Consents and Bills of Rights

Privacy Statement - California

This PRIVACY NOTICE IS APPLICABLE TO CALIFORNIA RESIDENTS(“consumers” or “you”) ONLY and supplements the information in Anchor MD’s general Privacy Policy. We adopt this notice to comply with the California Consumer Privacy Act of 2018 (“CCPA”), the California Privacy Rights Act("CPRA"), and other California privacy laws. Any terms defined in the CCPA or CPRA have the same meaning when used in this notice. Capitalized terms used but not defined here in have the meanings assigned to them in the Anchor MD Terms of Service or Privacy Policy.

Information We Collect

We collect information that identifies, relates to, describes, references, is capable of being associated with, or could reasonably be linked, directly or indirectly, with a particular consumer or device(“Personal Information”).

We have collected the following categories of Personal Information from California consumers in the preceding twelve (12) months onAnchor MD’s Platform:

Category A. Identifiers.

Examples: Account Name, Address, Beneficiary Name, Beneficiary Relationship, Client ID Number, Client Reference Number, Contract Number, Date of Birth, Date of Death, Driver’s License Number, Email Address, Emergency Contact Name, Emergency Contact Number, Employee Identification Number, Name, Passport Number, Phone Number, Policy Number, Policy Rating Information and similar data.

Collected: Yes

Category B. Personal information categories listed in theCalifornia Customer Records statute (Cal. Civ. Code § 1798.80(e)).

Examples: A name, signature, address, telephone number, employment, bank account number, credit card number, debit card number, or any other financial information, medical information, or health insurance information. Some personal information included in this category may overlap with other categories.

Collected: Yes

Category C. Characteristics of protected classifications under California or federal law.

Examples: Gender, age.

Collected: Yes

Category D. Commercial information.

Examples: Billing and collection information that you provide to us, payment processing information that includes billing information, such as a name, address, email address, and payment card information.

Collected: Yes

Category E. Biometric information.

Examples: The CCPA has specific definitions for biometric information. While we collect health-related information, such information is generally governed by HIPAA and CMIA and excluded from CCPA's scope as outlined below. We do not collect biometric information as defined by CCPA outside of these exclusions.

Collected: No

Category F. Internet or other similar network activity.

Examples: Browse history, search queries, interaction withour Platform, IP address, operating system, host domain, browser type, usage details, details of referring websites (URL), information collected through cookies, web beacons, and other tracking technologies.

Collected: Yes

Category G. Geolocation data.

Examples: Location data from your device or IP address.

Collected: Yes

Category H. Sensory data.

Examples: Audio, electronic or similar information when you contact our customer care center by phone.

Collected: Yes

Category I. Professional or employment-related information.

Examples: Occupation.

Collected: Yes

Category J. Non-public education information (per the Family Educational Rights and Privacy Act (20 U.S.C. Section 1232g, 34 C.F.R.Part 99)).

Examples: Education records directly related to a student maintained by an educational institution or party acting on its behalf, such as grades, transcripts, class lists, student schedules, student identification codes, student financial information, or student disciplinary records.

Collected: No

Category K. Inferences drawn from other personal information.

Examples: Inferences drawn from the information identified above to create a profile about a consumer reflecting the consumer’s preferences, characteristics, or predispositions.

Collected: Yes

Sources of Personal Information

We obtain the categories of Personal Information listed above from the following categories of sources:

• Directly from you when you provide it to us
• Automatically as you navigate through the Platform (e.g., usage details, IP address, and information collected through cookies, web beacons, and other tracking technologies).
• From third parties with whom we work to provide you services, such as     physicians, medical professionals, and pharmacies. This can include     subcontractors, analytics providers, advertising networks, and search     information providers, or third parties who share your information to     provide health care services to you.

Personal Information does NOT include:

• Information that is lawfully made available from federal, state, or local government     records (“Publicly Available Information”).
• De-identified or aggregate consumer information.
• Information excluded from the CCPA's scope, such as:
   
  • Health or medical information (Protected Health Information or "PHI") covered by the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and the California Confidentiality of Medical Information Act (CMIA) or clinical trial data. Anchor MD’s Notice of Privacy Practices, a separate document, governs how PHI about you may be used and disclosed.
   
  • "Medical information" governed by the CMIA, or other patient information we maintain in the same manner as PHI or "medical information".
   
