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Weighted Questions

Weighted Questions

On 13 Sep 2016, in

Boone Hospital Center’s certified bariatric nurse coordinator separates weight loss surgery fact from fiction.

By Jessica Park

Anyone who’s made an effort to lose weight is familiar with the flood of well-meaning advice from family and friends. Unfortunately, good intentions don’t always mean good information, particularly when it comes to advice about weight loss surgery. 

Lisa Schaffer, Boone Hospital Center’s bariatric coordinator, has heard many myths and misconceptions about weight loss surgery (also called bariatric surgery). A registered nurse with certification in bariatrics, Schaffer educates people who are considering weight loss surgery. This education includes separating fact from fiction, so that people understand the actual risks and benefits and make a decision that’s best for them.

“Just exercise more and eat less. Weight loss surgery is an easy way out.”

“I hear that one all the time. Our patients hear it all the time, too,” Lisa says. “Most of our patients have tried diet and exercise, usually more than once. And they’ve been successful to some degree, but regained the weight due to metabolic factors.”

Severe obesity – a BMI greater than 40 or a BMI greater than 35 with an existing comorbidity, such as diabetes, sleep apnea or high blood pressure – is a chronic condition. It’s not a sign that someone is weak, lazy or “addicted” to food.

The National Institute of Health has stated that for individuals with severe obesity, maintaining weight loss is nearly impossible except in patients who’ve undergone weight loss surgery. Chronic dieting and regaining weight has been shown to slow down the body’s metabolism, making weight easy to regain. An adult who weighs 170 pounds after gaining weight and dieting requires significantly fewer calories to maintain their weight than someone who always weighed 170.

Unlike restriction diets, weight loss surgery procedures change the digestive system anatomy to increase feelings of fullness and change the production of hormones that regulate hunger and appetite. Combined with healthy lifestyle changes, weight loss surgery patients see more success in maintaining weight loss.

 “Weight loss surgery presents more risks than obesity!”

 “That’s false,” Lisa says. “The risk of mortality is about .3% with the gastric bypass and sleeve gastrectomy procedures and about .06% with the lap-band. And the benefits are so much greater than the risks.”

For people who have severe obesity, losing weight isn’t just about fitting into smaller size clothes, it can be a matter of life or death. People with severe obesity are more likely to have conditions that increase their chance of premature death, such as diabetes, sleep apnea and high blood pressure. Studies have shown greater reductions in mortality for weight loss surgery patients than those with severe obesity who’ve not had surgery, as well as an improvement of obesity-related disease after weight loss surgery.

 “My insurance doesn’t cover weight loss surgery.”

Many employers now cover weight loss surgery, although coverage and requirements vary depending on your plan. 

“We can help navigate people through that process, including the prerequisites,” Lisa says. “And if they don’t have insurance that covers weight loss surgery, we have more affordable options and potential financing available for people paying out of pocket.”

“I probably don’t qualify for weight loss surgery.”

Most weight loss surgery methods are recommended for people with a BMI greater than 40 (that’s about 240 pounds or more for a 5’5” tall person), with or without a comorbidity such as sleep apnea, diabetes or high blood pressure, or a BMI of 30 or greater with a comorbidity, and a history of unsuccessful weight loss through diet and exercise.

Some insurance plans may require a minimum BMI of 35 with a comorbidity or require patients to first participate in a medically supervised weight loss program, but again, Lisa says the Boone bariatrics program can help patients figure out what their plan covers.

“Weight loss surgery won’t work. I’ll regain the weight anyway.”

Many studies of weight loss surgery patients show that more than 90 percent of patients are successful in maintaining 50 percent or more of their excess weight loss after surgery. 

"A lot of people are afraid of failure,” Lisa says. She understands; most patients have been unsuccessful repeatedly before considering weight loss surgery. However, weight loss surgery can help people who are familiar with making committed lifestyle changes achieve lasting results.

“I’ve had many patients tell me, ‘I’m doing all the same things before I had the surgery, and I wasn’t able to lose weight. Now I’m doing those things, and it’s finally working.’”

 Weight loss surgery patient education empowers people to find changes they can enjoy and commit to for life, rather than short-term restrictions.

“We don’t use the D-word,” Lisa says. “Our patients do have to make lifetime changes, but we focus on the positive.”

 In addition to annual follow-up visits, Boone Hospital’s weight loss surgery patients have other resources to stay on track.

“They can come back and meet with our dietitians. We also have a monthly support group of people at all points along the weight loss surgery process. Studies show that people who attend a support group after weight loss surgery are the most successful, and we require people about to undergo surgery to attend a meeting,” Lisa says.

 Patients can also join Boone Hospital’s WELLAWARE Fitness Center. The Fitness Center offers exercise classes, personal training and standard gym equipment in a supportive, non-traditional gym environment. Many fitness center members have similar experiences or medical conditions that weight loss surgery patients can relate to. For anyone who is new to regular exercise, the support makes a difference and encourages them to stay active.

 “There’s about ten or 12 of us in our support group who participate in the WELLAWARE 5K together,” Lisa says.

Make an educated decision!

Boone Hospital Center’s Bariatrics Program provides free seminars for anyone who wants to know more about weight loss surgery. The seminars include a dietitian, a registered nurse and surgeon James Pitt, DO, and cover surgical options, their risks and benefits, and lifestyle changes. Attendees can decide whether or not weight loss surgery is right for them.

“We recognize this an individual decision – we don’t give anyone the hard sell,” Lisa explains. “We just start the education process early so that people are fully informed when they make their decision.”

If you have questions about Boone Hospital’s bariatrics program or would like to attend a seminar, call 573-815-6466 or visit boone.org/weightloss -- you can also follow the Boone Hospital Weight Loss Surgery page on Facebook: facebook.com/Boone-Hospital-Weight-Loss-Surgery/

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