Dr. Stephen Haggerty (NorthShore) - 1:00 PM:
Good afternoon, I am a minimally invasive and bariatric surgeon at NorthShore. We have a comprehensive weight loss program, and I am happy to answer your questions.
Kathryn (Moderator) - 1:00 PM:
Our chat on healthy options for weight loss is now open! You can submit questions at any time during the chat.
Pauleen (Evanston , IL.) - 1:02 PM:
At what point do you decide to look into weight loss surgery? Is there a best option for weight loss between diet and exercise or surgery?
Dr. Stephen Haggerty (NorthShore)
Patients need to "qualify" for the surgery based on BMI (body mass index) and co-morbid medical conditions. BMI > 40 (at least 100lbs overweight) or BMI > 35 with 1 -2 conditions such as high blood pressure, diabetes, sleep apnea, arthritis can proceed.
Irma (Skokie, IL) - 1:05 PM:
Are bariatric procedures for weight loss invasive?
Dr. Stephen Haggerty (NorthShore)
The gold standard procedures we do for weight loss are gastric bypass or sleeve gastrectomy. Both are laparoscopic (small incisions) but still are fairly major operations. Some of our group also offer endoscopic options (through the mouth), but there is shorter term data on the weight loss.
Lisa (Evanston, IL) - 1:10 PM:
I am wondering about bariatric surgery for people with lupus. Is this type of surgery still an option? What sorts of special considerations would one need to take into account?
Dr. Stephen Haggerty (NorthShore)
There is some data regaring this. Bariatric surgery and the associated weight loss could help decrease the requirements for immunosuppresive medications. However; there may be higher risks of complications, infections and poor healing in patients with Lupus. So surgery is an option; we would like patients to be on the smallest doses of steroids possible.
Adriana (Evanston, IL) - 1:15 PM:
After bariatric surgery, how can patients keep losing weight/ maintaining the weight loss? What if we hit a plateau during our weight loss journey?
Dr. Stephen Haggerty (NorthShore)
Most patients lose significant weight over the first 12 months, and then it levels off and gets harder to lose. We recommend strict attention to diet (high protein, low carb) and add exercise as much as possible. We see our patients every year, or even every 6 months if they need help. We also have them routinely see a dietitian to stay on track. We offer monthly support groups at our Skokie and Vernon Hills offices, which also helps keep patients motivated
Marie (Lincolnwood) - 1:21 PM:
What can the Waist-to-Rip ratio tell us about what weight is "healthy" versus "unhealthy"? Should we look at that as an accurate determinant of health, and if not, what should we look at instead?
Dr. Stephen Haggerty (NorthShore)
We do not look at that ratio much in our practice. In general, more weight in the waist means more internal or "visceral" fat deposition, which increases risk of diabetes and heart disease more than subcutaneous fat, which would be in the hips. We use Body Mass Index as an indicator of obesity or morbid obesity, and if one is overweight, losing weight and decreasing the BMI should decrease health risks.
Mushtaq (Chicago, IL) - 1:24 PM:
I am 71 with type 2 diabetes. What options could help me reduce weight, specifically by cutting stomach fat?
Dr. Stephen Haggerty (NorthShore)
The first place to start is to strictly follow a diabetic diet and also add any exercise, including walking.
Weight loss and fat loss happens all over the body by decreasing caloric intake and burning off more calories. One cannot target the stomach and only lose fat there.
If you meet the criteria for weight loss surgery, gastric bypass will significantly improve or completely resolve type II diabetes over 90% of the time.
Danielle (Evanston, IL) - 1:30 PM:
Could you discuss some of the risks of bariatric surgery, and the success rates?
Dr. Stephen Haggerty (NorthShore)
Overall, bariatric surgery is very safe. The risk and success depends on the type of operation.
Gastric bypass: 2% risk of a major complication, highest average weight loss - 70% excess body wt.
Sleeve gastrectomy: 1-2% risk of complication, 60% average wt loss
Lap band: < 1% major complication rate, but up to 20% risk of needing late revision. Ave wt loss about 45% excess body weight
This means if you are 100 pounds overweight, you would lose about 45 lbs with lap band surgery.
Toni (Evanston, IL) - 1:36 PM:
What is the best way to tackle the challenge of age as part of healthy weight loss? It was 10x easier to lose weight in my 30s! Should I take an all over approach or just focus on my tummy and thighs where I want to tone/lose?
Dr. Stephen Haggerty (NorthShore)
I would take an overall approach. Focus on aerobic exercise and calorie reduction for weight loss/fat reduction. Use strength training (with some emphasis on the tummy and thighs) to keep muscle mass up and a high protein diet to prevent muscle breakdown.
Bertha (Chicago, IL) - 1:43 PM:
If you are too heavy to do exercise or you have shortness of breath easily, what types of things can you do to lose weight? I have cut back on my eating, but I’m still not losing weight.
Dr. Stephen Haggerty (NorthShore)
We know that becomes a difficult problem. Even walking for exercise can improve weight loss. A formal diet plan along with a behavior modification plan will help. At NorthShore, we work with several psychology groups who do this. Weight loss surgery is also a good option when you need to lose more than 100 pounds.
Jason (Vernon Hills, IL) - 1:46 PM:
What medications are available for weight loss prior to surgery and what are your thoughts on their usage?
Dr. Stephen Haggerty (NorthShore)
Our group does not prescribe medications for weight loss either before or after surgery. We work with some medical doctors who specialize in weight loss and may use them. I do not have enough experience to know what the success is of current weight loss meds. In the past, they had high rates of side effects and low success rates.
Danielle (Evanston) - 1:48 PM:
How long is the recovery period after bariatric surgery? What are some of the potential complications?
Dr. Stephen Haggerty (NorthShore)
For gastric bypass or sleeve gastrectomy, patients spend one or two nights in the hospital, and are off work for about 2 weeks on average. We encourage our patients to walk a lot as soon as they can after surgery and go out of the house.
Surgery can have complications including bleeding, infection, leakage from the staple line, obstruction, wound infection, and blood clots in legs. There is a total of 2% or less chance of complication.
Catherine (Evanston, IL) - 1:54 PM:
Do you offer lap band surgery and gastric "balloon" surgery at NorthShore?
Dr. Stephen Haggerty (NorthShore)
Yes to both. We all do lap band surgery and adjustments in the office, and so does Liz, our nurse practitioner and coordinator.
Two of our surgeons are placing the gastric balloon endoscopically. More information is available on the NorthShore website.
Antonia (Evanston, IL) - 1:57 PM:
What are your thoughts on detoxing by juicing and smoothies as part of weight loss. I want to jump start my weight loss; is this a good idea?
Dr. Stephen Haggerty (NorthShore)
I don't have much experience with this. We do have patients go on liquid only diets 2-4 weeks before surgery, and there is fairly significant short term weight loss. You need to make sure you get enough protein during this time and also drink straight water to not get dehydrated.
Kathryn (Moderator) - 2:01 PM:
This will be the end of our chat. Thank you for your questions! For more information on weight loss procedures or to schedule an appointment with a specialist like Dr. Haggerty, you can contact our
Bariatric Surgery department.
Dr. Stephen Haggerty (NorthShore) - 2:02 PM:
Thank you all for your excellent questions, I hope the information was helpful in your quest for healther living in 2016!