From bariatric surgery to instructor of “Insanity” workout

IMG_0607When Marni Gould topped out at 248 pounds, it became evident she needed to make a change.

Dance and exercise had been her passion since high school – and although she had remained active even through her weight struggles, she was finding more and more she couldn’t do it anymore.

At 35, the middle school math teacher was grappling with sky-high blood pressure and a resting heart rate of more than 100 beats per minute. Her knees hurt from carrying too much weight for her frame, and her ankle rolled far too often. She had tried a number of diets and none of them seemed to work.

“I knew I needed help with food. I never knew how to properly eat,” she said, noting cheeseburgers were a particular weakness.

Gould’s two sisters each had had bariatric surgery and after seeing the results, she decided to learn more. After going through a six-month process of medically-supervised weight loss, she still had not lost enough weight. She had the surgery April 2016 and was back at work in two weeks. She almost immediately went back to the gym, doing serious modifications to ease herself back into being active and avoiding core exercises at first to give herself time to heal.

Gould also was strict that first year in particular with her diet – lots of protein shakes and thoughtful meal choices, with PowerCrunch bars to satisfy sweet-tooth cravings. “This just let me reset. Now I know I can eat the right things in balance with the amount of activity I do,” she said.

While Gould’s one sister took up running, Gould gravitated more toward strength.

IMG_5384Four months after her surgery, she started a high-intensity endurance workout called Insanity Live. She modified everything and kept plugging away. She learned to love it.

In a year, her body fat had dropped from 48 percent to 25 percent. By 18 months, she had lost her 100-pound goal. At 138 pounds, she went from a size 22 to a 6/8.

When her instructor moved, Gould couldn’t imagine a Saturday without Insanity Live. She decided to teach it. “At the training, they said, ‘You don’t have to be the best at the moves. You just have to be the most motivating.’ That stuck with me.”

While some instructors bark orders and push students to work at top capacity, Gould remembers the importance of pacing herself. “I really want to pull in people who are scared of it – it’s called Insanity for a reason. I want them in there so they can see how much they change over time. When you start losing and toning, it helps you stay motivated and keep going.”

Gould is so passionate about sharing her transformation, that she regularly attends the TMC Bariatric Support group and manages a Facebook group for local patients, as well as another accountability group for those who need more regular check-ins. “I love inspiring others. I remember early on when I was frustrated with the pace of my weight loss, someone told me, ‘You’re on a trajectory.’ And that changed everything. It’s not about the Right Now. It’s about progress, not perfection.”

“I just want to help others. I feel like I’ve been given this gift – and what good is this gift to me if I am not spreading it and using it to assist others?”

Patient support at TMC Bariatric Center

Bariatric SurgeryRegardless of a person’s background, lifestyle or motivation – weight-loss is challenging. What approach works for one person might not work for another. Patients who choose weight loss surgery have the best outcomes with access to the right information and support. Fulfilling that crucial need is Rachel Deal, the TMC metabolic and bariatric coordinator.

“The TMC Bariatric Center is nationally accredited as a comprehensive center,” said Deal. “We provide education and assistance at every stage, from a patient’s first questions through years after a procedure – a patient is never in this alone.”

Getting started

Patients considering weight-loss procedures have questions about their unique factors and options. With a dizzying amount of information available on the web, it can be difficult to know where to start.

“With a quick phone call or email, we can get you started with information or a consultation with a bariatric specialist,” said Deal. “TMC also offers a monthly seminar on the second Tuesday of every month – It’s a great way to learn more about weight loss surgery in a comfortable and informal setting.”

 Personalized program

Weight loss procedures are often thought of as one particular surgery. In fact, there are many options available to meet the unique health factors, experiences and goals of each patient.

“Bariatric procedures are not a one-size fits all – everything in the program is personalized,” explained Deal. “We work as a team and take the time to make sure each patient has received all the information about their options and health, so they can make the most informed decision.”

Deal said this careful, custom and vital process can take months, but has an important side-effect that supports a successful outcome. “Patients say they feel empowered – the information gives them the control and authority to make an active decision about their health.”

Confident and prepared

Preparing for a medical procedure is not a common experience, and patients can rely on Ms. Deal to provide the support and help to feel confident and prepared.

