Integrative Medicine Programs

Holistic Weight Loss^TM Program
Frequently Asked Questions

THE PROGRAM

What is Holistic Weight Loss^TM?
Holistic Weight Loss^TM is a “whole person” approach to weight loss. It includes diet and exercise tracking, stress management to reduce cortisol levels, group processes for support, nutritional counseling, supplements to lessen stress-induced weight gain and appetite, and ear stapling to control cravings.

Who provides the Holistic Weight Loss^TM services?
All services at the Greenwich Hospital Center for Integrative Medicine are provided by appropriately licensed professionals.

• Henri Roca, MD, the center’s medical director, is board certified by the American Association of Family Physicians and the American Board of Holistic Medicine. He is also a licensed acupuncturist and clinical hypnotherapist as well as a massage therapist and an expert in functional medicine including herbs, vitamins, and supplements. Dr. Roca serves on the Board of the American Holistic Medical Association, created the Section of Integrated Medicine at Louisiana State University School of Medicine, and is an advisor to the Louisiana State Board of Medical Examiners.
• Mary Gocke, RD, is a registered dietitian and has extensive experience in weight loss and healthy eating education and coaching.
• Bernadette Johnson, MS, RN, the center’s administrative director, is a registered nurse and exercise physiologist.
• Roberta Brown-Brugo, RN, is a registered nurse and a certified relaxation instructor and healing touch provider. Christine Dunster is a registered nurse with expertise in stress management and aromatherapy.

How much does the Holistic Weight Loss^TM program cost?
The investment for the first phase of the program is $300. This includes an overview of nutrition, exercise, and stress management, ear stapling, progress tracking, and an individual nutrition assessment at week 3 to 4. The first group visit will take about 1.5 hours. The personal, individual Nutrition appointment will take 20 minutes. A non-refundable deposit of $150 is required at the time of setting the appointment. Supplements are not included in the cost of the group visit.

Follow-up visits, which occur at 6 weeks, are $200 – $250 depending upon the level of service you choose. Options include:

• Continuing the counseling program ($200 every 6 weeks)
• Continuing the counseling program with repeated ear stapling ($250)
• Continuing the supplements either alone or with either of the above follow-up options. Supplements are an additional charge.

What is ear stapling?
Ear stapling uses the principles of ear (auricular) acupuncture to stop or control cravings. Depending upon the craving and its relationship to stress, different points may be stimulated. As a result, ear stapling can be used to help a person with weight loss, smoking cessation, stress relief, and other problems.

How does ear stapling work?
A surgical staple is placed at specific points in the ear. This stimulation triggers a response from nerves that go to the brain and release ”feel good” hormones (endorphins) and “feel full” hormones (cholecystokinin). According to acupuncture theory, these points balance the stress and relaxation responses in the body and help people control their urges and cravings.

Who can get ear stapling?
Although nearly anyone can receive ear stapling, it appears to work best in those who have more weight to lose. We offer this procedure only to individuals with a Body Mass Index (BMI) of 28 or more. (To estimate your BMI, visit www.cdc.gov.) Those who have lower BMIs and want to lose a little weight can receive regular ear and/or body acupuncture. People who cannot receive ear stapling are those who a) have an active skin or ear infection, b) are allergic to stainless steel, or c) have documented keloid formation.

Does ear stapling hurt?
A skin numbing agent is used prior to the procedure, and most people report no discomfort. After the stapling, the ear may be itchy and sore for as long as a week.

How long does the staple effect last?
The effect varies by individual, but usually lasts 6 to 8 weeks. The longer the staples are in, the more the effect is reduced since the body gets used to the stimulus.

How much weight can be lost?
Since weight loss is so individual, no guarantee can be made regarding total or percent weight loss. Some people lose as much as 4 to 5 pounds a week, especially in the first few weeks – and when they participate in the complete program. Most people will sense a greater degree of control over their cravings. Nevertheless, ear stapling is only one aspect of the program. Some people report a re-shaping (loss of abdominal girth) rather than weight loss.

What are the steps involved in getting my ear stapled?

