Reflecting on her recent weight loss journey, 58-year-old Sonja C. says, “The moment I realized a big difference is when I was walking and found myself constantly pulling my pants up. I put on a smaller size and they were too big; I went down three sizes and didn’t even realize it…I took a look at myself in a full-length mirror and realized I did look smaller.”
Sonja is now riding her horse again, sleeping better, and taking less medication. Her gastric sleeve surgery earlier this year put her back on the path to healthier living, and she credits her continuing success to the bariatrics team at Texas Health Hospital Rockwall, including Lilo, Jane, Betsy and Dr. Stephens.
“During the insurance phase, Lilo and Jane were such a big support system for me. They could not wait to give me the call to tell me I had been approved. They cried with me!” Sonja said. “Betsy has always been supportive with nutrition questions and giving advice when needed. Then Dr. Stephens – he was and is so supportive. He is constantly giving advice to help with success and lets you know it is OK to not focus on the numbers on the scale but to be mindful of eating healthy and exercising.”
But Sonja’s weight loss success didn’t come without trials and tribulations. Just over 10 years ago, Sonja weighed in at 278 pounds, and she turned to lap band surgery – the only procedure that her insurance would cover at the time. In simple terms, a lap band restricts the size of the stomach by placing an inflatable band around the upper portion of the stomach to create a small pouch; the idea is that people will feel fuller faster, eat less, and lose weight.
“I was very successful with the surgery and lost approximately 130 pounds, going from size 24 tight to size 10 loose. I felt AMAZING,” Sonja explains.
But in 2015, she became ill and needed to have fluid removed from her lap band. Upon recovering from her illness, she decided to have the band refilled, only to lose its effectiveness. That’s when she looked into having revision surgery with Dr. Stephens and Texas Health Rockwall Bariatric Center.
“My final straw to revision weight loss surgery was when I got on the scale and found myself weighing over 200 pounds again – something I swore I would never let happen again, but I DID, and I was very disappointed in myself. I took a long look at myself, what I was eating, doing, etc. I tried on my own to get weight off but it was too hard without the tool. I may lose 10 pounds only to gain 11 back,” she said.
“Due to insurance issues, I waited three long years to receive my revision surgery…I did a lot of research and discovered the lap band did not have a great long-term weight loss success rate.”
Instead, she turned to Dr. Stephens for the revision surgery and the gastric sleeve.
“I am proud of the success I have achieved thus far and look forward to being a healthier, smaller version of me,” Sonja says. “I know they see many patients but when you walk in and they tell you how good you are looking, it boosts your confidence level which encourages me to keep doing what I am to be successful. I still have quite a ways to go but as Dr. Stephens told me recently, if I keep going at the rate I am or even slow down some I could lose 50 plus pounds within a year…WOW.”
Am I a Candidate?
While there are general guidelines regarding qualification for bariatric surgery, our program offers a variety of services, surgical and non-surgical, regardless of BMI, lifestyle and related illnesses. The Bariatric Center at Texas Health Rockwall will help you navigate your options so that you can find the weight loss solution that works best for you!
Texas Health Rockwall is proud to be recognized by Blue Cross Blue Shield of Texas with a Blue Distinction® Centers+ for Bariatric Surgery designation, as part of the Blue Distinction Specialty Care program. Blue Distinction Centers are nationally designated healthcare facilities that show a commitment to delivering high quality patient safety and better health outcomes, based on objective measures developed with input from the medical community and leading accreditation and quality organizations.
The Blue Distinction Centers for Bariatric Surgery program provides a full range of bariatric surgery care; including surgical care, post-operative care, outpatient follow-up care, and patient education. Texas Health Rockwall is proud to be recognized by Blue Cross Blue Shield of Texas for meeting the rigorous quality and cost selection criteria for bariatric surgery set by the Blue Distinction Specialty Care program.
“Our center takes tremendous pride in the quality, comprehensive program of services we offer,” says Jane Cauley, Bariatric Center program director. “We value the BDC+ criteria which aligns with our vision to make a significant, long lasting improvement in people’s lives as we have for over 1500 patients to date.”
