LISTEN: NewFit Doctors Nathan Allison and Ken Tieu Talk Surgical Weight-Loss On ‘Putting Your Health First’ Podcast
By Space Coast Daily // September 13, 2022
Podcast explores Health First’s robotics-assisted, minimally invasive bariatric procedures
BREVARD COUNTY, FLORIDA – Carrying extra weight may limit a person’s wardrobe choices and physical activities, but it does worse than that. It almost always means chronic conditions such as hypertension, diabetes, sleep apnea and more. The good news is that losing that weight improves or reverses these conditions.
Health First’s NewFit Surgeons Nathan Allison, MD, and Ken Tieu, MD, hopped on the “Putting Your Health First” podcast recently to discuss what patients must understand about their surgical weight-loss journey.
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The conditions that make for a likely candidacy for weight-loss surgery begin with a consideration of a person’s body-mass index (BMI) score – a score of 30 or 35 is table stakes. It will not surprise people to learn that insurance coverage of weight-loss surgery is a slightly higher threshold than strictly being a good candidate, Dr. Allison points out.
“The first appointment, we have an evaluation, and we calculate what the patient’s BMI is. We talk to them about their comorbid conditions, and then, what their goals are in terms of what they want to achieve. What weight would they like to get to? What comorbid conditions, if any, would they like to see either diminished or completely cured from surgery?”
At NewFit, Drs. Allison and Tieu’s bariatric surgeries are minimally invasive and robotically assisted. That is, small incisions are made in the patient’s abdomen, and long instruments are used to perform one of three procedures.
“In this procedure, what we’re doing is we’re putting a silicone band with a balloon around the top portion of your stomach,” says Dr. Tieu. “What that balloon does, it restricts and squeezes on the top portion, making your brain think your stomach is a lot smaller than it is. When you eat, say a four- or five-ounce portion, you feel full, and you feel full until you get to your next meal. Really, it’s tricking your brain and making your stomach restrictive and able to eat a small portion.
“People mistakenly think this procedure is named for us putting a sleeve or some sort of object around the stomach. That’s completely false. What the sleeve gastrectomy describes is actually the sleeve of the stomach is what remains. We go in and we remove approximately 70 to 80% of the stomach. A sleeve of stomach remains, and you’re able to eat the same thing as your well-adjusted lap band – four or five ounces – and you get full and satisfied from those portions,” says Dr. Tieu.
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“Gastric bypass is pretty much the gold standard in weight-loss surgery,” Dr. Tieu says, “and we’re able to do that procedure laparoscopically now and a lot quicker. Patients are in the hospital for, most of the time, two nights, then they’re out of the hospital.
“In that procedure, we go in and create a small stomach out of the top portion of your normal stomach. The remainder – I would say 90% of the stomach – is bypassed.”
Dr. Tieu says the lap band broadly cuts the excess pounds a person carries in half. The sleeve gastrectomy, meanwhile, will likely result in excess weight loss of about 70% or 75%. Meanwhile, a gastric bypass generally produces about 80% to 85% of lost excess weight.
No New Problems
The best procedure isn’t a question strictly of weight loss, Dr. Allison says. At NewFit, the preliminary evaluation considers what else is going on in the body that might optimize one or another surgery.
“One of the things that we do that sets us apart from other programs, we do quite a lot of gut and reflux workup,” he says. “We use that knowledge to be able to make sure that the surgeries that we’re gonna be doing do not cause you to have a new problem.
“If you have a ton of reflux before surgery, we’re not going to recommend something like a band or a sleeve, because it’s going to make your reflux worse. We do an endoscopy that we will perform to make sure that you don’t have any preexisting conditions that you may or may not even be aware of. Some of our patients have silent reflux that they don’t even know is happening.”
“Everyone has a different reason for being overweight,” Dr. Tieu said. “Everyone has a different reason for wanting to lose weight. So, No. 1, we must pick the right surgery for the patient, and that’s why we do all those extensive workups that Dr. Allison is talking about.”
The Real Work Begins
At the end of the day, the surgery is a tool – “a very powerful one,” Dr. Tieu says – and at NewFit, patients are given all the support to make their weight-loss journey a happy and successful one.
“After the surgery, that’s when the real work begins because you’re going to now use all of the educational pieces we’ve given you in your day-to-day life,” Dr. Allison says.
That includes nutrition, exercise physiology, even psychology.
“All those things – that’s what’s going to make the patient the most successful,” Dr. Tieu says.
CLICK HERE TO LISTEN.
For more news coverage of Health First, visit HF.org/news.