Weighing the Options: When is it time to consider weight loss surgery?

Erin Wilson, 26, had struggled with being overweight her whole life. “I was predisposed to high cholesterol and had already been put on a diet by the time I was five years old. I was active in sports in high school, but I just couldn’t seem to lose the weight.” Her breaking point came when she was asked to get off an amusement park ride in the summer of 2013 because the safety harness would not fit over her body. “I was so disappointed in myself. My little brother was heartbroken because he wanted me to come with him on his first roller coaster ride,” she says. “At that moment, I knew I had to get my weight under control and began exploring the option of bariatric surgery.”

In late August, Ms. Wilson attended a free information session held by GBMC’s Comprehensive Obesity Management Program (COMP), the first step toward weight loss surgery. She was so impressed with the information provided that she scheduled a consultation with bariatric surgeon Elizabeth Dovec, MD, before she left the session that day.

Ms. Wilson’s story is not unlike the experiences of our other patients, who also have faced moments of disappointment and sadness because of their weight and the limitations it imposes on their lives. The good news is that, with surgery, they can go on to live very normal, healthier lives.

Dr. Dovec and fellow board-certified bariatric surgeon Gustavo Bello, MD, Medical Director of COMP, offer the three main types of bariatric surgery:

• Laparoscopic Roux-En-Y Gastric Bypass: A stomach pouch is created to reduce the stomach’s size and restrict the amount of food that can be eaten. Bypassing part of the intestine reduces how much food and nutrients are absorbed which leads to weight loss.
• Laparoscopic Sleeve Gastrectomy: Most of the stomach is removed and the remaining portion is a long tube or “sleeve.”
• Laparoscopic Adjustable Gastric Band: An adjustable band is placed around the top portion of the stomach, limiting the amount of food a person can take in.

“Because all patients have different medical and surgical histories as well as different comfort levels regarding bariatric surgery, we tailor a plan to meet each patient’s individual needs,” says Dr. Dovec. “In Ms. Wilson’s case, we opted to go with gastric bypass surgery.”

Prior to surgery, patients undergo three to six months of weight loss supervision and nutrition counseling, depending on their insurance requirements. This helps patients prepare for the eating and exercise habits they must maintain after surgery and also allows for weight loss that makes the procedure itself safer and easier to perform. The goal of nutrition counseling is to teach patients how to make healthier food choices as well as identify barriers preventing weight loss, including overeating carbohydrates, grazing, eating late at night and skipping breakfast. COMP also partners with an exercise coordinator as well as psychologists to provide patients with a comprehensive approach to treating morbid obesity.

With COMP, patient support isn’t limited to the confines of GBMC. Although Melissa Frey, RN, facilitates support groups that are held on GBMC’s campus, a Facebook page is also available 24/7 for individuals who can’t attend in person or need assistance in between support group sessions. “Through Facebook, our patients are able to answer each other’s questions and encourage one another,” says Dr. Dovec. “I personally check the page daily to answer questions and monitor for quality assurance.”

This easily accessible support system is what makes COMP stand out in Ms. Wilson’s eyes. “The people going through the program with you are more than just fellow patients,” she says. “They become friends. You understand each other’s struggles. You work out with each other and offer encouragement at the exercise physiologist’s ‘bariatric boot camp’ exercise classes. You root for each other every step of the way.”

By following the program guidelines of a high protein, low carbohydrate diet and keeping a consistent exercise routine, Ms. Wilson lost 40 pounds before having her gastric bypass surgery on February 21 and is continuing to steadily lose weight.

Just one month post-op, Ms. Wilson was achieving key fitness milestones. “I am able to do cardio exercise for an hour straight. I am trying new classes at the gym and I am able to keep up with everyone else,” she says. “I take walks on my lunch break at work when the weather is nice, which I never would have done before my surgery. I feel great!”