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Bariatric Surgery and Healthy Weight Management
Dr. Kollar talks about bariatric surgery and healthy weight management. Dr. Kollar discusses who is the ideal candidate for weight loss surgery, when is the perfect time for surgery, and the health benefits that it can provide.
Featured Speaker:
J Christopher Kollar, DO
Dr. Kollar specializes in Laparoscopic and Bariatric Surgery. He performs all general surgical procedures from gall bladder, appendix, hernia and colon operations as well as breast and cancer surgery. He specializes in weight loss surgery as well as surgery for reflux disease. Dr. Kollar is Board Certified by the American College of Osteopathic Surgeons. He is currently the Director of Surgery at Meadowlands Hospital and past Surgical Residency Director at Pascack Valley Hospital. Dr. Kollar is a member of the American College of Osteopathic Surgeons and the American Osteopathic Association. Transcription:
Bariatric Surgery and Healthy Weight Management
Deborah Howell (Host): Weight loss surgery is becoming more and more common, especially in the wake of a two-year pandemic when so many of us put on some unwanted pounds. Dr. Christopher Kollar is the Chair of Surgery for Bergen New Bridge Medical Center and a bariatric and general surgeon. And he's here to talk to us about healthy weight management and weight loss surgery, including laparoscopic and bariatric procedures.
This is Wellness Waves, a Bergen New Bridge Medical center podcast. I'm Deborah Howell. Welcome, Dr. Kollar.
Dr Christopher Kollar: Well, thank you, Deborah, for having me.
Deborah Howell (Host): So lovely that you're here to talk to us. Now, who is a candidate for weight loss surgery?
Dr Christopher Kollar: Well, basically when we try to evaluate a patient for surgery, we're really looking at those types of patients who have had difficulties with losing weight on their own, who are at least approximately 100 pounds over their ideal body weight, and also suffer from medical conditions associated with morbid obesity.
Deborah Howell (Host): And who is not a candidate for weight loss surgery?
Dr Christopher Kollar: Typically, there are people out there who are 20 or 30 pounds overweight, who would like to shed those extra pounds and do it in a simpler way than having to diet and exercise. So those people are not really candidates for bariatric surgery. There are multiple ways of helping them lose weight, but certainly not surgically as far as taking care of their problem.
Deborah Howell (Host): Okay. Good to know. So when is it time for surgical intervention?
Dr Christopher Kollar: Well, for most patients who are candidates, they need to go through a fairly rigorous preoperative course, where they are making attempts at losing weight on their own, trying to change their lifestyle, both through diet and exercise and, for some people, even trying medications. If those things have failed, then more often than not, they will become candidates for surgery and they go through the evaluation, both psychologically and nutritionally, and then they get scheduled for an operation.
Deborah Howell (Host): Okay. And tell us a little bit about the procedure.
Dr Christopher Kollar: Well, there are several procedures out there for bariatric surgery. The most common one being performed today in the United States is something call the gastric sleeve. And this is really a reduction of the size of the stomach by approximately 70%, which helps people feel full at an earlier stage, as well as changes some of the hormones in the system to help with metabolism. There are also other Operations like a gastric bypass or a Lap-Band. Those operations are much less frequently done just simply because they are either not as successful or carry with them a lot more risks.
Deborah Howell (Host): Okay. And what's the recovery period after surgery?
Dr Christopher Kollar: For most patients, the recovery period is relatively quick. The operations are done through a telescope, so they're done laparoscopically without large incisions. So for most patients, they will be returning back to normal within a couple of days. The biggest restriction for most of them is that they need to kind of maintain a liquid diet for the first couple of weeks and then a pureed type of diet after that, just so that it mechanically allows the stomach to heal. But as far as physical activity is concerned, most of them can resume their normal physical activity or get back to work within a week.
Deborah Howell (Host): That's incredible. What about followup visits?