Bariatric surgery is the most effective treatment for severely obese patients because it allows for substantial, sustained weight loss, which leads to, improves, or resolves obesity-related co-morbidities like type 2 diabetes. On average, healthcare costs may be reduced by 29 percent within five years following bariatric surgery, due to the reduction or elimination of obesity-related conditions, based on findings by ASMBS.
To receive a Blue Distinction Centers for Bariatric Surgery designation, a healthcare facility must demonstrate success in meeting patient safety measures as well as bariatric- specific quality measures, including complication and readmission rate for laparoscopic procedures in sleeve gastrectomy, gastric bypass, and adjustable gastric band. All designated facilities must also be nationally accredited at both the facility and bariatric program-specific levels.
Author: Indrani Raman, MD
If you have gained weight during this quarantine time, you’re not alone! “Quarantine 15” is a popular term being used recently to refer to the pesky pounds that have crept onto waistlines since the shutdown began. It’s a phrase similar to “freshman 15,” where in the first year of college students gain 15 pounds.
There are several reasons this happens. Right now, many people are suffering from extra unwanted pounds because of the combination of the stress that we are going through related to Coronavirus pandemic and the fact that we are staying at home for extended periods of time surrounded by all the food we have stocked up. Add that to a lack of gym access and decreased physical activity and we are set up for a perfect storm of overeating and gaining weight.
Stress might not sound like it can lead to weight gain, but because it causes increased levels of hormones like cortisol and adrenaline, it actually makes people hungrier and leads to favoring more sugary and fatty foods. Not only that, but stress affects our ability to get a good night’s rest. This in itself can make people gain weight over time.
Trust me, this quarantine weight gain has gotten me too! If you have gained weight during this time, don’t beat yourself up. Show yourself some love and know that it’s a struggle we are all feeling right now. According to some experts, it’s normal for people to gain weight during a crisis time. You are not alone.
Instead of slipping even further (Quarantine 30, perhaps?), let’s get proactive! Here are some easy things you can do at home to lose some of that weight.
#1 – Make Your Scale (and Your Pants) Your Best Friend
The first thing you can do to tackle this issue is to start checking your weight on a regular basis.
I know how easy it is to wear those soft sweatpants and reach for snacks while catching up with your favorite TV shows. But that can lull us into comfort and not make us realize how our belly is getting a bulge or that our work pants are getting tight.
To curb this, I would suggest at least once or twice a week put on some regular work pants or your jeans and get on the scale so that you know where you’re at. I know that sounds like the opposite of all things fun, but believe me, when you maintain the awareness of your number, it will help you think twice when reaching for the sweets.
#2 – Get Your Groove Back
The next step is creating a new active routine for your day. Because all the gyms are closed, we are staying at home with ample time on our hands to add physical activity.
You don’t need to go crazy here and order hundreds of dollars of gym equipment. It can be the simple things that make a difference. Things, like playing with the kids or walking the dog, are great ways to increase physical activity!
Not to mention that there is free access to many online exercise classes that gyms and yoga studios have created. And there is a bunch of YouTube videos that are free as well.
#3 – Plan What and When You Eat
Next, let’s talk about planning out your meals. I completely understand that the lack of access to fresh groceries can throw you off the best-laid plans. But you will see progress if you stay strong and go with a list when you go shopping or order online. Make a meal plan and buy only the items that fit within your plan, especially if you’re following a low-carb or keto diet. Above all, resist the urge to add processed sugars, grains, white bread, and desserts into your cart.
Create a menu for the week and have a scheduled time for meals each day. This will be especially useful with kids when we can set up a time for them to have meals and also schedule a time for their snacks. Having a meal plan is always a great tool to cut down on extra eating.
#4 – Practice Mindfulness
The next step is to start being mindful of your diet. I highly suggest restarting a food journaling if you have gotten off the habit or start one now and use it regularly. We always get confused about whether we are thirsty or hungry. So whenever you feel the need to snack, think about the type of hunger it is, and have a glass of water before you reach for food.
Be conscious of the hunger scale. Mindfulness is about paying attention and being present. So, consider eating a meal at least one meal a day without sitting in front of the TV, being on your phone, or reading a book. And I think this is the best time to enjoy some family meals together. Since my son was in college for the past two years, we were not able to have family meals together. Now that he’s back home, it’s so nice to be able to eat as a family again.