  • Personal information covered by certain sector-specific privacy laws, including the Fair Credit Reporting Act (FRCA), the Gramm-Leach-Bliley Act (GLBA) or California Financial Information Privacy Act (FIPA), and the Driver's Privacy Protection Act of 1994.

Sensitive personal information means Information that reveals:

• Your social security, driver’s license, state identification card, or passport     number.
• Your account log-in, financial account, debit card, or credit card number in combination with any required security or access code, password, or     credentials allowing access to the account.
• Your precise geolocation.
• Your racial or ethnic origin, religious or philosophical beliefs, or union     membership.
• Contents of your mail, email, and text messages unless Anchor MD is the intended recipient of your communication.
• Your genetic data. Unless the information is publicly available, sensitive     personal information also includes:
• Processing of biometric information for the purpose of uniquely identifying you.
• Personal information collected and analyzed concerning your health.
• Personal information collected and analyzed concerning your sex life or sexual orientation.

Use of Personal Information

We may use or disclose the Personal Information we collect(subject to the exclusions noted above) for one or more of the following business purposes:

• To fulfill or meet the reason for which the information is provided. For     example, to complete any registration or other transactions or actions you  request online, such as payment processing, including determining     eligibility, use, and other benefits.
• For treatment, payment, or healthcare operational purposes.
• To provide you with information, products, or services that you request from us.
• To provide you with communications from Anchor MD, surveys, newsletters, and other information.
• To carry out our obligations and enforce our rights arising from any     contracts entered into between you and us, including for billing and     collections.
• To improve our Platform and present its contents to you, and to improve our products and services.
• For testing, research, analysis, and product development, including to     estimate how individuals access and use our Platform and to store     information about your preferences.
• As reasonably necessary and proportionate to protect the rights, property or safety of us, our clients, or others, and to enhance the safety and security or performance of our products and services. This includes     verifying your identity, preventing or detecting fraud or other     unauthorized or illegal activities.
• To respond to regulatory and/or law enforcement requests and as required by applicable law, court order, or governmental regulations.
• As described to you when collecting your personal information or as otherwise set forth in the CCPA.
• To service providers that assist us in the maintenance, improvement, and
  optimization of our Platform.

• To our affiliates and their employees.
• As otherwise required or permitted by law.
• To audit interactions on the Platform.
• To design, develop, and communicate with you about our features, products, and services.
• To identify bugs, repair errors, and ensure that services function as     intended. We will not collect additional categories of Personal     Information from those identified above or use the Personal Information we collected for materially different, unrelated, or incompatible purposes   without providing you notice.

Sharing Personal Information

We may disclose your Personal Information to a third party for a business purpose.

In the preceding twelve (12) months, we have disclosed the following categories of Personal Information about you for a business purpose: Identifiers (e.g., such as your email address, IP address, account login information, cookies or similar data), Internet or other similar network activity (e.g., browser history, activity, and service pages visited to help you get started, search history, and information regarding your interactions with our Platform), and Geolocation data.

We disclose your Personal Information for a business purpose to the following categories of third parties:

• Our affiliates.
• Service Providers and Vendors, such as service providers that help us run and maintain the technology and security infrastructure that support our   Platform or that provide services such as email delivery, auditing, and     similar services. This includes professional service organizations and     analytics providers for our Platform.
• Medical providers, including without limitation, physicians, healthcare facilities and organizations, pharmacies, and laboratories that provide any services to you.
• Third-party credit card processors.
• Entities that assist us with marketing and advertising.
• Third parties to whom you authorize us to disclose your personal information in connection with products or services we provide to you.
• To other third parties as required or permitted by law (e.g., to comply with   legal obligations or to protect rights and safety).

Selling Personal Information/Sharing for Cross-Context Behavioral Advertising

While we do not "sell" your data in the traditional sense for monetary gain, the CCPA defines this term broadly to include our use of certain third-party advertising and marketing services. You have the right to request that we do not sell or share your Personal Information for such purposes. You may request to opt-out of these cookies on our website by clicking "CCPA Do Not Sell My Personal Information"and changing your cookie settings, accessible from the footer of this website or through contacting using the contact information listed below. Sites may also be designed to respond to Global Privacy Control ("GPC") signals.

Your Rights and Choices

The CCPA provides California residents with specific rights regarding their Personal Information. This section describes your CCPA rightsand explains how to exercise those rights. These rights do not apply to PHI governed by HIPAA or "medical information" governed by CMIA.

