Obesity affects more than 130 million American adults and is a chronic and complex disease. Virtua Health is addressing this issue with its comprehensive weight-loss treatment options, designed to help individuals lose weight and improve their overall health. Virtua’s weight-loss specialists recognize that obesity is a chronic disease and are working to change the stigma associated with it.
Understanding Obesity and BMI
Obesity is characterized by a higher-than-healthy amount of body fat. It's important to remember that there's no single cause of obesity, and it doesn't reflect a lack of willpower. To be diagnosed with obesity, you have to have a body mass index (BMI) of 30 to 39.9, or 40 and higher to be diagnosed with severe obesity. Body mass index (BMI) is a screening tool that uses a calculation of your height and weight to place you into a weight category, such as underweight, healthy weight, overweight, and obese. A BMI of 40 or higher is considered severe obesity. When you have a BMI of 35 or more, it becomes infinitely harder to lose weight through diet and exercise alone. In addition, obesity puts you at risk for other diseases like diabetes, heart disease, sleep apnea, back pain, and joint issues.
Virtua's Comprehensive Weight Management Program
Virtua offers comprehensive weight-loss treatment options to help you lose a little or a lot of weight. Virtua’s Complete Weight Management Program is led by board-certified obesity medicine experts who deliver customized weight-loss approaches backed by science. Virtua’s weight-loss specialists work with you to evaluate your health history, BMI, diet and exercise habits, and weight-loss goals to determine the best option for you. Since weight loss is a journey, it’s realistic to expect that there will be ups and downs. We support you through your challenges and adjust your plan to help you overcome them.
The program includes psychological evaluations and counseling, nutritional and fitness counseling, support groups, and one-on-one guidance from a weight management navigator. Your treatment doesn't end after you've reached your weight-loss goal. Our weight-loss specialists, navigators, dietitians, and behavioral specialists stay connected to support you throughout your journey. We help you stay accountable to your goals and weight-loss success through check-ins with the team and our monthly support group.
Weight-Loss Medications
Virtua offers multiple FDA-approved weight loss medications that, along with healthy eating and exercise, can be a powerful tool for reaching your weight loss goals. At our practice, you may see a surgeon, but we are not pushing a sleeve gastrectomy or gastric bypass. Virtua offers the latest FDA-approved medications that, along with healthy eating and exercise, can help you lose weight. GLP-1 or GLP-1/GIP drugs mimic natural gut hormones that regulate your blood sugar and tell your brain you’re full, so you eat less. They include Zepbound, Wagovy and Saxenda. Zepbound can lead to an average weight loss of 20 to 22%, while Wagovy and Saxenda offer a 10% to 15% reduction. The medications can have side effects like nausea, constipation, heartburn, and fatigue. So it’s not unusual to switch medications. Weight-loss medications are one tool offered in our comprehensive program.
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Types of Medications Offered
- Zepbound (terzepatide): This GLP-1/GIP medication is given as one weekly injection.
- Saxenda (liraglutide): This GLP-1 daily injection helps suppress your appetite and decrease food intake.
- Phentermine: A trusted medication used since the 1960s, phentermine is a stimulant taken as a daily pill. It can only be used for a short time.
Side Effects of Weight-Loss Medications
Prescription weight-loss medications can have a variety of side effects. However, what you may experience is unique and depends on your prescribed medication. Gastrointestinal effects include nausea, vomiting, diarrhea, constipation, stomach pain, heartburn, bloating, and gas. Headaches and fatigue are also relatively common. If you feel any side effects, it's important to discuss them with your health care provider.
Who is a Candidate for Medical Weight Loss?
Medication might be an option if your body mass index (BMI) falls between 27 and 29.9 and you have a weight-related health condition like diabetes or high blood pressure. Medication is an option if your BMI is between 27 and 29.9 and you have a condition such as high blood pressure, coronary artery disease, diabetes, sleep apnea, or gastroesophageal reflux disease (GERD).
