Transcription:
New Year, New You: Why Maintaining a Healthy Weight is Important to Long Term Health

Cheryl Martin: A new year is always a great time to take a fresh look at your health coming up ways to successfully achieve and maintain a healthy weight for lifelong change. This is Transforming Your Health, the podcast from Trinity Health of New England. I'm Cheryl Martin, and joining me this episode is Dr. Shadi McArron, regional Director of the Weight Management Program at Trinity Health of New England.

Dr. McArron, delighted to have you on.

Dr. Shadi McArron: Thank you. Thank you for having.

Host: So why is a healthy weight and important part of long-term health and overall wellness?

Guest: Well, excess pounds. As we look at weight on everybody, look at, weight just by standing on the scale. Do more than increase weight. It does increase our risk of multiple health problems. Major health problems that in turn, but these major health problems are like diabetes, high blood pressure, high cholesterol, sleep apnea, which we consider silent killers.

And these are the ones that will lead to heart disease, strokes, cancer, not to mention the mental health problems like depression, which does affect our overall wellness and our long-term health.

Host: You mentioned healthy weight. Weight is relative, of course, to the individual. So what's considered a healthy.

Guest: So if we wanna consider it specifically the way the CDC report healthy weight is anything or what we consider a BMI between 18.5 and 25. And then you said that it is relative to the individual. That's correct. So, It all depends on the height. People used to think that it's all by standing on the scale and comparing one, person to the other.

It's actually depend on our height too, so that's why we look at what we call bmi, body Mass Index. And the body mass index is actually our weight based on the height. I always tell my patients this, you know, I try to compare them and tell them, somebody who is 300 pounds and five feet or four foot 10 is definitely different than somebody who is 300 pounds and seven foot two or seven foot three.

The seven foot two is considered a normal weight. So we have to take into consideration the height and that's why the BMI vary. And based on the bmi, like I said, the CDC consider a BMI between 18.5 and 25 as a healthy weight and anybody can be able to calculate their own BMI by just going on the computer and research BMI calculation.

Host: Are we finding that more and more Americans are not at that healthy?

Guest: over time. Well, this is interesting too, like you can see in a department. Of public health that they show the range or how we change in the United States, our weight. And you see the BMI actually vary and it's been on a steady increase over time. This has to do with multiple things. The lifestyle that we live, being always on the move, having no time to exercise, no time to spend, having better choices on our food, our healthy choices.

So all of this has been affecting us over time. And yes, we've. gradually increasing in our BMI and gradually going toward a heavier.

Host: Talk about then some of the medical reasons or the science behind why certain people may find weight loss such a challenge.

Guest: So in order for us to answer this question, we have to go to the basis of. Morbid obesity. So we try to differentiate obesity from morbid obesity. Like I said, anything of a BMI over 25 is considered overweight or obesity. But when we get to a level which is significantly overweight, which is morbid obesity, that becomes a chronic disease.

So it's not anymore a lifestyle. It's not because. I was in a certain situation or certain, let's say a holiday, I overate, I gained some weight. I have to lose that, which could be very easy. But when we talk about morbid obesity, which is a chronic disease, it is very difficult. It's just like diabetes.

It's just like high blood pressure, every single time we eat, we gain the weight and then we'll make it very difficult for us, for patients who are overweight from the emotional and physical standpoint. to be able to lose the weight and this will resist them pursuing healthcare, which is the most important thing, and that's the reason for this interview today, is to say that healthcare or finding the appropriate physician, whether for medical weight loss or surgical weight loss, is a must to help us go, beyond this point and help us to lose that weight to achieve a healthier.

Host: So what is your advice to the person who says, I've tried everything. I'm still not able to get to or maintain a healthy weight. And also, what is your advice to the person dealing with morbid obesity?

Guest: so same thing all goes hand in hand. One reason for not being able to lose the weight or maintain a healthy weight, for any individual, is it in part because we usually our body fight our own biology.

in other words when we lose the weight or we start losing weight, our metabolism or metabolic rate will be lowered. So anybody who is, living, we. Or scientifically, we are always in a state of equilibrium, meaning whatever we eat is the body burning it. So the input is equal to the output.

As we lose the weight, the output or the burning will gradually go down. So our basic or resting metabolic rate will, will get lowered. So in order for us to be able to lose the weight, we have to always be, increase our metabolic rate, whether it is by exercise or on the other hand, we have to drop Our input or eating less. And that's why we come in as a medical or a surgical weight loss. Surgical weight loss help us to drop the input, help us to have a better control on how much we eat, and sometimes certain medical weight loss that we give certain patients, it'll increase the metabolism and by increasing the metabolism will be able to the weight.

So to answer your question, the reason is biologically our own biology is fighting by dropping our resting metabolic.

Host: So what's the answer for those seeking help with weight loss or weight management? How does Trinity Health of New England prepare patients for their journey, especially with weight management? I.

Guest: Yeah. So, as you said, we are an institute. we are not just surgeons. We have surgeons, medical doctors, dieticians psychologists, or sometimes psychiatrists that we work all together to help anybody achieve their goal. everything starts with meeting with the patient on a one-to-one basis.

We always have our physician involved in these, one-to-one. If you wanna call 'em meeting or interviews and we go over the requirements. Some patients will be great candidates to go medical weight management. We try to put them on the right track. We try to show them the options. Other patients might be considered candidate for surgery, and then we also give them the options that what we do, but behind everything, we have to always start at the basis of healthy eating.

And that's why we send them to see our dieticians or our physician assistants who are trained in medical. Too, and they tell them about all the healthy diet, healthy eating. We usually make, each approach is specific for the individual. And also if we needed to, we have, we send them to see a psych for psychological evaluation, some weight problems or, difficulty losing weight has to do with a psychological factor, whether it is eating or overeating because they are happy eating, overeating because they're sad.