Access to Specific Information and Data Portability Rights

You have the right to request that we disclose certain information to you about our collection and use of your Personal Information in the twelve (12) months preceding your request. Once we receive and verify your request, we will disclose to you any of the following in accordance with your request:

The categories of Personal Information we collected about you.

The categories of sources for the Personal Information we collected about you.

Our business or commercial purpose for collecting or selling that Personal Information.

The categories of third parties with whom we share that Personal Information.

The specific pieces of Personal Information we have collected about you (also called a data portability request) – but only if specifically requested by you.

If we have sold or disclosed your Personal Information for a business purpose, two separate lists disclosing: Sales, identifying the personal information categories that each category of recipient purchased; and Disclosures for a business purpose, identifying the Personal Information categories that each category of recipient obtained.

Correction Requests

You have the right to request that we correct inaccurate Personal Information that we maintain about you. After we receive and verify your request, we will use commercially reasonable efforts to correct the information. We will disclose to you the actions taken pursuant to yourrequest.

Opting Out of Use and Disclosure of Sensitive Personal Information

You have the right to request that we limit the use and disclosure of your Sensitive Personal Information to that use which is necessary to perform the services or provide the goods reasonably expected by an average consumer who requests those goods or services, or for other permitted purposes under the CCPA (such as ensuring security and integrity,short-term transient use like non-personalized advertising, performing services on behalf of the business, or undertaking activities to verify or maintain quality or safety). We use your Sensitive Personal Information as necessary to provide services to you or for other permitted purposes under applicable law.

Deletion Request Rights

You have the right to request that we delete (and direct ourProviders to delete) your Personal Information from our records. Subject to the exceptions set forth below, we will comply with your deletion request and will direct our Providers to delete your Personal Information.

Deletion Request Exceptions

We (or our Providers) do not have to comply with yourdeletion request with regard to your Personal Information that we (or ourProviders) maintain for any of the following reasons:

• Complete the transaction for which we collected the personal information, provide a good or service that you requested, take actions reasonably anticipated within the context of our ongoing business relationship with you, or otherwise perform our contract with you.
• Detect security incidents, protect against malicious, deceptive, fraudulent, or illegal activity, or prosecute those responsible for such activities.
• Debug products to identify and repair errors that impair existing intended   functionality.
• Exercise free speech, ensure the right of another consumer to exercise their free speech rights, or exercise another right provided for by law.
• Comply with the California Electronic Communications Privacy Act (Cal. Penal Code § 1546 seq.).
• Engage in public or peer-reviewed scientific, historical, or statistical research     in the public interest that adheres to all other applicable ethics and privacy laws, when the information's deletion may likely render impossible or seriously impair the research's achievement, if you previously provided informed consent.
• Enable solely internal uses that are reasonably aligned with consumer     expectations based on your relationship with us.
• Comply with a legal obligation.
• Make other internal and lawful uses of that information that are compatible with the context in which you provided it.

Exercising Access, Data Portability, and Deletion Rights

To exercise the access, data portability, and deletion rights described above, please submit a verifiable consumer request to us by either:

• Submitting a request in writing to care@takeanchor.com.
• Calling us at +1 (888) 629-2608.

Only you or a person registered with the California Secretary of State for which you authorize to act on your behalf, may make averifi able consumer request related to your Personal Information. You may also make a verifiable consumer request on behalf of your minor child.

You may only make a verifiable consumer request for accessor data portability twice within a 12-month period. The verifiable consumer request must:

 Provide sufficient information that allows us to reasonably verify your identity or your authority to make a request on behalf of a California resident. We must verify your identity or authority to make the request and confirm the Personal Information relates to you, or others. To do so, we collect your name, e-mail address, phone number to verify your identity.We also may contact you by e-mail or by telephone to verify your identity and ask you additional questions so that we can match your identity with the data we have about you. In some instances, we may ask you to declare under penalty of perjury that you are the consumer whose Personal Information is the subject of the request.

· Describe your request with sufficient detail that allows us to properly understand, evaluate, and respond to it.

We cannot respond to your request or provide you with Personal Information if we cannot verify your identity or authority to make the request and confirm the personal information relates to you. Making averifiable consumer request does not require you to create an account with us. Personal Information provided will only be used by us to verify the requestor's identity and/or authority to make the request.

