FAQ
Q: What does it mean to be “morbidly obese”?
A: Patients who meet the following criteria are morbidly obese:
- At least 100 pounds overweight or 100 percent above ideal weight
- Inability to sustain a healthy body weight
- Associated health risks (comorbidities) caused or aggravated by morbid obesity
Obesity is measured by the body mass index (BMI) formula. This formula is derived by multiplying your weight in pounds by 703 and then dividing it twice by your height in inches. You can also find your BMI by using the BMI calculator at www.caloriecontrol.org. A BMI of 40 or more indicates morbid obesity.
Q: What is Body Mass Index (BMI)?
A: BMI is a measure used to index a person’s height and weight. BMI allows healthcare professionals and patients to better understand health issues associated with a specific weight classification (classifications such as obesity and morbid obesity).
Q: What health risks are associated with morbid obesity?
A: The health risks associated with morbid obesity (co-morbidities) can affect nearly every organ in the body. Some of these co-morbidities include:
- Sleep apnea
- Kidney disease
- Heart disease
- High blood pressure
- High cholesterol
- Shortness of breath
- Type 2 diabetes mellitus
- Heartburn and Reflux disease
- Gallbladder disease
- Urinary incontinence
- Joint pain
- Degenerative arthritis of weight-bearing joints or lumbar-sacral spine
- Colon, prostate or endometrial cancer
- Emotional and/or psychological disorders including depression
Q: Is Dr. S.Y. Ghodsian a bariatric surgeon?
A: No. Dr. S.Y. Ghodsian is a bariatric medical specialist who treats bariatric surgery patients before and after weight loss surgery. He does not perform the surgeries himself. Dr. S.Y. Ghodsian also has a medically supervised program for patients who do not wish to have surgery but still want to lose weight.
Q: Why do I need to see Dr. S.Y. Ghodsian before my weight loss surgery?
A: Dr. S.Y. Ghodsian is independent of any surgeon or weight loss program so he will be able to give you an honest answer weather you need surgery or not and what surgery is best for you. He will honestly tell you what your personal risk of surgery is and what to expect from your surgery. The long term pros and cons of your surgery will be explained to you as well. If you do decide on surgery, then Dr. S.Y. Ghodsian will make sure you are safe for the surgery and that the risks to your heart and lungs during surgery are minimized. You will also be given counseling on what things you need to do to to keep healthy and maintain weight off after your surgery. Psychological and motivational counseling will be given to you so you are mentally prepared for surgery. Nutritional counseling will be given to you so you know what to eat and what not to eat after surgery.
Q: Why do I need to see Dr. S.Y. Ghodsian after my weight loss surgery?
A: After bariatric surgery, your surgeon will have you come back for follow up visits. These visits are designed to make sure that you have not developed any surgical post operative complications. Some patients make the mistake of thinking that at the end of these visits they do not need to follow up with a bariatric medical specialist. Unfortunately, these patients are the ones who gain weight back and have long term health and nutritional problems related to their surgery. That is why it is extremely important that after surgery you make an appointment to see Dr. S.Y. Ghodsian. There are few physicians who have as much knowledge to prevent you from gaining weight back after surgery as Dr. S.Y. Ghodsian has. Nor are there many physicians like Dr. S.Y. Ghodsian who have the experience of preventing and treating health and nutritional problems for post bariatric surgery patients.
Q: Can I continue seeing my primary doctor if I see Dr. S.Y. Ghodsian?
A: Absolutely. Dr. S.Y. Ghodsian works with your primary physician to make sure you do well after surgery. However, Dr. S.Y. Ghodsian is a specialist in the field of bariatric medicine and most primary physicians are not. Therefore, because of his unique experience, Dr. S.Y. Ghodsian can prevent and treat problems related to your surgery that your primary physician most likely cannot.
Q: Can I lose weight without surgery if I am obese?
A: Absolutely. There is a growing trend in advertisement to make you believe that you cannot lose weight without surgery. This is nonsense. With the right plan of eating, inspiration, fitness and counseling you will lose as much weight as you want safely.
Q: What does the non surgical weight loss program of Dr. S.Y. Ghodsian consist of?
A: This is a physician supervised program that treats the whole body and mind. It is based on accepted medical knowledge and an understanding of human physiology to get you to lose as much weight as you want. The foundation of the program is to make sure you remain healthy before, during and after your weight loss and you do not gain the weight back. An M.D. is in charge.
Q: Will I be seeing Dr. S.Y. Ghodsian at every visit?
A: Yes, Dr. S.Y. Ghodsian is a double board certified bariatric specialist with skills not possessed by nurses, physician assistants, nutritionists and others posing as “weight loss specialists.” He has gained a reputation for successful treatment of obesity even when other programs have failed. The people that graduate from Dr. S.Y. Ghodsian’s program do not experience the “yo-yo effect” of weight loss followed by weight gain seen with self help diets or commercial weight loss programs.
Q: Do I have to buy expensive meals?
A: No. Most foods sold by commercial weight loss programs are overpriced meals you can easily prepare yourself. Dr. S.Y. Ghodsians program teaches you how to make these healthy meals. If you desire, there is also a chef who can prepare meals for you.
Q: Can Dr. S.Y. Ghodsian refer me to a bariatric surgeon?
A: Dr. S.Y. Ghodsian works independantly of any bariatric surgeon so he can give you the best advice of who is the most skilled and best known surgeon for a any particular bariatric procedure. He can give you recommendations for fantastic surgeons, but he wants you to make the ultimate decision based on your personal prefrences.
Q: How Does Bariatric Surgery Work?
A: In order to understand how bariatric surgery works, it is important to understand how the body’s gastrointestinal tract works (see diagram below). After you swallow food it enters the stomach, which acts as a holding tank for food. From the stomach, small amounts of food are released into the digestive tract. Bile from the liver and enzymes from the pancreas enter the duodenum (first part of the small bowel) and aid in the digestion and absorption of the food. Most absorption of food takes place in the duodenum.
There a several different types of bariatric operations, but most surgeries entail two main components:
- Reducing the volume of the stomach by removing or bypassing a portion of the stomach. This means that the stomach can only hold a limited amount of food before a person feels full.
- Directing bile and pancreatic enzymes away from the food, so that digestion and absorption of food is delayed – takes place further down in the jejunum (small bowel).
Q: What are the Different Kinds of Bariatric Procedures?
A: Since there are various types of bariatric procedures, a surgeon will determine which one is the most appropriate for each patient. Among the most common procedures performed are:
Roux-en-Y Gastric Bypass – this is the most frequently performed bariatric procedure, and is considered to be the gold standard in weight loss surgery. The Roux-en-Y surgery closes off most of the stomach, through stapling, to decrease the amount of food a patient can eat, and also rearranges the small intestine to reduce the amount of calories that a patient’s body can absorb.
Vertical Banded Gastroplasty – in this bariatric procedure, the surgeon creates a small pouch by stapling and dividing the upper portion of the stomach. This, in turn, reduces the size of the stomach and the amount of food that can be held in it.
Adjustable Gastric Banding – this is a laparoscopic procedure in which the surgeon places an adjustable elastic band around the upper section of the stomach to create a small pouch that restricts food passage.
Q: Are there drugs approved for long term treatment of obesity?
A: Yes, the FDA has approved medicines for long term treatment for obesity. However, a physician needs to be trained in the use of these medicines. If not used appropriately, these drugs can cause illness and discomfort.
