Weight Loss Surgery Catherine Beck M.D. and Jeffrey Eakin M.D. ABOUT US Dr. Catherine Beck Dr. Jeffrey Eakin Center for Minimally Invasive and Bariatric Surgery Jordan Valley Medical Center www.cmibs.com 1 FOR STARTERS Dr. Catherine Beck Dr. Jeffrey Eakin Center for Minimally Invasive and Bariatric Surgery Jordan Valley Medical Center www.cmibs.com 2 Section 1 Taking the first step Congratulations...because reading or hearing this material is the first step toward loosing weight and changing your life! Commitment is necessary for such a big change, and it starts with small steps and the decision to change. 3 Section 2 Why loose weight •Not just for appearances •Everyone has their own reason •Often people do it to: • feel better •be able to be more active with kids •have more energy •be healthier • respond and fix a new medical problem • live longer •stop taking medications •decrease the need for so many doctor’s appointment 4 BMI Dr. Catherine Beck Dr. Jeffrey Eakin Center for Minimally Invasive and Bariatric Surgery Jordan Valley Medical Center www.cmibs.com 5 Section 1 What is BMI? BMI is short for body mass index Basically...it is your weight divided by your height 6 Section 2 Sample BMI calculation Example Calculation If a patient is 5’5” tall and they weigh 275 lbs BMI = 45.8 7 Section 3 What is my BMI? 8 Section 4 Same for definitions men and women 9 WEIGHT LOSS OPTIONS Dr. Catherine Beck Dr. Jeffrey Eakin Center for Minimally Invasive and Bariatric Surgery Jordan Valley Medical Center www.cmibs.com 10 Section 1 4 Main Options •Diet •Exercise •Medically supervised weight loss •Weight loss (bariatric) surgery 11 Section 2 Diets •Diets don’t work •“Diet” implies a transient state of being = short term fix •Need complete change of lifestyle •Many people have medical illnesses limiting their abil- ity to exercise - like arthritis •Overweight individuals often embarrassed to exercise of join a gym 12 Section 3 Motivation and Habits Motivation is what gets you started; Habit is what keeps you going 13 Section 4 Diets •Studies show high rate of weight regain •no singular diet has been proven to be be best •Diets (on average) only produce an 8 pound weight loss •Only sustained over a 2 year period 14 Section 5 Diets and exercise •Successful diets and exercise are done in tandem •Should lose of one pound per week •Thus, over 3 months = 12 pound weight loss •That is successful! •But...usually frustrates patients because it’s slow •Almost doesn’t feel worth the hard work 15 Section 6 4 Main Options copy •Diet •Exercise •Medically supervised weight loss •Weight loss (bariatric) surgery 16 Section 7 Medically supervised weight loss •Regular appointment with: •medical weight loss physician •registered dietitian •Techniques used: •behavioral changes •prescriptions medications • 17 Section 8 Medically supervised weight loss •Treatment focuses on: •educations...what to eat and how to exercise •stimulus control...break old habits •cognitive restructuring...retraining the brain •goal setting...where are you going...1 lb. a week •self monitoring...keeping a journal...or mobile app •contracting...commitment •social support...family, friends and other patients 18 Section 9 Medically supervised weight loss •Can achieve: •10% weight loss (400 lbs = 40 lbs) •25% excess body weight loss (400 lbs = 50 lbs) •duration loss depends on duration of treatment •Weight loss of merely 5% can improvement illnesses •So if 100 pounds overweight...losing 5 pounds can im- prove some of your medical problems! 19 Section 10 Bariatric surgery •Diet •Exercise •Medically supervised weight loss •Weight loss (bariatric) surgery 20 Section 11 Surgical weight loss for Obesity realted illnesses 21 Diabetes Hypertension Coronary artery disease Heart Disease Arthritis Daytime tiredness from sleep apnea Section 12 Weight loss (bariatric) surgery results 22 weight loss of 50-60% excess body weight Reduction in death from cancers (especially colon and breast cancers) 60% Reduction death from heart disease 60% Reduction in death from diabetes 90% Section 13 Weight loss (bariatric) surgery results 23 diabetes gone and off meds 75% No longer have high blood pressure 60% No longer have sleep apnea 80% No longer have high cholesterol 60% Section 14 What to expect after deciding to pursue surgery Team Approach Two Bariatric Surgeons •Dr. Catherine Beck •Dr. Jeffrey Eakin Medical Weight loss Specialist •Dr. Gayle Stewart Registered Dietitian • Ariel Miller RD 24 Section 15 Process before weight loss surgery •Insurance Verification •Initial visit with the surgeon...best operation •Psychologic assessment •3 - 6 month medically supervised weight loss •Insurance approval, pre-op diet, surgery scheduling •1 - 2 day hospital stay 25 Section 16 Process before weight loss surgery •Follow-up schedule after surgery: •2 weeks •4 weeks •Every 3 month for 2 years 26 Section 17 Psychological asessment before surgery •Why the psychology assessment? •Insurances require it •It ensures you resources available to make a com- plete change in lifestyle •Ensures you can handle major changes after surgery •Rule out illness (e.g. drug and alcohol abuse 27 Section 18 Why the 3 - 6 month period of weight loss? •Most insurances require a trial period of weight loss •It ensures you have the education and tools to have successful weight loss. •Unfortunately everyone can “eat through any surgery.” 