Dr levine, pp presentation,,tsfl staff training, medifast 12-5-10

Dr. Levine’s Staff Training Guide

to Implement Take Shape for Life

Dr. Ellyn Levine(858) [email protected]

About the Company Highlights of the Program How Weight Loss Occurs Safe & Effective Teaching Patients the Program Habits of Health DVD

Staff Training Overview

2

BeSlim Discount Program Specialty Products Transition Maintenance When Ready to Implement Ordering Instructions My Office in Motion Support

Program is called Take Shape for Life (not Medifast)

( (“TSFL “)

TSFL is the coaching division of Medifast, Inc. (NYSE: MED)

Physician Developed -- Brainchild of Dr. Wayne Anderson who believed that permanent weight loss is more likely by taking a time honored clinically proven program and combining it with an individual for support and guidance throughout the weight loss process.

About the Company

3

Patients eat five pre-portioned, soy based meal replacement program and one healthy meal (“5 & 1”) consisting of a lean protein and non-starchy vegetables (“Lean & Green”).

Patients Lose 2 – 5 lbs. per WEEK while on the “5 & 1” program

Simple to Teach, Easy to Learn, and Patients love the Program

Straight Forward Patient Protocols & Contraindications

Clinically Proven, Safe & Effective

Highlights of the Program

4

Low Calorie with Average intake of 900 calories/day Reduced Carbohydrates (less than 85gm/day) Metabolism improves Ketosis (from low carbohydrate intake)

◦ Ketosis is the key to the 2-5 lbs/week weight loss◦ Takes 3-5 days to get into Ketosis◦ Reduced carbs cause body to metabolize stored fats◦ Fat-Burning State

Reduces Hunger Increases Energy Prevents muscle loss Alcohol, grains, pasta, fruit and high starchy vegetables like carrots or corn are not

permitted in the beginning phase because they are too high in carbohydrates.

How Weight Loss Occurs

5

Johns Hopkins University◦ Used program for over 20 years as their weight loss program of choice.◦ Many clinical studies conducted including it superior to the ADA Plan

for Diabetics in a 45 week study.

Medifast® Meals ◦ Introduced in 1980◦ Used by More than 1 million people◦ Over 20,000 doctors recommend the product currently◦ Majority of meals earn distinction of the FDA heart healthy label due to

low fat content

Safe & Effective

6

Teach the “5 & 1” Explain the Lean & Green Reviewing Meal Plan Cost Overview Review Quick Start Guide Provide Custom Overview (I will personalize for you) Take & Input Order

Teaching Patients

7

Teaching Patients: About the “5 & 1”

Eat 5 Medifast Meals + 1 Lean and Green Meal

Each day choose 5 meals from over 70 Medifast meal choices. All meals are interchangeable so you can choose a variety or even choose thesame product for your 5 meals/day.

Enjoy one self-prepared meal consisting of a “lean” protein like fish, meat, or tofu and a serving of non-starch vegetables for your “green”.Can be at any time that works with your schedule.

8

Teaching Patients: Lean & Green Meal: The “Lean”

Choose meats that are grilled, baked, broiled or poached – not fried.Note: Serving ounces represent cooked weight (not raw).

•Fish: cod, flounder, haddock, orange roughly, grouper, tilapia, mahi mahi, tuna (yellow fin steak or canned in water), wild catfish

•Shellfish: crab, scallop, shrimp, lobster•Game meat: deer, buffalo, elk•Ground turkey or other meat: ≥ 98% lean•Meatless options:•14 egg whites•2 cups of Egg Beaters®

•2 Boca Burger ® Morningstar Farms®, or Garden Burgers® patties, or other varietieswith < 6 grams of carbohydrates /patty

LEANER: Choose a 6-oz portion Plus 1 Healthy Fat Serving

LEANEST: Choose a 7-oz portion Plus 2 Healthy Fat servings

• Fish: swordfish, trout, halibut• Chicken: breast /white meat

without skin• Ground turkey or other meat:

95–97% lean• Turkey: light meat• Meatless options:• 15 oz extra-firm tofu• 2 whole eggs plus 4 egg whites

LEAN: Choose a 5-oz portion No Healthy Fat Choice

• Fish: salmon, tuna (blue fin steak), farmed catfish, mackerel, herring

• Lean beef: steak, roast, ground• Lamb• Pork chop or pork tenderloin• Ground turkey or other meat:

85–94% lean• Chicken or turkey: dark meat• Meatless options:• 15oz firm or soft tofu• 3 whole eggs (limit to once a week

9

Portions based on COOKED weight.