Bariatric Surgery at Virtua
For individuals with severe obesity, bariatric surgery may be a viable option. Virtua's board-certified bariatric surgeons offer minimally invasive and robotic bariatric surgery options, including gastric sleeve, gastric bypass, duodenal, modified duodenal switch (SADI-S), and revision surgeries. Virtua was the first health system in South Jersey providing robotic surgery for bariatric procedures and bariatric revision surgery.
The Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) designated Virtua Health as a comprehensive bariatric surgery center. This accreditation means our program meets nationally recognized bariatric surgical standards for safe, patient-centered care. Virtua registered dietitians are part of Virtua’s bariatric surgery center of excellence, designated by the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP).
Determining Candidacy for Bariatric Surgery
The Virtua Weight-Loss Surgery Program follows guidelines supported by the National Institutes of Health in order to determine a patient's eligibility for weight- loss surgery. Rather than using weight, we use body mass index (BMI) as a criteria for surgery-excess fat in relation to height.
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You may be a candidate if:
- Your BMI is greater than 40.
- Your BMI is between 35 and 40 with major obesity-related medical problems, such as diabetes, hypertension, hyperchloremia (electrolyte disturbance), or sleep apnea.
It’s important to remember that surgery is not a solution for everyone. We only determine whether a patient meets the requirements for surgery. It’s only after a complete evaluation, intensive education and discussion with the patient, that he or she may decide to pursue surgery.
Types of Bariatric Surgeries Offered
Virtua offers a range of bariatric surgery options, including:
- Gastric Sleeve
- Gastric Bypass (RYGB)
- Duodenal Switch (DS)
- Modified Duodenal Switch (SADI-S)
- Adjustable Gastric Banding (Lap-Band)
- Revision Surgeries
Risks of Weight-Loss Surgery
All major surgery comes with risks, and the risks are different for each patient. Virtua weight-loss surgeons have excellent below-national benchmark risk outcomes.
Expected Weight Loss After Surgery
The amount of weight you lose-and how fast you lose it-depends on what weight-loss surgery you have and your commitment to following the program. Patients who have adjustable gastric banding (Lap-Band) procedures usually lose weight more slowly the first year than those who have gastric bypass (RYGB), vertical sleeve gastrectomy (VSG) or duodenal switch procedures (DS). Typically, the average patient loses between 60 to 80 percent of his or her excess body weight after RYGB or DS and between 60 to 70 percent after VSG. Weight loss with gastric banding is less predictable. The amount of weight loss also depends on your age, gender, starting BMI and your ability to adhere to lifestyle changes necessary to make surgery a success.
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Pregnancy After Weight-Loss Surgery
Weight-loss surgery has actually been linked with producing a sudden positive change in fertility. After bariatric surgery, women with fertility problems linked to obesity may begin ovulating regularly for the first time in years. However, women should avoid pregnancy for at least 18 months after surgery. Please discuss any pregnancy plans with your surgeon during one of your scheduled appointments.
Insurance Coverage for Bariatric Surgery
Insurance coverage depends on your individual insurance plan. For example, some insurance companies require a patient to be in a physician-supervised weight-loss program for at least a year before surgery or meet other specific requirements. Before you come in for your initial appointment with the surgeon, please call your insurance company to find out if weight-loss surgery is covered.
The Surgical Process and Recovery
Your hospital stay will depend on the type of weight-loss surgery you have. Generally, hospital stays are between 1 to 5 days depending on the surgical procedure. Depending on the type surgery the patient had, most individuals can return to work in 2 to 3 weeks after surgery. You will have low energy for a while after surgery and may need to take some half days, or work every other day for your first week back. You can exercise right away. You will take gentle, short walks even while you are in the hospital. The key is to start slow, listen to your body and your surgeon. If you lift weights or do sports, stay “low impact” for the first month (avoid competition, think participation). Build slowly over several weeks.
Potential Need for Plastic Surgery
Most patients have some loose or sagging skin, but it’s often more temporary than expected. You will experience many changes between 6 and 18 months after surgery. Your individual appearance depends upon several things, including how much weight you lose, your age, your genetics and whether or not you exercise or smoke. Generally, loose skin is well-hidden by clothing. Some patients will choose to have plastic surgery to remove excess skin. Most surgeons recommend waiting at least 18 months, but you can be evaluated before that. Plastic surgery for removal of excess abdominal and breast skin is often covered by insurance for reasons of moisture, hygiene and rash/skin issues. Arms and other areas may not be covered if they are considered “purely” cosmetic by your insurer.
