For those struggling with obesity, UPMC’s Central Pennsylvania Weight Management Center offers both non-surgical and minimally invasive surgical options.
Here, Dr. Justin Rosenberger, DO, a bariatric and general surgeon with UPMC Central Pennsylvania Surgical Associates, and Samantha Hionis, a certified family nurse practitioner and Obesity Medicine Association-certified clinician, answer pressing questions about what to expect from UPMC on your weight loss journey.
What are the benefits of weight reduction and losing weight?
Hionis: Benefits include improving your quality of life and reducing your risk for type 2 diabetes, cardiovascular disease, and sleep apnea.
What resources do you offer at UPMC Central Pa. Weight Management Services?
Hionis: We offer our patients a wide range of tools, information, and support to achieve and maintain a healthy weight. You do not have to face those challenges alone. Our medical team offers comprehensive medical management. You work with a provider, nutrition services, exercise, and behavioral support, and we have medication options that can help.
What are the non-surgical options available at UPMC?
Hionis: We have support groups, weight loss medication, and diet counseling. We’re here to support you on your weight loss journey. We can also control or reverse any weight-related diseases you may have, such as type 2 diabetes, high blood pressure, sleep apnea, or other breathing issues.
What if I’ve tried everything to lose weight and nothing has worked?
Hionis: Each plan is personalized per patient. What I tell my patients is medical weight loss is not an exact science. A lot of it is trial and error, especially trying to find the right diet plan. Finances are a little bit difficult for people at the moment, so it’s trying to figure out how to have food security while promoting weight loss. Weight loss drug options can also help with that. So far, more than 80% of our patients have lost weight, and some have lost as much as 100 pounds.
How long is each program typically?
Hionis: Usually we go by how effective it is and measuring that about every 12 weeks. It’s sometimes insurance-driven depending on how long they’ll cover it, but we’ve seen some patients for years. Some reach their goal weight and leave the program, others stay with us just to remain accountable and maintain their weight loss.
How do you help patients achieve their weight loss needs?
Hionis: We do that through office visits with our nurse practitioners, physician assistants, and doctors, as well as diet nutrition plans and sometimes working with a registered dietitian, exercise guidelines, lifestyle changes, mental health support, and weight loss drug options.
Let’s turn to surgical options. What are the benefits of weight loss surgery?
Dr. Rosenberger: Weight loss is one thing, but you may be able to get rid of obesity-related diseases such as hypertension, diabetes, sleep apnea, and a myriad of other comorbidities. The two big ones are diabetes and high blood pressure. When patients get surgery, they sometimes need to stay overnight in the hospital. By the next day, they may be getting their medications decreased before they even go home. That’s just a great thing to encourage them.
What type of patients do you see?
Dr. Rosenberger: Most of the patients that come to our office have had multiple diet attempts medical-wise and failed. Some don’t go through the medical weight loss program, they just tried on their own and that’s fine, but once they come to us we talk about surgery a lot of the time. Surgery is not the end-all be-all, and that’s why we work closely with our medical management arm of the program. But surgery is a great option for patients who have more than 100 pounds to lose. It can be hard to do that medically on your own.
What weight loss surgery does UPMC offer?
Dr. Rosenberger: The first surgery we do, and probably the most popular, is the sleeve gastrectomy. We take part of the stomach out of the body, about 70% to 80%, so you’re left with a small tube of stomach. That gives you a lot of restriction when you eat so you feel full with less food. That helps you lose a good bit of weight.
The other surgery we do is the gastric bypass. We create a small pouch at the top part of the stomach about the size of a golf ball and reroute the small intestine to bring some of that up to the pouch. That gives you malabsorption in addition to restriction to lose weight.
Any second surgery after your original procedure is called revisional bariatric surgery. This may be due to problems like increasing reflux, ulcer disease, or problems like that, but some are due to failed weight loss. Sometimes, people lose a little bit of weight and gain it back, and they need a little more encouragement to get the weight off with another surgery.
Do you help guide patients in choosing which surgery is best for them?
Dr. Rosenberger: Yes, there are things with each surgery that can cause problems afterward. If you have significant reflux disease, for example, you’d be a bad candidate for the bypass. Sometimes, patients with severe type 2 diabetes will do better with the bypass, but others, like younger patients, may do better with the sleeve.
We have providers, nurse practitioners, physician assistants, and a bunch of other medical personnel to help guide patients through the surgery they want. Once they meet the surgeon, we will go over all the options again and try to guide the experience that will benefit their weight loss the best.
What does follow-up look like after surgery?
Dr. Rosenberger: These patients are lifetime followers with us starting six months before surgery, then every three to six months after surgery, and yearly after that. It’s a great friendship we build with patients for life.
For more information about UPMC’s Central Pennsylvania weight management services, visit UPMC.com/CentralPaWeightLoss or call 717-231-8221.