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The Weight Loss Battle: How Bariatric Surgery Can Bring You Back to Healthy
Diet and exercise can help some individuals lose weight, but others need additional solutions. Dr. Jennifer Salluzzo, Bariatric and Gastrointestinal Surgeon, discusses weight loss surgery.
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Learn more about Jennifer Salluzzo, MD
Jennifer Salluzzo, MD
From a young age, Dr. Jennifer Salluzzo was fascinated by the way science could be used to treat disease. That’s particularly true when it comes to conditions such as obesity, where controlling one’s metabolism – paired with the advanced technology behind today’s surgical weight-loss procedures – work together to radically change and improve a person’s quality of life.Learn more about Jennifer Salluzzo, MD
Transcription:
The Weight Loss Battle: How Bariatric Surgery Can Bring You Back to Healthy
Scott Webb (Host): Some of us want to lose weight and some of us need to lose weight. Diet and exercise work for some while others are forced to consider weight loss surgical options. My guest today, is Dr. Jennifer Salluzzo, a Bariatric and Gastrointestinal Surgeon at VCU Health. Dr. Salluzzo specializes in minimally invasive surgical procedures, which result in shorter hospital stays, less pain after the operation and the ability to get patients back to work and life sooner. So, let’s talk to Dr. Salluzzo.
This is Healthy with VCU Health. I’m Scott Webb. Doctor, thanks for joining me today. Let’s start here. If someone is interested in weightless surgery, what are the first steps?
Jennifer Salluzzo, MD, FACS (Guest): The first step would be to identify a weight loss center like VCU. We have a bariatric or weight loss surgery program where patients can come get information. Typically, we recommend that patients start with a weight loss seminar. It is an information session. It is noncommittal. You can come, sit, chat with people who are part of the program, see how it is a multidisciplinary approach to weight loss and discuss the process and how you get from that seminar to an actual surgery in the future.
Host: Is surgery only for the obese or can others elect to go the surgical route and if it’s more of an elective surgery; how does insurance play into that?
Dr. Salluzzo: Right now, weight loss surgery if covered by insurance has to be for patients who have a BMI or body mass index of greater than 35, as long as they have a weight-related medical problem like high blood pressure, high cholesterol or diabetes, sleep apnea. Otherwise, the requirement is that the body mass index has to be 40 without one of those medical problems.
With those, there are several other requirements that an insurance company will require. Patient will have to go through diet visits, usually a psychological evaluation and then any other medical clearances that we recommend. At that point, an insurance company would approve a patient, however we do recommend that patients check with their individual insurance companies because they do have to have something called a bariatric rider that not all insurance companies have. However, Medicaid and Medicare do cover weight loss surgeries.
Host: Okay, so lots of options there. There are many things to consider. What is the time, let us say from the initial visit or attending a surgery seminar; from there to surgery, and how long is that process for people?
Dr. Salluzzo: At VCU Health it is actually easy to go from the seminar to an appointment, usually we can get patients in within a week to see a surgeon. From the initial visit with a surgeon; it can take anywhere from four months to seven months to a year depending on the type of insurance in order to get to the actual operation.
Host: Okay and I know we were discussing before we started here that it is a little difficult to do this without pictures. But can you briefly explain the two different surgeries as best you can?
Dr. Salluzzo: The laparoscopic sleeve gastrectomy is a weight loss surgery where I would remove 80% of the floppy portion of the stomach and it makes the stomach look like a banana. Food would go down the esophagus, into the banana shaped stomach and into the small intestine in the regular direction that it always had gone before. It would just be a smaller stomach. The other option is a gastric bypass and that surgery I would make a golf ball sized pouch out of the stomach and then attach a piece of intestine to it bypassing the large portion of the stomach and the first part of the small intestine. This way there is restriction from the small pouch and there is malabsorption from the bypassed portion. Therefore, it gives you the benefit of both for weight loss.
Host: Well you know you did great job even without the pictures. I can somewhat rather picture the two. My mom did have the sleeve surgery. It does sound to me like the second one is a little more complicated for you. Do you prefer one or the other? Do you recommend one or the other for patients?
Dr. Salluzzo: Definitely, there are times where one surgery is better for one patient versus another. Usually that’s a discussion we have one on one. If a patient doesn’t have any particular contraindications to one surgery or the other though, I’m happy to do either one. The gastric bypass is a little bit more technically complex, but it is an equally safe surgery to the sleeve gastrectomy. And people do well with weight loss with either one.
Host: Okay, that’s good to know. And what are the benefits? I am sure there are many, not just losing weight.
