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Clinician delivering treatment to a patient in a treatment room at Padda Institute, St. Louis

Medical Weight Loss

Ask whether physician-led weight management belongs in your care plan. Complete the form and we will contact you.

Overview

For a large number of our patients, weight and pain are not two separate problems. Adipose tissue is metabolically active and pro-inflammatory, and it adds mechanical load to exactly the joints that already hurt. Treating one while ignoring the other is why some patients plateau.

This programme is led by Dr. Gurpreet Singh Padda, MD, MBA, MHP, who is board certified in Obesity Medicine as well as Anesthesiology, Pain Medicine, Interventional Pain Management and Addiction Medicine. It is a clinical programme built on your own metabolic and inflammatory markers — not a commercial diet.

Diagnostic ultrasound cart and exam table at Padda Institute, St. Louis

What the Programme Includes

  • Health coaching — structured, ongoing accountability rather than a single consultation.
  • Nutritional counselling — built around whole food, adequate protein and reducing the refined carbohydrate and industrial seed oils that drive inflammation.
  • Medication where clinically appropriate, prescribed and monitored by a physician as part of the programme rather than on its own.
  • Lifestyle medicine — sleep, circadian alignment and the daily patterns that determine whether any of the above holds. See our lifestyle medicine page.
  • Exercise therapy — graded movement that respects the structural problem instead of aggravating it.

How We Start

A physician-led evaluation that looks at the metabolic terrain, not just the scale: metabolic and inflammatory markers, sleep, nutrition, medication review and the structural sources of pain that limit movement. From there we build a plan and decide together which of the five components you actually need.

Do not start, stop, or change any medication without consulting your physician. Individual results vary.

Counseling and group therapy room at Padda Institute, St. Louis

What the Evidence Supports

Weight, load and joint pain

Messier and colleagues reported in JAMA in 2022 that diet and exercise together produced greater reduction in knee pain than control in adults with knee osteoarthritis and overweight or obesity. Their earlier IDEA trial, also in JAMA, showed intensive diet and exercise reduced knee joint loads and inflammatory markers.

Metabolic health

The DiRECT trial, published in The Lancet, showed that a primary-care-led weight management programme produced remission of type 2 diabetes in a substantial proportion of participants, with durability demonstrated at two years. Weight is a lever on metabolic disease, and metabolic disease is a lever on pain.

What This Is Not

  • Not a cosmetic programme. The goal is function, metabolic health and pain.
  • Not a guarantee. We do not publish success percentages, and individual results vary.
  • Not a substitute for treating the structural problem — see interventional pain management.
  • Not a standalone prescription. Medication without coaching, nutrition and movement is the approach that has already failed most people who come to us.

Related Reading

Wide view of the interventional procedure suite with C-arm fluoroscopy during a procedure at Padda Institute, St. Louis

Treat the Metabolic Driver, Not Just the Symptom

Serving St. Louis, St. Louis County and St. Charles, and drawing patients from across Missouri and Illinois. Call or text us to discuss whether this fits your plan.

Call Us : 314-481-5000

What Our Patients Say

Individual results vary. These are unpaid patient testimonials shared with permission and are not a guarantee of outcome. See all patient stories.

Medical Weight Loss: Frequently Asked Questions

Because in many patients the two problems are the same problem. Excess adipose tissue is metabolically active and pro-inflammatory, and it increases mechanical load on weight-bearing joints. A randomised trial published in JAMA in 2022 found that diet and exercise together produced greater reduction in knee pain in adults with osteoarthritis and overweight or obesity than control. Treating the load and the inflammation is treating the pain generator. Individual results vary.

Five components, used in combination and adjusted to the individual: health coaching; nutritional counselling; prescription medication where clinically appropriate; lifestyle medicine; and exercise therapy. It is physician-led, not a commercial diet plan, and it is built around your metabolic markers rather than a fixed template.

Medication is one of the tools we use, prescribed and monitored by a physician as part of the wider programme rather than on its own. Whether medication is appropriate for you, and which one, is a clinical decision made at evaluation. Do not start, stop, or change any medication without consulting your physician.

For patients on long-term opioid therapy, metabolic and nutritional participation is part of the treatment agreement rather than an optional extra, because it is what allows medication to come down safely. If you are already under our care, ask at your next visit and we will fold it into your existing plan.

No, and we will not promise that. Weight is one driver among several, and structural problems still need structural treatment. What the evidence supports is meaningful improvement in pain and function for many patients, alongside better metabolic health. Individual results vary.

Padda Institute Center for Interventional Pain Management, 4477 Woodson Road, Suite 100, St. Louis, MO 63134, with a second location at 12174 Natural Bridge Road, Bridgeton, MO 63044. Book at painmd.tv/appointment/, call (314) 481-5000 or text (314) 886-5902.

References

  • Messier SP, Beavers DP, Queen K, et al. Effect of diet and exercise on knee pain in patients with osteoarthritis and overweight or obesity: a randomized clinical trial. JAMA. 2022;328(22):2242–2251. PMID 36511925.
  • Messier SP, Mihalko SL, Legault C, et al. Effects of intensive diet and exercise on knee joint loads, inflammation, and clinical outcomes among overweight and obese adults with knee osteoarthritis: the IDEA randomized clinical trial. JAMA. 2013;310(12):1263–1273. PMID 24065013.
  • Lean ME, Leslie WS, Barnes AC, et al. Primary care-led weight management for remission of type 2 diabetes (DiRECT): an open-label, cluster-randomised trial. Lancet. 2018;391(10120):541–551. PMID 29221645.
  • Lean MEJ, Leslie WS, Barnes AC, et al. Durability of a primary care-led weight-management intervention for remission of type 2 diabetes: 2-year results of the DiRECT open-label, cluster-randomised trial. Lancet Diabetes Endocrinol. 2019;7(5):344–355. PMID 30852132.

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Part of our complete guide to Interventional Pain Management in St. Louis.