Weight loss by exercise and diet alone doesn't have the needed impact for some people. Bariatric surgery enables select patients to improve health by assisting weight loss.
Dr. William A. Graber, weight loss surgeon and Bariatric Surgery Director, shares what life after weight loss surgery is like.
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Life After Bariatric Surgery
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Learn more about William A. Graber, MD
William A. Graber, MD
Dr. William Graber recognized the need for a weight loss surgery program in Upstate New York in 2002 and has been performing bariatric surgery since then. His practice has performed over 6,000 bariatric surgeries on those affected by obesity, in both his Utica/New Hartford and Syracuse, NY locations.Learn more about William A. Graber, MD
Transcription:
Bill Klaproth (Host): Severe or morbid obesity is a chronic condition that is difficult to treat, although people think dietary modification and exercise alone can solve the problem when in fact bariatric surgery such as gastric bypass or gastric sleeve may be the best option for lasting weight loss but misconceptions on the long term lifestyle changes turn people off. Here to talk about life after bariatric surgery is Dr. William Graber, a weight loss surgeon and the Bariatric Surgery Director at St. Joseph’s Health. Dr. Graber thank you so much for your time. So polling data of Americans show the majority of people believe diet and exercise to be a more effective treatment for weight loss compared to bariatric surgery, yet the research shows the complete opposite of this. Why do you think this is?
Dr. William Graber (Guest): Thanks for inviting me. There’s a lot of misconceptions about obesity. People think it’s almost a lifestyle choice. People think there may be some ethical issues or moral issues or intellectual issues, but in reality people are not obese because they want to be obese. They have jobs, they have families, they’re responsible, and when they think about – we’re trying to teach people that it’s a chronic disease so when they don’t see it as a disease they sort of take it upon themselves. Well I can fix this problem. I have a good job. I have a family. I can eat less. I can exercise more, but the reality is those – what I just told, those sentences of eat less, exercise more, what does that mean? Obesity is a disease where if all we had to do was not eat potato chips then no one would be heavy, so this is a complicated, genetic, environmental issue that we really don’t understand but it’s still engrained in people’s thoughts. So the second thing about surgery is I’m a surgeon and I don’t want surgery because there’s potential complications and there are issues, but the reality is surgery does work much, much better. Diet and exercise really don’t work well at all, not that you aren’t supposed to diet and you are supposed to exercise, but the surgery reaches down to your genetic level; it reaches down to your hormonal level and it works. Not only it works on people but it works on experimental animals and rats too, so you don’t even have to think about it.
Bill: So Dr. Graber, let’s talk about reasons that people don’t consider bariatric surgery and there are misconceptions about short and long term lifestyle changes after bariatric surgery that have been cited as reasons this treatment option is not utilized more often. So can you shed some light on what life is like immediately and long term after surgery to help people better understand the day to day reality after surgery?
Dr. Graber: Right good question, so the important things to know about weight loss surgery patients is they have the same rules as any other patients. So they have to drive at the speed limit. They have to pay their taxes. They have to exercise. They have to eat properly. Now immediately after surgery they have some restrictions because they just had surgery. So there’s some weight limits on how much weight they can lift for example. They have a special graduated diet that goes from liquid to gel to pudding to cottage cheese to scrambled eggs because they want everything to heal, but after six weeks when its healed enough then there – and this is very important, that they need to switch over to real solid food that anyone else would eat. So for example a meal is a piece of chicken, a piece of broccoli, and a potato and salt and pepper is good. Garlic is good. Soy sauce is good. Tabasco sauce is good. So real food that tastes good and after within a few months of surgery, if you’re eating a meal with a weight loss surgery patient, you won’t know they had surgery but they won’t be eating a big meal. The important thing to know is the 42 ounce prime rib is out for sure.
Bill: So no big steak, okay. Gotcha there, but it sounds like real food which makes sense and speaking of food then, I think people worry about, or wonder, or think their diet is going to be constricted and worry about nutritional deficiencies but it sounds like if they’re eating properly real food that’s not necessarily a problem. Is that right?
Dr. Graber: Right, so that’s the important thing to know. If they eat real food then their chance of dietary insufficiency is very low or remote. We also recommend extra vitamins. So everyone is asked to take a multivitamin twice a day with some supplemental iron which is in the vitamins, B12 once a day, extra calcium, and vitamin D, but that’s it. The key thing is live a normal life, exercise, and eat real normal foods. Think about Top Chef. It should be one of those little gourmet meals, no problem.