Dr Christopher Kollar: Well, I'm a big believer that the success rate with this operation is directly linked to the patient's ability to follow up. Unlike most surgical procedures where you take out their appendix or you fix a hernia, you see them once in the office afterwards, and then they go on their own. The problem with most bariatric surgeries are that they require an intensive long-term followup because there are multiple components that go into a patient's success. And if they don't follow up, it's not unusual to see people fail over the long term. So in my practice, I basically have people constantly following up for the rest of their lives. Their visits might be spread out to every six months or a year, but I do see the patients forever basically.
Deborah Howell (Host): Okay. Got it. And how much weight can a person reasonably expect to lose?
Dr Christopher Kollar: Well, the real answer to that has a lot to do with where they start at. But typically, what we will see with something like a gastric sleeve is a weight loss anywhere between 60% to 70% of their excess body weight. So if somebody is a hundred pounds overweight, it is not unusual to see them lose approximately 70 of those pounds.
Deborah Howell (Host): Incredible. And what are the health benefits of losing those pounds?
Dr Christopher Kollar: Well, the biggest thing that we see in all bariatric patients is the medical problems associated with weight. So it is not unusual for a bariatric patient to have high blood pressure, arthritis, diabetes, sleep apnea, and these are all closely linked, been associated with morbid obesity. So typically, after these operations have been completed and the patient loses their weight, a lot of times these problems resolve completely or are significantly improved.
Deborah Howell (Host): Yeah, lovely. Is there any physical therapy regimen following surgery?
Dr Christopher Kollar: Well, every program, depending on the physician, is different. There are some that do recommend patients undergo physical therapy, after their procedure. And typically, those are types of patients who have had difficulty ambulating and moving around in the first place. So if you see somebody who is 500 pounds, those typically do have difficulties moving around. For the standard patient though, no, physical therapy is not recommended. It's more just a good solid exercise program.
Deborah Howell (Host): Okay. Fair enough. You've spoke to this a little bit about the short term, but what about diet and nutrition postsurgery in the long run?
Dr Christopher Kollar: Yes. Most patients, especially if we're going to talk about the most common operation, a gastric sleeve, find that the volume of food that they can consume is run relatively restricted. So it's important that they concentrate on taking in their proteins first, so that if they do get filled up, they're filling themselves with good nutritional value, as opposed to eating, you know, bread or something like that, which has very, very loose calories. But as far as following a really strict nutritional program, it is usually not recommended and the body will find its own way and let you know what you need.
Deborah Howell (Host): Got it. Now, do most of your patients maintain a healthy weight for years after their surgery?
Dr Christopher Kollar: The statistics nationwide are approximately two-thirds of the patients will maintain a good weight and stay where they need to be. And one-third of them will start to suffer from weight regain. I think one of the biggest variables is, like I said, I like to follow my patients for the rest of their lives. And I find that those patients that do maintain a good followup typically will do much better than those that don't, probably more from a psychological perspective of just feeling obligated to make sure that their result maintains a good steady course.
Deborah Howell (Host): Right. And setting goals and all that really helps stay on track. What do your patients tell you about their new lives without the excess weight?
Dr Christopher Kollar: Well, most of them are completely ecstatic. It's interesting how the things that most people take for granted, the ability to get up and walk around without assistance, the ability to go exercise, not getting short of breath when you're walking up a hill, are all detriments to their lives when they are morbidly obese. So for most of them, when they start to realize wow, that all of these things that I could have never done before, but now can do, is really life-altering and they're exceedingly grateful.
Deborah Howell (Host): I love it. What do you enjoy most about your work?
Dr Christopher Kollar: It's nice to see the transformation. You know, being part of the long haul with this and to get to know these patients different than most other types of surgical patients, because their followup is lifetime. And because you get to know them very well. It's very satisfying to see how their lives have improved and how much happier they are. And it's really a very rewarding field to be in.
Deborah Howell (Host): Oh, it must be gratifying. Well, thank you so much, Dr. Kollar. It's been such a pleasure having you with us today.
Dr Christopher Kollar: Well, thank you very much, Deborah. I appreciate your time.
