics, including metaflammation, mitochondrial fitness, and the gut-immune-brain connection, which is central to metabolic wellness. During his insightful lecture on the gut-immune-brain axis, LaValle delved into the complex, multifaceted, and synergistic relationship between these three critical systems. He explored the nuanced factors that influence each axis component, shedding light on how their intricate interplay contributes to the development of various health conditions, such as obesity, diabetes, and metabolic disorders. Throughout his presentation, LaValle provided a comprehensive understanding of the gut-immune-brain axis, empowering them with the knowledge necessary to develop targeted, personalized interventions for their patients.

Lecture Notes

Understanding the Gut-Immune-Brain Axis

• Intricate connections between the gut, immune system, and brain must be considered to ensure effective, comprehensive patient care.

• Disruptions in gut health impact inflammatory responses, metabolic disorders, and cognitive functions — all three aspects of the gut-immune-brain axis. 

• Inflammation, immune responses, and altered brain volumes are linked to obesity-related and cognitive health issues. 

• Chronic stress, microbiome dysbiosis, and drug effects impact metabolic pathways.

• Heightened activation of the immune system as a result of gut issues in obesity plays a role in the development of type 2 diabetes, metabolic syndrome, and cardiovascular diseases.

Managing Gut Health

• Strategies to promote a healthy gut microbiome include introducing probiotics, dietary modifications, lifestyle interventions, and more. 

• Addressing leaky gut, dysbiosis, and endotoxins is vital to mitigate inflammation and metabolic complications.

• Microbial imbalances and endotoxins (e.g., lipopolysaccharides) play significant roles in metabolic disorders.

Navigating Neurotransmitter Imbalances

• Neurotransmitter regulation has a direct influence on eating behaviors and the success of weight management strategies. 

• For example, serotonergic signaling impacts food intake, cravings, and weight regulation. Dopamine and serotonin imbalances contribute to obesity via food cravings, satiety levels, and disrupted reward mechanisms, also known as reward deficiency syndrome.

Medications and the Microbiome

• In addition to antibiotics and NSAIDs, drugs that commonly affect the microbiome and can lead to gut dysbiosis include corticosteroids, oral contraceptives, hormone replacement therapies, proton pump inhibitors (PPIs), metformin, statins, antipsychotics, opioids, and likely numerous others that have yet to be studied.

These are just a few learning points derived from the program’s expert-led presentations; the full breadth of the knowledge shared over the two-day event cannot be distilled into an article, reflecting the depth of insight and level of understanding course participants have gained. 

As the inaugural class of A4M-certified weight management specialists, these pioneering healthcare professionals are now ready to guide their patients toward achieving healthy, sustainable, and long-term weight loss. Armed with the most advanced, evidence-based strategies and a thorough grasp on the complex factors involved in weight management, these trailblazers are set to transform the lives and health outcomes of countless individuals struggling with obesity and related health challenges, paving the way for a healthier future.

Your next chance to become a certified clinical weight management expert awaits in Boston, MA, this October!

Following the resounding success of the inaugural event and in response to the growing number of practitioners eager for this training, A4M has organized the second iteration of the Clinical Weight Management Certification Program to take place between October 24-25, 2024, in Boston, MA. Click here to learn more about this game-changing certification and secure your early-bird spot!