After more than 25 years of practicing bariatric and medical weight loss medicine in Savannah, Georgia, Dr. Don Gates has heard nearly every question a patient could ask. Many of these questions come up again and again — which means they are worth answering well, clearly, and publicly. In this article, Dr. Don Gates of Scale Solutions addresses the questions patients ask most frequently, with the same honesty and clinical grounding he brings to every patient encounter.
Question: “Why Have I Failed at Weight Loss Before?” — Dr. Don Gates’ Answer
“Failed” is not a word Dr. Don Gates uses with patients, and it is worth unpacking why. When a patient has lost weight and regained it, or has been unable to achieve lasting results despite genuine effort, that is not a personal failure — it is a signal that the approach was not adequately matched to the patient’s biology. The body actively resists weight loss through compensatory mechanisms: decreased metabolic rate, increased appetite hormones, and reduced energy expenditure all kick in as weight drops. These are physiological responses, not character defects.
Research published in The New England Journal of Medicine demonstrated that hunger-regulating hormones remain altered for at least a year after weight loss, creating ongoing biological pressure toward regain. This is precisely why ongoing physician oversight at Scale Solutions in Savannah, Georgia is so important — the body requires continued support, not a one-time intervention.
Question: “Are GLP-1 Medications Safe?” — Dr. Don Gates’ Answer
When used appropriately and under physician supervision, GLP-1 receptor agonists have an established safety profile documented across tens of thousands of participants in clinical trials. The most common side effects — nausea, vomiting, constipation, and diarrhea — are typically mild to moderate and often resolve as the body adjusts to the medication. Serious adverse events are uncommon in patients without contraindications.
Dr. Don Gates is careful to note that “safe under physician supervision” means something specific. These medications should not be used by patients with personal or family histories of medullary thyroid carcinoma or multiple endocrine neoplasia type 2. They require careful management in patients with diabetes, where they may necessitate adjustments to glucose-lowering medications. And their quality matters: Scale Solutions sources all GLP-1 medications exclusively through licensed, accredited pharmacies to ensure that patients receive medications of verified purity and dosing accuracy.
Patients can find current evidence summaries at Scale Solutions’ GLP-1 resource page.
Question: “How Much Weight Can I Realistically Lose?” — Dr. Don Gates’ Answer
This is a question Dr. Don Gates answers honestly rather than optimistically. The answer depends on several factors: the patient’s starting weight, their metabolic profile, the treatment approach used, and their engagement with behavioral and nutritional changes. In the landmark STEP trials for semaglutide, participants achieved an average weight reduction of approximately 15 percent of body weight. The SURMOUNT trials for tirzepatide showed average reductions of 20 to 22 percent in participants without diabetes.
These are averages — some patients achieve significantly more, others less. Dr. Don Gates sets individualized expectations at the first appointment based on each patient’s clinical profile and helps patients understand the realistic timeline for progress. Early losses are often faster; sustainable long-term results require the behavioral changes and ongoing medical monitoring that Scale Solutions in Savannah, Georgia is designed to provide.
Question: “Do I Need Surgery?” — Dr. Don Gates’ Answer
Most patients who come to Scale Solutions do not need bariatric surgery to achieve clinically meaningful weight loss. The emergence of GLP-1 receptor agonists has narrowed the effectiveness gap between medical and surgical approaches for many patients. That said, Dr. Don Gates does not steer patients away from surgical evaluation if their clinical picture makes it appropriate — patients with very high BMI, severe diabetes, or a history of inadequate response to multiple medical approaches may benefit from a surgical consultation.
What Dr. Don Gates consistently emphasizes is that medical weight loss should be the first step for the majority of patients, and many will not need to go further. For those who might, the Scale Solutions physician profile page explains the practice’s philosophy on comprehensive patient care and referral.
Question: “Will I Have to Take Medication Forever?” — Dr. Don Gates’ Answer
This is one of the most important questions patients ask, and it deserves a candid answer. For many patients, weight management medications may be required long-term, much the same way that a patient with hypertension typically remains on antihypertensive medication indefinitely. The biological factors that contribute to excess weight do not disappear when a target weight is reached — the research shows clearly that stopping GLP-1 medications leads to significant weight regain for most patients.
That said, this is not a universal rule. Some patients build sufficient lifestyle habits during the period of medical treatment that they are able to maintain results with medication reduction or discontinuation under close medical supervision. Dr. Don Gates assesses this possibility individually for each patient during their ongoing care at Scale Solutions in Savannah, Georgia.
