Local Bariatric Surgeon Offers Advice to Consider First

Thinking About Losing Weight?

The numbers tell the story.

Nearly one in three adults are overweight, more than two in five adults have obesity, and about one in 11 adults have severe obesity.

When most people think of obesity, their thoughts usually don’t go much further than the notion of being overweight. But, in truth, there is a lot more to obesity than the numbers on the scale.

“Obesity is itself a disease that often triggers a number of severe health conditions. Over time, those conditions can become chronic, progressive, debilitating, and potentially life-threatening,” said Dr. John Romanelli, medical director of Bariatric Surgery and chief of the Division of General Surgery at Baystate Health. “For many, the struggle to lose weight is complicated by the challenge of managing those health conditions. Individuals who are unable to sustain a healthy weight and are experiencing chronic conditions are often strong candidates for weight-loss surgery.”

Factors that may contribute to excess weight gain among adults include genetics; types and amounts of food and drinks consumed; level of physical activity; degree of time spent on sedentary behaviors, such as watching TV, engaging with a computer, or talking and texting on the phone; sleep habits; medical conditions or medicines; and where and how people live, including their access to and ability to afford healthy foods and safe places to be active.

“Obesity is itself a disease that often triggers a number of severe health conditions. Over time, those conditions can become chronic, progressive, debilitating, and potentially life-threatening.”

Here, Romanelli answers several key questions for those considering losing weight to benefit their health.

Q: Why should you always check with your primary-care physician before starting any diet?

A: Changing your diet could alter how your medications work, and you need to be certain that you are in good cardiovascular health before starting a fitness plan.

Q: How can you determine if you truly need to lose weight?

A: The bottom line is, if you think you need to lose weight, you likely do and should discuss it with your primary-care physician. Normal body-mass index (BMI) is 25 or below. Sadly, most Americans are above this number. BMI is your weight in kilograms divided by height in meters squared. There are many BMI calculators available online to help.

Q: Why is it important to lose weight?

A: Our body physiology works more effectively when we are the correct weight. Virtually every body system is adversely affected by being overweight. The most obvious systems are cardiovascular — high blood pressure, heart disease — and endocrine (diabetes). But all body systems work less well when you are overweight.

Q: Losing weight safely and at a realistic pace is the best way to reach your healthy weight and to maintain that loss in the long term. How much should you lose in a week or month?

A: It is different for all patients, so this is hard to generalize. But the best weight-loss intervention is to do something that is sustainable in the long term. Otherwise, you risk reverting to ‘normal’ eating behaviors and habits, which got you into the need to diet in the first place.

Q: How do you make heads or tails among all the advertising promoting various diets?

A:  Any significant diet should be discussed with a healthcare professional prior to starting it. Two tenets: if it sounds too good to be true, you are likely correct, and if it sounds like it isn’t good for you, you are also probably correct.

Q: How can a dietitian help?

A: Most of us know very little about how to eat correctly, and what we are taught in schools is inaccurate, unhelpful, and, for those of us in our 40s or older, has been debunked. Dietitians can teach many things about hunger, appetite, and making good food choices. For example, do you read the labels on the food products that you buy? You should, but very few people do so.

Q: When should bariatric surgery be considered?

A: It should be seriously considered when sustained efforts at dieting and exercise have failed, and a doctor thinks it is the next step for a patient. Ours is a comprehensive program that will take patients anywhere from six months to one year to complete. Patients need to know that this is not something that can be done overnight. Weight-loss surgery is a tool that can be very helpful when employed the right way and only works well in coordination with calorie-burning exercise, substantial behavioral changes, and a firm commitment to eating a better diet.

Weight-loss surgery is an option for people who are severely obese (about 100 pounds over your ideal body weight and a BMI of 35 and above) and cannot lose weight with diet and exercise alone. Improving your lifestyle, eating right, and staying active is still important.