Can I be a patient at Southern New Hampshire Weight Management? 

All individuals who are struggling with weight related issues are welcome to come in for a visit to discuss weight management options.The diagnosis of overweight or obesity is based on a measurement called Body Mass Index (BMI).Generally, patients with a BMI over 27 who have weight associated medical conditions such as diabetes, hypertension, high cholesterol, or sleep apnea are considered candidates for medically supervised weight management.
 

What is Body Mass Index (BMI)?

BMI is a calculated number based on a patient’s height and weight that allows us to estimate their body fat content.It is not the most accurate measurement of overweight or obesity, but it is easy to calculate and is closely associated with body fat in most individuals. A normal BMI is somewhere between 18.5-25.Patients with a BMI of 25-30 are considered overweight, and patients with a BMI over 30 are considered to be in the obese range.
 

Why should I care about my BMI?

The weight management treatments that we offer are based on a patient’s BMI.For patients who have a BMI in the overweight category, we generally recommend nutritional counseling and exercise. Patients with a BMI over 27 with weight-related medical issues (comorbidities) are offered weight loss medications. Patients with even higher BMI may qualify for weight loss (bariatric) surgery.
 

What are weight-related comorbidities?

There are several diseases that are associated with being overweight or obese, and these medical conditions are known as weight-related comorbidities.There are numerous medical conditions that are associated with or perhaps even caused by obesity.Some of these diseases include high blood pressure, adult onset diabetes mellitus, high cholesterol, obstructive sleep apnea, polycystic ovarian syndrome, and heartburn.Many other medical problems are made worse when associated with obesity including cancer, fatty liver disease, osteoarthritis, and asthma.


What is metabolic syndrome?

Metabolic syndrome is a cluster of diseases that occur in conjunction with obesity.Specifically, patients with increased blood pressure, increased blood sugar, abnormal cholesterol and/or lipid levels, and excess abdominal fat have metabolic syndrome.This disease process is associated with increased risk of heart attack, stroke, and diabetes.Weight loss is the most effective treatment for metabolic syndrome and can result in resolution of some or all medical conditions associated with this syndrome.


Who is a good candidate for weight loss medication?

As with all treatments for overweight and obesity, BMI is used to make decisions regarding initiation of therapy with weight loss medications.  Patients with a BMI over 30 are considered candidates for medication therapy, as are patients with a BMI over 27 who have obesity related comorbidities.


When is surgery an option in the treatment of obesity?

Patients who have a BMI greater than 40 are considered candidates for weight loss (bariatric) surgery if they meet a list of criteria listed below.  Similarly, patients with a BMI over 35 who have obesity related comorbidities are considered surgical candidates.  The other criteria for surgery include the following: Prior unsuccessful attempts at weight loss, psychologically stable condition, able to understand risks and benefits of surgery, physically capable of tolerating surgery, no tobacco or nicotine use, and commitment to ongoing weight management.


What if my BMI is over 40 but I don’t want surgery?

Surgery is currently the most successful treatment for obesity, but not everyone wants or qualifies for surgery.  Studies have shown that weight loss of even 5% has many beneficial effects on a patient’s overall health.  If you are suffering from obesity but don’t want surgery, we still encourage you to participate in our medically supervised weight loss program.


I have been heavy my entire life and nothing has ever helped before.  Will this be any different?

Obesity is defined as a chronic, progressive disease.  Currently there is no cure for obesity.  In the past few years, obesity has been recognized as a disease and has been studied intensively.  There are currently several FDA-approved medications as well as improved understanding of the role of behavioral health, nutrition counseling, and physical activity in the management of obesity.  The advice to “eat less and exercise more” was not helpful in the past and is still inadequate in the treatment of obesity.  With the current medical and surgical options available, obesity treatment is more successful than ever.


My doctor told me I was too heavy or too ill to have bariatric surgery, do I have any options?

Yes, you do!  There are many patients with obesity who are not ready for surgery for one reason or another.  Patients in this situation are encouraged to come in for an evaluation.  Often, we can develop a program in conjunction with our other medical specialists, nutritionists, and physical therapists to help get the ball rolling in the right direction.  With proper care and guidance, we can help people lose weight and improve their health enough that surgery becomes an option.


What is the age range for bariatric surgery?

Currently we offer bariatric surgery to patients age 18-70.  Younger patients can participate in the medical weight loss program until they reach age 18 or can be referred to tertiary care pediatric centers if surgery is urgent.  Patients over age 70 are evaluated on a case by case basis, and sometimes will qualify for surgery.  As always, any patient who cannot have surgery is still a candidate for a medically supervised weight loss program.


I have a LapBand and need follow up care, can you provide that?

Yes. While we no longer place Laparoscopic Adjustable Bands for new patients, we are still able to provide care for patients who had the bands placed previously.  We offer band adjustments, band removals, and conversion procedures where the band is removed, and a gastric bypass performed.


I’ve had bariatric surgery in the past, and now I am gaining weight again.  Can you help?

Yes, we can help.  Approximately 40% of patients who had a prior bariatric surgery will experience either inadequate weight loss or weight regain.  We have a standard treatment algorithm for patients in this situation.  Our top priority is to make sure that nothing has changed with your anatomy since the original surgery.  If there is a problem with your anatomy, then revision surgery is an option.  In most cases, the weight regain is not due to a problem with the initial surgery, but rather progression in the disease of obesity.  In those cases, we can offer counseling, support, and weight loss medication to help get you “back on track.”  


Where is the surgery performed?

All surgery for patients in our program is performed at Southern New Hampshire Medical Center.


How long will it take for me to go from my first visit to surgery?

The length of the program depends upon several factors.  Most patients can complete the program requirements in 6 months or less.  Some patients, particularly those with multiple medical problems, will take longer to complete the process.  Some insurance companies also have strict guidelines on the length of the program.  We will take all factors into account and then work to get you through the process as quickly as we can.


How long does the surgery take, and how long will I be in the hospital?

The surgery for a sleeve gastrectomy takes about an hour and most patients are home by the end of the following day.  The surgery for a gastric bypass takes closer to two hours, and most patients can go home about mid-day on the second day after surgery.