Dr. Salluzzo: For weight loss surgery, the benefits really are exceptional. People really have a physiologic transformation such that their blood pressure improves, their cholesterol improves, diabetes improves, and they no longer require CPAP for sleep apnea, on top of just having weight loss. It is a true body transformation as well a mind transformation. People can now live their lives more successfully and spend time running around with their children or their grandchildren and do so with energy and without feeling short of breath.
Host: That’s amazing the way you put it. The transformation of the mind and the body. Moreover, I’m sure one of the questions people have is how quickly can they get back to their lives? How quickly can they get back to work? So, what’s the recovery time?
Dr. Salluzzo: Most people are in the hospital one or two nights and then we usually recommend that people have at least two weeks off work or off of any heavy lifting where they can recover and get used to the surgery. Then depending on the type of work that an individual does; they could potentially go back to work at two weeks, although some people do prefer to stay out four weeks.
Host: Okay so either way, even at the longer side of things; it’s still pretty good. People are still back to their lives in a pretty short period of time. That’s great to know. So, tell us about the surgery seminars. This seems really interesting to me and it think a great entry point for a lot of people just even considering this. Tell us about the seminars.
Dr. Salluzzo: The seminar is a wonderful resource. Our bariatric coordinator runs it; and our dietician is often involved. It’s a very low stress, group setting lecture and demonstration of the program here at VCU. You get to look at all of the doctors. You get to see all of the people who are part of this big team that help our patients successfully navigate the process. And it’s also a really great forum to ask questions and then afterwards, usually there’s a support group, which many people will choose to stay for just to listen, to get a little bit more information about before and after life with the surgery.
Host: That’s awesome and do previous patients attend and speak to the group?
Dr. Salluzzo: Yup. We have previous patients who have been coming for years. We have new patients who are newly postop or patients who are actually preop and like to go to learn from the people who have already had surgery.
Host: That is so cool. So, what else can we tell listeners about the surgery seminars, about the surgeries themselves, the benefits? Sum it all up for everybody.
Dr. Salluzzo: I think the most important thing is that this is not a quick fix. We are dealing with a complex problem that affects every aspect of the body and the mind and we want our patients to be successful at the end. Therefore, we want them to understand that this is a process and a program. We’re here to help them get from point A to point B but they have to be patient and stick with us along the way so that we can get them to a healthier point in their lives where they can live happily and enjoy everything.
Host: That’s great. Thanks so much for your time and insight today, Doctor. I really appreciate it. And if you’d like to learn more, the weight loss surgery team at VCU Health offers a free weight loss surgery seminar several days throughout the month. Please call 804-827-0045 or email helpforobesity@vcuhealth.org to sign up. To hear more about how you can take control of your health, listen to other episode of Health with VCU Health at www.vcuhealth.org/podcasts. This is Healthy with VCU Health. I’m Scott Webb. Thanks for listening.
The Weight Loss Battle: How Bariatric Surgery Can Bring You Back to Healthy
Scott Webb (Host): Some of us want to lose weight and some of us need to lose weight. Diet and exercise work for some while others are forced to consider weight loss surgical options. My guest today, is Dr. Jennifer Salluzzo, a Bariatric and Gastrointestinal Surgeon at VCU Health. Dr. Salluzzo specializes in minimally invasive surgical procedures, which result in shorter hospital stays, less pain after the operation and the ability to get patients back to work and life sooner. So, let’s talk to Dr. Salluzzo.
This is Healthy with VCU Health. I’m Scott Webb. Doctor, thanks for joining me today. Let’s start here. If someone is interested in weightless surgery, what are the first steps?
Jennifer Salluzzo, MD, FACS (Guest): The first step would be to identify a weight loss center like VCU. We have a bariatric or weight loss surgery program where patients can come get information. Typically, we recommend that patients start with a weight loss seminar. It is an information session. It is noncommittal. You can come, sit, chat with people who are part of the program, see how it is a multidisciplinary approach to weight loss and discuss the process and how you get from that seminar to an actual surgery in the future.
Host: Is surgery only for the obese or can others elect to go the surgical route and if it’s more of an elective surgery; how does insurance play into that?
Dr. Salluzzo: Right now, weight loss surgery if covered by insurance has to be for patients who have a BMI or body mass index of greater than 35, as long as they have a weight-related medical problem like high blood pressure, high cholesterol or diabetes, sleep apnea. Otherwise, the requirement is that the body mass index has to be 40 without one of those medical problems.
With those, there are several other requirements that an insurance company will require. Patient will have to go through diet visits, usually a psychological evaluation and then any other medical clearances that we recommend. At that point, an insurance company would approve a patient, however we do recommend that patients check with their individual insurance companies because they do have to have something called a bariatric rider that not all insurance companies have. However, Medicaid and Medicare do cover weight loss surgeries.
