With another year coming to a close and 2015 mere days away, many people will start of the new year with a resolution to lose weight, and there are many options from which to choose, including surgery.
While many people who have done every diet known to man on their weight loss journey, and are considering surgery as a solution to their problem after seeing the many successful stories, surgeon Dr. Charles Diggiss, founder of the multi-disciplinary weight management program RiteWeigh cautions that weight loss success with surgery still requires the patient to do work when it comes to exercise and diet.
"Success with surgery is not 100 percent no matter which procedure you choose. It requires you to still do some of the work with sticking to exercise and diet. It's not going to stand alone as a magic or silver bullet. It is only one tool in the fight against morbid obesity," said Dr. Diggiss.
"Even when you look at the best procedure, up to 30 percent of patients may not maintain lost weight. Some in this 30 percent may even put the weight back on -- so we have to start out on that sobering note, that three out of 10 patients may fail to lose the weight or even put weight back on after obesity surgery," stressed the doctor. He emphasized the seriousness in the decision for surgery. He said the first thing a person needs to do is to find out whether they would make a candidate for weight loss surgery.
"You need to know if you need to lose up to or more than 100 pounds. If so, then you are morbidly obese and you may be at risk for other diseases such as diabetes, sleep apnea, a number of heart conditions and sudden death syndrome. Also you need to know that obesity takes at least 10 years off your life, so the first thing you need to know is that your health and life is at risk," said Dr. Diggiss.
"Unfortunately in our culture we try to get people to feel really good about being fat -- for example with big and beautiful beauty pageants and avoid the reality that excess body fat is simply not healthy," he said.
Dr. Diggiss said obesity brings an added complication to an already challenged life, and that it is a condition in which a person has excess stored body fat, for example in the abdomen and under the skin.
The surgeon said that at least 60 percent of the adult population in The Bahamas is overweight.

Success for one young woman
LapBand patient and advocate Sophia Moss has lost 145 pounds since making the decision to have the surgery in January 2012 at which time she was 335 pounds. Moss said that health issues were the key factors in her decision to do the surgery.
"I had health issues. I had pressure [hypertension] and arthritis in my knees and spine. I couldn't for the life of me figure out how I was going to get rid of this because I did everything. I did the weight loss by pills, I did diets... The only thing I did not do was the needles because I could not stand the idea of pain," said Moss. She currently weighs 190 pounds.
In the minimally invasive procedure that Dr. Diggiss described as painless, little holes are created in the tummy wall using telescopes and modern equipment. He said patients are not cut open. The surgery can be as short as one hour or can take three to four hours.
There are three restrictive procedures offered by RiteWeigh at The Surgical Suite -- the LapBand which Dr. Diggiss first began performing in 2008; The Gastric Plication and the Gastric Sleeve (in which they take away about 70 percent of the stomach. Gastric bypass surgery is not offered.
The basis of the LapBand and other restrictive procedures is to take away hunger and appetite control that he said is do-able but requires commitment.
"The stomach has a great capacity, like a collapsed volleyball. What we want to do is take that size/shape to a banana. The other thing is that as well as influencing how quickly you feel full. We also want to make you less hungry less often. It's not just about being hungry, but also about feeling full so the patient has to learn how to eat with the band in order to succeed," said the surgeon.
Moss' journey to losing 145 pounds began with a friend who also had the weight loss surgery. She said they decided to do it together with a three-month introductory program before they committed to having surgery.

Screening
The RiteWeigh team screens all patients to ensure that they meet the criteria for surgery, including delving into the patient's mind-set at the time. Dr. Diggiss said preparation is important because RiteWeigh deals with successful and sustained weight loss and are not just trying to get people into surgery.
"We understand that everyone is not going to be successful so we exclude those who don't have the mindset," said Dr. Diggiss. "We understand that everyone may not have the commitment and mindset to succeed. It has to be a maximum likelihood of being successful. Three months for some, one month for others, would be the kind of thing we have to put you through -- the counseling, the medical evaluation and the nutrition/exercise. If you need to lose 70 to 200 pounds, then surely you can commit to lose 10 percent in preparation for surgery?"
Moss recalled an incident at a buffet shortly after her surgery, and of piling her plate with all of her favorite items, and of feeling full after she took one bite of chicken and a few spoons of the broth. She could not eat another bite.
"My greed was still with me. I still wanted to eat, but I couldn't because now I had a control mechanism inside of me." She recalled crying that she couldn't eat more.
"The intent of the surgery is to make you feel full. What's driving you is that you have the capacity. So, if we reduce that capacity, and use a scientific approach that you can only eat so much, and get you to eat more often, but your caloric intake is less and then you put activity on top of that and get you to exercise three times a week, then you are in a negative balance and gradually you are going to lose two to three pounds a week," said Dr. Diggiss.
The surgeon said that it takes a patient about one to two years to achieve their weight loss goals at an average weight loss of 50 to 80 pounds in the first year. But he said the reality of it is that it is a life journey as obesity will be a challenge for the person for the rest of their life. And than when they slip and make poor choices they have to realize that they have to make modifications.
With the weight loss comes the loose skin. According to Dr. Diggiss, their goal is to ensure they get their patients healthy first. When body image becomes a challenge, they then get them in to a plastic surgeon to get work done.
Dr. Diggiss said that people who are obese need to first acknowledge that they are obese, and that it is stopping them from reaching their true potential, and that the RiteWeigh Support Group at The Surgical Suite at the Centreville Medical Centre is a great first step for interested people because it is free and they can speak with people who have had the procedure and hear first-hand what they are going through.

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