Healthy Fat (Add 0-2 fat servings as indicated on the “Lean” table One fat serving is equal to one of the following:

◦ 1 teaspoon of oil (canola, flaxseed, walnut or olive)◦ 5-6 black or green olives◦ Up to 2 tablespoons of salad dressing (must be <6gm of carbs and <5gm of fats/serving)◦ 1 teaspoon of trans fat-free margarine◦ Other less healthy fat choices include 1 tbsp of skim, 1%, 2%, whole or half & half

Teaching Patients: Healthy Fat Servings

10

Teaching Patients: Lean & Green Meal: The “Green”

All vegetables promote healthful eating; however, during the weight-loss phase of yourPlan, we do eliminate the highest-carbohydrate vegetables (such as carrots, corn, peas, Potatoes, onions, edamame, and brussel sprouts) in order to enhance your weight-lossresults.

LOWER CARBOHYDRATE

•1 cup: collards (fresh/raw), endive, lettuce (green leaf, butterhead, iceberg, romaine), mustard greens, spinach (fresh/raw), spring mix, watercress.

•½ cup: celery, cucumbers, white mushrooms, radishes, sprouts (alfalfa, mung bean), turnip greens, arugula, nopales, escarole, jalapeño (raw), Swiss chard (raw).

MODERATE CARBOHYDRATE

•½ cup: asparagus, cabbage, cauliflower, eggplant, fennel bulb, kale, portabella mushrooms, cooked spinach, summer squash (scallop or zucchini).

HIGHER CARBOHYDRATE

•½ cup: broccoli, red cabbage, collard or mustard greens (cooked), green or wax beans, kohlrabi, okra, peppers (any color), scallions (raw), summer squash (crookneck or straightneck), tomatoes (red, ripe), turnips, spaghetti squash, hearts of palm, jicama (cooked), Swiss chard (cooked).

11

3 Servings of Vegetables Listed Below

Enjoy up to 3 servings a day. Each of the following equals 1 serving:

◦ ¼ - ½ teaspoon: most dried herbs & spices◦ ½ teaspoon: catsup, BBQ sauce, cocktail sauce◦ 1 teaspoon: soy sauce, balsamic vinegar◦ 2 teaspoons: lemon or lime juice◦ 1 tablespoon: yellow mustard, tomato salsa, most fresh herbs, unsweetened

milk or soy milk, chopped onion◦ 1-2 tablespoons: zero calorie, sugar free flavored syrup such as in Torani® or

DaVinci® brands. ( Can be used on Medifast pancakes or added to beverages) ◦ Up to 3 tablespoons: hot sauce, Tabasco® sauce; red, white or cider vinegar◦ 1 packet: artificial sweetener (Equal®, Splenda®, etc.)

Teaching Patients: Condiments & Seasonings

12

In addition to the “5 & 1” Plan When Needed Not meant to be used daily as they contribute to unwanted additional calories and may hinder weight loss. Snacks are not to be eaten in place of Medifast Meals Can be eaten at any time of day, does not follow the 2-3 hour rule Choose ONE of the following optional items/day:

◦ 3 celery stalks◦ 1 fruit flavored sugar-free Popsicle®◦ ½ cup of sugar-free gelatin dessert, such as Jell-O®◦ Up to 3 pieces of sugar-free gum or mints◦ 2 dill pickle spears◦ 1 Tbsp peanut butter◦ ½ oz of nuts: 10 whole almonds or 7 walnuts halves or 20pistachio kernels * ◦ Medifast has a snack line with soy crisps and crackers-only 1 package per day