Also, I know most of you have started cooking at home, so it might be the best time to try out some recipes and see how they go. I’m sure the kids also would like to join you in kitchen experiments.
#5 – Develop Stress Resiliency
Next, I want you to consider working on developing stress resiliency. By that, I mean add a new type of relaxation in your daily routine. There are so many experts out there now who are teaching meditation and breathing techniques for free with online courses. You can start by adding at least one minute of meditation or mindful breathing into your daily routine.
#6 – Improve Your Sleep Habits
I also consider the lack of sleep as a factor for weight gain. And this is even more important for those of you who are binging on Netflix at night and not sticking to a regular sleep routine.
Lack of sleep can increase your hunger hormones and can worsen the stress emotions. Not getting enough sleep will make your mood swings worse than your usual mood fluctuations and can slow down your metabolism.
This is actually the best time to get an extra hour of sleep and regulate your sleep routine so that you are going to be on time every night and are getting somewhere between seven to nine hours as recommended.
#7 – Stay Connected
Social distancing means only limiting physical contact with the outside world or family and friends. I think many people now are familiar with using Zoom and Google Hangouts for work, and you can also use them to connect with your family members and long-lost friends. If not a video chat, at least pick up the phone every day and talk to somebody you haven’t spoken to in a while. That’s a kind of soul healer and can bring people together during this time.
This quarantine time shall pass sooner or later. Don’t use the time staying at home as an excuse to lose your focus on your health. A recent article published showed that people affected by obesity or higher BMI were at increased risk of getting worse complications with COVID-19 compared to somebody with a healthy weight. [https://www.sciencenews.org/article/coronavirus-covid19-obesity-risk-factor] Also, being obese can decrease your immunity level because food can be inflammatory and can cause inflammation which can give you more susceptibility to infection.
So the next time you reach for foods that are only there to make you feel good temporarily (you know which ones I’m talking about: doughnuts, chips, cookies, etc.), remember, they’re only a temporary fix and you’re just buffering the situation. Instead, work on some of the more long-term solutions we covered above. Setting up healthy habits will help you beat this sheltering time and come out “Quarantine Strong.”
How often do you catch yourself grazing? You know that slight nagging hunger that makes you reach for a snack or two or more. Grazing can be one of the biggest habits to overcome; and one of the most damaging in terms of adding weight. Furthermore rarely does grazing involve foods of nutritional value. The interesting thing about grazing is that often the root cause of this hunger is not what it seems.
Oftentimes, the source of this hunger is actually dehydration because not having enough water can cause you to feel hungry, even after a big meal. Yes, if you’ve ever caught yourself grazing shortly after a meal you might have actually been dehydrated. If the body is lacking in water, it will crave anything that can offer refreshment, including food. This phenomenon, known as head hunger is further exacerbated by poor dietary and lifestyle choices including:
• Drinking significant quantities of coffee or other caffeinated beverages. Caffeine is a diuretic, meaning it flushes water out of the body.
• Drinking alcohol. Similarly, alcoholic drinks can cause dehydration, one of the reasons why we have such painful hang-overs a day later.
• A diet high in sodium. No matter how low in calories, excess sodium can cause dehydration and bloating too. With so many processed foods containing massive amounts of sodium, it’s no wonder we’re always hungry.
• Diabetics and pre-diabetics may lose more water than most as the body tries to flush excess glucose through increased urine output.
• Certain prescription medications, ironically often needed because of excess weight, can cause additional urination.
• Stress, crash diets and a host of other issues can trigger head hunger too.
That’s why one of the most important parts of a healthy diet is to consume plenty of water which offers the benefits of increased energy and feeling fuller. And those benefits help encourage us to live an active, healthy life which means those frustrating cases of head hunger may diminish.
The exact amount of water to consume depends on the patient, the climate and their activity level. The rule of thumb is 64 ounces per day, which should be sufficient to get all the benefits staying hydrated, however some patients may require even more. Remember, by the time you feel thirsty, you’re already dehydrated. Now, we’ll readily admit that consuming 64 ounces, or 8 glasses, per day can be pretty difficult, but there’s no getting around it. Some like to tote a gallon of water everywhere they go, while others prefer more frequent refills of smaller bottles. There’s no wrong way to hit the water quota.