If you use an authorized agent, you or your authorized agent must: submit proof that the authorized agent is registered with the California Secretary of State and that you have authorized them to act on your behalf, submit evidence that you have provided the authorized agent with power of attorney pursuant to the California Probate Code, or provide the authorized agent written and signed permission to act on your behalf, verify your identity with us, and directly confirm with us that you have provided the authorized agent permission to submit the request. We may deny a request from anauthorized agent who does not submit sufficient proof to act on your behalf.

Response Timing and Format

We endeavor to respond to a verifiable consumer requestwithin 45 days of its receipt. If we require more time (up to 90 days intotal), we will inform you of the reason and extension period in writing. Anydisclosures we provide will only cover the 12-month period preceding theverifiable consumer request's receipt. The response we provide will alsoexplain the reasons we cannot comply with a request, if applicable. For dataportability requests, we will select a format to provide your personalinformation that is readily usable and should allow you to transmit theinformation from one entity to another entity without hindrance.

We do not charge a fee to process or respond to yourverifiable consumer request unless it is excessive, repetitive, or manifestlyunfounded. If we determine that the request warrants a fee, we will provide youwith a cost estimate and rationale before completing your request. We alsoreserve the right to deny excessive, repetitive, or manifestly unfoundedrequests.

Non-Discrimination

We will not discriminate against you for exercising any ofyour CCPA rights. Unless permitted by the CCPA, we will not:

• Deny you goods or services.
• Charge you different prices or rates for goods or services, including through granting discounts or other benefits, or imposing penalties.
• Provide you a different level or quality of goods or services.
• Suggest that you may receive a different price or rate for goods or services or a different level or quality of goods or services.

Changes to Our Privacy Notice

We reserve the right to amend this Privacy Notice at our discretion and at any time. It is our policy to post any changes we make to our Privacy Policy on this page. The date this Privacy Policy was last modified is identified at the top of the page. You are responsible for ensuring we have an up-to-date, active, and deliverable email address for you, and for periodically monitoring and reviewing any updates to this Privacy Policy. Your continued use of our Platform after such amendments will be deemed your acknowledgment of these changes to this Privacy Policy.

Contact Information

If you have any questions or comments about this notice, our Privacy Policy, the ways in which we collect and use your personal information,your options and rights regarding such use, or wish to exercise your rights under California law, please do not hesitate to contact us at:

          Phone: +1 (888) 629-2608

          Email: care@takeanchor.com

          Postal Address:

          Anchor MD, LLC

          30 N Gould St

         Sheridan WY 82801

You may also message us through the Platform.

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FLORIDA
InformedConsent Related to Treatment of Weight Loss Conditions Through Telehealth

Purpose:

Pursuant to Florida Medical Board Rule, Standards for the Prescription of Drugs to Treat Obesity (64B8-9.012(5)), licensees, prior to prescribing, ordering dispensing, or administering an anti-obesity drug, must obtain written informed consent from the patient discussing “potential benefits versus potential risks of weight loss treatments”. A copy of the signed informed consent shall be included in the patient’s medical record.
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This draft consent document is meant to capture the required statements around “potential benefits versus potential risks of weight loss treatment”. The Rule does not require this consent to contain any specifically worded language.

Purpose.

The purpose of this informed consent form is to make sure you are aware of the potential benefits - and risks - of starting a weight loss program.

It is vitally important for you to advise your health care provider(s)of ANY concerns, problems, complaints, symptoms, or questions even if you may think it is not terribly important, so the provider team can determine the best course of treatment. Keeping your health care team informed of any questions or symptoms you have affords the best chance of providing you with necessary information and developing a path forward.

Potential Benefits 

Medically significant weight loss (usually about 10 percent of initial weight, or as an example, losing 20 pounds from 200 pounds starting weight) can: 

• Lower blood pressure, reducing the risks of hypertension; 
• Lower cholesterol, reducing the risks of heart and vascular disease; 
• Lower blood sugar, reducing the risks of diabetes

If you are taking medications for one or more of these conditions, dosages may need to be adjusted as your overall health improves. You agree to see your primary care provider, if you have one, as needed to have your need for these medications reassessed, if applicable. 

Other benefits may also be obtained but cannot be guaranteed. Increasing activity level can favorably affect the above conditions and may have the additional benefit of helping you sustain weight loss. Weightloss and increased activity may provide important psychological and social benefits, as well. 

