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BARIATRIC SURGERY JUST THE BEGINNING TO SUCCESSFUL WEIGHT LOSS

The following article has been reproduced with the kind permission  of St Andrew's War Memorial Hospital, publishers of Best Practice Magazine.

Currently bariatric surgery is the most effective treatment for obesity  and associated co-morbidities such as diabetes. However, to sustain long-term weight loss success and for resolution of co-morbidities, St Andrew’s War Memorial Hospital’s upper GI and laparoscopic surgeon, Dr Phil Lockie warns that surgery needs to be combined with behavioural and dietary change.

Latest results from Dr Lockie’s practice, demonstrate weight loss outcomes better than the national average, and he credits these results to his team approach before and particularly following a patient’s surgery.

“We know, through experience, that bariatric surgery is not an easy option, and it is important that patients participate in the pre and post-operative psychological and dietetic support that we offer to sustain their weight loss,” said Dr Lockie.

Dr Lockie’s patients at 12 months post-surgery had an average BMI of 30 (compared to a national average of 32.5); an excess weight loss of 80.2% (compared to a national average of 64.8%); and a total weight loss of 31.3% (compared to a national average of 25.5%).

Dr Lockie’s pre and post-operative care program for patients includes the following key elements:

Bariatric co-ordinator: a complimentary consultationfor patients to discuss their surgical options and learn how the practice works. This helps guide the patient through the process and acts as a point of contact for questions.

Dietician: regular sessions in person and over the phone with a dietician to discuss diet changes immediately post-surgery, and then at specific intervention points like hair loss at three months and managing appetite beyond twelve months. Vitamins and micro-nutrients are checked
on a regular basis by Dr Lockie and the dietician.

Psychologist: patients are provided with pre- and post-op sessions to help put in place the fundamental lifestyle changes required to help consolidate behavioural change. Behavioural change is essential for long-term weight management. The team’s psychologist specialises  in bariatric patients and has completed a PhD in weight  loss patients.

Weight loss support group: a monthly support group provides the opportunity for patients to discuss their concerns in a group setting under the supervision of a psychologist. Guest speakers present on a regular basis on a range of topics including post-weight loss plastic surgery.

Specialist consultations: as part of weight loss surgery is managing and improving weight related co-morbidities such as diabetes, we collaborate with a number of specialists at St Andrew’s, both pre-operative, in-hospital and post-operatively, to ensure patients are as well as possible prior to surgery, have the best possible management of their co-morbidities in hospital and as they lose weight post-operatively.

Exercise: patients are encouraged to attend the support group with an exercise physiologist and have the opportunity to book individual one-on-one sessions with the exercise physiologist. Formal and incidental exercise is important for long-term weight management.   

Dr Lockie said bariatric surgery should be regarded as a tool to aid weight loss and the importance of behavioural factors (eating behaviour, diet and exercise) cannot be overemphasised.

“Modification of poor behaviour or food choices, through dietary and psychological assistance is important for long-term success. Our team members, have been working together for ten years, and are here to provide as much support as needed,” he said.

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