Benefits Beyond Weight Loss
Bariatric surgery offers numerous health benefits beyond just weight loss.
Diabetes Improvement
Obesity is a major cause of type 2 diabetes, and people who have severe obesity are 10 times more likely to have it. Bariatric surgery improves type 2 diabetes and resolves it in 80-95 percent of patients, depending on the bariatric procedure performed (for example, duodenal switch provides more powerful results than other procedures). In fact, some people experience an improvement in, or resolution of, type 2 diabetes by the time they’re home from surgery; others may see improvement more gradually.
Heart Health Improvement
In addition to improving heart-related diabetes risks, the weight loss that comes with bariatric surgery can reduce the fat around the heart, leading to better heart health overall.
Resolution of Obstructive Sleep Apnea (OSA)
Obstructive sleep apnea (OSA) is a common, yet life-threatening, obesity-related sleep disorder that many people face. OSA occurs when the soft tissues in the airway narrow or close during sleep. Episodes of OSA can lead to sudden cardiac death, irregular heartbeat, or high blood pressure. OSA also is linked to an increased risk for diabetes and can make diabetes harder to control. Bariatric surgery is shown to improve or resolve OSA in the majority of patients. As you lose weight, you lose the fatty tissue that causes the narrowing of the airway and breathing interruptions. However, some patients continue to use treatments like CPAP (continuous positive airway pressure) to manage OSA.
Reduced Joint Strain
Weight loss from bariatric surgery helps physically relieve that strain and helps restore physical function. In addition, bariatric surgery is an effective solution for people with arthritis who need joint replacement but are required by insurance to lose weight before the surgery.
The Importance of Personalized Nutrition and Dietitian Support
Virtua registered dietitians work with you to understand your food preferences, exercise habits, lifestyle, and goals. Virtua registered dietitians can help you reach your peak performance. We can help you create an eating plan to support your goals, such as gaining muscle or improving endurance. Virtua registered dietitians are part of Virtua’s bariatric surgery center of excellence, designated by the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP).
If your plan needs to include fast food or your favorite treat, it will! Depending on your condition, you might need to make dietary changes to feel better, ease symptoms, and avoid serious complications. We teach you how to track your food and symptoms, including how to use easy-to-navigate food-tracking phone apps. At your first appointment, your registered dietitian will get to know you. If you pursue weight-loss medications or bariatric surgery through our Complete Weight Management Program, we will help you make diet, nutrition, and behavior changes to support lifelong success.
Getting Started with Virtua's Weight Loss Program
If you’re interested in weight-loss surgery, please call 1-888-VIRTUA-3 to schedule an initial consultation. Virtua Health, the largest health system in South Jersey, has recently launched the Virtua Complete Weight Management Program. Patients in the program receive personalized, medically supervised weight loss plans that may include weight loss medication options and bariatric surgery options based on health history, health status, and goals. Our personal navigators will help you register for an information session where you will learn more about our program and our weight-loss surgery options. Take the first step and schedule a consultation with a Virtua weight-loss specialist. We'll review your medical and behavioral health history and current medications. We also discuss your goals, lifestyle behaviors, and habits so that we can personalize a plan that meets your needs. We’ll continue supporting your success once you've reached your weight-loss goal. After the first appointment, how long will it take before I have surgery? This depends on your insurance provider and the criteria they require, as well as the tests and requirements the surgical team deems necessary.
Patient Success Story
Dan Shaw, age 36, from Sicklerville, NJ, committed to losing weight when his three-year-old son Bear Patrick was diagnosed with Stage 4 kidney disease. “I decided at that moment to lose weight,” he stated. Dan has been a patient of Dr. Sharma and the program’s registered dietician since December 2023. “I feel great. I can do more now. I am running, biking, and weightlifting,” Dan explained. “I am committed to this weight loss journey because I know that my weight loss and healthier lifestyle will not only help me but will also help my son.