Possible Side Effects and Risks

The possibility always exists in medicine that the combination of any significant disease with methods employed for its treatment may lead to previously unobserved or unexpected ill effects, including death. Should one or more of these ill effects occur, additional medical or surgical treatment may be necessary. In addition, it is conceivable that other side effects could occur, which have not yet been diagnosed or observed. 

Reduced Weight.

When you reduce the number of calories you eat to a level lower than the number of calories your body uses in a day, you lose weight. As a result of this weight loss, your body makes some other adjustments in body processes. Some of these adjustments are responsible, in some participants, for improvements in blood pressure and blood sugar. However, you also may experience other temporary side effects or discomforts, including an initial loss of body fluid through increased urination, momentary dizziness, a reduced metabolic rate or metabolism (the rate at which you convert food to energy),sensitivity to cold, a slower heart rate, dry skin, fatigue, diarrhea or constipation, bad breath, muscle cramps, a change in menstrual pattern, dry andbrittle hair or hair loss. Generally, these responses are temporary and resolve when calories are increased after the period of weight loss. 

Reduced Potassium Levels.

Low potassium levels can cause serious heart irregularities. When someone has been on a reduced calorie diet, a rapid increase in calorie intake, especially overeating or binge-eating, can be associated with bloating, fluid retention, disturbances in salt and mineral balance, or gall bladderattacks and abdominal pain. 

Gallstones.

Overweight people develop gallstones at a rate higher than normal weight individuals. The occurrence of symptomatic gallstones (pain,diagnosed stones and/or surgery) in individuals 30 percent or more over desirable body weight (50 pounds or more overweight) not undergoing current treatment for obesity is estimated to be 1 in 100 annually, and for individuals who are 20-30 percent overweight, about one-half that rate, or 1 in 200 annually. It is possible to have gallstones and not know it. One study of individuals entering a weight loss program showed that as many as 1 in 10 had"silent" gallstones at the onset. As body weight and age increase, so do the chances of developing gallstones. These chances double for women, women using estrogen, and smokers. Losing weight--especially rapidly--may increase the chances of developing stones or sludge and/or increasing the size of existing stones within the gallbladder. The most common symptoms of gallstones are fever, nausea, and a cramping pain in the right upper abdomen. If you develop any of these symptoms or if you know or suspect that you may already have gallstones, let your provider team and primary care provider know immediately. Gallbladder problems may require medication or surgery to remove the gallbladder, and, less commonly, may be associated with more serious complications of inflammation of the pancreas or even death.

Pancreatitis.

Pancreatitis, or an inflammation or infection in the bile ducts, may be associated with the presence of gallstones and the development of sludge or obstruction in the bile ducts. The symptoms of pancreatitis include pain in the left upper abdominal area, nausea, and fever. Pancreatitis may be precipitated by binge-eating or consuming a large meal after a period of dieting. Also associated with pancreatitis is a long-term abuse of alcohol and the use of certain medications and increased age. Pancreatitis may require surgery and may be associated with more serious complications and death. 

Pregnancy.

If you become pregnant, you should immediately stop any and all of your weight loss medications, and report this to your health care team and primary care provider, if applicable, immediately. Your diet must be changed promptly to avoid further weight loss because a restricted diet could be damaging for a developing fetus. You must take precautions to avoid becoming pregnant during the course of weight loss. 

Binge Eating Disorders.

Binge eating disorder is defined as the habitual,uncontrolled consumption of a large amount of food in a short period of time.Participation in a calorically restricted diet has been shown in one study to increase binge eating episodes temporarily. Several other studies have demonstrated reduced episodes of binge eating following a calorie deficit and portion-controlled diet. Extended binge eating episodes are associated with weight gain. 

The Risk of Weight Regain.

Obesity is a chronic condition, and the majority of overweight individuals who lose weight have a tendency to regain all or some of it over time. Factors that help to maintain a reduced body weight include regular physical activity, adherence to a restricted calorie, low fat diet, and planning a strategy for coping with weight regain before it occurs. Success full treatment may take months or even years. Medical studies of calorie deficit/portioned-controlled diets (including modified fasting) have shown varying results for patients who maintain weight loss. Some studies have shown that fewer than 5% of weight loss patients were able to maintain a reduced body weight after five years. Another study showed that after three years, weight loss patients, on average, maintained about one half of their initial weight loss. If you have had fluctuations in your weight in the past, it may be more difficult to maintain the weight you lose during and after this program. A published medical study indicated people whose body weight fluctuates greatly or often have a higher risk of heart disease and death compared with persons of relatively stable body weight, and such weight fluctuations may play a role in the development of other chronic diseases.

