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Obesity Can Be A Matter of Life and Death: Weight Loss Surgery at TMC

More than 12.5 million Americans are severely overweight, according to the U.S. Department of Health and Human Services. Obesity, which refers to excessive body fat, can cause many health problems and put you at a higher risk for diseases such as high blood pressure, diabetes, heart disease, stroke, sleep apnea and other respiratory problems. 

Many people who are seriously overweight have tried different diets, medications and professional weight-loss services for years without long-term success. 

Listen as Dr. Ikram Kureshi, General and Weight-Loss Surgeon and member of the medical staff at Texoma Medical Center, discusses weight loss surgery to help those struggling with obesity get the long-term weight loss they need to lead a longer, healthier life.

Obesity Can Be A Matter of Life and Death: Weight Loss Surgery at TMC
Featured Speaker:
Ikram Kureshi, MD
Ikram Kureshi, MD is a General and Weight-Loss Surgeon and a member of the medical staff at Texoma Medical Center.
Transcription:
Obesity Can Be A Matter of Life and Death: Weight Loss Surgery at TMC

Melanie Cole (Host): More than 12 million Americans are severely overweight according to the US Department of Health and Human Services. Many people who are seriously overweight have tried different dies, medications, and professional weight loss services for years without long term success. My guest today is Dr. Ikram Kureshi. He is a general and weight loss surgeon and a member of the medical staff at Texoma Medical Center. Welcome to the show Dr. Kureshi. So what is defined as severely overweight or severe obesity?

Dr. Ikram Kureshi (Guest): Well the definition actually has to do with what we call body mass index, which is basically a ratio of your height and weight. But to make it simple, essentially if you’re at least 50 or more pounds overweight you would be in the category of severely overweight or obese.

Melanie: If people are severely overweight or obese, they have some options, maybe they’ve tried diets or medical weight loss programs. When it comes to bariatric surgery this is a big decision. What goes into making that decision? Is it psychological counseling, is it health history, what goes into making that decision?

Dr. Kureshi: It’s multifactorial. I think there’s all of the things you mentioned plus some other issues. First of all, each person needs to make the decision themselves based on their history of weight loss in the past. For example, if they’ve tried medications or different weight loss programs and have had minimal success or only temporary success then surgery is an option for them. But they also have to keep in mind that surgery is a permanent change to your body and you have to be mentally ready for that and ready for making some changes with your eating habits as well afterwards. But I think if someone does feel that way it is the most successful way to permanently lose significant amount of weight.

Melanie: And then what would be the parameters under which you would tell them yes we can perform this type of procedure?

Dr. Kureshi: Well first of all we make sure their body mass index is meeting the criteria so that at least 50 pounds or more overweight. We also want to make sure that they’ve tried other things for weight loss, for example medications or weight loss programs. And if they haven’t had success then technically they meet the criteria to proceed with surgery as long as they are mentally prepared and ready for it.

Melanie: And mentally prepared, what does that mean?

Dr. Kureshi: Well I did mention earlier that people we’re changing your body during a weight loss procedure and changing your stomach to a certain extent, there are some eating changes that have to be made after surgery. Namely you do have to eat a lot slower, really chew your food well. We want our patients eating a high protein, low carb, low sugar diet. And that’s critical to being successful with weight loss surgery. If you plan on just eating all the wrong things even after surgery you won’t get the results that you want. So we want to make sure that each of our patients is mentally prepared for that and motivated to do that.

Melanie: Before we talk about the type of procedures, Dr. Kureshi, what would you like them to do in advance as far as exercise and eating and should they still try to lose weight and do some strength training or maintain their medications. What would you like them to do in advance?

Dr. Kureshi: Well we always encourage ongoing weight loss even prior to surgery, but most importantly I think it’s making sure that they get accustomed to eating the right things that they’re going to need to continue after surgery. So like I mentioned, lots of protein, low carb, low sugar diet. Maybe even practicing eating slower and chewing well. Starting an exercise regimen that they feel comfortable with and feel like they can maintain after surgery as well. So we try to get our patients to start all of that beforehand so it makes the transition a lot easier afterwards.

Melanie: So let’s discuss the types of bariatric surgery that you perform at Texoma Medical Center. So there’s a few types people have heard of. They’ve heard of the adjustable gastric band or a sleeve gastrectomy or the gastric bypass. So what don’t you start with the bypass. Explain a little bit about what that means, what that is and a little about the procedure.

Dr. Kureshi: Well the gastric bypass is the oldest of all the procedures you’ve mentioned. It’s been around a long time. It is the most invasive of all the procedures. Meaning we are changing the digestion of each individual person the most. So what we do in a gastric bypass is we actually take the stomach, make it smaller, and connect it directly to the intestines. So you have a smaller stomach but also you don’t absorb a lot of the nutrients that you do eat. And so for that reason it is very effective. The weight loss is very fast. However, because it’s very invasive there are a few more complications that can occur with gastric bypass. Some of them being the patient cannot absorb enough vitamins and minerals. So for that reason it is just not as popular as it used to be especially now that the other procedures you also lose the same amount of weight but don’t have as many issues compared to a gastric bypass.

