Weight loss
WEIGHT LOSS SURGERY
Being overweight is not something we consciously set out to do, but 40% of Americans can be considered “obese,” which means they have an unhealthy proportion of body fat. Obesity commonly impacts a person’s entire life, causing them to suffer physically, socially, and emotionally. Insurance companies have recognized the value of weight loss surgery and will cover the procedure in all patients with a BMI over 40. If your BMI is between 35 and 40 and you have certain medical problems like diabetes, high blood pressure, sleep apnea or high cholesterol it is also covered. There is also evidence that some people with a BMI between 30 and 35 would benefit from weight loss surgery and Dr. Thoman has operated on many of these people, but insurance will not help with the cost. Your BMI can be calculated here.
CAUSES OF OBESITY
Your body has a set point for weight, just like it has a set point for your temperature. If your set point is 250 pounds and you start running 10 miles a day and eat only celery you will lose weight. You will be happy with the pounds coming off and proud of yourself for putting in the effort, but your body thinks there is something very wrong. It will slow your metabolic rate so that you hold on to every calorie. It will release hormones that make you incredibly hungry. Over time the body almost always wins and people start regaining all of the weight they lost. Only now your body is afraid this could happen again and it try to put on extra weigh as a cushion. That’s how people start at 250 pounds, work hard to get down to 180 pounds and end up at 275 pounds. This is often referred to as Yo-Yo Dieting and has nothing to do with someone’s will power and everything to do with how our body works. The currently performed weight loss surgeries work not by giving you a small stomach and restricting how much you can eat, but by changing the way hormones are released and thus changing your set point for weight. A year or so after surgery most people can eat an almost normal amount of food. What keeps their weigh down is the new set point. Your body thinks you should weigh 150 pounds, not 275 pounds and it keeps you there. Why have surgery? Because once your 80 pounds or more overweight diet and exercise aren’t going to work, only surgery has been proven effective in the long run.
Your body tightly controls the amount of fat it chooses to store via an array of complex hormones interacting on your brain and gut. Losing weight requires either changing this set point or fighting it. Dieters who have struggled to lose weight and then slowly put it back on over the coming years know how hard it is to fight the set point. It is the reason only 2-3% of dieters experience long term success. Currently, only surgery has been shown to reliably change your body’s set point. That is the reason weight loss surgery has been shown to create long term lasting weight loss. It actually has nothing to do with just making a small stomach.
WHAT ABOUT WEIGHT LOSS DRUGS?
The new GLP-1 agonists like Ozempic are the first truly effective weight-loss drugs. These have been proven safe and effective and could certainly be tried first. Obesity is a challenging chronic condition and there is no single silver bullet. Diet, exercise, surgery and medications may all be required to keep weight in check. Unfortunately, the GLP-1 agonists are relatively new and we don’t know what will happen if they are taken for many years. It does appear that most people who stop using them regain their weight, so long term use is likely. Much more research is needed before we know how best to use these drugs.
OPTIONS FOR SURGERY
LAP BAND
Between 2000 and 2012 Dr. Thoman performed around 700 Lap Bands but has since abandoned this approach, along with most weight-loss surgeons. Evidence started to come out at that time that metabolic changes had to be made for long-term success, not just restricting food. There was little evidence the lap band was changing metabolism. Despite this, there are still many patients with bands who are happy and there is no reason to take it out unless there is a problem. Dr. Thoman will discuss the options if it causes problems or stops being effective.
DIET AFTER SURGERY
After surgery on the stomach it is important to not stress it until it has healed. That is the reasoning behind taking only liquids for the first 2 weeks and then mushy foods for 2 weeks and then slowly advancing to a more normal diet. Protein is important for healing and this is emphasized early on. Also important is staying hydrated. It can be difficult to even drink initially while your stomach is still swollen. Taking small sips all-day long works best. Sugar free popsicles will often go down when water doesn’t. Adding cucumber or fruit to your water also can help it go down easier. After 6 weeks everything has healed and your diet should include only healthy whole-foods and nothing processed. There is no need to take protein shakes after 6 weeks. You have a new set point for weight and your body is trying to get you down to it by decreasing your hunger. If you are not hungry then don’t eat. If you are hungry then eat healthy. This will apply for the rest of your life. There is no reason to “diet” anymore. Some people feel better taking multiple smaller meals, which is fine. Everyone is different and the important thing is to listen to your body and stop eating when you are full. Eating slowly is also important for the rest of your life, as should we all!
FOLLOW-UP
Dr. Thoman will see you at 2 weeks after surgery to make sure you are healing ok. Then he will see you at 2 months, 6 months and on your 1-year anniversary every year until he retires. At these visits we will talk about exercise and how you are doing. Blood work will be done before each of these to make sure you’re healthy and your vitamin levels are ok.
Success Stories
Be inspired to take control of your weight loss struggle. Read the testimonials and success stories shared by some real patients who visited Dr. Thoman for weight loss surgery in California.
THE SILVAS’ GASTRIC BYPASSES
When it comes to weight loss, there’s success in numbers. The Silvas know that firsthand – this husband and wife decided to begin their weight loss journey together, and relied on Dr. Thoman to help them on their way. For each other and their children, they decided that their transformation couldn’t wait any longer, and they have nothing but kind words for Dr. Thoman and his staff.
LYNDA GORDON’S GASTRIC BYPASS
After spending over half her life morbidly obese, Lynda was constantly tired, depressed, and embarrassed because of her size. Being the mother of 3 young children and a kindergarten teacher, she decided it was time to change her life when her weight reached 305 pounds. Read her story of success after visiting Dr. Thoman for minimally-invasive gastric bypass weight loss surgery in California.
GEORGE’S WEIGHT LOSS SURGERY
I just wanted to take a moment to say thank you to all staff and to Dr. Thoman for the excellent care I received through my whole weight loss experience.