Deborah Howell (Host): That's Dr. Christopher Kollar, the Chair of Surgery for Bergen New Bridge Medical Center and a bariatric and general surgeon. For more information about our bariatric center, please visit our website www.newbridgehealth.org. And if you found this podcast helpful, please share it on your social channels and be sure to check out the entire podcast library for topics of interest to you.
Thanks for tuning into this episode of Wellness Waves. I'm Deborah Howell. Have yourself a terrific day.
Bariatric Surgery and Healthy Weight Management
Deborah Howell (Host): Weight loss surgery is becoming more and more common, especially in the wake of a two-year pandemic when so many of us put on some unwanted pounds. Dr. Christopher Kollar is the Chair of Surgery for Bergen New Bridge Medical Center and a bariatric and general surgeon. And he's here to talk to us about healthy weight management and weight loss surgery, including laparoscopic and bariatric procedures.
This is Wellness Waves, a Bergen New Bridge Medical center podcast. I'm Deborah Howell. Welcome, Dr. Kollar.
Dr Christopher Kollar: Well, thank you, Deborah, for having me.
Deborah Howell (Host): So lovely that you're here to talk to us. Now, who is a candidate for weight loss surgery?
Dr Christopher Kollar: Well, basically when we try to evaluate a patient for surgery, we're really looking at those types of patients who have had difficulties with losing weight on their own, who are at least approximately 100 pounds over their ideal body weight, and also suffer from medical conditions associated with morbid obesity.
Deborah Howell (Host): And who is not a candidate for weight loss surgery?
Dr Christopher Kollar: Typically, there are people out there who are 20 or 30 pounds overweight, who would like to shed those extra pounds and do it in a simpler way than having to diet and exercise. So those people are not really candidates for bariatric surgery. There are multiple ways of helping them lose weight, but certainly not surgically as far as taking care of their problem.
Deborah Howell (Host): Okay. Good to know. So when is it time for surgical intervention?
Dr Christopher Kollar: Well, for most patients who are candidates, they need to go through a fairly rigorous preoperative course, where they are making attempts at losing weight on their own, trying to change their lifestyle, both through diet and exercise and, for some people, even trying medications. If those things have failed, then more often than not, they will become candidates for surgery and they go through the evaluation, both psychologically and nutritionally, and then they get scheduled for an operation.
Deborah Howell (Host): Okay. And tell us a little bit about the procedure.
Dr Christopher Kollar: Well, there are several procedures out there for bariatric surgery. The most common one being performed today in the United States is something call the gastric sleeve. And this is really a reduction of the size of the stomach by approximately 70%, which helps people feel full at an earlier stage, as well as changes some of the hormones in the system to help with metabolism. There are also other Operations like a gastric bypass or a Lap-Band. Those operations are much less frequently done just simply because they are either not as successful or carry with them a lot more risks.
Deborah Howell (Host): Okay. And what's the recovery period after surgery?
Dr Christopher Kollar: For most patients, the recovery period is relatively quick. The operations are done through a telescope, so they're done laparoscopically without large incisions. So for most patients, they will be returning back to normal within a couple of days. The biggest restriction for most of them is that they need to kind of maintain a liquid diet for the first couple of weeks and then a pureed type of diet after that, just so that it mechanically allows the stomach to heal. But as far as physical activity is concerned, most of them can resume their normal physical activity or get back to work within a week.
Deborah Howell (Host): That's incredible. What about followup visits?
Dr Christopher Kollar: Well, I'm a big believer that the success rate with this operation is directly linked to the patient's ability to follow up. Unlike most surgical procedures where you take out their appendix or you fix a hernia, you see them once in the office afterwards, and then they go on their own. The problem with most bariatric surgeries are that they require an intensive long-term followup because there are multiple components that go into a patient's success. And if they don't follow up, it's not unusual to see people fail over the long term. So in my practice, I basically have people constantly following up for the rest of their lives. Their visits might be spread out to every six months or a year, but I do see the patients forever basically.