Sudden Death.

Patients with severe obesity, particularly those with serious hypertension, coronary artery disease, or diabetes mellitus, have a statistically higher chance of suffering sudden death when compared to normal weight people without such medical problems.

Florida WeightLoss Consumer Bill of Rights

(a) Warning: Rapid weight loss may cause serious health problems. Rapid weight loss is weight loss of more than 1 1/2 pounds to 2 pounds per week or weight loss of more than 1 percent of body weight per week after the second week of participation in a weight-loss program.

(b) Consult your personal physician before starting any weight-loss program.

(c) Only permanent lifestyle changes, such as making healthful food choices and increasing physical activity, promote long-term weight loss.

(d) Qualifications of this provider are available upon request.

(e) You have a right to:

1. Ask questions about the potential health risks of this program and its     nutritional content, psychological support, and educational components.
2. Receive an itemized statement of the actual or estimated price of the weight-loss program, including extra products, services, supplements, examinations, and laboratory tests.
3. Know the actual or estimated duration of the program.
4. Know the name, address, and qualifications of the dietitian or nutritionist who has reviewed and approved the weight-loss program according to s.     468.505(1)(j), Florida statutes.

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NEW JERSEY
Informed Consent Related to Treatment of Weight Loss Conditions Through Telehealth

Purpose. 

The purpose of this informed consent form is to make sure you are aware of the potential benefits - and risks - of starting a weight loss program.

It is vitally important for you to advise your health care provider(s) of ANY concerns, problems, complaints, symptoms, or questions even if you may think it is not terribly important, so the provider team can determine the best course of treatment. Keeping your health care providers informed of any questions or symptoms you have affords the best chance of providing you with necessary information and developing a path forward.

Potential Benefits

Medically significant weight loss (usually about 10 percent of initial weight, or as an example, losing 20 pounds from 200 pounds starting weight) can:

• Lower blood pressure, reducing the risks of hypertension;
• Lower cholesterol, reducing the risks of heart and vascular disease;
• Lower blood sugar, reducing the risks of diabetes

If you are taking medications for one or more of these conditions, dosages may need to be adjusted as your overall health improves.You agree to see your primary care provider, if you have one, as needed to have your need for these medications reassessed, if applicable.

Other benefits may also be obtained but cannot be guaranteed. Increasing activity level can favorably affect the above conditions and may have the additional benefit of helping you sustain weight loss. Weightl oss and increased activity may provide important psychological and social benefits, as well.

Possible Side Effects and Risks 

The possibility always exists in medicine that the combination of any significant disease with methods employed for its treatment may lead to previously unobserved or unexpected ill effects, including death.Should one or more of these ill effects occur, additional medical or surgical treatment may be necessary. In addition, it is conceivable that other side effects could occur, which have not yet been diagnosed or observed.

Reduced Weight. 

When you reduce the number of calories you eat to a level lower than the number of calories your body uses in a day, you lose weight. As a result of this weight loss, your body makes some other adjustments in body processes. Some of these adjustments are responsible, in some participants, for improvements in blood pressure and blood sugar. However, you also may experience other temporary side effects or discomforts, including an initial loss of body fluid through increased urination, momentary dizziness, a reduced metabolic rate or metabolism (the rate at which you convert food to energy),sensitivity to cold, a slower heart rate, dry skin, fatigue, diarrhea or constipation, bad breath, muscle cramps, a change in menstrual pattern, dry and brittle hair or hair loss. Generally, these responses are temporary and resolve when calories are increased after the period of weight loss.

Reduced Potassium Levels.

 Low potassium levels can cause serious heart irregularities. When someone has been on a reduced calorie diet, a rapid increase in calorie intake, especially overeating or binge-eating, can be associated with bloating, fluid retention, disturbances in salt and mineral balance, or gallbladder attacks and abdominal pain.

Gallstones. 

