Right now, almost 34 million Americans are living with diabetes, and 90% of those have type 2 diabetes. This is a growing epidemic, but health care providers can play a critical role by helping patients manage and reverse type 2 diabetes. While diet changes and medication are typically the first recommendations for managing type 2 diabetes, there’s a more significant treatment increasingly being recommended: bariatric surgery.Read More
Weight management has historically been a difficult provider-patient conversation. But, having a discussion about a patient’s weight is not an attack on their character—it’s just another conversation about their overall risk profile. No matter where your patient is on their weight-loss journey, Inspira’s Weight Management and Bariatric Surgery programs are here to help redefine weight loss.
A Look Into Inspira’s Weight Management Program
At Inspira, weight management does not fit into one box, but rather on a multidisciplinary, integrated spectrum of weight loss and management tools. Inspira offers bariatric surgery including sleeve gastrectomy, gastric bypass and intragastric balloons, but believes dietary counseling with lifestyle integration is the epicenter of weight management.
“The cornerstone of the program is our dietary component. Every patient must see a dietitian and know the granular elements that go into a healthy lifestyle and eating,” said Keith Kreitz, M.D., medical director for Bariatric Surgery at Inspira Medical Center Mullica Hill. “Non-medical weight loss is always the first step. Some patients don’t want or can’t have surgery, so it’s important to start conservatively.”
The program begins with patient education, dietary and exercise counseling. “The most important thing to tell patients is that their journey is not about just going on a diet. This has to be a lifestyle change. They have to learn how to treat their bodies well to be happy and healthy,” said Rebecca Fraid, D.O., a family medicine provider at Inspira Medical Center Vineland.
Surgery is not always the answer. For many patients, the solution lies within their control, such as changing dietary habits, adopting better sleep schedules, increasing their physical activity, doing general medical nutrition therapy, and continuing with those components regularly.
Why Gaining Weight Can be a Symptom, Not Always a Disease
To improve their health, patients must learn to connect obesity to medical conditions—like an increased risk for heart disease, diabetes and behavioral health disorders. This can be a hard conversation to have, but once a patient realizes their weight has lifestyle impacts, they will be able to see the options they have available. Options that start at the primary care level.
“Talking to your patients invites them into a world where nutritional resources, medical weight management, surgical options, addiction support and even mental health counseling are accessible,” said Dr. Fraid. “A huge part of weight management is mental health. Forty-three percent of adults with depression are obese, meaning something drove these patients to gain weight. Instead of focusing on lowering the number they see on the scale, we need to show patients the tools and techniques to regain their mental stability, making weight loss an added perk throughout the process.”
The Other “F” Word
When speaking with patients about their weight, there are three things you should remember to convey: It is not their fault; there is nothing to be guilty about; and it is not a personal attack.
“We do not like to use the ‘f’ word around here,” said Dr. Kreitz. “As a community of providers, we need to bring it down to a medical level. Ask your patients: What’s happening to your body? Could weight be playing a role in your blood pressure? The goal is to be compassionate and remind them we are all human.”
While bariatric surgery has specific inclusion eligibility, everyone struggling with weight management is recommended to learn about Inspira’s Weight Management program and bariatric services. “Oftentimes, the desire to lose weight comes from an emotional event, like not being able to buckle a seatbelt on an airplane, fit on a roller coaster or even play with their children,” said Bradee Rojas, M.S., R.D.N., an outpatient dietitian nutritionist at Inspira Medical Center Mullica Hill. “People come in with the question: How did I get to this point? And while we may not ever find that answer, we believe it doesn’t matter where you came from, because you know where you want to go.”
Weight management has come a long way in the last several years. Specifically, injectable medications such as Liraglutide or Semaglutide are aimed at helping patients maintain weight loss, treat insulin resistance, and stimulate appetite satiety. Other medications such as Qsymia, which can increase energy/metabolism and suppress appetite, are making waves in the weight loss community.
“We can spend all day talking to patients about techniques that fit in with their lifestyle, but it really comes down to one thing: They need to want it. They need to make those lifestyle changes for themselves,” said Rojas.
Inspira Bariatric Services offers full virtual support free of charge. For more information on weight loss management, access to seminars and information on support groups, visit www.inspirahealth.org/bariatrics.