Teaching Patients: Optional Snacks

*Nuts are sources of healthy fat and additional calories. These do not substitute for the other healthy fat options

13

Example Day:◦ 6:00am Wake Up◦ 6:30am Medifast (MF) #1 - Shake◦ 9:00am MF#2 - Crunch Bar◦ 11:30am MF#3 – Soup◦ 2:00pm MF #4 – Crunch Bar◦ 3:00pm Snack – 3 celery sticks◦ 5:30pm Lean & Green Mean: 6 oz chicken breast, 1 cup lettuces, ½ cup

tomatoes, ½ cup cucumber with 2 tbs salad dressing(low fat/low carb)

◦ 8:30pm MF#5 – Pudding

◦ Notice how meals are spaced 2- 3 hours apart

Teaching Patients: Write Out Your Daily Meal Plan

14

Read “Quick Start Guide” before starting the program. Always have the Lean and Green Reference Guides accessible when planning your

lean and green meal Have an accurate weight scale in your home to gauge your progress You should lose 2-5lbs/week in the initial phase of the program. If this does not

occur seek guidance from your health coach or the Medifast support team since you may be inadvertently exceeding the 85gm of carbs recommended per day.

First 3 days can be very difficult for some. Once in Ketosis, the fat burning state, it will become much easier, so hang in there.

It is common to have a plateau phase so do not get discouraged. Continue the program exactly as described and weight loss should resume.

“BeSlim” club members receive automatic reordering reminders and special discounts. If you are not on “Be Slim”, re-order by week 3 so you don’t run out of food.

Teaching Patients: What Patients Need to KnowTo Achieve Weight Loss

15

Plan Your Meals and Meal Times◦ Eat 5 Medifast Meals and 1 “Lean and Green”/day◦ Plan your Lean and Green meal in Advance◦ Space meals 2-3 hours apart◦ Eat first meal no later than 60 minutes after awakening to “kick start“

your metabolism◦ Consider setting your alarm on your cell phone as reminder◦ Carry extra Medifast crunch bars or pretzels when away from home to

keep routine from getting interrupted◦ Medifast Meals are interchangeable; choose any product combination,

even if they are all the same Example: 5 Medifast crunch bars and 1 lean and green meal is ok. Avoid Medifast

maintenance bars in the initial loss phase since they are higher in carbs than crunch bars.

Teaching Patients: When Patient Food Arrives-Getting Started

16

Never Skip a Meal (Very important since you can become nutritionally depleted of essential vitamins/minerals & hair loss may even occur.)

Drink at Least 64 oz of water/day Cut Back the Caffeine to less than 3/day since your low calorie state may make you

more sensitive to the effect of caffeine. Do Not Cheat ! (not even a little). Absolutely no alcohol, no bread, no fruit or you will

kick yourself out of the fat-burning state which takes 3 days to get back into. Measure Food Portions and Lean/Green Guidelines Strictly with a food scale &

measuring cups/spoons. 1 Snack per Day is optional. Have only if you need it. Try to avoid daily use. Don’t Over Exert Yourself. If not exercising, best to wait 2-3 weeks while body gets

adjusted. Keep exercise to less than 45 min/day while in weight loss phase. Find a Buddy. Co-workers, family members and friends are great to have join you

in this lifestyle change.

Teaching Patients: Tips for Success

17

Sugar Free Fiber or Probiotics◦ Constipation can occur due to reduced calories. (less in = less out). If needed,

use sugar free fiber for regularity like Psyllium.◦ Consider adding a probiotic like Medifast’s Essential 1 Digestive Health

supplement if you experience excessive gas or bloating.

