Weight and Lifestyle Optimization

Our w8ality™️ Wheel approach to helping you get into a healthy weight and body fat.

What is w8ality™️?

w8ality™️ is a Physician-supervised individualized weight optimization wellness program that uses Dr. Kainkaryam’s concept of the w8ality™️ Wheel as the premise of making comprehensive lifestyle changes, augmented by medication when clinically appropriate.

Obesity Medicine is considered its own specialty, which requires additional training, board certification, and expertise.  These services are considered outside the scope of the Direct Primary Care practice.

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Your Team is Waiting for You

We are excited to share with you the benefits of our w8ality™️ program.  Everyone who is a part of it believes in your journey.  Now, it’s up to you.

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How do you enroll in the program?

Our w8ality™️ program is available to everyone, including members of our Direct Primary Care practice and the general community.  Individuals who are not members of the Direct Primary Care practice start with a Comprehensive Onboarding Process ($275), which consist of 3 in-person visits, lab ordering, and glucose monitoring:

  • Readiness for Change and Mindset Evaluation (30 minutes with Deb, in-person)
  • Lifestyle History, Body Composition, and Medical History (45 minutes with Paul, in-person)
  • Lab orders (including lipid panel, thyroid, insulin resistance testing)
  • Glucose monitoring (blinded)
  • Physician Visit (45 minutes) to review data, discuss treatment plan

For Direct Primary Care patients, all patients receive one w8ality™️ Comprehensive Onboarding Visit, which consists of a joint visit with RN Paul and Dr. Kainkaryam to review the medical history, labs, treatment options, etc.  Glucose monitoring and labs are not included in the complimentary consult and are either billed to insurance or using the practice direct pay rates.

What happens at the end of the Onboarding Visit?

When you complete your visit with Deb and Paul, they will send their recommendations to Dr. Kainkaryam, who at his visit with you, will review all of the information and recommendations and determine a comprehensive treatment plan for you, which may include recommendations for:

  • Educational Foundation Seminars – universally recommended
  • Personal Training and Fitness Coaching (Movement/Motivation)
  • Mindset coaching (Motivation/Stress)
  • Medical Nutrition Therapy (Sustenance/Supplementation)
  • Medication Assisted Weight Loss (Medication/Metabolism)
  • Micronutrient Testing (Supplementation/Metabolism)
  • Advanced Cardiometabolic Testing (Metabolism)
  • Continuous Glucose Monitoring (Metabolism)
  • Additional workup by your Primary Care Physician (Sleep/Metabolism)

How does a patient choose what to do next?

Patients will review the recommendations made, consider their own personal financial situation, and decide on the program components they want to participate in.  Ideally, the choice should be made soon so that the labs and testing remain relevant without repeating.  The overall plan presented to the patient will be considering the w8ality
™️ Wheel to be as comprehensive as possible, and success is most likely when they are following the full plan.

Personal Training and Fitness Coaching

Fitness Coaching is done through 4 Elements Health & Wellness LLC through partnership with Pursuit Fitness LLC to offer the 4 Elements Pursuit Fitness Membership at $400/4 weeks which includes:

  • A maximum of two (2) 45-minute sessions per week either in-person at the microgym at 4 Elements Direct Primary Care & Wellness Space or virtually
    • Debrief
    • General warm-up
    • Specific warm-up
    • Strength training
    • Workout
    • Cool Down
    • Next steps
  • Home exercise programming
  • Access to the training app truCoach
  • Additional sessions may be offered based on client’s need
  • Sessions are not transferable

Nutrition Coaching & Medical Nutrition Therapy

Nutrition is an extremely important part of making lifestyle change, and we are pleased to have Juhi Gupta, RD, as part of our team.  Juhi works with you one-on-one in a medical nutrition therapy format to help develop meal plans, help you think of shopping, and answer very specific customized ways of eating that are also culturally sensitive for you.

Intro sessions are 1 hour and cost $100.  Follow-up sessions are $75 and are 30 minutes.  

Mindset and Readiness Coaching

Not everyone is ready to make change, and that’s okay.  And different people are on different parts of the change spectrum.  This coaching process allows you to identify your own barriers to change and to help overcome them to enhance motivation.  This coaching is offered through our partnership with Deborah Maccarone, a trained school psychologist and a clinical hypnotherapist, who offers mindset coaching using various motivation tools.

A 90-minute session is $155 and a 60-minute session is $105.  For individuals who want a package, an intro package which is a 90 minute session and two 60-minute follow-up sessions is $350.  Follow-up session packages of 3 60-minute sessions is $300.

Clinical Hypnosis

Clinically hypnosis uses suggestions based on your goals to be able to influence the subconscious to drive toward specific goals that you have.  Through relaxation you go into a deep relaxation state and suggestions are offered to your subconscious, which can choose to accept or reject those suggestions based on your goals.  You will meet with Deb to consult based on your goals to create those suggestions.  These are offered by Deborah Maccarone, a certified clinical hypnotherapist.