In the end, consuming adequate quantities of water can stave off head hunger and mitigate many diet-busting lifestyle issues. Plus, it’ll help you decipher when that hunger is real, allowing you to truly enjoy your food. If you feel hungry shortly after a big meal or during times when you really shouldn’t be, take a glass of water, wait 20 minutes and see how you feel. You could cut hundreds of calories from your diet every single day.
As an Integrative medicine doctor, I am asked frequently about good health practices. Following are three aspects, I believe everyone should incorporate into daily life.
Americans, in general, tend to eat too many high glycemic carbohydrates, bad fats, sugar-laden beverages and processed foods. Did you know that the most commonly consumed foods are breads, chicken dishes, energy or sports drinks, pizzas, burgers and desserts? These foods are pro-inflammatory, full of additives, altered fats and promote insulin resistance. They lower immunity and make your body prone to gain weight, increase risk of diabetes, cancer and heart disease. Start by eating fresh and unprocessed foods at home, avoid sugar-laden beverages, read the labels on the products, and eat more vegetables, nuts and fruit. Healing begins from within your body.
Almost 50% of the adults in the United States do not meet the minimum criteria of 150 minutes of moderate physical activity per week. This is shown to have an inverse relationship with the risk of heart disease and mortality. For people trying to achieve weight loss the physical activity needed is up to 250 minutes per week. This does not have to be intensive, even a moderate aerobic workout including resistance training will do the trick. In addition to health benefits, being active is also a great stress-buster and promotes release of endorphins that make you happy. So what are you waiting for? Get off the couch and go take a walk today.
Management of stress
Stress can affect your health. Everyone feels stressed at some point in their life therefore it is important to learn how to manage stress so that it does not affect your physical and mental wellbeing. Chronic stress can sometimes be so much a part of life that we’re unable to even recognize its symptoms. Chronic stress can affect your immune system, digestion, sleep, hormonal balance, cause weight gain, headaches and increase the risk of heart disease. Make time in your daily schedule to include some type of relaxation activity that does not include social media or watching TV. I highly recommend learning breathing techniques, volunteering, physical activity, practicing mindfulness and self-compassion. It also helps if you have a great social support group and are spiritual.
If one can manage these big hurdles they are certainly on their way to achieve optimal Health and Wellness.
The decision to have bariatric surgery is not a simple one. While the benefits of a surgical solution to lose weight are very real, it certainly isn’t anyone’s preference. Wouldn’t we all prefer to lose weight organically and easily! However, just considering bariatric surgery is a great first step to improve your life and your health.
Why are you here?
Perhaps you can no longer tie your shoelaces or the simplest tasks take too much effort. Sometimes routine chores are more difficult than you ever thought. Perhaps playing with your children or traveling is almost impossible. Maybe you live in constant pain or your physician has diagnosed you with a condition related to extra weight. Whatever your reason for getting here the fact remains that you feel held back and life isn’t as enjoyable as it was or should be. We have seen each of these scenarios and many more at our practice – all causing pain (physical and psychological) and anxiety.
When you’re desperate, you might start considering surgery. But what if we told you that bariatric surgery is not really a desperate move? In fact, when you consider the dangers of untreated morbid obesity, the risks of surgery are very often lower than living with the disease.
What’s your goal?
It’s important to remember that the term weight loss surgery is somewhat misleading. One of your goals will be to lose weight however the primary goal is to improve your life and/or resolve the risks of morbid obesity including high blood pressure, high cholesterol, sleep apnea, certain forms of cancer and more. Consider the weight loss and looking great as just a pleasant side effect!
Further, many patients come to us thinking that all they need is surgery. Not true. Losing weight is hard work and surgery will only be successful with lifestyle change. You goal must include a commitment to your health. Achieving that goal is a great accomplishment – and can change not only your life but the lives of your loved ones too!
What’s Right for You?
Bariatric surgery is not right for everyone and the benefits must outweigh the risks. For that reason and more, we have a comprehensive pre-operative qualification process that not only looks at your weight and history of obesity, but the many and varied factors that can affect your success after surgery.