Melanie: What’s life like for someone who’s had the bypass? They’ve got that small pouch now that’s where their food goes. What’s life like and what are they supposed to do afterwards as far as eating?

Dr. Kureshi: Well the good thing is that those folks they get full very quickly so you either eat very small meals, usually half a cup of solid food is enough to fill the pouch and you fill full. But again, you don’t absorb a lot of what you eat so you have to be very careful about making good food choices and taking the appropriate supplements that you have to take permanently afterwards. But if you can do that then the weight loss is extremely effective and it is permanent. But again, it’s important ot make those eating changes to be successful.

Melanie: And what about the gastric sleeve, what is that?

Dr. Kureshi: The gastric sleeve actually is one of the newer procedures and its actually become very popular because it is not as invasive as the gastric bypass. And what I mean by that is in a sleeve gastrectomy we do make the stomach smaller into a smaller pouch but you still absorb all of your food the exact same way as you do before. So we don’t have the issues of malnutrition or malabsorption with the sleeve procedure, but at the same time you still get full very quickly with a very small quantity of food. And the weight loss is just as effective as the gastric bypass but without all the issues that we had mentioned earlier.

Melanie: Does it involve a shorter hospital stay?

Dr. Kureshi: It is. Yes. Because it’s less invasive we’re talking about an overnight hospital stay with the sleeve procedure going home the next day, most people are back to work within a week after surgery. And again you don’t have to take long term supplements as long as you eat a balanced diet you get all the nutrition that you need but at the same time losing the weight that you want to.

Melanie: And tell us about the gastric band, what is that?

Dr. Kureshi: Well the lap band procedure is also not a very invasive procedure. What I mean by that is it basically creates again a very small stomach pouch so eating a small amount of meal fills you up quickly but without having to effect the digestive or absorption of the nutrients that we take in. Now the issue with the lap band is that it is a foreign body and we are placing this device around the stomach. For some people it has led to issues such as the band moving out of position or infection, so that’s something that we have to consider when doing a lap band. But it is very effective. The weight loss is a little bit slower compared to a sleeve procedure or a gastric bypass procedure so that’s a consideration. But is is effective for long term weight loss.

Melanie: One question I’m sure you hear a lot; how much weight can they expect to lose with any of these procedures?

Dr. Kureshi: It of course depends on the weight that each person is starting at. For the most part most people can lose anywhere from 100-200 pounds with any of the procedures that we discussed. And that may take anywhere from 6 months to 2 years post-op to lose that much weight depending on the procedure that you have. But that’s about the rang of weight loss that we’re talking about. And again, most importantly I think this is permanent weight loss. So whatever weight you lose with a weight loss surgery, you’re going to keep it off forever.

Melanie: And you’ve mentioned lifestyle management and proper eating a few times in this segment Dr. Kureshi, what would you like listeners to know about the lifestyle after surgery as far as their activity and the foods that you’d like them to steer clear of and what they can do? What would you like them to know?

Dr. Kureshi: Well I think if you talk to anyone that’s had weight loss surgery they will tell you that it is a lifestyle change. So it’s not just a matter of doing surgery on the stomach, but it’s also your mental outlook on approaching eating. And that’s a very important part of this whole process to be successful. And the main things like I mentioned are making good food choices. So high protein foods, low carb foods, not doing a lot of bread or rice or pasta or potatoes. Not doing a lot of sugar. For example, sodas, that’s another thing we have our patients limit or completely eliminate from their diet. And that’s not easy to do for anybody. But it is very important to be successful. And then of course exercise is another critical component to this. And so we want our patients to be ready and willing to do an exercise program again that fits their lifestyle, fits their health and what works for them. But I think if you can do those things along with surgery you’ll be very successful in significant weight loss for a long period of time.

Melanie: And why should they come to Texoma Medical Center for their care?

Dr. Kureshi: Here at Texoma Medical Center we have a comprehensive program for weight loss surgery. And what I mean by that is not only are you taken care of from your physicians but also our nurses, our operating rooms, our recovery areas. Even we have a support group that meets every month for our patients. We have dieticians and even psychologists that help our patients from before surgery, during, and after to make sure that our patients are successful. We are actually an accredited, certified center for weight loss surgery here at Texoma Medical Center and we’re very proud of that again because it means that we proceed the utmost care and attention to our patients who have weight loss surgery.

Melanie: Thank you so much Dr. Kureshi for being with us today. You’re listening to TMZ Health Talk with Texoma Medical Center. For more information you can go to TexomaMedicalCenter.net. Physicians are independent practitioners who are not employees or agents of Texoma Medical Center. The hospital shall not be liable for actions of treatments provided by physicians. Individual results by very associated with any surgical procedure. Talk with your doctor about these risks to find out if surgery is right for you. This is Melanie Cole thanks so much for listening.