“We help educate for pre-op and post-op, so patients understand the dos and don’ts and know what to expect,” says Deal. “In addition, we facilitate resources for aftercare, and make exercise, diet and action plans for the first year after surgery.

More than medicine

The TMC Bariatric Center was designed to be a comprehensive program, assisting patients with all aspects that affect weight loss.

“There are many factors that contribute to successful weight loss,” Deal said. “That’s why the TMC program also provides a dietitian, exercise physiologist and psychologist.”

Weight-loss surgery patients also have the opportunity to participate in a monthly support group, and discuss triumphs and challenges with individuals who are having like-experiences.

“We also have insurance specialists available to assist with information about coverage and payment options – we want to leave no stone unturned.”

Success

Deal says the TMC Bariatric Center has combined medical, clinical and professional support with one focus. “Patient success is our goal – we hope to be each patient’s partner here after.”

If new weight loss challenges arise after surgery, Deal explained her role is to help keep patients motivated, determine new plans and provide needed information or referral resources. “Our patient partnerships are meant to last a lifetime – not just for the first or second year after surgery.”

Deal also explained why patient success is so important to her. “It’s amazing to see the bliss and happiness when patients reach their goals – and not all successes involve the scale.”

Success can mean being healthy enough to walk up the stairs unassisted, or being fit enough to comfortable take family on a trip to Disneyland.

“Mostly, I hear patients say they never could have imagined life being this good.

Rachel Deal has a degree in dietetics and nutrition. She has a passion for patient care and has worked in bariatric medicine for several years. When time allows, Ms. Deal enjoys sampling healthy dishes at Tucson’s diverse restaurants and traveling with her husband and young son.

For more information about Tucson Medical Center’s Bariatric Center of Excellence and to sign up for a FREE seminar see our website or call (520) 900-1842 today.

 

 

 

Comprehensive Weight-Loss Program now available at TMC

TMC Weight Loss Program 3Super foods – juice cleansing – metabolism kick starters – core workouts. Weight-loss is very challenging and the dizzying number of diets, fads and exercises can make it even harder. Tucson Medical Center’s Comprehensive Weight-Loss Program offers safe and effective plans that are personalized to meet each patient’s needs.

These days, busy lifestyles are common– stretching schedules for career, family, activities and so much more. With only so many hours in a day, it’s hard to make time for health and easy to put on pounds fast. More than 70 percent of American adults are overweight and we understand that everyone faces unique challenges to achieving a weight loss goal.

TMC Wellness Director Mary Atkinson explains how the TMC Weight-Loss Program is different. “We look at the whole person,” she said. “Registered dietitians and certified exercise-professionals will work with you to create a personalized plan you can live with, so you can lose weight and keep it off.”

Weight-Loss Counseling Program The 12-week program includes three, one-hour initial appointments and eight follow-ups that last about 30 minutes. Periodic assessments help determine what is working best and allow you and your team to make adjustments to keep

  • Nutrition, fitness and general wellness assessments
  • Reliable advice that you can use
  • Tracking of weight and estimated body composition
  • Development of personalized nutrition and fitness plans
  • Strategies to promote long-term weight-loss success

Weight-Loss Surgery from the TMC Bariatric Center

The TMC Bariatric Center, a comprehensive center accredited by the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program, guides you every step of the way on your weight-loss journey:

  • Pre-surgery counseling and evaluations
  • Post-op care that includes nutritional counseling
  • Psychological support
  • Instruction on incorporating exercises into your lifestyle
  • Discussion groups – build relationships with others who have had bariatric surgery at TMC
  • Some services may be covered by insurance.

TMC Weight Loss Program 4Weight Management Support Group

No matter what method you have used to lose weight, sticking to your new good habits and keeping the weight off can be a challenge. Don’t try to tackle it alone. Join our monthly support group, led by a certified health coach, to learn new tips and stay motivated.

Program Pricing

  • Flat fee for the entire program: $400
  • Weekly rate: $60 for one-hour sessions, $30 for 30-minute sessions (total of $480 for entire program)
  • Weight management support group = $5 per meeting (meets monthly at The Core at La Encantada)

For more details, please contact TMC Wellness, (520) 324-4163 or wellness@tmcaz.com.

