Worth the Weight Loss: Solid Options for Long-Term Success

Intro: This is Weekly Dose of Wellness brought to you by MemorialCare Health System. Here's Deborah Howell.

Deborah Howell (Host): Hello and welcome to the show. I am Deborah Howell, and today's guest is Dr. Michael Russo, a general surgeon specializing in bariatric surgery with the MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center. Welcome, Dr. Russo.

Michael Russo, MD: Thank you for having me. I'm looking forward to this.

Deborah Howell (Host): A true pleasure. So according to the Centers for Disease Control and Prevention, more than one-third or 78.6 million of US adults are obese. Let's talk a bit about recent data regarding weight loss success rates and the new minimally invasive technology available to surgically treat obesity. First off, what is obesity and why does it need to be treated as a life-threatening disease?

Michael Russo, MD: Well, as you so eloquently said, obesity affects one-third of Americans, and obesity is defined as a body mass index or BMI of greater than 30. And any of our patients or prospective listeners can actually calculate this themselves, it's easy to find BMI calculators online. A normal BMI is 18 to 25, overweight is 25 to 30, and people that are obese are greater than 30. So this is really a life-threatening disease. It affects the body from head to toe. It causes diseases such as high blood pressure, diabetes, sleep apnea, dementia, cancer, among many, many others. And it really does affect one's life and reduce life expectancy.

Deborah Howell (Host): All right, and at what point should someone seek out additional weight loss assistance beyond a diet and exercise plan?

Michael Russo, MD: Well, it's interesting, diet and exercise, we used to think that it succeeded in about 2% of our obese population. However, there was a study done in England recently of 150,000 patients, and it showed that in patients with a BMI of greater than 40, or class 3 obesity, diet and exercise only got them to normal weight 0.1% of the time, one in a thousand. It just plain doesn't work for this group of patients. So if you're over a BMI of 30, you should really seek additional tools to get that weight off for your health.

Deborah Howell (Host): Okay. Since diet and exercise alone aren't always successful as you've just said, what are some minimally invasive surgical options now available that one should consider?

Michael Russo, MD: Well, we're very excited because this is a great time of reform in the bariatric surgery world. We've got two exciting new technologies that just emerged onto the market. One of which is called the intragastric balloon or gastric balloon, sometimes referred to as the belly balloon. It's a new technology in which it's really non-surgical, it's done through placement using a camera through the mouth using an endoscope so there are no incisions. It's safe, effective at getting weight off, and it's also temporary. So if someone doesn't want to alter their body's anatomy permanently, this is a great option for them. The balloon stays in place for about six months, during which a patient essentially has a modified diet and exercise program and sees some serious weight loss results. It's three times more effective than diet and exercise alone.

Deborah Howell (Host): That is incredible. Again, what is that called?

Michael Russo, MD: That's called the intragastric or gastric balloon. Another technology was the vBloc device. That's a device that's implanted under the skin and it has little wires that attach to your vagus nerve which lives right near your stomach and esophagus and actually controls your hunger and how full you feel. And this acts like a pacemaker blocking the nerve signal, and this leads to less feelings of hunger, more feelings of being satisfied and early satiety, and contributes to weight loss. But this is also a minimally invasive and reversible tool for patients that is new on the market.

Deborah Howell (Host): Absolutely phenomenal. So you've mentioned a couple of reasons, but what makes these surgical techniques different than the ones we've heard about in the past decade?

Michael Russo, MD: So mainly in the past decade, we know about the band, the gastric sleeve, the gastric bypass, all of which are done through incisions on the belly wall. They're minimally invasive operations, but you still require incisions. So with the intragastric balloon, you no longer require incisions, you don't need to be admitted to the hospital, you literally go home within about 30 to 45 minutes after the procedure, which is pretty remarkable and really appealing to many of our patients. Interestingly enough, the band, which used to be the most commonly performed bariatric operation between the years of 2006 to 2011, we call that in the business the band boom. It's now being less frequently done and is now the least frequently done bariatric operation because the band hasn't seen the favorable results that we would expect. So we're removing more bands than we're placing. So instead of the bands, these new technologies are replacing those bands, and additionally, the sleeve has really hit the forefront of the market in being a great, great, great low-risk option for patients, which really contributed to the band kind of going by the wayside because we're so good at what we do. Our operations are actually very safe, and that's a big change that we've made over the last ten years, just increasing the amount of safety and decreasing the invasiveness of the different therapies that we offer.

