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Online Chat - Reshape Your Life and Health with Bariatric Surgery

Online Chat - Reshape Your Life and Health with Bariatric Surgery

Wednesday April 11, 2012

Dr. Schram:
Hello everyone. I am Dr. Jon Schram, a surgeon specializing in bariatric surgery for weight loss with Spectrum Health Medical Group. Today our topic of discussion is the health and wellness concerns and issues of patients who are interested in exploring bariatric surgery to facilitate weight loss.

Comment From Lind:
I have already tried Optifast and lost 50 pounds, 35 of which have found me again. Do I have to do a trial of a medical program before surgery?

Dr. Schram:
It depends on your current weight and current BMI and insurance company. Some insurance companies require a 6 months medically supervised weight loss program, but others do not.

Dr. Schram:
If you have more specific questions regarding your situation you may contact our office at 616-994-6677 and we can let you know if you need to do anything further

Spectrum Health:
FACT: Regular physical activity is important for good health, and it's especially important if you're trying to lose weight or to maintain a healthy weight.

Comment From Lind:
What is the entire recovery time (both off work and back to work)

Dr. Schram:
It depends on the surgery that you have. Most people are back to work within two weeks of surgery.

Comment From Sara:
I need to lose 100 pounds to have a "normal" BMI. Do you recommend surgery for me?

Dr. Schram:
Sara, surgery would likely provide you the most successful option to lose 100 pounds.

Dr. Schram:
If you are unsure of your BMI, there are multiple websites that you can visit to plug in your height and weight which will calculate your BMI for you.

Dr. Schram:
Most insurance companies will cover weight loss surgery for people who have a BMI of 35 or higher with some comorbidities, or a BMI of 40 or greater without comorbidities.

Comment From Lind:
Is follow up support also available? Specifically to prevent bad habits from staying?

Dr. Schram:
Yes, we have behavioralists and dietitians available

Spectrum Health:
FACT: Most weight loss occurs because of decreased caloric intake. However, evidence shows the only way to maintain weight loss is to be engaged in regular physical activity.

Comment From Justin:
If a person's genetics are a main factor in their particular obesity, are there any cases of bariatric surgery simply not effectively overcoming that genetic condition?

Dr. Schram:
Regardless of the cause of your obesity, over 90% of patients who undergo weight loss surgery will have long term success.

Dr. Schram:
Insurance companies typically cover surgical treatment for these comorbidities associated with obesity: diabetes, high blood pressure, and sleep apnea

Spectrum Health:
FACT: Certain groups of people, such as the Pima Indian tribe in Arizona, have a very high incidence of severe obesity. They also have significantly higher rates of diabetes and heart disease than other ethnic groups.

Comment From Guest:
What about knee problems?

Dr. Schram:
Are you asking about insurance coverage?

Dr. Schram: It would depend on your BMI, if your BMI is over 40 surgical treatment would likely be covered.

Spectrum Health:
FACT: Bariatric surgery is more effective for sustained weight loss than dieting and exercise, and therefore has longer impact on medical problems associated with obesity.

Comment From Guest:
It may not be quite there yet.

Dr. Schram:
You are welcome to call our office at 616-994-6677 and we can check your specific policy as well your BMI for you.

Comment From Guest:
Do you have an office in Grand Rapids as well?

Dr. Schram:
Our main office in located in Holland, there is a surgical weight loss office in Grand Rapids, however I do not practice there currently.

Spectrum Health:
FACT: The rate of obesity differs from state to state, which is probably a reflection of various lifestyle, age and economic factors. Michigan residents rank tenth in obesity in the United States, according to data collected between 2008 and 2010 and published in a report issued by Trust for America’s Health and Robert Wood Johnson Foundation.

Comment From Justin:
In general, how do you determine whether a patient would benefit from non-surgical weight loss over surgical (or vice versa)? Is it mainly BMI, or are there other factors as well?

Dr. Schram:
Weight loss is obviously a very challenging goal for many people. We always recommend that patients try non operative measures first. If they find this unsuccessful, surgery has been shown to have long term success in the vast majority of patients.

Comment From Judy:
What procedure has the best long term results?

Dr. Schram:
We have good long term data regarding the Gastric Bypass operation which shows that 90% of patients are able to keep at least 50% of their excess weight off for 10 years or longer

Dr. Schram:
The long term data regarding Gastric Sleeve is not available yet, although we know that it appears to be very similar to Gastric Bypass at 5 years

Dr. Schram: The long term results for Gastric Banding are highly variable. Some patients have spectacular long term results and a number of patients find weight loss very challenging with a Band

Comment From Sara:
Why does diabetes increase your risk of obesity? Do I need to be concerned that the weight will come back if I have the surgery?

Dr. Schram:
Actually obesity increases your risk to develop diabetes. The treatment for diabetes also causes some people to gain weight. Therefore they feed on each other.

Dr. Schram:
84% of the patients that have diabetes and undergo Gastric Bypass or Gastric Sleeve have resolution of their diabetes. Your long term success is dependent on how well you use the tool that has been built within you.

Comment From Judy:
If a lapband is done & not very successful is it an option to have a gastric bypass done?

Dr. Schram:
Yes, we have converted Band patients to Gastric Bypass or Gastric Sleeve with good long term success.

Spectrum Health:
FACT: Obesity is a disease that affects 34 percent of adults age 20 and over in the United States, which amounts to more than 72 million people. About 32.2 percent of American men and about 35.5 percent of American women are obese.

Spectrum Health:
FACT: Roux-en-Y gastric bypass surgery creates a small stomach pouch, about the size of an egg, which then bypasses the upper part of the small intestine. As opposed to vertical sleeve gastrectomy, the remaining stomach is not removed, making this procedure reversible or adjustable if needed. According to the American Society for Bariatric Surgery, Roux-en-Y gastric bypass is one of the most frequently performed weight loss procedures in the United States.

Comment From Sara:
Will I need to be on a liquid diet after the surgery? How will that work? Can I ever eat real food again?

Dr. Schram:
After all of the surgeries patients are on liquids for one week, pureed foods for one week, soft foods for one week and then regular foods from then on. You will always have to cut things small, chew carefully, and eat slowly.

Comment From Guest:
Do you do surgery at the Holland Hospital ?

Dr. Schram:
All the surgeries are done at Spectrum/Zeeland Community Hospital

Spectrum Health:
FACT: Weight loss as small as 10 percent of total body weight can improve your health.

Spectrum Health:
FACT: Numerous scientific studies have established that your genes play an important role in your tendency to gain excess weight. The body weight of adopted children shows no correlation with the body weight of their adoptive parents, who feed them and teach them how to eat. Their weight does have an 80 percent correlation with their genetic parents, whom they have never met. Identical twins, with the same genes, show a much higher similarity of body weights than do fraternal twins, who have different genes.

Spectrum Health:
FACT: Remember that a portion size is the amount of a single food item served in a single eating occasion, normally a meal or a snack. People often confuse portion size with serving size, which is a standard unit of measuring foods (a cup or an ounce are good examples). Portion size is the amount offered in the packaging of prepared foods, or the amount a person chooses to put on his or her plate.

Dr. Schram:
Thank you for taking the time to participate in this online chat. I hope that I have been able to answer your questions. To learn more about our weight loss program and whether or not bariatric surgery is a viable option for you, please don’t hesitate to contact our office at 616.994.6677. We are located at 3290 North Wellness Drive, Suite 150, in Holland. You may also visit shmg.org to learn more.

Spectrum Health:
Enroll in MySpectrum to view lab results, renew prescriptions, track your health information and more in a secure online environment.

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