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Why a personalized protocol, and not just another diet
Obesity and overweight are chronic diseases with a biological basis, not failures of willpower. Data from recent decades is clear: restrictive diets work in the short term and fail in the long term in the vast majority of cases. Not because patients are weak, but because the body defends its weight with powerful hormonal, neurological, and metabolic mechanisms.
Effectively managing weight therefore requires a clinical, multidisciplinary, and personalized approach. At Santé Clinics, we do not apply a single method or a single product. We build protocols that combine, depending on the patient, medicine, clinical nutrition, exercise, and body contouring devices. This article explains how we do it and what you can expect.
The starting point: a thorough clinical consultation
Everything begins with a medical consultation for a comprehensive assessment:
- Complete medical history: background, interventions, medication, comorbidities.
- Weight history: how your weight has evolved, previous weight loss attempts, moments of change.
- Nutritional history: relationship with food, previous diets, social and work context.
- Body composition: weight, height, BMI, abdominal circumference, bioimpedance to distinguish lean mass from fat mass.
- Analytical markers: glucose, insulin, HOMA-IR, lipid profile, liver and thyroid function, ferritin, vitamin D.
- Physical examination and blood pressure.
- Patient's goals, explicit and realistic.
From here, the plan is decided. Without this assessment, everything else is noise.
The tools we have
Weight Medicine (when indicated)
The big change in recent years has been GLP-1 receptor agonists (semaglutide in its Ozempic and Wegovy presentations) and dual GIP/GLP-1 agonists (tirzepatide, Mounjaro/Zepbound).
Indication: obesity (BMI ≥30) or overweight (BMI ≥27) with at least one associated comorbidity (hypertension, type 2 diabetes, dyslipidemia, sleep apnea, established cardiovascular disease). In type 2 diabetes, specific indication.
Documented benefits: weight loss of 15–22% depending on the drug and dose at 12–18 months, with significant metabolic improvements.
What it is not: it is not an “aesthetic” treatment to lose the last few pounds in a normal BMI. That indication does not exist.
How we do it: progressive titration, monthly medical follow-up, management of digestive tolerance, always accompanied by mandatory clinical nutrition.
Clinical Nutrition
The central piece of any protocol. What Santé's nutritionist does:
- Personalized plan according to objective, context, history, and preferences.
- Protected protein intake (1.2–1.6 g/kg of ideal weight/day) to preserve muscle mass.
- Nutritional density: vitamins, minerals, omega 3, hydration.
- Habit education for sustainability: meal distribution, quality, craving management, social life.
- Support: reviews every 2–4 weeks in the initial phases, monthly or bimonthly thereafter.
The nutrition consultation has its own cost as a specialized consultation and is part of the protocol.
Exercise
Without strength training, lost weight takes muscle as well as fat. Building/maintaining muscle during weight loss is what determines:
- Better final body composition.
- Better basal metabolism.
- Better ability to maintain the result.
- Better energy and well-being.
General recommendation: 2–4 strength training sessions per week + cardio as preferred + mobility. The nutritionist coordinates with your routine; if you need specific guidance, we refer you to trusted exercise professionals.
Body Contouring Devices
As significant weight is lost, the following often appear:
- Skin laxity in the abdomen, arms, inner thighs, buttocks, décolletage, double chin.
- Cellulite that becomes more visible with volume loss.
- Residual localized fat that does not go away with overall loss.
For each, there is an appropriate tool:
- Body HIFU: focused ultrasound for moderate laxity. Stimulates contraction and collagen production.
- INDIBA / Diathermy Radiofrequency: edema, microcirculation, skin quality, maintenance.
- Collagen stimulators (Sculptra, Radiesse): buttocks, arms, abdomen, inner thigh.
- Body Mesotherapy: personalized cocktails for light laxity, cellulite, skin quality.
- Lipolytic injections and cryolipolysis: residual localized fat.
- Lymphatic drainage and pressotherapy: complement for fluid retention and cellulite.
How a protocol is built: three real examples
Case A: 42-year-old woman, 88 kg, BMI 32, fatty liver, prediabetes
- Medical indication: GLP-1 (semaglutide or tirzepatide).
- Nutrition: plan with 1.4 g/kg protein intake, distributed in 3–4 meals, digestive management.
- Exercise: 3 strength sessions/week + 2 cardio sessions.
- Body contouring devices: INDIBA + mesotherapy from the start for cellulite. Body HIFU upon consolidating loss (month 6+).
- Follow-up: monthly medical, nutritional every 2–3 weeks, bioimpedance control.
Case B: 36-year-old man, 95 kg, BMI 29, abdominal circumference 102 cm, high work dispersion
- Medical indication: GLP-1 if comorbidity present. If not, nutritional plan + exercise without medication.
- Nutrition: plan adapted to irregular schedules, protected protein intake, strategy for eating out.
- Exercise: 3 strength sessions compatible with his schedule.
- Body contouring devices: submental lipolytic if prominent double chin. Cryolipolysis if localized abdominal fat upon weight stabilization.
Case C: 55-year-old woman, peri-menopause, 72 kg, BMI 26, abdominal redistribution and laxity
- Medical indication: probably not GLP-1 (criteria), although individually assessed. Nutritional strategy + exercise + body contouring devices.
- Nutrition: high protein intake (1.5 g/kg), adapted meal pattern, supplementation according to analytics.
- Exercise: priority strength + impact.
- Body contouring devices: body HIFU on abdomen, firming mesotherapy on arms, collagen stimulators on buttocks.
Three patients, three profoundly different plans.
What realistic results are
- With GLP-1 + support: average losses of 15–20% of body weight at 12–18 months in patients with obesity.
- Without medication, with well-executed nutrition and exercise: losses of 5–10% are consistently achievable and, if sustained, clinically very significant (improvement in metabolic markers, blood pressure, lipid profile, fatty liver, quality of life).
- The quality of the result (body composition, skin, consolidated habits) depends on the complete plan, not just the medication.
What we do not do
- We do not prescribe GLP-1 without medical assessment.
- We do not prescribe GLP-1 without mandatory nutritional follow-up.
- We do not sell restrictive diets without a clinical basis.
- We do not promise dramatic losses in short periods.
- We do not treat patients with normal weight to lose the last few pounds for aesthetic reasons. The indication must exist.
Frequently asked questions
Is the initial consultation free? No. It is a specialized medical consultation with its corresponding cost; we will confirm it when you book.
Do I have to take GLP-1 no matter what? No. Some patients have very good results with nutrition and exercise. The indication for GLP-1 is medical and decided by the team during the consultation.
How long does a protocol last? The minimum recommended support is 6–12 months for consistent results and habit consolidation. The rest depends on each case.
What happens if I stop injecting? If you have consolidated habits, you can maintain the result. If not, you will most likely regain weight. That is why we insist on the complete plan.
Do you coordinate with my doctor or endocrinologist? Yes, no problem. We share reports and coordinate.
Can I do all the follow-up at Santé? Yes. Doctor, nutritionist, body contouring devices, and, if you need associated facial treatments (facial HIFU, mesotherapy, stimulators), everything is done in the same clinic.
Book your assessment for your weight loss protocol
The first step is to come for a medical consultation that looks at your complete case, not just your scale. From there, we build a plan that you can sustain.
Make an appointment via WhatsApp at +34 699 14 58 87. Avenida Diagonal 384, Barcelona.
