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The Struggle Is Real

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LEXINGTON Genetics and lifestyle contribute to gradual weight gain leading to obesity, with the one commonality that it doesn’t happen overnight. But with weight loss surgery, an individual obtains the power to control their weight again.

“The biggest thing we teach our patients is that weight loss surgery does not eliminate the struggle with weight, but it does give an individual tremendous help with their battle,” says Amanda Nighbert, RD, LD, bariatric dietitian at the KentuckyOne Health Weight Loss Surgery at Saint Joseph East.

Two full-time bariatric surgeons at the Center perform gastric bypass and gastric sleeve procedures, and they are cautiously evaluating whether to add gastric balloon to their scope of surgical services, waiting for more outcome data of its long-term success.

“It is imperative to determine not only if a patient is a good candidate medically and psychologically for surgery but also to determine which procedure best meets and addresses the patient’s medical and behavioral needs. Patients should not choose a procedure based on anything other than their own medical and surgical history and their eating habits,” states Program Director Karen Hillenmeyer, BS, PA-C.

Medical Director Joshua P. Steiner, MD, FACS, received his surgical training at the University of Kentucky (UK) and completed his laparoscopic fellowship at Cedars Sinai Medical Center in Los Angeles. Steiner joined the Center for Weight Loss Surgery at Saint Joseph East in July of 2002. His partner, Thomas H. Greenlee, MD, FACS, also a UK trained surgeon began his general surgery career in 1984 and bariatric surgery in 2003. Both surgeons, Steiner and Greenlee, also perform a variety of advanced laparoscopic surgery, including anti-reflux procedures, gallbladder surgery, hernia surgery, and colon surgery.

Over 5,000 laparoscopic bariatric procedures have been completed at the KentuckyOne Health Center for Weight Loss Surgery since Hillenmeyer developed the program over 14 years ago.

Medical Director Steiner states that the operation is just one piece in the success of the weight loss program. “The initial evaluation and education, follow-up, and the Center’s team are more important than the operation itself,” he says. “Without the support staff – the exercise physiologist, the dietitian, the counseling – you will not have long-term successful patients.”

“These patients work very hard,” he continues. “We work for about an hour during the surgical procedure, and the patient works for a lifetime to achieve goals and maintain their weight loss”

Greenlee adds, “The longevity of our program is a testament to the success of our patients. We have people who have lost extreme amounts of weight and eliminated diabetes, sleep apnea, and hypertension, among other medical conditions, and kept that weight off for over 10 years. Not many programs can say that.”

A Comprehensive Team Effort

A patient’s weight loss work is done with considerable help from the team at the Center, led by Hillenmeyer. It actually starts prior to surgery, when Hillenmeyer, Nighbert and Exercise Physiologist Billi Benson, BA, Med, meet with the patient during the initial visit. A patient’s current diet and activity level, as well as medical, surgical, and physical issues or limitations are presented, and what type of support system the patient has.

“I believe that the dietary and exercise intervention and education are as important as the operation itself,” Nighbert says. “Without the education on how to use the tool, the tool doesn’t work. It is imperative to have a comprehensive multidisciplinary team such as ours to support the patient.”

Nighbert, who has been with the Center since its formation, has been instrumental in contributing to the success of many patients. One of the more unique aspects of the program is the presence of a full-time exercise physiologist.

“People in the medical field are impressed that the hospital has hired an exercise physiologist to work with our patients,” says Benson, who joined the practice in 2003 with the purpose of educating and encouraging patients. “After surgery, we develop an exercise routine that can be done at home or at a local gym that works all of the major muscles. This promotes more fat loss and builds more muscle.”

Currently about 60 percent of the patients are women, says Benson, but the number of male patients has increased in the past few years. Candidates for bariatric surgery must have a minimum of 35 BMI with at least one significant co-morbidity such as diabetes, high blood pressure, or sleep apnea or a BMI of 40, perhaps without one of these life threatening comorbidities.

Hillenmeyer says that “proven success requires the patient staying informed, connected, and motivated. Our program does this by being readily available to our patients. Follow-up visits are coordinated with visits to the dietician or exercise physiologist. Both written and verbal instructions are given at each visit. Our patients always know what they should be doing from the time they walk through our door until they return at their next visit.”

“We also offer a Back on Track program for patients that are having difficulty with weight control in a group setting so patients see they are not alone,” Nighbert says. “It’s fun to come back when you’re succeeding and we’re all celebrating, but often patients are hesitant to return when they’re struggling. That’s the most important time to come back because we understand and want to help our patients be successful. We understand that hectic schedules that limit exercise time and encourage fast food options are significant hurdles to sticking with a healthy lifestyle.”

“Old habits that don’t die will cause a patient to not lose as much or even put some weight back on,” Benson says. “But a successful patient who sticks to the program, everything changes. What they can physically do, how they plan meals, how they cook, how they move, as well as their mental state. It’s not uncommon to see a total transformation to a much healthier and happier patient.”

The struggle with weight is real and involves a team effort.

Weight Loss Surgery At Saint Joseph East160 N. Eagle Creek Drive Lexington, KY 40509 859.967.5520