Question: “How Is Scale Solutions Different?” — Dr. Don Gates’ Answer
Dr. Don Gates is succinct on this: “We are a physician-led medical practice, not a wellness center. Every treatment decision is grounded in clinical evidence and driven by the individual patient’s laboratory data and health history. I have been practicing bariatric medicine since 1999 and trained at Loma Linda University. My patients get that depth of experience alongside current evidence-based tools like GLP-1 medications — delivered in a practice that operates to clinical, not commercial, standards.”
Scale Solutions serves patients in Savannah, Pooler, and Hinesville, Georgia from its multiple locations, ensuring geographic access across coastal Georgia.
Frequently Asked Questions
How does Dr. Don Gates at Scale Solutions determine the right treatment for me?
Dr. Don Gates conducts a comprehensive medical evaluation including physical examination and laboratory testing before making any treatment recommendation. The plan is built around your specific metabolic profile, comorbidities, medication history, and personal goals.
What is Dr. Don Gates’ educational background?
Dr. Don Gates trained at Loma Linda University and has been practicing bariatric and medical weight loss medicine since 1999. He brings over 25 years of specialized clinical experience to his work at Scale Solutions in Savannah, Georgia.
Are GLP-1 medications available at all Scale Solutions locations?
Yes. GLP-1 receptor agonist therapies are available at Scale Solutions’ Savannah, Pooler, and Hinesville locations for patients who are clinically appropriate candidates, following Dr. Don Gates’ evaluation and prescribing protocols.
What if my weight loss stalls during the program?
Weight loss plateaus are common and have clinical explanations. Dr. Don Gates will investigate the cause — reviewing labs, assessing medication dosing, and evaluating dietary and activity factors — and adjust the treatment plan accordingly. Plateaus are not the end of the road; they are a clinical signal to evaluate and respond.
How do I schedule an appointment with Dr. Don Gates at Scale Solutions?
Call Scale Solutions at (912) 352-7546 or email info@scale-solutions.com. The practice accepts new patients at its Savannah, Pooler, and Hinesville, Georgia locations.
Medical Disclaimer: Responses in this article represent general clinical perspectives and educational information. They are not a substitute for individualized medical advice. Individual results from any weight loss program will vary based on clinical factors specific to each patient.
Have questions that weren’t answered here? Dr. Don Gates and the Scale Solutions team are ready to answer them in person. We work only with licensed, accredited pharmacies and provide rigorous, physician-led care to every patient. Call (912) 352-7546, email info@scale-solutions.com, or book your consultation today. Serving patients in Savannah, Pooler, and Hinesville, Georgia.
Frequently Asked Questions
How does Dr. Don Gates at Scale Solutions determine the right treatment for me?
Dr. Don Gates conducts a comprehensive medical evaluation including physical examination and laboratory testing before making any treatment recommendation. The plan is built around your specific metabolic profile, comorbidities, medication history, and personal goals.
What is Dr. Don Gates’ educational background?
Dr. Don Gates trained at Loma Linda University and has been practicing bariatric and medical weight loss medicine since 1999. He brings over 25 years of specialized clinical experience to his work at Scale Solutions in Savannah, Georgia.
Are GLP-1 medications available at all Scale Solutions locations?
Yes. GLP-1 receptor agonist therapies are available at Scale Solutions’ Savannah, Pooler, and Hinesville locations for patients who are clinically appropriate candidates, following Dr. Don Gates’ evaluation and prescribing protocols.
What if my weight loss stalls during the program?
Weight loss plateaus are common and have clinical explanations. Dr. Don Gates will investigate the cause — reviewing labs, assessing medication dosing, and evaluating dietary and activity factors — and adjust the treatment plan accordingly. Plateaus are not the end of the road; they are a clinical signal to evaluate and respond.
How do I schedule an appointment with Dr. Don Gates at Scale Solutions?
Call Scale Solutions at (912) 352-7546 or email info@scale-solutions.com. The practice accepts new patients at its Savannah, Pooler, and Hinesville, Georgia locations.
About the Physician
Dr. Donald L. Gates, MD
Dr. Don Gates is a Loma Linda-trained physician practicing bariatric medicine in coastal Georgia since 1999. He leads Scale Solutions Medical Weight Loss, with offices in Savannah, Pooler, and Hinesville, GA. He provides physician-supervised GLP-1 therapy — including semaglutide and tirzepatide — paired with personalized nutrition and metabolic guidance. Spanish-speaking. Read full bio →
Call to schedule: (912) 352-7546 · Email: info@scale-solutions.com
Ready to work with Dr. Gates?
Bariatric medicine since 1999 — Loma Linda trained, Spanish-speaking, serving Savannah, Pooler, and Hinesville.