Anyone who recalls the Fen-Phen and Redux craze of the mid-1990's will appreciate the challenge faced by Dr. Hayward and other primary care physicians at the time. The media and the overweight population were fascinated by the promise of easy weight loss with these drugs. They were heavily marketed and widely reported upon. Patients demanded that their physicians prescribe the drugs for them.

Dr. Hayward was very worried about the safety of these drugs. Furthermore, she felt strongly, and still believes, that overweight people are not going to find their answers in a pill or other weight loss quick-fix product. In Dr. Hayward's experience, anyone with long-term weight concerns faces complex emotional and physical challenges, and addressing them requires good listening skills and sound coaching from a team of people who have expertise in multiple areas.

Many patients insisted on being prescribed Fen-Phen or Redux despite Dr. Hayward's concerns, and some were so desperate to get the drugs that they threatened to change doctors and go elsewhere to get them prescribed. Dr. Hayward felt that merely getting the drugs from another physician was not in these patients' best interests. She had spent years caring for them, and understood the difficulties in their lives that were keeping them from losing weight and getting fit.

This situation prompted Dr. Hayward to create The Get Fit Group, an integrative medicine program that brought together professionals with expertise in nutrition, physical therapy, group therapy, tai chi, acupuncture, and primary care internal medicine. This program served women who wanted to lose weight, especially those who wanted Fen-Phen and Redux. The program met weekly, and those who were medically cleared to take the medications could do so, under Dr. Hayward's supervision.

The design, development, and implementation of the program went on for three years. With the help of funding received from the Kenneth B. Schwartz Center at Massachusetts General Hospital, the program studied certain parameters, including blood pressure, blood sugar, insulin resistance, cholesterol profile, weight changes, depression, anxiety, and stages of change.

The program found no improvement in weight, or any medical measurements, but did find positive changes in how people scored on the Beck Depression Test. Nearly all participants had entered the program at least moderately depressed. After one year, all participants had improved their scores and were either no longer depressed or only mildly depressed.

These findings confirmed Dr. Hayward's experience in her clinical practice. In order to make permanent lifestyle changes, people with long-term weight concerns need ongoing, multidisciplinary, integrative care from a team of professionals who can work with them on their stresses and emotional ups and downs.