Next-generation diet pills and hormones are helping the rich lose weight

When Fabiana Saba was a young model, the 5ft, 10in, 100lb beauty graced the covers of Elle and Marie Claire in her native Brazil, shared a magazine spread with Gisele Bundchen and walked the runways at New York Fashion Week , Paris, Milan, Tokyo and St. Paolo with the likes of Alessandra Ambrosio – all before she became a TV presenter. As she grew up, her weight increased to a still slim 130 pounds.

But after having two children and surviving the first few months of the pandemic, Saba found herself in a body that no longer felt like her own. As of the second half of 2020, she weighed 186 pounds and struggled with joint pain and breathing issues.

“Like so many people, I took up baking during the pandemic, and I didn’t just eat a slice; I would eat the whole pie,” Saba, now 44 and a resident of New York’s Sutton Place, told The Post. The prospect of losing the weight on her own was daunting — “I’d tried many times in the past… and it never worked out well,” she said — so she turned to her uptown neighbor, Dr. Caroline Knife.

Fabiana Saba in a green caftan
In her most difficult phase, Fabiana Saba had breathing problems and joint pain.
Glam selfie by Fabiana Saba
After model Fabiana Saba’s weight rocketed to 186 pounds during the pandemic, she sought treatment from stars’ endocrinologist Caroline Messer, who helped her lose nearly 50 pounds.
Handouts by Fabiana Sutton
A college of covers with Fabiana Saba
In her heyday, Fabiana Saba was a top model and covered major fashion magazines in her native Brazil.

Messer diagnosed her with prediabetes and high cholesterol, and prescribed her both an anti-anxiety medication and an appetite suppressant. The medication helped her drop to 137 pounds relatively easily in less than a year.

“One doctor changed everything,” enthused Saba, who continues to take the medication.

Full length photo of Fabiana Saba in a black mini dress
Thanks to Dr. Messer prescribed medication, Fabiana Saba now weighs 137 pounds.
Handouts by Fabiana Sutton

The city’s rich and fabulous looking to lose weight don’t babble it with fad diets and Noom subscriptions. They spend thousands of dollars to work with Messer, a well-known endocrinologist whose patients include Saudi royalty, A-list stars, industry titans, professional athletes and public figures 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 assume they’ve easily measured hormonal 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 that takes a holistic approach to treating metabolic issues. In addition to Messer and two other endocrinologists, it is staffed by a psychologist, two fitness trainers and a nutritionist. A bariatric surgeon and a pulmonologist are also available to patients.

Messer, which doesn’t have insurance but is sometimes covered as an off-network expense, offers a $900 initial diagnostic visit that includes a full medical history and physical exam, including a thyroid panel. She then works with her team to create a plan that works best for the patient.

“I assess their activity levels and nutrient levels, as well as whether they need cognitive behavior modification,” said Messer, who charges $450 for follow-up appointments. Visits to other members of her team range from $80 to $600.

The Well by Messer plan often includes medication.

Headshot of Dr.  Caroline Knife
An initial consultation with Dr. Caroline Messer costs $900.
Photo courtesy of Well by Messer

Her popular treatments include GLP1 and GIP, replications of hormones secreted by the gut that trigger feelings of satiety and slow digestion. The trendy new 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, reducing the price from about $1,400 to $250 a month.

Other drugs in Messer’s arsenal include Contrave, an antidepressant approved for weight loss, and methamphetamine, which has been used for years with mixed success for weight loss.

“They have risks but are life-saving 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 avoid the pandemic pounds.

“I had a family history of diabetes and I knew people were sitting around gaining weight, so I wanted to take the negativity that was going on around me and turn it positive,” said the New Rochelle resident. 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 Messer’s help. “I went from being at risk of diabetes to being in the normal range. I could never have done it without their support.”

Doctors gathered around a desk at Well by Messer
At Well by Messer, patients have the opportunity to meet with a range of experts including Dr. Barrie Weinstein (from left); Registered Dietitian Jean Hanks; and psychologist Dr. Jess Kovler.
Photo courtesy of Well by Messer

In addition to health for weight loss, Well by Messer offers luxury health extras such as metabolic tests and beauty treatments such as Kybella injections to remove fat under the chin.

But it’s the innovative approach to weight loss that patients rave about the most.

“I won’t be walking runways again soon, but I’m running in the park with my kids again,” Saba said.

State-of-the-art drugs that endocrinologists prescribe for weight loss

List of medications that Dr.  Caroline prescribes knives to help clients lose weight.
dr Caroline Messer prescribes a range of pills to help clients lose weight based on their health conditions.
Getty Images


This cutting-edge weight-loss drug contains semaglutide, a hormone produced by the body to induce feelings of fullness after eating. While effective — shown to reduce overall weight by 15% — it’s also expensive, costing up to $1,300 a month.


Contrave is a combination pill used to combat binge eating and contains naltrexone – traditionally prescribed for alcohol and drug addiction – and bupropion, an antidepressant often sold under the name Wellbutrin. It was approved by the FDA in 2014, but like all drugs, it has potential side effects, including an increased risk of seizures.


This controversial weight loss drug was also sold under the Alli name. It works by preventing the body from absorbing some fats, but the lifestyle cost is high: It can cause a range of nasty side effects, from gas and bloating to fecal incontinence.


Think of it as gastric bypass – in pill form. Twenty minutes before a meal, dieters swallow three Plenity capsules along 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 abdomen. It was FDA approved in 2019 and costs $98 per month.


Do you remember Fen-Phen? While the previous drug fenfluramine was pulled from the market in 1997 because of potential heart damage, the appetite suppressant phentermine is still available. But that doesn’t mean it’s risk-free. This amphetamine-like pill can cause mania-like symptoms like insomnia and heart palpitations.