Deborah Howell (Host): Okay. Got it. And how much weight can a person reasonably expect to lose?
Dr Christopher Kollar: Well, the real answer to that has a lot to do with where they start at. But typically, what we will see with something like a gastric sleeve is a weight loss anywhere between 60% to 70% of their excess body weight. So if somebody is a hundred pounds overweight, it is not unusual to see them lose approximately 70 of those pounds.
Deborah Howell (Host): Incredible. And what are the health benefits of losing those pounds?
Dr Christopher Kollar: Well, the biggest thing that we see in all bariatric patients is the medical problems associated with weight. So it is not unusual for a bariatric patient to have high blood pressure, arthritis, diabetes, sleep apnea, and these are all closely linked, been associated with morbid obesity. So typically, after these operations have been completed and the patient loses their weight, a lot of times these problems resolve completely or are significantly improved.
Deborah Howell (Host): Yeah, lovely. Is there any physical therapy regimen following surgery?
Dr Christopher Kollar: Well, every program, depending on the physician, is different. There are some that do recommend patients undergo physical therapy, after their procedure. And typically, those are types of patients who have had difficulty ambulating and moving around in the first place. So if you see somebody who is 500 pounds, those typically do have difficulties moving around. For the standard patient though, no, physical therapy is not recommended. It's more just a good solid exercise program.
Deborah Howell (Host): Okay. Fair enough. You've spoke to this a little bit about the short term, but what about diet and nutrition postsurgery in the long run?
Dr Christopher Kollar: Yes. Most patients, especially if we're going to talk about the most common operation, a gastric sleeve, find that the volume of food that they can consume is run relatively restricted. So it's important that they concentrate on taking in their proteins first, so that if they do get filled up, they're filling themselves with good nutritional value, as opposed to eating, you know, bread or something like that, which has very, very loose calories. But as far as following a really strict nutritional program, it is usually not recommended and the body will find its own way and let you know what you need.
Deborah Howell (Host): Got it. Now, do most of your patients maintain a healthy weight for years after their surgery?
Dr Christopher Kollar: The statistics nationwide are approximately two-thirds of the patients will maintain a good weight and stay where they need to be. And one-third of them will start to suffer from weight regain. I think one of the biggest variables is, like I said, I like to follow my patients for the rest of their lives. And I find that those patients that do maintain a good followup typically will do much better than those that don't, probably more from a psychological perspective of just feeling obligated to make sure that their result maintains a good steady course.
Deborah Howell (Host): Right. And setting goals and all that really helps stay on track. What do your patients tell you about their new lives without the excess weight?
Dr Christopher Kollar: Well, most of them are completely ecstatic. It's interesting how the things that most people take for granted, the ability to get up and walk around without assistance, the ability to go exercise, not getting short of breath when you're walking up a hill, are all detriments to their lives when they are morbidly obese. So for most of them, when they start to realize wow, that all of these things that I could have never done before, but now can do, is really life-altering and they're exceedingly grateful.
Deborah Howell (Host): I love it. What do you enjoy most about your work?
Dr Christopher Kollar: It's nice to see the transformation. You know, being part of the long haul with this and to get to know these patients different than most other types of surgical patients, because their followup is lifetime. And because you get to know them very well. It's very satisfying to see how their lives have improved and how much happier they are. And it's really a very rewarding field to be in.
Deborah Howell (Host): Oh, it must be gratifying. Well, thank you so much, Dr. Kollar. It's been such a pleasure having you with us today.
Dr Christopher Kollar: Well, thank you very much, Deborah. I appreciate your time.
Deborah Howell (Host): That's Dr. Christopher Kollar, the Chair of Surgery for Bergen New Bridge Medical Center and a bariatric and general surgeon. For more information about our bariatric center, please visit our website www.newbridgehealth.org. And if you found this podcast helpful, please share it on your social channels and be sure to check out the entire podcast library for topics of interest to you.
Thanks for tuning into this episode of Wellness Waves. I'm Deborah Howell. Have yourself a terrific day.