Host: Okay, so lots of options there. There are many things to consider. What is the time, let us say from the initial visit or attending a surgery seminar; from there to surgery, and how long is that process for people?
Dr. Salluzzo: At VCU Health it is actually easy to go from the seminar to an appointment, usually we can get patients in within a week to see a surgeon. From the initial visit with a surgeon; it can take anywhere from four months to seven months to a year depending on the type of insurance in order to get to the actual operation.
Host: Okay and I know we were discussing before we started here that it is a little difficult to do this without pictures. But can you briefly explain the two different surgeries as best you can?
Dr. Salluzzo: The laparoscopic sleeve gastrectomy is a weight loss surgery where I would remove 80% of the floppy portion of the stomach and it makes the stomach look like a banana. Food would go down the esophagus, into the banana shaped stomach and into the small intestine in the regular direction that it always had gone before. It would just be a smaller stomach. The other option is a gastric bypass and that surgery I would make a golf ball sized pouch out of the stomach and then attach a piece of intestine to it bypassing the large portion of the stomach and the first part of the small intestine. This way there is restriction from the small pouch and there is malabsorption from the bypassed portion. Therefore, it gives you the benefit of both for weight loss.
Host: Well you know you did great job even without the pictures. I can somewhat rather picture the two. My mom did have the sleeve surgery. It does sound to me like the second one is a little more complicated for you. Do you prefer one or the other? Do you recommend one or the other for patients?
Dr. Salluzzo: Definitely, there are times where one surgery is better for one patient versus another. Usually that’s a discussion we have one on one. If a patient doesn’t have any particular contraindications to one surgery or the other though, I’m happy to do either one. The gastric bypass is a little bit more technically complex, but it is an equally safe surgery to the sleeve gastrectomy. And people do well with weight loss with either one.
Host: Okay, that’s good to know. And what are the benefits? I am sure there are many, not just losing weight.
Dr. Salluzzo: For weight loss surgery, the benefits really are exceptional. People really have a physiologic transformation such that their blood pressure improves, their cholesterol improves, diabetes improves, and they no longer require CPAP for sleep apnea, on top of just having weight loss. It is a true body transformation as well a mind transformation. People can now live their lives more successfully and spend time running around with their children or their grandchildren and do so with energy and without feeling short of breath.
Host: That’s amazing the way you put it. The transformation of the mind and the body. Moreover, I’m sure one of the questions people have is how quickly can they get back to their lives? How quickly can they get back to work? So, what’s the recovery time?
Dr. Salluzzo: Most people are in the hospital one or two nights and then we usually recommend that people have at least two weeks off work or off of any heavy lifting where they can recover and get used to the surgery. Then depending on the type of work that an individual does; they could potentially go back to work at two weeks, although some people do prefer to stay out four weeks.
Host: Okay so either way, even at the longer side of things; it’s still pretty good. People are still back to their lives in a pretty short period of time. That’s great to know. So, tell us about the surgery seminars. This seems really interesting to me and it think a great entry point for a lot of people just even considering this. Tell us about the seminars.
Dr. Salluzzo: The seminar is a wonderful resource. Our bariatric coordinator runs it; and our dietician is often involved. It’s a very low stress, group setting lecture and demonstration of the program here at VCU. You get to look at all of the doctors. You get to see all of the people who are part of this big team that help our patients successfully navigate the process. And it’s also a really great forum to ask questions and then afterwards, usually there’s a support group, which many people will choose to stay for just to listen, to get a little bit more information about before and after life with the surgery.
Host: That’s awesome and do previous patients attend and speak to the group?
Dr. Salluzzo: Yup. We have previous patients who have been coming for years. We have new patients who are newly postop or patients who are actually preop and like to go to learn from the people who have already had surgery.
Host: That is so cool. So, what else can we tell listeners about the surgery seminars, about the surgeries themselves, the benefits? Sum it all up for everybody.
Dr. Salluzzo: I think the most important thing is that this is not a quick fix. We are dealing with a complex problem that affects every aspect of the body and the mind and we want our patients to be successful at the end. Therefore, we want them to understand that this is a process and a program. We’re here to help them get from point A to point B but they have to be patient and stick with us along the way so that we can get them to a healthier point in their lives where they can live happily and enjoy everything.
Host: That’s great. Thanks so much for your time and insight today, Doctor. I really appreciate it. And if you’d like to learn more, the weight loss surgery team at VCU Health offers a free weight loss surgery seminar several days throughout the month. Please call 804-827-0045 or email helpforobesity@vcuhealth.org to sign up. To hear more about how you can take control of your health, listen to other episode of Health with VCU Health at www.vcuhealth.org/podcasts. This is Healthy with VCU Health. I’m Scott Webb. Thanks for listening.