1. Read this information and sign a consent form.
2. Fill out an eating behavior survey.
3. We will weigh you on a special scale, then clean your ear and numb it with ointment.
4. Using a special acupuncture device, Dr. Roca will identify the points to be stapled, staple the ear, and apply antibiotic ointment.
5. You will complete a Daily Diary survey and e-mail it or FAX it to us every week. (FAX: 203-863-4538 attention Mary Gocke)
6. At week three you will attend your personal nutrition session.
7. Six weeks later, return for more nutrition, exercise, and stress management information and get your staple replaced.

How do I care for my ear staple?

1. Keep the site clean and dry.
2. Place a small amount of alcohol on the site each night to clean the area. Do not use hydrogen peroxide.
3. Avoid touching the staple with your hands or fingers. Use clean swabs. For additional craving control, however, you may stimulate the area by tugging on your ears.
4. Apply triple antibiotic ointment twice a day for a week or so.
5. If your ears are sore, take Tylenol or Advil. The soreness goes away in a week or so. Again, don’t touch the staple with your fingers.
6. Have someone else check your ears at least twice a week. The site may be a little red but should not be swollen, extremely tender or oozing.

What are the potential problems with ear stapling?
If you are allergic to the staples, your ears will be extremely itchy and red but will not hurt. In this case the staples should be removed.

If the staple site gets infected, damage to the ear cartilage can result. This is acutely painful and often accompanied by an opaque, oozing liquid. If this happens, see your primary care physician or set up an appointment with Dr. Roca to remove the staple and administer antibiotics. Do not delay.

Some people may experience persistent pain in which case the staple should be removed. Some people may develop keloid scars, which may not resolve over time.

If you keep your staple in for longer than recommended, you may develop permanent holes in your ear. Usually the staple site closes and heals within 10 days of removal.

It is your responsibility to make an appointment to have the other ear stapled or to have the existing staple removed. Do not attempt removal on your own. Call early so that we can more easily accommodate your schedule.

Do I need to be worried about the complications?
You should make your decision about ear stapling with full knowledge of the possible complications. Because there is no specific study of this procedure, the general number of complications cannot be estimated. Practitioners report, however, that these complications tend to be rare. As always, there is no guarantee that the procedure will be complication-free. In Dr. Roca’s experience, infections occur approximately 3% of the time and persistent pain about 1% of the time.

When do I come back for a followup visit?
Be sure to arrange time to return in 6 weeks. The staples will then be removed and new ones placed. Additional nutritional, exercise, and stress management counseling will occur at every six week visit. You will continue to submit your Daily Diaries on a weekly basis via email or FAX. Additional services may be accessed by you on an individual basis. The menu of these services will be given to you on your first visit. Follow-up group visits last about an hour. Dr. Roca will remove the existing staple at no charge if you return within 6 weeks. Those who return later will need to pay an additional fee.

What do I need to do to continue the ear stapling?
First, submit your Daily Diary for 6 consecutive weeks in an electronic or written format. The diary helps you track what you eat for breakfast, lunch, and dinner; your snacks; your fluid intake; and your exercise activity. In addition, make sure you attend your personal nutrition appointment. Ear stapling is only one part of a complete weight loss program. Exercising and watching what you eat are essential to achieving long term weight loss.

Is weight loss guaranteed?
While most people lose weight, there can be no guarantee. However, the Holistic Weight Loss^TM program enhances the likelihood that significant weight can be lost if the program if followed.

What happens if I still have cravings?
If this happens, remember to stimulate you ear staple by tugging the ear or, after 1 week, by gently pressing on the staple. In addition, continue to follow the other components of the Holistic Weight Loss^TM program.

How will you keep track of my weight loss process?
You will have the opportunity to schedule time for ear stapling every 6 weeks. At each session you will be weighed and the recordings placed in your chart. Your Daily Diary entries with your weekly weights will be filed in your chart as well.

What benefits have been reported by people who have had ear stapling?

1. Decreased weight
2. Decreased appetite
3. Decreased cravings for sweets and carbohydrates
4. Early feeling of fullness
5. Improvement in mood
6. Decreased stress
7. Decreased muscle pain
8. Better sleep
9. Decreased smoking/drinking/repetitive behavior