Bill: So it’s all about eating healthy. No processed foods. No junk foods, and you also mentioned supplements as well and Dr. Graber can you talk about the follow up visits as well, as checkups after help the patient stay on track with these lifestyle modifications.
Dr. Graber: Sure so we initially operate, the patients typically go home the next days or two days. We typically see them in a couple of weeks within surgery with things like they’re staying hydrated, making sure their wounds are healing, that there’s no signs of any problems like a blood clot in their legs or an infection or dehydration. We make sure they’re following our instructions and then we tease them a couple months after that to make sure they’re moving along. Of course, they’re free to call us if there’s something happening and we see them about six months after that, so we start stretching it out but by now they’ve lost quite a bit of weight and they’ve had to go shopping to buy new clothes, so they should be on a regular diet and getting used to their new life. We see them about a year after surgery and then we sort of pretty much see them every year or when they call us because life goes on. They don’t really need to see us much anymore.
Bill: And speaking of a new life, what effects do you see weight loss surgery having on family friends around a patient?
Dr. Graber: Yeah these operations changes everything about these patients. So it helps their medical diseases get better for example diabetes, high blood pressure, helps their arthritis pain improve. It changes the entire outlook on the world around them. They are often much happier. Their interactions with other people change drastically. When patients have lost weight and are more energetic and more active, it changes their family because now the whole family is exercising more and going on hikes more and interacting with each other in completely different ways, and also our patients are eating healthier and healthier eating is driven by the surgery. We ask them to do that but the surgery itself makes changes in their brain and their body that pretty much drives them to pick the healthier food because their taste buds change and their sense of smell changes, which we can’t explain but we know that and the family loses some weight too and it’s connected in ways that we can’t explain.
Bill: This is very interesting. So it sounds like what you’re saying is weight loss surgery helps people become healthier.
Dr. Graber: Correct, it changes their lives amazingly. Not only that, a lot of our patients, women, are infertile, they can’t get pregnant because of the hormonal changes associated with obesity. After the surgery and after they start losing some weight, their hormones come back into line and it’s a lot easier and safer to get pregnant for the mom and the baby.
Bill: So a lot of really good reasons to consider bariatric weight loss surgery, so make sure you check out bariatric weight loss surgery. It very well could be the solution for your. Dr. Graber, thank you so much for your time today. For more information about bariatric weight loss surgery, please visit sjhsyr.org/bariatric, that’s sjhsyr.org/bariatric. There’s a lot of great information on that page. I urge you to check it out. This is St. Joseph’s Health Medcast from St. Joseph’s Health. I’m Bill Klaproth, thanks for listening.
Bill Klaproth (Host): Severe or morbid obesity is a chronic condition that is difficult to treat, although people think dietary modification and exercise alone can solve the problem when in fact bariatric surgery such as gastric bypass or gastric sleeve may be the best option for lasting weight loss but misconceptions on the long term lifestyle changes turn people off. Here to talk about life after bariatric surgery is Dr. William Graber, a weight loss surgeon and the Bariatric Surgery Director at St. Joseph’s Health. Dr. Graber thank you so much for your time. So polling data of Americans show the majority of people believe diet and exercise to be a more effective treatment for weight loss compared to bariatric surgery, yet the research shows the complete opposite of this. Why do you think this is?
Dr. William Graber (Guest): Thanks for inviting me. There’s a lot of misconceptions about obesity. People think it’s almost a lifestyle choice. People think there may be some ethical issues or moral issues or intellectual issues, but in reality people are not obese because they want to be obese. They have jobs, they have families, they’re responsible, and when they think about – we’re trying to teach people that it’s a chronic disease so when they don’t see it as a disease they sort of take it upon themselves. Well I can fix this problem. I have a good job. I have a family. I can eat less. I can exercise more, but the reality is those – what I just told, those sentences of eat less, exercise more, what does that mean? Obesity is a disease where if all we had to do was not eat potato chips then no one would be heavy, so this is a complicated, genetic, environmental issue that we really don’t understand but it’s still engrained in people’s thoughts. So the second thing about surgery is I’m a surgeon and I don’t want surgery because there’s potential complications and there are issues, but the reality is surgery does work much, much better. Diet and exercise really don’t work well at all, not that you aren’t supposed to diet and you are supposed to exercise, but the surgery reaches down to your genetic level; it reaches down to your hormonal level and it works. Not only it works on people but it works on experimental animals and rats too, so you don’t even have to think about it.
