It sounds as if Mayo is pretty proactive with community and personal weight loss support. I haven’t been able to find anywhere with the same focus where I live; they are all about medical wt loss inc surgery or meal supplements etc. I can’t afford all that and know it wouldn’t be right for me anyway. I need help with exercising with RA, meal planning and motivation as well as psychological issues which keep me from being successful. I have asked my PC and she just does not have any helpful insights (‘find a gym’-I can’t afford one, ‘find a counselor’-I haven’t found any that are weight issues oriented, ‘get in a group’-there aren’t any in the rural area I live in, etc). My rheumatologist, who is 3 hours away in a university setting probably has access to all this but she knows I live too far away for her recommendations. I know myself and how I need a comprehensive, interdisciplinary and inexpensive (I’m on Medicare for disability and don’t work) approach to succeed but have no luck locating any programs after all my searching. It’s very overwhelming as I am 140 lbs overweight and can’t see my way out of this without some direction. Any suggestions of how to proceed? Are there any behavioral or other clinical trials? How can you help patients who are 5 hours away from Mayo? I can’t afford to buy your Mayo Clinic Diet program but I have insurance.