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Hospitals offer comprehensive obesity programs

Data: 29.6% of Md. adults are obese

The rate of obesity among adults in Maryland continues to grow, according to data from The Trust for America’s Health and the Robert Wood Johnson Foundation.

It now stands at 29.6 percent – up from 28.3 percent in 2013, according to the report released in September.

As the rates increase slightly every year, those who are morbidly obese may consider seeking medical help to lose weight through local hospital bariatrics programs.

Claims that advise people to eat less and move more may be too simplistic, according to Dr. Gustavo Bello, of the Greater Baltimore Medical Center’s Comprehensive Obesity Management Program.

“It’s so far from the truth. Obesity is a very complicated disease,” he said. “It only takes a few things to be off, not to work well in your body to promote obesity.”

When first consulting with patients, Bello said he often asks them how long they have considered having weight loss surgery. He estimates the average is about two years.

“That tells me that it is hard to take that step to make a decision to try to come to deal with [obesity],” he said. GBMC offers prospective patients the option of watching an information session online or attending one in-person.

While many focus on the surgery aspect of bariatrics programs, area providers aim for a holistic, comprehensive approach by preparing patients through pre- and post-surgery support groups and multiple meetings with a dietitian. “Before you go to surgery you do have to have a good grasp on the nutrition side of things,” Bello said. “Our dietitians have to deem the patients ready (before surgery is performed).”

At LifeBridge Health Bariatrics Program at Northwest Hospital, they encourage patients to come back in every year after surgery to get their weight checked, get tips and check for any metabolic issues that may have arisen.

“A lot of surgeons do the surgery and then say, ‘Good luck’ and [not follow up but] we pride ourselves that we ask our patients to come back and get followed,” said Dr. Christina Li, head of bariatrics and minimally invasive surgery for LifeBridge Health. “[We] think of the long-term health of our patients because it’s not just about losing weight. It’s about keeping it off. That’s one of the emphasis [of the program]. My job is not just to help people lose weight but to keep it off long-term.”

In order to qualify to have surgery, patients must have a body mass index (BMI) of 40 or over or a BMI between 35 to 40 with serious health issues, such as heart disease or Type 2 diabetes. Three options are available to make the stomach smaller and limit food intake: a gastric bypass, band or sleeve. Both Li and Bello said the bands are not done much anymore due to low satisfaction rates.

The patients get to choose which option they would prefer.

“We try to guide them to what we think might be better if there is anything that is clearly better than the other for that particular patient,” Bello said.

There are several ways patients may be successful with their surgery.

“They have to remember that this is not an easy way out and this is not magic,” Bello said. “A lot of work comes with this tool in order to be successful. They have to be committed to do lifelong changes on their lifestyle. … If they use this tool properly, that’s a guarantee of success.”

Li said patients need regular sustained exercise, proper attention to nutrition, watching their weight and scheduling regular follow ups with their bariatric doctor.

Both Li and Bello have stories they cherish from their patients’ journeys. Little things that most take for granted like crossing their legs and fitting into a booth at a restaurant.

Li recently saw a patient for a follow up who had surgery eight years ago. Short and weighing about 260 pounds when Li first met her, the patient said she rarely wore a seatbelt because they never fit her comfortably, which led to multiple tickets from police officers.

Today, the patient has kept off the 130 pounds she lost thanks to the surgery.

“She looks great,” Li said. “She feels great. She gets her seatbelt around very comfortably, and she has more money because she doesn’t get pulled over for tickets.”