Deborah Howell (Host): Absolutely. It's going to get many, many more people into your offices and get them the help that they need.

Michael Russo, MD: Absolutely. There are a lot of patients out there that need help, and still, even with as many bariatric procedures as we're doing, we're doing more than ever, still only about 2% of patients that could benefit from weight loss surgery are getting weight loss surgery or any sort of treatment. So there's a huge amount of patients out there that still aren't getting treated as they should.

Deborah Howell (Host): I'm so glad you're on the show. We're getting the word out that there is help and it's non-surgical help.

Michael Russo, MD: Absolutely.

Deborah Howell (Host): How does someone know which procedure is best for them?

Michael Russo, MD: So it's really best to talk to a specialist like us to really weigh all of the options. Each treatment plan is individualized for the patient. So coming to a place like MemorialCare Center for Obesity and us at Smart Dimensions, we really help weigh all the options and tailor-fit a treatment that's best for you.

Deborah Howell (Host): Okay. And knowing which surgical options are available, you know, it's always a great first step. But what should someone look for in a comprehensive medically supervised weight loss program over time?

Michael Russo, MD: Well, it's really important that you realize that that multidisciplinary approach, the comprehensive approach, is really what makes all the difference. The reason we get such great results is because we have a wonderful team around us that are really dedicated to a patient's success. So that includes a patient's primary care physician, a weight loss surgeon with extensive expertise. Expertise is very important. You need to have psychosocial services to address the relationship that a patient may have with food using it as a coping mechanism. And remember, about 80% of our patients have some sort of anxiety or depression contributing factor that needs to be addressed.

Deborah Howell (Host): Did you say 80%?

Michael Russo, MD: 80. 80. Eight zero. It's really impressive and it's important to realize that. Our patient population is very unique, which is why it takes expertise to really treat them appropriately and most effectively. But don't forget, you also need people like a dietitian on staff, regular visits when you feel like you're not succeeding, and you need to feel welcomed, not shamed for coming in if you're having some difficulty.

Deborah Howell (Host): Absolutely. That would lend myself to think that wow, support groups have to be very, very key.

Michael Russo, MD: Oh, that's so true and support groups are essential to help you on your journey to a better quality life. It's so important, and support groups are easier to find than ever. We run two support groups. I'm a member of two major Facebook social support groups which include over 100,000 patients. So, and I take an active role in addressing patients' concerns, supporting them on their journey. I mean, this is really, it's a journey to a better life, and we like to tell patients that we enable them to live the life that they deserve. The better quality life, because we want to make the outside match what's on the inside.

Deborah Howell (Host): Just not only for them, but for their families as well.

Michael Russo, MD: That's right. Everyone benefits when someone gets bariatric surgery or loses a significant amount of weight because there's a lot of lifestyle changes that are involved. And everyone in the house actually benefits. It's very interesting, it's called the halo effect, where when you have a family and someone in the family gets weight loss surgery, everyone in the family starts losing weight because of better dietary choices, a more active and high-quality lifestyle, everyone feels better. So it's almost contagious, which is really exciting.

Deborah Howell (Host): This is a brand new day. Thank you so much, Dr. Russo, for bringing hope and help to so many.

Michael Russo, MD: It's my pleasure. I love what I do, and we have a passion for it over here.

Deborah Howell (Host): Well, it's been so great to have you on the program today. Very informative. To listen to the podcast or for more information, please visit memorialcare.org/podcasts. That's memorialcare.org/podcasts. I'm Deborah Howell. Thanks for listening and have yourself a wonderful day.