Obesity, particularly morbid obesity, significantly impacts various aspects of life, turning simple tasks into challenges, straining relationships, and leading to severe health complications. The Kelsey-Seybold weight loss program offers a range of solutions, from bariatric surgery to lifestyle interventions, tailored to individual needs.
Bariatric Surgery: A Life-Changing Tool
For individuals grappling with morbid obesity, defined as a body mass index (BMI) of 40 or higher or being more than 100 pounds overweight, bariatric surgery can be transformative. It is also an option for those with a BMI of 35 or higher who have at least one obesity-related health condition, such as Type 2 diabetes, hypertension, high cholesterol, osteoarthritis, or nonalcoholic fatty liver disease.
Pre-Surgical Requirements and Preparation
Most bariatric surgeons, including those at Kelsey-Seybold, require a mental health assessment to identify any psychological or substance abuse issues that could hinder a successful surgical outcome. Additionally, patients typically need to complete three or more visits with a registered dietitian to learn healthy eating and exercise habits. This pre-surgical preparation is crucial for maximizing and sustaining weight loss after surgery.
Types of Bariatric Surgery Offered at Kelsey-Seybold
Bariatric surgery is currently the most effective weight loss tool available. These procedures reduce the size of the stomach, leading to earlier satiety and reduced food intake. At Kelsey-Seybold, three primary surgical options are offered: sleeve gastrectomy, gastric bypass, and loop duodenal switch (SADI-S). The choice of procedure is determined in consultation with the patient, considering their medical history, conditions, and expectations. All three options are performed laparoscopically, using small incisions (1-2 cm), which typically results in a one-night hospital stay and a week off work, with restrictions on heavy lifting (over 15 pounds) for four to six weeks.
Sleeve Gastrectomy
Also known as gastric sleeve, this is the most popular bariatric surgery option. It involves removing approximately 75% of the stomach, leaving a banana-shaped tube. The small intestine is not modified during this procedure. Patients typically lose about 55% to 65% of their excess body weight. For example, someone weighing 250 pounds with an ideal weight of 150 pounds could expect to lose 55 to 65 pounds. Sleeve gastrectomy has fewer lasting issues compared to gastric bypass and loop duodenal switch procedures but can cause long-term gastric reflux or heartburn, which is usually manageable with medication.
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Gastric Bypass
This procedure, performed laparoscopically, involves dividing the stomach to create a small gastric pouch, about the size of your thumb. The small intestine is then connected to this pouch, so food goes into the pouch and then into the small intestine. This not only aids in portion control but also reduces fat absorption and alters gastrointestinal hormones. Gastric bypass tends to be more effective than sleeve gastrectomy in terms of weight loss, curing Type 2 diabetes, and eliminating hypertension and hyperlipidemia. It also tends to treat acid reflux and heartburn. However, it carries long-term risks of marginal ulcers, dumping syndrome, and internal hernias.
Loop Duodenal Switch (SADI-S)
The laparoscopic loop duodenal switch (SADI-S) surgery is a newer procedure. First, a sleeve gastrectomy is performed, removing about 75% of the stomach. Next, the first portion of the small intestine, the duodenum, is cut and reconnected to the small intestine much further downstream. In some ways, this operation combines the sleeve gastrectomy and gastric bypass procedures. This option is great for weight loss and curing conditions such as Type 2 diabetes, hypertension, and high cholesterol. Theoretically, this operation has significantly less risk of marginal ulcers, dumping syndrome, and internal hernias compared to gastric bypass. As of now, we don’t have a clear picture of how it affects gastric reflux. It’s also extremely important that patients stick to their diets and take the required vitamins, since the risk of malnutrition and vitamin deficiencies is higher with this procedure.
Benefits of Bariatric Surgery
The most apparent benefit of bariatric surgery is weight loss. Most people lose 50% to 80% of their excess body weight within a year or two after surgery. By 12 to 18 months, many patients lose around 100 pounds. However, bariatric surgery is not the end of the journey.
