Our Bariatric & General Surgery Blog
Also Requests Expanded Coverage of Behavioral Therapy
Washington, D.C. — July 9, 2020 U.S. Senators Bill Cassidy (R-La.) and Thomas Carper (D-Del.) are calling on the Centers for Medicare & Medicaid Services (CMS) to lift regulations that deny insurance coverage for obesity drugs and that limit coverage of Intensive Behavioral Therapy (IBT) amid the COVID-19 pandemic.
In a letter sent to CMS Administrator Seema Verma in early July, the senators request the agency use its administrative authority to update a nearly two-decade-old statute in the Medicare Part D prescription drug program that specifically excludes obesity drugs from Medicare coverage.
Two of the most common comorbidities, or obesity related diseases, that we come across in our patients are type 2 diabetes and high blood pressure. Most of our patients will have been managing these conditions using drug therapy for years before considering surgery as a more permanent, curative solution. When we discuss the benefits of bariatric surgery, we often point out the fact that money can be saved in the form of reduced or eliminated drug therapy. And while every patient will experience different improvement and resolution rates, we have some recent research, presented at the ASMBS National Clinical Symposium on Obesity Prevention Treatment and Research in June 2019, that helps quantify the benefit.
NYU Winthrop Surgical Associates is proud to welcome Dr. Venkata Kella as our newest bariatric surgeon. Dr. Kella is board certified in general surgery, specializes in bariatric surgery, and brings with him an impressive list of credentials and experience that will undoubtedly build upon our dedication to the most effective bariatric procedures and the very best patient care.
Michele Lubin, MS, RD, CDN
The holiday season is quickly approaching. It starts with those Halloween “fun size” candy bar temptations, continues with the Thanksgiving Feast, carries on with the office and house parties through December, entices us with the cakes and cookies brought into the office, and ends with a New Year’s Eve celebration. What a season — you spend a seemingly enjoyable time stressed out instead of having some fun. You stress about so many things: What am I going to eat? What will I tolerate well? Will they serve healthy options? Will I gain weight? Will I have time to exercise? How will I ever reach my goals with all of this tempting food surrounding me at all times?
When deciding if bariatric surgery is the right choice for you, it is natural to wonder what life after surgery will look like. A big part of that is what your diet will look like. For healthy, sustained weight loss, many patients will be making major diet modifications as well as changes to their lifestyle. But many people are surprised by just how normal a bariatric patient’s diet can be once the initial phases are over and you adjust to a full diet.
When our patients start their weight loss surgery journey, we try to stress the importance and permanence of the commitment they are making. Not only does bariatric surgery permanently change your body, it is ultimately changing the way your gastrointestinal system works. Whether you choose a gastric sleeve or gastric bypass, you will be eating differently than before and your body will now react to food differently. Because of this, we want to be very aware of how your body is maintaining levels of certain vitamins and minerals that we know can be affected by weight loss surgery. If you don’t take your vitamins, they can’t help you. So, what happens if you don’t take the recommended vitamins and minerals?
Swimming is without a doubt one of the best and most effective exercises that a postoperative bariatric patient can start. Just a few of the many benefits of the swimming include:
Vitamin D is an essential part of a balanced and healthy lifestyle. Without vitamin D, our bodies would not be able to properly absorb and process calcium to strengthen our bones. A deficiency in vitamin D, similar to a deficiency in calcium, can lead to osteoporosis. Vitamin D has many other uses and studies have shown that it can improve our mental well-being by helping depression and even enhancing low calorie diets to lose weight.
By Collin E.M. Brathwaite, MD, FACS, FASMBS
These are wise words that we often hear in our lives, and we should take heed. The journey for weight loss is not what we “get to”. It is about taking a lifetime to travel through and maintain a healthy weight.
Bariatric Surgeons often talk to their patients about measurable and attainable number goals. We measure abdominal girths, calculate BMI’s and discuss excess weight percentages. I find this to be a bit misleading for the patient. I think it is better to look at the weight loss after bariatric surgery, regardless of which procedure, as a continuum of care, rather than a finite number patients need to attain.
By Barbara Brathwaite, RN, MSN
The most important thing to remember in trying to maintain healthy habits is that you must allow your health and well being to come before anything else. All the other things will follow.
- Assess your readiness— Motivation must come from within with a heartfelt desire to change.
- Plan realistic SMALL changes— Major changes can seem overwhelming. Instead, start small.
- Believe in yourself —confidence in your ability to change is essential.
- Track behavior— monitor your behaviors – studies show people who use a food diary are more effective in making changes.
- Sleep— adequate sleep is so important in trying to make changes. Lack of sleep can lead to poor decisions and irritability, which can affect your attempts to change. Remember: anxiety and irritability can contribute to emotional eating.
- Manage stress— stressful situations can detour the best of healthy intentions. To be successful we need to find ways to cope, we need to set aside time to relax, and we need to let go or delegate some responsibilities.
- Surround yourself with support— family and friends and support group participants encourage and reinforce positive changes.
- Bounce back— Old habits can be ingrained and occasional lapses will occur. We are not perfect. It’s important to get back on track with another small step forward and carry on.