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Next-gen diet pills and hormones help the rich lose weight



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When Fabiana Saba was a younger mannequin, the 5-foot, 10-inch, 100-pound stunner graced the covers of Elle and Marie Claire in her native Brazil, shared {a magazine} unfold with Gisele Bündchen and walked the runways at style week in New York, Paris, Milan, Tokyo and St. Paolo with the likes of Alessandra Ambrosio — all earlier than turning into a TV host. As she grew into maturity, her weight rose to a still-slender 130 kilos.

However, after having two youngsters and enduring the primary few months of the pandemic, Saba discovered herself in a physique that not felt like her personal. By the second half of 2020, she weighed 186 kilos and struggled with joint ache and respiratory points. 

“Like so many individuals, I began baking in the course of the pandemic, and I wasn’t simply consuming one piece; I might eat the entire cake,” Saba, now 44 and residing on New York’s Sutton Place, advised The Publish. The prospect of dropping the burden on her personal was daunting —  “I had tried many occasions prior to now … and it by no means went properly,” she stated — so she turned to her uptown neighbor, Dr. Caroline Messer.

Fabiana Saba in a green caftan
At her heaviest, Fabiana Saba skilled respiratory issues and joint ache.
Glam selfie of Fabiana Saba
After mannequin Fabiana Saba’s weight ballooned to 186 kilos in the course of the pandemic, she sought out remedy from endocrinologist to the celebs Caroline Messer, who helped her lose nearly 50 kilos.
Handout from Fabiana Sutton
A college of magazine covers featuring Fabiana Saba
In her heyday, Fabiana Saba was a prime mannequin, masking main style magazines in her native Brazil.

Messer recognized her with pre-diabetes and excessive ldl cholesterol and prescribed her each an anti-anxiety medicine and an urge for food suppressant. The meds helped her drop all the way down to 137 kilos in lower than a yr with relative ease. 

“Having a health care provider modified all the pieces,” gushed Saba, who stays on the medicines.

Full-length photo of Fabiana Saba in a black minidress
Fabiana Saba now weight 137 kilos, because of medicines prescribed by Dr. Messer.
Handout from Fabiana Sutton

Town’s wealthy and fabulous trying to drop some pounds aren’t slogging it with fad diets and Noom subscriptions. They’re spending hundreds of {dollars} to work with Messer, a famous endocrinologist whose sufferers embrace Saudi royals, A-list stars, titans of trade, skilled athletes and socialites trying to slim down and supercharge their well being.

“There’s positively a pattern towards seeing endocrinologists … as a result of now we have extra therapies now that tackle hormonal imbalances that result in weight acquire,” stated Messer. “Lots of people suspect they’ve simply measured hormonal imbalance, but it surely’s typically one thing extra delicate.”

The 44-year-old has had a conventional endocrinology observe on Fifth Avenue for years and he or she’s simply opened a boutique clinic, Properly By Messer, on East sixtieth Avenue that takes a holistic method to managing metabolic points. Along with Messer and two different endocrinologists, it’s staffed by a psychologist, two health trainers and a dietician. A bariatric surgeon and pulmonologist are additionally accessible to sufferers.

Messer, who doesn’t take insurance coverage however is usually lined as an out-of-network expense, gives an preliminary $900 diagnostic go to, which entails a full historical past and bodily together with a thyroid panel. She then crafts a plan along with her group greatest fitted to the affected person. 

“I assess their degree of exercise and nutrient content material, in addition to whether or not they have a necessity for cognitive behavioral change,’’ stated Messer, who prices $450 for follow-up appointments. Visits to different members of her group vary from $80 to $600.

Typically the Properly by Messer plan contains medicine. 

Headshot of Dr. Caroline Messer
An preliminary session with Dr. Caroline Messer prices $900.
Photograph courtesy Properly by Messer

Amongst her common therapies are GLP1 and GIP, replications of hormones secreted by the intestine that set off a sense of satiety and gradual digestion. The fashionable new therapies — “Half the well-heeled ladies I see on the Higher East Aspect are on these hormones for weight reduction, and they’re working” stated a Manhattan plastic surgeon — are notoriously expensive. However, Messer orders them from a Canadian pharmacy, decreasing the worth from roughly $1,400 to $250 monthly.  

Different meds in Messer’s arsenal embrace Contrave, an anti-depressant authorised for weight reduction, and methamphetamines, which have been used to shed kilos for years with combined success.

“They’ve dangers however are life saving for actual binge-eating issues,” Messer stated. 

Marc Schwartz, the 57-year-old head of world advertising and marketing for a pharmaceutical firm, turned to Messer to assist keep away from packing on the pandemic kilos. 

“I had a household historical past of diabetes, and I knew that folks had been sitting round and gaining weight, so I wished to take the negativity occurring round me and switch it optimistic,’’ the New Rochelle resident stated. Messer put him on medicine to decrease his blood sugar, and he or she inspired him to develop into an endurance runner.

“She actually motivated me, so I had an unimaginable sense of pleasure and goal,’’ stated Schwartz, who misplaced 23 kilos with Messer’s assist. “I went from being in peril of diabetes to regular vary. With out her help I by no means might have accomplished it.’’

Doctors gathered around a desk at Well by Messer
At Properly by Messer, sufferers have the choice of assembly with a lot of consultants, together with Dr. Barrie Weinstein (from left); registered dietitian Jean Hanks; and psychologist Dr. Jess Kovler.
Photograph courtesy Properly by Messer

Along with weight loss health, Properly by Messer gives luxe well being extras, reminiscent of metabolic price testing, and sweetness therapies like Kybella injections to take away fats from below the chin. 

However, it’s the cutting-edge method to trimming down that sufferers most frequently rave about. 

”I’m not strolling any runways quickly, however I’m again to working with my youngsters within the park,” stated Saba.   

Chopping-edge medicine endocrinologists prescribe for weight reduction

List of the drugs Dr. Caroline Messer prescribes to help clients slim down.
Dr. Caroline Messer prescribes a variety of tablets to assist purchasers slim down, relying on their well being.
Getty Photos


This cutting-edge weight reduction drug comprises semaglutide, a hormone produced by the physique to set off emotions of fullness after consuming. Whereas it’s efficient — it has been proven to cut back total weight by 15% — it’s additionally costly, costing as much as $1,300 a month.


A mix tablet used to focus on meals habit, Contrave comprises naltrexone — which has historically been prescribed for alcohol and drug dependence — and bupropion, an antidepressant typically bought below the identify Wellbutrin. It was FDA authorised in 2014, however like all medicines, it comes with potential unintended effects, together with an elevated threat of seizures.


This controversial weight reduction drug has additionally been bought below the identify Alli. It really works by blocking the physique from absorbing some fat, however the way of life prices are steep: It could actually trigger a variety of nasty unintended effects, from flatulence to fecal incontinence.


Consider it as a gastric bypass — in tablet kind. Twenty minutes earlier than consuming, dieters swallow three Plenity capsules together with 16 ounces of water. As soon as within the abdomen, the tablets launch gel particles, which then increase and forestall customers from consuming an excessive amount of by actually taking over house within the stomach. It was cleared by the FDA in 2019 and prices $98 a month.


Bear in mind Fen-Phen? Whereas the previous drug, fenfluramine, was taken off the market in 1997 for probably inflicting coronary heart harm, the urge for food suppressant phentermine remains to be accessible. However that doesn’t imply it’s risk-free. This amphetamine-like tablet can induce mania-like signs reminiscent of insomnia and coronary heart palpitations.