So we try to address those problems so that we will ha we will have no problem if they decided to go into a medical weight loss using certain medications. or a surgical weight loss. in addition, if they were able to achieve any of their goals just by, meeting with our dieticians or psychologists, that would be great.

And after that, after we do the one-on-one, meeting with the patients, we decide what will be the best options and from there we go to the next level. to get the insurance requirements that we need. And then from there, if they're a candidate for medical weight loss, we support 'em all the way through.

If unfortunately they went through that and they failed, there's always a surgical option. And that's why we are all one institute that work together. Our information are shared among us. And from there it's all our main concern is the success of the weight loss and the health and benefit of the patient.

Host: So you were there with them before and after surgery.

If surgery is required

or recommended,

Guest: Correct. So, like I said, if they are a candidate for surgery, they've already been established to our practice. They have met myself or one of my colleagues, and from there we can start the process to get them to surgery. And surgery is not just a, we choose what's for them.

We give them the options, we tell them what is the best option. Back in the day, there used to be multiple options for surgery, and now we try to focus on the most successful ones. . and from there we show them how we gonna go from there. We get the, pre-certification or pre-qualification from the insurance company, and then we take them through surgery after surgery.

We don't just do the surgery and go, you probably heard of lot of stories of patients traveling to South America or one of the islands and being able to undergo the surgery and go from there. it's well known. That it's not a successful way of, pursuing weight loss. That's why we are involved with our patients throughout the, weight loss, process.

After the surgery. We see them at three weeks post-op to, advance their diet. And then from there we see them every three months until we get them down to the weight that it is comfortable for them. Now I'm saying comfortable for them because not anybody can reach the healthy weight loss that we mentioned.

Which is a BMI less than 20. all the studies have shown actually that any type of surgery will help to lose, on average, between 75 to 80% of their excess body weight. So not everybody, like I said, could achieve the 25 bmi, but we can get them as close as possible to where they feel comfortable, to where they feel healthy.

And that's why we always are involved. And as soon as they meet their target or where they feel comfortable from there on, we stay with them every year just to make sure that they did not have any, falls and they were able to gain some of the weight or, falls and they gained most of the weight.

So we intervene ahead of time, whether by. Medication, putting them through a medical weight loss program or certain situation, we might do some form of a redo surgery that will, support them, give them an excess support to go back on track to lose all the weight or to maintain the weight.

Host: So realistically, this process could take years and they need to be patient.

Guest: Correct. That's why we tell them it's not a quick fix. That's what a lot of people think, that they're gonna come in, have the surgery and be done, and that's why we have the psychological evaluation ahead of time. It's a life lifelong change. They have to change their behaviors. They have to change the way they eat.

They have to have a better choices. They have Have some exercise, some activities, some function in their life that keep their metabolism going because despite the surgery, despite that, we cut down and like we said initially, the input on how much they eat, we still have to have that output going on.

We don't want to have the resting metabolic stages drop down and they stop losing the weight. So all of this is a long-term process. All of this will take years. we will be with them for good. We tell our patients that just like your primary care physician, we are part of your healthcare From now on,

Host: That's great. Any new developments that have come about recently?

Guest: So when we talk about new developments, we talk about anything that been discussed as a way or a mean of helping to lose weight by far what's been shown to be the best or what. And Trinity Health of New England have, come to the conclusion that is the best for our patients, is introducing the robot into doing our cases.

because by using the robot, we have actually much easier access to achieve a better, surgical outcome. To put it this way, this way our patients will have less. Risk of failing afterwards from surgery because we'll be able to take more of the stomach, whether it is a sleeve gastrectomy or being able to bypass and make the stomach smaller during gastric bypass surgery.

But there are other means that's coming up and we do some of them, such as doing endoscopic surgeries or endoscopic redo surgeries to downsize. The stomach or the gastric pouch. But we have tried, we were not too, keen or eager about some of those whether endoscopic, slaving, putting some clips to make the stomach smaller, but we found out that on the long run it does not work as good.

there are a lot of, research going out there, which we haven't tried, about, physicians injecting Botox into the stomach to paralyze the stomach muscle, and this way the patients or the individual will feel full for a longer period of time. But we didn't see any specific data that will, make us choose that as an option for our patients.

But in Trinity Health New England, we utilize the robot extensively, which has been shown to. Successful, less risk, greater outcome, and the patients recovering and going home faster.

Host: Great. So where can people go if they want more information?

Guest: we have our website, I'm know you're gonna share it with our patients at the end of our interview. But, it is mainly Trinity Health of New England or Trinity Health of ne.org/y. Wait, which was our main thing when we started our program, our institute, we consider why wait as our logo?

Because nobody should wait. You should not, wait until you get the medical conditions that will lead to long-term complications. You should. Aim at getting healthy as, fast as possible. So that's our website. We have also have our main phone number,

we can reach out to our lead nurse that will direct them to the doctors based on their area. we extend from Western Massachusetts in Mercy Hospital all the way to Hartford, which is San Francis and to, St. Mary's, which is in water.

Host: Dr. Shadi McArron a great conversation about the importance of maintaining a healthy weight and the surgical options available for achieving that goal. Thank you so much.

Guest: Thank you. Thank you for having.

Host: You can learn more at our website, Trinity Health of e.org/y. Wait, that's trinity health of e.org/the letter Y, then W e I g h t or call a three three. 7, 6, 8, 1, 1, 0 0. That's 8 3 3 6 7 8 1 1 0 0. If you found this information helpful, please share it with others, especially on your social media and thanks for listening to the Transforming Your Health Podcast.