When Fabiana Saba was a young model, the 5ft, 10in and 100lb stunner graced the covers of Elle et Marie Claire in her native Brazil, shared a magazine with Gisele Bündchen and walked the week’s runways fashion in New York, Paris, Milan, Tokyo and Saint-Paul with Alessandra Ambrosio, all before becoming a television host. As an adult, his weight increased to a still slim 130 pounds.
But, after having two children and enduring the first months of the pandemic, Saba found herself in a body that no longer resembled her. In the second half of 2020, she weighed 186 pounds and suffered from joint pain and breathing problems.
“Like so many people, I started cooking during the pandemic, and I wasn’t just eating one piece; I would eat all the cake,” Saba, now 44 and living in Sutton Place in New York, told The Post. The prospect of losing weight on her own was daunting – “I had tried many times in the past…and it never went well,” she said – so she turned to her uptown neighbor, Dr. Caroline Messer.
Messer diagnosed him with pre-diabetes and high cholesterol and prescribed him both an anti-anxiety drug and an appetite suppressant. The drugs helped her drop to 137 pounds in less than a year with relative ease.
“Having a doctor changed everything,” said Saba, who continues to take medication.
The city’s rich and fabulous looking to lose weight aren’t doing it on fad diets and Noom subscriptions. They spend thousands of dollars working with Messer, a renowned endocrinologist whose patients include Saudi royals, A-list stars, industry titans, professional athletes and socialites looking to lose. weight and improve their health.
“There’s definitely a trend to see endocrinologists…because now we have more treatments that address hormonal imbalances that lead to weight gain,” Messer said. “A lot of people suspect they have an easily measurable hormone imbalance, but it’s often something more subtle.”
The 44-year-old has had a traditional endocrinology practice on Fifth Avenue for years and has just opened a boutique clinic, Well By Messer, on East 60th Street, which takes a holistic approach to managing metabolic issues. In addition to Messer and two other endocrinologists, it is made up of a psychologist, two fitness trainers and a dietitian. A bariatric surgeon and a pulmonologist are also available to patients.
Messer, who doesn’t take insurance but is sometimes covered as an out-of-network expense, offers a $900 initial diagnostic visit, which involves a full history and physical exam, including a thyroid panel. She then develops with her team a plan that is best suited to the patient.
“I assess their activity level and nutrient content, as well as whether they need cognitive behavior change,” said Messer, who charges $450 for follow-up appointments. Visits to other members of his team range from $80 to $600.
Often the Well by Messer plan includes medication.
Among its popular treatments are GLP1 and GIP, replicating hormones secreted by the gut that trigger feelings of fullness and slow digestion. The new hyped treatments — “Half the well-heeled women I see on the Upper East Side take these hormones for weight loss, and they work,” said a Manhattan plastic surgeon — are notoriously expensive. But Messer orders them from a Canadian pharmacy, bringing the price down by about $1,400 to $250 a month.
Other drugs in Messer’s arsenal include Contrave, an antidepressant approved for weight loss, and methamphetamines, which have been used for weight loss for years with mixed success.
“They are risky but lifesaving for true binge eating disorder,” Messer said.
Marc Schwartz, the 57-year-old head of global marketing for a pharmaceutical company, turned to Messer to help him avoid putting on the pounds of the pandemic.
“I had a family history of diabetes and knew people sat still and gained weight, so I wanted to take the negativity around me and make it positive,” the New Rochelle resident said. Messer gave him medication to lower his blood sugar and she encouraged him to become an endurance runner.
“She really motivated me, so I had an incredible sense of joy and purpose,” said Schwartz, who lost 23 pounds with help from Messer. “I went from diabetes risk to a normal range. Without his support, I would never have been able to do this.”
In addition to weight loss, Well by Messer offers luxury health extras, such as metabolic rate tests and beauty treatments like Kybella injections to eliminate fat under the chin.
But it’s the cutting-edge approach to size reduction that patients rave about most often.
“I won’t be walking any tracks soon, but I’m starting to run again with my kids in the park,” Saba said.
Endocrinologists prescribe breakthrough drugs for weight loss
This breakthrough weight loss drug contains semaglutide, a hormone produced by the body to trigger feelings of fullness after eating. While it’s effective — it’s been shown to reduce overall weight by 15% — it’s also expensive, costing up to $1,300 a month.
A combination pill used to target food addiction, Contrave contains naltrexone – which is traditionally prescribed for alcohol and drug addiction – and bupropion, an antidepressant often sold as Wellbutrin. It was approved by the FDA in 2014, but like all medications, it comes with potential side effects, including an increased risk of seizures.
This controversial weight-loss drug was also sold under the name Alli. It works by preventing the body from absorbing certain fats, but the lifestyle costs are high: it can cause a range of unpleasant side effects, from flatulence to fecal incontinence.
Think of it like gastric bypass – in pill form. Twenty minutes before eating, dieters swallow three Plenity capsules with 16 ounces of water. Once in the stomach, the pills release gel particles, which then expand and prevent users from overeating by literally taking up space in the stomach. It was cleared by the FDA in 2019 and costs $98 per month.
Do you remember Fen-Phen? While the old drug, fenfluramine, was taken off the market in 1997 for potential heart damage, the appetite suppressant phentermine is still available. But that doesn’t mean it’s risk-free. This amphetamine-like pill can induce manic-like symptoms such as insomnia and heart palpitations.