A dedicated group of bariatric professionals supports patients before, during and well after surgery.
Having successful bariatric (weight loss) surgery is far from a solo journey. Of course, having a really skilled surgeon is key—and Clara Maass Medical Center (CMMC) has three who specialize in the procedure. “Surgery is a tool, but it’s only part of the equation,” says Naveen Ballem, MD, Director of Bariatric Surgery at CMMC. “We also have a full team that supports the patient before, during and after the surgery.”
The bariatrics team at CMMC is comprehensive. It includes a secretary, a nurse manager, a nurse navigator (who is the contact person for patients, helping to provide medical information and direct them to other resources) and a clinical reviewer. The team also includes bariatric dietitians and an exercise physiologist who meet with patients to help them permanently transform their bodies with healthy lifestyle choices.
Food for Thought
Patients meet with a dietitian anywhere from two to six times over the course of their treatment. “We start seeing patients after they’ve met with a surgeon, but before they have the surgery—and sometimes even before they’ve made up their minds to go ahead with it,” says Kristin Carlino, RD, Bariatric Dietitian. “After meeting with the surgeon, they have a good understanding of what the operation will entail, but not necessarily a good understanding of what their diet will be like.”
Many patients are apprehensive about how their eating habits will need to change, and the dietitians can address some of those concerns. “We want patients to learn to think differently about their food,” says Carlino. “For instance, a patient might ask me to recommend the healthiest fast food. Instead, I urge them to prep their meals the night before, so they don’t have to rely on fast food restaurants.” Dietitians talk about portion sizes, vitamin needs and general healthy eating habits. “We’re teaching healthy eating for life,” she says. In some bariatric surgery programs, patients only get 15 minutes with a nutritionist, or only meet with a nutritionist as part of a group, says Silvana Blanco, RD, Bariatric Dietitian. But at CMMC, the meetings are individual, and last for an hour.
Some of the nutritional advice patients receive has more to do with behavior than with what specific foods to eat. “We talk about things like eating slower, turning off the TV while you eat, handling stress eating,” explains Blanco.
Getting Active
The same kind of individualized support is applied to fitness by Steve Gonnelli, CPT, the bariatric team’s exercise physiologist. “I meet with patients once before and once after the surgery,” he explains, “and I make recommendations based on each person’s strengths and weaknesses.”
Many patients have knee pain, back pain, or shoulder pain and haven’t been active in a while. “But I try to convey before we meet that they’re not coming to see me for a brutalizing workout,” Gonnelli says. “No one is forced to do anything they don’t want to do. I show them some movements. For some, all they can do at first is lean against a wall or desk, and focus on contracting their abdominals, or do a wall-sit with knees slightly bent. I alter each exercise to suit each patient.”
Exercise, he says, is important for several reasons. “If they don’t exercise, they might lose too much muscle mas s.” In addition, strength training—and building muscle—can help mask the loose skin that sometimes remains after extreme weight loss. Pre-surgery, patients also consult with a psychologist and may need clearance from a cardiologist or pulmonologist as well.
A Lasting Bond
Post-surgery, in addition to visits with the dietitians and exercise physiologist for a personalized exercise prescription, patients have several ways to stay in touch. They visit their surgeon once a year for follow-ups— for life. They can also join a monthly bariatric support group at the hospital. Recent meetings have included a Zumba class, a farmers market, yoga, stress relief, holiday eating and vitamin information.
Some patients continue attending the group for years. “And they’re really welcoming to new people,” says Carlino. The team at CMMC sees approximately 500 patients a year, ranging in age from the late teens into the 70s. Team members say they love seeing the changes in their patients’ lives—changes that often go way beyond fitting into a smaller clothing size.
“Yesterday we found out that one of the patients who lost 100 pounds got a new job,” says Blanco. “She couldn’t work before because she was in too much pain from excess weight.” Like so many, that patient reaped the rewards of hard work and good health habits—with the help of a great team.
Learn more about bariatric surgery at Clara Maass Medical Center, or attend one of the monthly “Surgical Options for Weight Loss” seminars led by one of CMMC’s bariatric surgeons.