Maggie McKay (Host): If you've ever considered bariatric surgery but aren't sure where to start, joining us is Dr. Sarah Shields Tarwater, a board-certified bariatric surgeon, to discuss the details.

Welcome to the Better Health Podcast presented by Tidelands Health. I'm your host, Maggie McKay. Thank you so much for joining us, doctor.

Dr. Sara Shields Tarwater: Thank you so much for having me.

Host: So, tell us about the bariatric program at Tidelands Health.

Dr. Sara Shields Tarwater: So, the bariatric surgery program is a multidisciplinary team of myself, another partner who also does bariatric surgery, a clinical nutritionist, a bariatric surgery coordinator, a bariatric nurse, and then a clinical psychologist. So, we work with multiple disciplines to help get patients successfully through the pre and post-op period, and have them feeling comfortable on the day of surgery.

Host: And what are some benefits to patients?

Dr. Sara Shields Tarwater: So, the benefit of bariatric surgery, and really the reason why we do it, is to help patients with their obesity-related comorbidities. So, medical problems like high blood pressure or cardiovascular disease, arthritis, those are problems that can all be alleviated by a weight loss surgery to help improve or sometimes completely cure those medical problems.

Host: And fill us in on some facts about bariatric surgery, because I know sometimes there are misconceptions or misinformation. Like who's a candidate? How does it work? What's recovery look like?

Dr. Sara Shields Tarwater: Bariatric surgeries are a group of procedures that change the way that patients absorb food, and also restrict how much food they can eat and, in turn, result in weight loss. But it also changes the conversation that your brain and your digestive system has about food. So, it can help with weight loss in several different ways. Patients are candidates for surgery if they have a body mass index greater than 35 with one of the obesity-related comorbidities that we've talked about, or if they have a body mass index of 40 or higher.

Host: And what does recovery look like?

Dr. Sara Shields Tarwater: I tell patients the biggest restriction they have after surgery is they can't lift more than 15 pounds, which is no different from any of my other laparoscopic or robotic procedures for the first two weeks. The big difference between bariatric surgery and other minimally invasive surgeries is your lifestyle, obviously, is going to change for the whole post-operative period. So, the food choices that you make, the commitment that you make to following up both with me, getting yearly labs, continuing to take a daily multivitamin, and sort of staying on top of your health and wellness after as part of the recovery too. But I would say at the two week followup, most patients are ready to get back to work and ready to start resuming their regular physical activity.

Host: Wow. So, I'm guessing they have to change their whole diet, right?

Dr. Sara Shields Tarwater: They do. There's a slow progression from more of a liquid-based diet back to solid foods. It really takes patients about six weeks to get back to eating somewhat normally. But the things that they eat are going to change. We really emphasize eating a high-protein diet and getting sugar-free clear liquids in. Depending on the procedure that they have, this can change too. So, patients with gastric bypasses sometimes cannot tolerate high sugar or high carb foods. And so, that's a lifestyle change for life.

Host: What do you think the biggest misconception about bariatric surgery is?

Dr. Sara Shields Tarwater: I think the biggest misconception about bariatric surgery is that it's unsafe or that there are a lot of risks. So, at the beginning of bariatric surgery, and I would say maybe up until 25 years ago, when there were a lot of open bariatric surgeries and laparoscopic and minimally invasive procedures hadn't taken off, there were a lot of complications, not just with bariatric surgery, but with a lot of surgeries. Today, bariatric surgery has the same safety profile as an outpatient hysterectomy laparoscopically, or a laparoscopic gallbladder surgery. So, it is a life-changing event, but doesn't mean it's an unsafe or risky thing to do to change your life.

Host: So, it sounds like the surgery itself has evolved over the years. How long have they been doing it?

Dr. Sara Shields Tarwater: Bariatric surgery has actually been around since 1960s, 1970s. But, you know, laparoscopy really had its boom in the 1990s and hundreds of thousands of people have bariatric surgery every year.

Host: This has been so informative. Is there anything else you'd like to add?

Dr. Sara Shields Tarwater: A lot of patients ask what's the prep work to get to surgery. So, I think setting an expectation or having an idea of what's going to happen when you see me is helpful. So, patients can either self-refer or they can be referred by a primary care or another physician specialist. When they come to see me, I go through their personal risk and their expected outcomes for all of the surgeries that I offer, and we make a decision together about what's the best way to proceed. After we do that, they see a clinical nutritionist, a psychologist. They have some labs to check on their current nutritional status. And then, I sometimes have them get radiology studies to check on their anatomy and just see if there are going to be any unexpected findings or things that might change what I do in the surgery based on those results.

After that, I schedule them for surgery. So, it takes about three or four months to sort of get through the process of learning about how your diet and lifestyle is going to change after and getting through the workup before surgery happens. And then, after that, on the day of surgery, patients come in. I do all of the surgeries robotically. They spend one night in the hospital and most patients go home the next day.

Host: Wow. That's amazing. That's come a long way since the way they used to do it cause I knew a couple of people and the recovery was, longer and they were in the hospital longer. So, that's awesome that it's come so far in such a short amount of time. All right. So for people who want to find out more, they can go to tidelandshealth.org or call 1-866-TIDELANDS. Again, thank you so much for being here today.

Dr. Sara Shields Tarwater: Thank you so much for having me.

Host: That's Dr. Sarah Shields Tarwater. And if you found this podcast helpful, please share it on your social channels and check out our entire podcast library for topics of interest to you. Thanks for listening. I'm Maggie McKay. This is Better Health Podcast from Tidelands Health.