Bill: So Dr. Graber, let’s talk about reasons that people don’t consider bariatric surgery and there are misconceptions about short and long term lifestyle changes after bariatric surgery that have been cited as reasons this treatment option is not utilized more often. So can you shed some light on what life is like immediately and long term after surgery to help people better understand the day to day reality after surgery?
Dr. Graber: Right good question, so the important things to know about weight loss surgery patients is they have the same rules as any other patients. So they have to drive at the speed limit. They have to pay their taxes. They have to exercise. They have to eat properly. Now immediately after surgery they have some restrictions because they just had surgery. So there’s some weight limits on how much weight they can lift for example. They have a special graduated diet that goes from liquid to gel to pudding to cottage cheese to scrambled eggs because they want everything to heal, but after six weeks when its healed enough then there – and this is very important, that they need to switch over to real solid food that anyone else would eat. So for example a meal is a piece of chicken, a piece of broccoli, and a potato and salt and pepper is good. Garlic is good. Soy sauce is good. Tabasco sauce is good. So real food that tastes good and after within a few months of surgery, if you’re eating a meal with a weight loss surgery patient, you won’t know they had surgery but they won’t be eating a big meal. The important thing to know is the 42 ounce prime rib is out for sure.
Bill: So no big steak, okay. Gotcha there, but it sounds like real food which makes sense and speaking of food then, I think people worry about, or wonder, or think their diet is going to be constricted and worry about nutritional deficiencies but it sounds like if they’re eating properly real food that’s not necessarily a problem. Is that right?
Dr. Graber: Right, so that’s the important thing to know. If they eat real food then their chance of dietary insufficiency is very low or remote. We also recommend extra vitamins. So everyone is asked to take a multivitamin twice a day with some supplemental iron which is in the vitamins, B12 once a day, extra calcium, and vitamin D, but that’s it. The key thing is live a normal life, exercise, and eat real normal foods. Think about Top Chef. It should be one of those little gourmet meals, no problem.
Bill: So it’s all about eating healthy. No processed foods. No junk foods, and you also mentioned supplements as well and Dr. Graber can you talk about the follow up visits as well, as checkups after help the patient stay on track with these lifestyle modifications.
Dr. Graber: Sure so we initially operate, the patients typically go home the next days or two days. We typically see them in a couple of weeks within surgery with things like they’re staying hydrated, making sure their wounds are healing, that there’s no signs of any problems like a blood clot in their legs or an infection or dehydration. We make sure they’re following our instructions and then we tease them a couple months after that to make sure they’re moving along. Of course, they’re free to call us if there’s something happening and we see them about six months after that, so we start stretching it out but by now they’ve lost quite a bit of weight and they’ve had to go shopping to buy new clothes, so they should be on a regular diet and getting used to their new life. We see them about a year after surgery and then we sort of pretty much see them every year or when they call us because life goes on. They don’t really need to see us much anymore.
Bill: And speaking of a new life, what effects do you see weight loss surgery having on family friends around a patient?
Dr. Graber: Yeah these operations changes everything about these patients. So it helps their medical diseases get better for example diabetes, high blood pressure, helps their arthritis pain improve. It changes the entire outlook on the world around them. They are often much happier. Their interactions with other people change drastically. When patients have lost weight and are more energetic and more active, it changes their family because now the whole family is exercising more and going on hikes more and interacting with each other in completely different ways, and also our patients are eating healthier and healthier eating is driven by the surgery. We ask them to do that but the surgery itself makes changes in their brain and their body that pretty much drives them to pick the healthier food because their taste buds change and their sense of smell changes, which we can’t explain but we know that and the family loses some weight too and it’s connected in ways that we can’t explain.
Bill: This is very interesting. So it sounds like what you’re saying is weight loss surgery helps people become healthier.
Dr. Graber: Correct, it changes their lives amazingly. Not only that, a lot of our patients, women, are infertile, they can’t get pregnant because of the hormonal changes associated with obesity. After the surgery and after they start losing some weight, their hormones come back into line and it’s a lot easier and safer to get pregnant for the mom and the baby.
Bill: So a lot of really good reasons to consider bariatric weight loss surgery, so make sure you check out bariatric weight loss surgery. It very well could be the solution for your. Dr. Graber, thank you so much for your time today. For more information about bariatric weight loss surgery, please visit sjhsyr.org/bariatric, that’s sjhsyr.org/bariatric. There’s a lot of great information on that page. I urge you to check it out. This is St. Joseph’s Health Medcast from St. Joseph’s Health. I’m Bill Klaproth, thanks for listening.