28 Section 19 Visits before surgery •Visit with surgeon •Dietitian evaluation •Psychology evaluation •Physical therapy evaluation •Medical weight loss counseling 29 Section 20 Scopes before surgery •Possible colonoscopy •Upper endoscopy •Possible reflux and acid testing 30 Section 21 Tests before surgery •Chest x ray •X-ray of esophagus and stomach •Blood draws •EKG •Study of esophagus and how it works •Possibly mammogram •Ultrasound to look for gallstones 31 Section 22 Things to stop before surgery •Smoking cessation...never again! •Cessation of hormonal birth control 32 Section 23 Things to stop before surgery Did we mention smoking cessation? 33 Section 24 You can do it for a new “me” •Feels like: •A lot of work •Enormous commitment and •A lot of appointments •...It is 34 Section 25 You can do it for a new “me” •We want you to be safe and be successful! •Guide you through each step so its not overwhelming •Your heaviest weight will be at your first appointment •You can do it! 35 WHO QUALIFIES FOR WEIGHT LOSS (BARIATRIC) SURGERY 36 Section 1 Am I a candidate for weight loss surgery If you make the decision to go with surgical solutions...how do you know if you qualify? Requirements to Qualify for Bariatric Surgery •BMI > 35 with 2 or obesity related illnesses •BMI >40 with or without obesity related illness 37 Section 2 Obesity realted illnesses High blood pressure Diabetes Weight bearing arthritis Cardiovascular disease Obstructive sleep apnea 38 Section 3 Obesity realted illnesses 39 Diabetes Hypertension Coronary artery disease Heart Disease Arthritis Daytime tiredness from sleep apnea Section 4 Other illnesses related to obesity 40 high blood pressure high cholesterol Diabetes Sleep apnea pulmonary hypertension Thyroid Disease Heart Disease Back Pain Osteoarthritis depression infertility/PCOS gallstones uterine cancer breast cancer esophageal cancer cancer gallbladder cancer cancer colon and rectum cancer kidney cancer thyroid cancer liver disease Section 5 Same for definitions men and women 41 Section 6 Cost for weight loss surgery •Different plans = different coverage and requirements •Some say...“one surgery per lifetime” limitations •There are self pay options •Our team will takes care of all of this 42 Types of weight loss (bariatric) surgery 43 Section 1 Laparoscopic Gastric Banding 44 Section 2 Advantages of laparoscopic Gastric Banding •Excess body weight loss 40% •Stomach is not cut or stapled •No new connections ( e.g. between stomach and bowel) •Short hospital stay •Reversible and adjustable •Low risk of vitamin deficiencies 45 Section 3 What is laparoscopic Gastric Banding 46 Section 4 Disadvantages of Laparoscopic Gastric Banding •Slower weight loss •Foreign body implantation (chance for infection) •Band can slip and erode into stomach •May cause damage to (hole in) esophagus •Requires strict compliance •Requires constant follow-up •Highest rate of reoperation 47 Section 5 Laparoscopic sleeve gastrectomy 48 Section 6 Advantages of laparoscopic sleeve gastrectomy •Decreased the amount of food that can be eaten •Helps brain response to hunger •Helps hormonal response to hunger •Weight loss similar to gastric bypass •No foreign body •No new connections (like in gastric bypass) •Short 1 Day Hospital Stay 49 Section 7 What is a laparoscopic sleeve gastrectomy 50 Section 8 Disadvantages of Laparoscopic Sleeve Gastrectomy •Not reversible •Potential for vitamin deficiencies •Unknown effect of reflux disease •Possibility for a leak after surgery 51 Section 9 Laparoscopic (roux-en-y) gastric bypass 52 Section 10 Advantages of laparoscopic gastric bypass •Decreases the amount of food that can be eaten •Decreases absorption of fats and carbs •No foreign bodies •Treats (usually cures) reflux disease •Can be done on patients with gastroparesis 53 Section 11 What is a laparoscopic gastric bypass 54 Section 12 Disadvantages of Gastric Bypass •Vitamin deficiencies •Not reversible •Life-long compliance is essential - with all operations ;) •Potential for: •obstruction of the intestines •hernias inside •ulcers in the pouch 55 Section 13 Key to success! •Support Groups •Meet with people who are in your same situtation •Meet with someone who has been through the pro- gram and been successful •Share your tips for success with others and be their inspiration •Follow up (surgeon, dietary) 56 Section 14 Support group topics •Support Groups •dietary changes •exercise and fitness •common concerns and questions •open forums 57 Section 15 Exercise support •Once a month s @ Jordan Valley Physical therapy gym •Third Wednesday of every month •Once a week open gym time for patients •Every Thursday from 6-7pm •Options to join the gym for patient •Options for one on one training for patients 58 Section 16 Where is exercise support Jordan Valley Physical therapy gym 59 Section 17 How do I start making instant changes? Call the number below to set up your initial evaluation 60 Click to call us from website Section 18 Where can I see the doctors? Jordan Valley Medical Center West Valley Campus 61 Section 19 Thank you for sharing your time with us! 62 www.cmibs.com
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