Stan Dorn’s jeans sag around his middle as he emerges from an appointment at the National Center for Weight and Wellness in Washington, D.C.
The 55-year-old Chevy Chase resident has lost 10 pounds in less than a month. He aims to drop 20 more, and Dr. Scott Kahan is the man who’s going to help get him there.
Dorn knows that overweight patients often are stigmatized as lazy. But with Kahan “there’s not a hint of judgment,” Dorn says. “It’s just about how we are going to move forward.”
In recent years, Kahan has emerged as a leader in the field of obesity, thanks to his holistic approach to weight loss. The Bethesda resident blogs about weight for The Huffington Post and at www.scottkahan.com; speaks about obesity at national medical conferences; serves on the advocacy committee of The Obesity Society, a national organization devoted to advancing scientific understanding about obesity; is the clinical adviser for the Strategies to Overcome and Prevent (STOP) Obesity Alliance; and addresses the U.S. Congress on the topic.
He was co-director of the George Washington University Weight Management Program, but when that center closed in December due to a lack of funding, Kahan opened the National Center in January, financing it himself with a business loan. He has been putting in 15- to 18-hour days since.
Kahan oversees three medical doctors, including a psychiatrist and an endocrinologist, four psychologists, three registered dieticians and a personal trainer. The staff sees about 150 patients a week, many of whom have followed Kahan from GW or learned of his compassionate approach via word of mouth.
New patients typically meet with Kahan to sketch out a treatment plan. The clinic doesn’t accept insurance, so they pay according to the services they receive, which might mean $60 for a private nutritional consultation, $120 for a physician visit or $60 for group therapy. Bundled rates also are available.
Kahan currently is helping Dorn, a health-policy researcher who occasionally travels, figure out how to incorporate restaurant meals into his weight-loss plan. He’ll help others learn how to fit exercise into their schedules, rebound from a period of weight gain, or pinpoint the triggers of binge eating.
“People often think of a weight program as someone waving a finger and putting people on a diet,” Kahan says. “To me, it’s about the whole person rather than just his or her weight.”
Kahan describes himself as a weight-management doctor rather than a diet doctor, and the distinction is key. “What Scott is doing is using all of the science out there that talks about how different approaches work for different patients and how best to interact,” says Christine Ferguson, director of the STOP Obesity Alliance, a George Washington University-based coalition of more than 50 organizations committed to combating obesity and weight-related health risks.
Kahan is doing his best to spread the word about those approaches. In addition to his other roles, he serves on the faculties of both the Johns Hopkins Bloomberg School of Public Health in Baltimore and the George Washington University School of Medicine and Health Sciences,
where he instructs first- and second-year medical students in nutrition and the treatment of obesity.
Kahan knows what it’s like to be obese. At 11, he was told by the family doctor that he was 25 pounds overweight, had high cholesterol and borderline high blood pressure.
“When a child is 20 to 30 pounds overweight, that’s the equivalent of 75 pounds for an adult,” Kahan says. “It was hard. There was some teasing and not wanting to take [my] shirt off at the swimming pool.”
The McDonald’s near his dad’s dental office was a regular afternoon stop for Kahan and his younger brother. His mother, a teacher managing the dental practice at the time, called a halt to that after his visit with the doctor.
By high school, Kahan “tried to eat as little as I could and keep myself busy so I wouldn’t think of food.”
It wasn’t until he was a bioengineering student at Columbia University in New York and later a medical student at the Medical College of Pennsylvania in Philadelphia that Kahan began to understand how food and metabolism work and how to better control his weight in a healthy manner.
Kahan has never forgotten being overweight, though, and he channels his childhood experiences into lessons he shares with his patients.
Grace McMillan, a high school teacher who lives in Kensington, is among those patients. She lost 98 pounds in a year, thanks to Kahan.
“He and his team are really good at opening up the conversation,” she says. “They ask about what parts of your life are not well. If you’re frustrated in your job, in your relationships, if you have leftover issues from childhood, leftover ways of beating yourself up—those things have to be addressed in order to deal with the weight.”
In dealing with those issues, patients often benefit in other areas of their lives. The summer after she lost weight, McMillan learned to scuba dive and studied yoga on Bali. That fall she began cycling to work and dating a fellow employee.
Through it all, Kahan “was so joyfully happy for me,” she says.
Kahan helped McMillan with the challenges of maintaining diet and exercise regimens while dating. And when she got married, Kahan also helped her husband, Pete. He had health issues but suffered anxiety over going to doctors, so Kahan found him a primary care physician with a good bedside manner.
“I feel like Scott is always going to be there for me and for my husband,” McMillan says. “He will go to incredible lengths to build a relationship and build a trust and make people feel safe.”
Kahan, who seldom wears his white lab coat, regularly goes to what other doctors might view as extremes—answering patient concerns via email late into the evening and setting up after-hours support groups for patients who are too heavy to feel comfortable in regular group settings.
He even wrote a recommendation for one patient who is now completing a master’s program in public health. Kahan says the woman felt her life had lost meaning. He gave her an internship before recommending her for graduate school.
More than two-thirds of American adults are overweight, according to the Centers for Disease Control and Prevention in Atlanta. It’s an alarming statistic, but lack of willpower isn’t the problem, Kahan says. Rather, he cites a conglomeration of factors, including the billion-dollar ad campaigns for processed foods, and pricing that makes junk foods cheaper than healthy foods.
“Then you look at physical activity,” Kahan says. “It’s much more difficult to be active today because most people have to be in cars to get to work, and many towns are not particularly walkable. You just have this slow but somewhat inexorable tendency toward weight gain.”
The solution? In addition to the individual approach, Kahan says it requires a media onslaught similar to the decades-long campaign conveying the dangers of cigarette smoking. “Fifty-five percent of the [U.S] population smoked during the 1950s; only about 21 percent smoke now,” he says.
Louis Drummond, 54, is among Kahan’s converts. The Annandale, Va., resident followed Kahan from GW to the new clinic on L Street despite already having achieved his weight-loss goal of 90 pounds in nine months.
Drummond no longer takes the blood pressure medicine he relied on a year ago, and he recently enjoyed a stand-up paddle surfing activity during a Hawaiian vacation, something he’d never done before.
Buoyed by his progress, he plans to continue meeting with Kahan and a nutritionist once a month. During his appointment on a recent winter day, Drummond asked to add a fifth small meal daily. He thought it would prevent hunger and a drop in energy, and Kahan agreed.
Like many of the patients Kahan encounters, Drummond was overweight most of his life. “My [primary care] doctor would tell me to lose weight, but never offered any help on how to do it,” he says.
Drummond tried popular weight-loss plans, only to see the pounds come back. He never truly incorporated exercise into his life.
“This is the first program that’s a full program,” he says. “You are not just counting something. They are teaching you about your emotions and what makes you want to eat.”
Since seeing Kahan, Drummond has become confident that he can keep the weight off. Like McMillan, he’s enjoying life. He’s not short of breath climbing stairs or drenched in sweat after walking from his office to his car.
To Kahan, that’s what it’s about. “We all just want to be healthy and happy,” he says.
Dana Scarton is a Washington, D.C.-based freelance writer who frequently writes about health and fitness.