A 90-minute session is $155 and a 60-minute session is $105.  For individuals who want a package, an intro package which is a 90 minute session and two 60-minute follow-up sessions is $350.  Follow-up session packages of 3 60-minute sessions is $300.

w8ality™️ Educational Seminar Membership

These monthly seminars are offered by 4 Elements Health & Wellness LLC are a low-cost way to learn from industry experts in a group setting that fosters community and shared goals. 

They are led by Paul Taft, RN, PN-L1, CF-L2Deb Maccarone, MA, CH; Juhi Gupta, RDN, CDCES, and happen on a monthly basis, typically on a Saturday morning.

While these seminars are not intended to provide individualized plans of care, they offer a high level of education and information that each person can apply to their own lives.  Topics include using exercise bands, overcoming motivational barriers, functional movements, strategies for smart grocery shopping, reading nutrition labels, creating sustainable habit changes, cooking alternatives, etc.

You will develop relationships with other attendees to foster group accountability and support, and also with your educators so that if you feel there could be benefit from individualized work with them, you have the established rapport.

Up to 6 seats are available each month, and individuals can purchase a package of 6 months in advance (at a discounted rate of $100/month) or purchase monthly ($125/month) depending on availability.

Follow-up visits for medication-assisted weight will be $125 for non-DPC members, and $100 for DPC members, as these visits for medication-assisted weight loss management are outside the scope of traditional primary care and are overseen by Dr. Kainkaryam in his capacity as a Board Certified Obesity Medicine Physician and Paula Rocha, APRN, with almost 20 years in Endocrinology. 

Each follow-up visit is 30 minutes and will include a body composition analysis to identify changes that are happening.  They may also include blood draws to follow trends.  Follow-up visit frequency is determined by clinical response and guidelines and will be up to the discretion of the Physician.  Adherence to follow-up will be required for ongoing medication prescription.

Medication-Assisted Weight Loss

If patient wishes to proceed with medication-assisted weight loss, this will be a part of the discussion with Dr. Kainkaryam during the consultation, where all options will be reviewed.  However, patients will have received a list from Paul during their visit with him to do some research with their insurance companies regarding coverage for medication options so they can bring that information to their visit with Dr. Kainkaryam.


If patients are interested in pursuing medication-assisted weight loss, they will sign an informed consent document which will outline the expectations of medications, risks and benefits, as well as long term plan.


Dr. Kainkaryam will only be managing the medication related to the weight loss, and comorbid conditions must be managed by the primary care physician.  After the initial consultation with Dr. Kainkaryam, follow-up and titration of medications will be done with visit with Paula Rocha, APRN, but approximately every fourth visit will be with Dr. Kainkaryam.


Payment Plans

We partner with Cherry that allows you to take a comprehensive payment program and break it up into affordable monthly payments, often times with 0% interest for 3 months if you qualify.  You may choose to apply for a Cherry payment plan online on our website and can use it for specific aspects of our program (w8ality Onboarding Consultations, Follow-up Clinical Visits, Registered Dietician Visits). 

Micronutrient Testing

In addition to standard labs, we know that when people are eating calorie deficits there is a risk of nutritional deficiencies.  We will recommend appropriate supplementation to ensure you are getting the right supplements and will at times recommend micronutrient testing to do a deep dive into your micronutrients to ensure that you are getting the right balance of minerals and vitamins.

The cost of this Micronutrient Testing including consultation/interpretation is: $250.

Other Wellness Services

For individuals who want to know more about their bodies, we offer advanced cardiometabolic testing through Boston Heart Diagnostics as well as Food Inflammation Testing through KBMO Diagnostics.  

The cost of these services are:

  • Boston Heart Diagnostics Advanced Cardiac Risk Screening – test is billed to insurance or paid directly to the lab.  Consultation is included in DPC membership, and for non-members, it is $250.
  • Food Inflammation Testing – test cost is between $190-490 depending on how extensive the test is and is inclusive of one virtual follow-up consultation for interpretation.
  • Gut Microbiome Testing – Please reach out to learn more.

Who can participate in each of the service offerings through the program?

Some services that are offered are also offered to the general public, and other services require medical consultation evaluation either through the w8ality Onboarding Process or as members of the Direct Primary Care practice.

  • Services offered to the general public
    • Personal Training
    • Clinical Hypnosis
    • Mindset coaching
    • Body Composition Analysis with InBody
    • Micronutrient Testing and Consultation
    • Boston Heart Diagnostics Testing and Consultation
  • Services that require the w8ality Onboarding Consultation or for DPC members
    • Registered Dietician visits/Medical Nutrition Therapy
    • Medication-assisted weight loss
    • Continuous Glucose Monitoring