Throughout the decision-making process you will have a team of dedicated professionals by your side. And our team includes several bariatric surgery patients themselves – so they understand where you are and what you are feeling. You’ll also have the opportunity to attend support groups and meet those in all stages of weight loss following their procedures. There you will hear first-hand from those who are living out their experience.
Bariatric surgery is a very personal decision and we don’t take that lightly. We won’t pressure you but we will listen to you and provide options to help you make the best decision for yourself. And whatever that decision is, our hope is that it leads you to a full, healthy and active life.
Facebook recommendations are where it’s at when searching out a new restaurant or the most reliable auto mechanic but when it comes to your health it pays to dig deeper.
It’s true that hearing from other firsthand accounts provides insight into office practices, wait times or ease of scheduling but when it comes to selecting a surgeon much more should be considered.
Call it personality or bedside manner but the ability to connect and feel comfortable with your surgeon and the practice as a whole is important. You will spend many hours over the course of the journey with the caregivers you choose so having a trusting relationship is one key to success. Will you feel comfortable sharing your concerns with the surgeon? Can you honestly talk about your medical condition and/or lifestyle challenges? If the answer is no then consider whether that is the right place for you. It may have been perfect for someone else yet not the right fit for you.
Of course you want a surgeon with experience but experience goes deeper than the number of procedures performed. What situations have they encountered? How much do they delve into your lifestyle, needs and wants to help determine the best option for you?
Is the program committed to your long term, offering a variety of support tools? How do they support you after surgery and what fees, if any, are required for that support? You may not think you need it now but you don’t want to leave any questions unanswered that might cause additional worry later.
Everything they do is only as good as the quality care you receive. Do your research and make sure the program you choose has been evaluated and maintains high standards of care. There are several ways to do this including searching out an accredited program through MBSAQIP and other online reporting services.
So when it comes to seeking recommendations go ahead and ask others just remember that your opinion is the one you live with.
Her story begins in a doctor’s office however Donna wasn’t the patient she was an employee. She began to have knee pain and opted for injections that worked for a period of time. She continued to limp painfully through her days until the pain got so bad she visited an orthopedic surgeon. The surgeon told her he wouldn’t do a replacement because she was too heavy and she needed to have weight loss surgery. Donna recalls thinking “This guy is crazy. I am not having any kind of surgery to lose weight.”
Unfortunately, her condition did not improve. With worsening knees she had more difficulty moving and found herself in a wheelchair fulltime with a diagnosis of Rheumatoid Arthritis. The combination did not help her weight. At this point Donna was afraid she would die.
Donna found the strength to do something. Hear how Donna tells the rest of her story. “I did my research and found Dr. Kennedy and Your Solution. I was so impressed with her and the whole office that I decided to do it! It was the BEST decision of my life. The only thing I wish is that I had actually listened to my doctor and done it years ago. Look at me now! I am walking (after getting double knee replacement), going to the gym and getting stronger with each passing day, doing things I couldn’t have ever done without the gastric bypass. I went in at 350 and I am holding around 188! I thought I would never see the day I would be less than 200 lbs. and I have bypassed that!”
Life changing is how Donna and others describe their decision to take control of their future. Donna is living life and doing more when just a few years ago she was afraid she might die. That is a great representation of life changing.
If you have researched weight loss surgery options you surely came across this logo and wondered what it means.
MBSAQIP stands for – wow that says a lot. But what does it mean? And should you care?
It does mean a lot and yes, you should care. The MBSAQIP is a joint accreditation of two organizations, the American College of Surgeons and the American College for Metabolic and Bariatric Surgery, resulting in a single accreditation program that shows that the center is committed to quality.
By choosing a program that is accredited you can be assured that center is following the highest standards for quality and safety. Knowing that they have been evaluated and reviewed against strict benchmarks should give you added reassurance. Additionally, these accredited centers must report surgical outcomes as an added layer of evaluation but also to provide documentation of the benefits of bariatric surgery in reducing health risks associated with obesity.
There is a lot to consider when selecting a weight loss surgery center and the information can be daunting. Start your search by selecting a MBSAQIP program then dig deeper to learn more about the personality of the program and the surgeon before making that final selection.
You can learn more about the MBSAQIP at their website here https://www.facs.org/quality-programs/mbsaqip
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