Overweight people develop gallstones at a rate higher than normal weight individuals. The occurrence of symptomatic gallstones (pain,diagnosed stones and/or surgery) in individuals 30 percent or more over desirable body weight (50 pounds or more overweight) not undergoing current treatment for obesity is estimated to be 1 in 100 annually, and for individuals who are 20-30 percent overweight, about one-half that rate, or 1 in 200 annually. It is possible to have gallstones and not know it. One study of individuals entering a weight loss program showed that as many as 1 in 10 had"silent" gallstones at the onset. As body weight and age increase, so do the chances of developing gallstones. These chances double for women, women using estrogen, and smokers. Losing weight--especially rapidly--may increase the chances of developing stones or sludge and/or increasing the size of existing stones within the gallbladder. The most common symptoms of gallstones are fever, nausea, and a cramping pain in the right upper abdomen. If you develop any of these symptoms or if you know or suspect that you may already have gallstones, let your provider team and primary care provider know immediately. Gallbladder problems may require medication or surgery to remove the gallbladder, and, less commonly, may be associated with more serious complications of inflammation of the pancreas or even death.

Pancreatitis. 

Pancreatitis, or an inflammation or infection in the bileducts, may be associated with the presence of gallstones and the development of sludge or obstruction in the bile ducts. The symptoms of pancreatitis include pain in the left upper abdominal area, nausea, and fever. Pancreatitis may be precipitated by binge-eating or consuming a large meal after a period of dieting. Also associated with pancreatitis is a long-term abuse of alcohol and the use of certain medications and increased age. Pancreatitis may require surgery and may be associated with more serious complications and death.

Pregnancy. 

If you become pregnant, you should immediately stop any and all of your weight loss medications, and report this to your health care providers and their team and your primary care provider, if applicable,immediately. Your diet must be changed promptly to avoid further weight loss because a restricted diet could be damaging for a developing fetus. You must take precautions to avoid becoming pregnant during the course of weight loss.

Binge Eating Disorders. 

Binge eating disorder is defined as the habitual,uncontrolled consumption of a large amount of food in a short period of time.Participation in a calorically restricted diet has been shown in one study to increase binge eating episodes temporarily. Several other studies have demonstrated reduced episodes of binge eating following a calorie deficit and portion-controlled diet. Extended binge eating episodes are associated with weight gain.

The Risk of Weight Regain. 

Obesity is a chronic condition, and the majority of overweight individuals who lose weight have a tendency to regain all or some of it over time. Factors that help to maintain a reduced body weight include regular physical activity, adherence to a restricted calorie, low fat diet, and planning a strategy for coping with weight regain before it occurs. Successful treatment may take months or even years. Medical studies of calorie deficit/portioned-controlled diets (including modified fasting) have shown varying results for patients who maintain weight loss. Some studies have shown that fewer than 5% of weight loss patients were able to maintain a reduced body weight after five years. Another study showed that after three years, weight loss patients, on average, maintained about one half of their initial weight loss. If you have had fluctuations in your weight in the past, it may be more difficult to maintain the weight you lose during and after this program. A published medical study indicated people whose body weight fluctuates greatly or often have a higher risk of heart disease and death compared with persons of relatively stable body weight, and such weight fluctuations may play a role in the development of other chronic diseases.

Sudden Death.

 Patients with severe obesity, particularly those with serious hypertension, coronary artery disease, or diabetes mellitus, have a statistically higher chance of suffering sudden death when compared to normal eight people without such medical problems.

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New York Weight Loss Bill of Rights

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N.Y. Gen. Bus. Law § 642 outlines the rights of consumers seeking professional weight-loss services. Please read these rights below:

WEIGHT LOSS AND DIETING INFORMATION

a. WARNING! Rapid weight loss may cause serious health problems. Rapid weight loss is weight loss of more than 1 1/2 to 2 pounds per week or weight loss of more than 1 percent of body weight per week after the second week of participation in a weight loss program.
b. Consult your physician before starting any weight loss program or using any diet medications or formulas.
c. Long term weight control is the safest and most important goal of any diet program. Permanent lifestyle changes such as eating nutritious foods, calorie control and increasing physical activity help promote long term weight loss according to medical experts.
d. Ask the person providing or selling you weight loss advice or diet products,medications or formulas about their qualifications and training in nutrition and health. e. You have the right to:
(i) Ask questions about the potential health risks of this program or product,its nutritional content, and its psychological-support and educational components;
(ii) Know the price of treatment, including the price of any extra products,services, supplements and laboratory tests; and
(iii) Know the program duration of the program recommended to you.

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