Rigorous study confirms what TMC bariatric surgeons preach about surgery benefits for diabetics

A recent study done at the University of Minnesota and published in the Journal of the American Medical Association suggests bariatric surgery is a more effective way to reduce and even reverse diabetes than medication and lifestyle changes.  The findings, which came from one of the most rigorous studies of its kind, could lead to changes in who qualifies for the surgery.

Dr. Scott Welle TMC Bariatric Surgeon

Dr. Scott Welle
TMC Bariatric Surgeon

TMC Bariatric Surgeon Dr. Scott Welle said the research corresponds with exactly what he and other bariatric surgeons have said all along – that weight loss surgery is an effective tool for getting diabetes under control and even having it go into remission.  “It’s a lot more common for people to come into my office saying they want to get off their diabetes medicine rather than wanting to lose the weight.  Losing the weight is just the bonus.”  Type 2 diabetes affects more than 20 million Americans.  Most of these patients are overweight or obese, and are at a higher risk for heart disease and stroke, among other things.  Diabetes that is not controlled properly can damage the kidneys, eyes and blood vessels.

The yearlong study indicated that gastric bypass, the most common bariatric surgery in which the stomach is stapled to create a small pouch and attached to a lower part of the intestines, can effectively treat diabetes in patients who are considered mild to moderately obese.  “We’re finding this especially true for patients with a lower BMI, who are about 50 to 70 pounds overweight.  Our overall success rate is more effective with this patient population typically because they haven’t been diabetic as long as patients who are morbidly obese,” said Dr. Welle. 

To qualify for weight loss surgery outside of a research institution, a patient must have a BMI of at least 35, and a comorbid condition like diabetes, hypertension, or sleep apnea.  That magic number, 35, Dr. Welle explained, was recommended from the National Institutes of Health in the early 1990’s.  Newer research, which looks at treating people with a lower BMI, may lead to updated recommendations if the surgery is proven to be safe and effective.

“We’re starting to see these patients when they just barely qualify for surgery based on their BMI.  They’re coming in when they’re 80 to 100 pounds overweight, for example, wanting to get off their diabetes medication rather than waiting until they’re 300 pounds overweight,” he said.

Even then, Dr. Welle said, he and his team are not quick to operate.  “It’s not like diabetic patients come into our office, and we schedule a surgery date.”  The amount of time from the consultation to the actual surgery day can range from two to eight months.  There is a pre-authorization and pre-screening process.  Patients are given a psychological evaluation, and undergo nutritional counseling.  The pre-op workup is intense.  Plus, by the time a patient even hits his door, they’ve typically put considerable thought into their decision.  “Nine times out of ten, someone who presents for bariatric surgery has been thinking about it for at least five years on average,” he said. 

clip_image002Since 2011, TMC has been a Bariatric Center of Excellence, an accreditation from the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP).  All bariatric surgeries performed at TMC are minimally invasive, and some are even done using the da Vinci surgical robot.  Dr. Welle said the surgery requires a one-to-two-day hospital stay,  and oftentimes patients are off their diabetes medication by the time they are discharged.  “Yes, it happens that quickly with metabolic procedures like gastric bypass.  A majority of my patients leave the hospital off their diabetes medication.”  Most patients resume their normal lifestyle in one to two weeks.

The study did mention an alarming complication rate.  About a third of the 60 adults who underwent gastric bypass developed serious problems within a year of the operation, although some cases were not directly linked to the surgery.  For more serious complications, including infections, intestinal blockages and bleeding, the rate was six percent. 

“If you look at the study, the number of people who had a complication in the surgery group was 22 out of 60.  If you look at the non-surgical group, 15 of those 60 people also had a complication.  It’s important to realize that no deaths were reported.  So when we say bariatric surgery is safe and effective, it truly is.  When you see high complication rates like this in a study, you need to really delve in and look at how strict they’re classifying their complications,” Dr. Welle said.  Patients in the surgery group ended up using an average of three fewer medications than patients in the non-surgical group.  “That’s medications for diabetes, high blood pressure, and high cholesterol.  It’s not just diabetes, rather the gamut of the metabolic syndrome that can be treated effectively with bariatric surgery,” Dr. Welle explained.

For more information about TMC’s Bariatric program, please click here.


Tucson Medical Center | 5301 E. Grant Road | Tucson, Arizona 85712 | (520) 327-5461