Michael Barbagallo was used to being the “big dude.” He told himself he’d one day get a grip on his weight, and that because he was young, he didn’t have to worry.

“But then things end up getting really bad and then you end up in a spot in your life where you’re very unhappy with the way everything’s going and you need people around you to get you through it,” says the 22-year-old from New Hyde Park, N.Y. “As much as it seems like a process where you have to really rely on yourself, the tools are there for you and they’re around you and if you utilize them the right way, they’ll do wonders for you.”

Barbagallo sought the help of Dr. Andre Giannakopoulos, a physician board certified in internal medicine and obesity management at Westbury, N.Y.’s Center for Medical Weight Loss. Barbagallo was put on a meal replacement plan of five protein shakes and three bars a day, and in six months, he was down 110 pounds.

“Anybody who goes on a diet can lose weight,” Dr. Giannakopoulos tells Metro. “[But] 95 percent of people who try to do it on their own will gain it all back within a year … We have to fix the physiology and that’s the absolute bottom line.”

Doctors specializing in weight loss, like Dr. Giannakopoulos, view obesity through the lens of medicine. Dr. Giannakopoulos does a comprehensive medical exam on all patients, taking into account bloodwork, medications and family history. Medical weight loss doctors can prescribe shakes, pills and lifestyle modifications for their clients. Many are also trained to offer behavior modification services, like cognitive behavioral therapy, to change eating habits and attitudes about food.

“I’m ruling them out for borderline hypothyroidism, polycystic ovarian syndrome, for depression, for anxiety,” says Dr. Melina B. Jampolis, a California-based physician nutrition specialist. She has patients complete a food journal so she can “review and troubleshoot and make suggestions” on their meals. Patients see her once every 10-14 days “because once a week, you’re [just] chasing a scale on a number.”

Prospective patients shouldn’t be embarrassed to come in for help, Dr. Giannakopolous says, because “most people don’t realize that there could be some underlying factor that makes it difficult to keep weight off.”

And out-of-pocket fees don’t have to be a concern, as many insurances now cover diet doctor office visits.

“Insurance companies finally recognized that this is a chronic disease and that there’s a cost savings for helping people to lose weight, ” he says. “They wind up living longer with less medical problems and less costs involved as well.”

One patient’s story

A few weeks shy of his 50th birthday, Mark (who didn’t want to use his last name here), began seeing Dr. Giannakopolous. Two years later “I’ve lost over 100 pounds and l look substantially younger,” he says. “I went from a size 44 waist to a 32 and I’m happier. I’m able to move my body. … Sometimes I got choked up when I had to see pictures of myself — I was like, who is that person? When I show people my driver’s license, which was taken a few weeks prior to my starting the diet, they don’t even know who that it is.”