Vitamins / Minerals ◦ Medifast meals are fortified with vitamins and minerals◦ Supplemental vitamins and minerals are acceptable but avoid those that are in

liquid, chewable or powder forms as they often have added carbohydrates which may interfere with the fat burning state

◦ Medifast® Essential 1® supplement product line available for purchase

Teaching Patients: Supplements

18

Habits of Health” Books/DVD

Habits of Health series teaches patients: Healthy Choices Beginning non-gym exercise Companion Workbook to reinforce learning DVD to walk patient thru book and workbook Available individually or as a “combo pack”

Book - $29.95 Workbook - $17.95 DVD – $14.95 All 3 for $64.95

19

Always put patients on this to begin◦ Free Shipping (orders over $225)◦ 5% Discount (progresses to 8% after 3 months and 12% after 6 months)◦ Free Week of Meals (each of first two orders)◦ Monthly Re-order. ◦ Make sure patient knows username and password

BeSlim is an acronym used for the Take Shape for Life program. ◦ B- Breakfast L - Low Fat Meals◦ E- Exercise I - Individual Meals◦ S- Support M – Monitor by following weight regularly

BeSlim Discount Program

20

There are Medifast ® meals that are:◦ Gluten Free◦ Kosher◦ Dairy Free◦ Lactose-Free◦ Vegetarian◦ Diabetic Forumulations

◦ Ask your health coach for guidance when these dietary modifications are necessary

Specialty Products Available

21

Transition (4-16 Weeks)

Follow Published Guide Four one-week stages are recommended:

Stage 1: One Cup additional veggies + “5 & 1” Stage 2: One medium-size piece fresh fruit + “4 & 1” Stage 3: ½ cup low-fat or fat-free dairy + “4 & 1” Stage 4: One serving of whole grain + “3 & 1”

Habits of Health and guide book helps them choose Length of Stage 4 varies based on weight loss from 4 – 16

weeks.

22

Transition (continued)

23

Calories Taken In = Total Energy Expenditure Calculate the BMR for the patient (details in guide) Many do well with 2-3 Medifast Meals® to keep

calories in check

Maintenance

24

Maintenance:Calculating BMR

25

Maintenance:Total Energy Expenditure Chart

Example for 5’4” Female

26

1. Place posters in waiting room and exam rooms

2. Prepare patient information handouts.

3. Instruct patients to see staff on way out of office for teaching and ordering or have patients make return appointment specifically for teaching and ordering

4. Teach patients various support options available

5. Have patient sign consent form

When Ready to Implement

27

Recommend Placing First Order For Them Set Up BeSlim Variety Pak vs. Individual Items◦ Variety Pack – 5 Weeks of Food – Sampling of Best Sellers◦ If picky, or has strong dislikes, order 20 boxes of individual items

Make sure patients aware that only the first month is ordered Provide patients with their username and password either at

the time of ordering or by follow up email.◦ Username: I use first / last name combined (e.g. JudySmith)◦ Password: I always use “welcome”

Ordering Instructions

28

Website for Take Shape for Life Coaches:◦www.MyOfficeInMotion.com◦ User Name is your 8 digit TSFL number assigned in welcome

email.◦ Password in shopping cart password used to purchase

enrollment (I usually set up as “welcome”). Use this site to:◦ Look Up / Track Client Orders◦ Commission Reports◦ Co-branded Website Management◦ Library of Documents

My Office In Motion

29

Support Options

Dr. Ellyn Levine(858) 663-1671

www.TheObesityZone.com (Office Guide)www.DrLevine.TSFL (Product Orders)[email protected]

Martin GoodmanCertified Health Coach(619) [email protected]

Support in Motion 24 hour online supportwww.tsflsupportmotion.com

Nutrition Support Monday-Friday 9am-5pm [email protected]

Nurse’s CallMonday 8:30pm-9pmET(646) 519-5860 pin 0971#

Doctor’s CallWednesday 8:30p – 9pm ET(646) 519-5960 pin 0971#

Maintenance CallWednesday 8pm-8:30pmET (512) 225-9427 pin 77421#

Client Contact CenterMonday-Friday 8:00am-11:00pm ETSaturday-Sunday 9:00am-6:00pm ETPhone: 800-572-4417 option 1Fax: [email protected]

30