Healthy Living Workshop: Incorporating Healthy Habits
The Healthy Living Workshop is a multi-class virtual series designed for adults wanting to incorporate healthy habits into their daily life. In the first three classes, dietitians help establish a healthy relationship with food and nutrition, set sustainable goals, and provide exercise tips. Class 4 is for those who have been using the methods discussed in classes one through three for a meaningful amount of time without seeing results.
The Role of Obesity Medicine
Dr. Sokunbi, certified in Obesity Medicine, emphasizes the importance of weight management in preventing numerous medical conditions. She highlights the need to "walk the walk and not just talk the talk," advocating for personalized approaches to weight loss.
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Dr. Sokunbi's Personal Approach
Dr. Sokunbi's personal routine involves early morning exercise (30-45 minutes, five days a week) and a protein-rich breakfast. She follows the adage of eating breakfast like a king, lunch like a prince, and dinner like a pauper. She identifies snacks as her "downfall" and avoids them to maintain weight loss.
The Internal and External Impact of Excess Weight
From an internal perspective, increased fat mass impairs bodily functions, exacerbating conditions like diabetes and high blood pressure. Excess weight also strains the heart and blood vessels and can lead to sleep apnea. Externally, it can limit physical activity and interaction with family.
Addressing the 'Why' of Weight Gain
Dr. Sokunbi addresses the underlying reasons for weight gain, particularly stress, which leads to increased cortisol levels and unhealthy choices. She also emphasizes the importance of knowledge about nutrition, such as understanding the role of fiber and the impact of sugary drinks.
Seeking Knowledgeable Guidance
Dr. Sokunbi recommends seeking guidance from professionals knowledgeable in weight management, such as those certified in Obesity Medicine at Kelsey-Seybold. She stresses that weight loss is personal and requires understanding individual circumstances.
Personalizing the Approach
As a physician, Dr. Sokunbi draws a picture of every person’s situation. If someone starts gaining weight abruptly, she look to see what life change happened that made them start gaining weight and address that. There’s only one you. And you have to be at your best for everything else to follow. Choosing you is the best solution to making a lot of things work. Give yourself permission to choose you. I think everyone deserves at least one hour a day to focus on themselves. Choose yourself and make yourself a priority because you do matter.
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Success Stories: Joan's Weight Watchers Journey
Joan's story exemplifies the success of the Weight Watchers program at Kelsey-Seybold. After struggling with weight since childhood, Joan lost 48 pounds and is on a maintenance program.
Overcoming Challenges
Joan faced challenges losing weight after having children and was diagnosed as borderline diabetic. A Kelsey-Seybold dietitian helped her understand carbs and healthy eating. Inspired by friends' success with Weight Watchers, she joined the program and focused on her diet, later incorporating exercise.
The Importance of Support
Joan's husband is proud of her and encourages her to make healthy choices. She was inspired by her mother.
CoolSculpting: A Non-Surgical Fat Reduction Option
For those with stubborn fat that resists diet and exercise, CoolSculpting offers a non-surgical alternative. It is not a weight loss solution for obese individuals but rather a fat-reduction procedure for specific areas.
The CoolSculpting Procedure
CoolSculpting is FDA-approved for the flanks (love handles), abdomen, and thighs. During the procedure, fat cells are crystallized (frozen), and the body processes and eliminates these dead cells. The length of a CoolSculpting session varies depending on the number of areas being treated during one visit.
What to Expect
As the cooling begins, you’ll feel pressure and intense cold. This soon dissipates. You may also experience deep pulling, tugging, pinching, numbness, or slight discomfort. Following the procedure, typical side effects include temporary numbness, redness, swelling, bruising, firmness, tingling, stinging, and pain. Rare side effects may also occur.
Who Should Avoid CoolSculpting?
The CoolSculpting procedure is not for everyone. You should not have the CoolSculpting procedure if you suffer from cryoglobulinemia or paroxysmal cold hemoglobinuria. The CoolSculpting procedure is not a treatment for obesity.
Recovery and Results
Typically, you can return to normal activities immediately. You may start to see changes in as quickly as three weeks after your treatment, and you will experience the most dramatic results after two months.