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If you’ve ever tried to lose weight, you know it’s really hard to shed pounds and even harder to keep them off. But there’s a vast difference between wanting to fit into your favorite jeans and knowing your excess weight could kill you. Billions of dollars are spent on diets, pills and various services that make weight-loss success seem so simple – and yet more than 40 percent of Americans are excessively, and even dangerously, overweight. There are many reasons for this. The South Jersey experts we gathered for our virtual roundtable laid it all out for us – including the commitment you have to make to get off the weight loss rollercoaster.

Participants:

Marianne Aleardi, Publisher, SJ Magazine

Marc Neff, MD, Medical Director, Center for Surgical Weight Loss, Jefferson Health NJ

Michelle Hunt, Clinical Psychologist, Virtua Surgical Group

Adeshola Fakulujo, MD, Director, Minimally Invasive Surgery, Jefferson Health NJ

Rohit Patel, MD, Director, Center for Metabolic and Bariatric Surgery, Cooper University Health Care

Cristin Polizzi, Wellness Program Coordinator (and former patient), Jefferson Health NJ

Adarsh Gupta, DO, Director, Center for Medical Weight Loss & Metabolic Control, Rowan Medicine

Nicolas Fantazzi, patient

Diana Wind, Outpatient Clinical Dietitian, Inspira Health

 

On why so many people are overweight…

We’ve turned evolution upside down. We were designed to store calories for famine, store food while hunting and store nutrition so we could run away from saber tooth tigers. Now, there’s a Wawa at every corner.
Marc Neff

Because of the stigma around obesity, for the longest time medical professionals never addressed it. Doctors would never tell you that you’re fat, but they would easily tell you you’re diabetic, you have high cholesterol or you have high blood pressure.
Adarsh Gupta

Eating is a mindless activity for many people. And when we’re not paying attention to our food, that’s when we may be inclined to overeat, not taste our food, eat things that if we had given it more thought, we may not have intended to make those choices.
Michelle Hunt

 

On obesity as a disease…

Controlling obesity takes lifelong management of our metabolism, our lifestyle. It could be caused by different issues at different times in our lives. It may be an issue with mobility at one point. It may be an endocrine issue or a result of a medication that has been added later on.
Rohit Patel

When you explain that obesity is a disease, it takes away that whole shame and blame that many patients come in with. This is a disease process like any other disease process, and it’s linked to 65 different medical conditions and 15 different cancers.
Marc Neff

 

On what it’s like to be a patient…

At the introduction seminar for weight loss surgery, they say, “We’re going to take 80 percent of your stomach away and you can’t put it back in.” Think what an impact that has. It’s a tough, tough decision. And you really think it’s the end of your life going into it. But then you do it, and it’s like getting a colonoscopy. You never have to worry about over-eating again. It is just the greatest thing that real food addicts could do for themselves.
Nicolas Fantazzi

I had a hysterectomy about 3 years ago, and my hormones changed, my metabolism changed, and no matter what I did I kept gaining weight. By the look of my activity levels, you would never have thought I would have a problem losing weight. I also have a family history of high blood pressure, diabetes, high cholesterol, and so many cancers run in my family. I didn’t want to get to the point where I’ve tried everything and now I’m sicker on top of that. So I intervened early. I had my surgery in September. I’ve lost 60 pounds since then.
Cristin Polizzi

Regarding younger patients, the good news is that you have the whole rest of your life to enjoy the benefits of this surgery, but the bad news is you have the whole rest of your life to live with all these lifestyle changes.
Michelle Hunt

 

On how weight loss surgery differs from diets…

One of the best aspects of surgery is that it teaches you the correct foods to eat, when to eat, what hunger feels like, what thirst feels like – so many people don’t know the difference between hunger and thirst. You learn how to eat over the long-term as opposed to “Okay, I’m going to do this for a month and lose 20 pounds, feel really good about myself, and then stop.” That’s when the yo-yo starts again.
Cristin Polizzi

With surgery, we alter the gastrointestinal hormones. Just based on that, most patients will see an improvement in their diabetes or high blood pressure or their sleep apnea before they begin to see weight loss.
Adeshola Fakulujo

 

On obesity and Covid…

Recent data has shown that, during the pandemic, people who are obese or morbidly obese have had worse outcomes. If you address obesity, it takes that comorbidity factor out.
Adarsh Gupta

For some patients, when they get to bariatric surgery, that’s their last option to lose weight. Delaying the surgery because of Covid just added stress to the patient’s life and their comorbidities can get worse.
Adeshola Fakulujo

With the pandemic, now instead of people walking 10,000 steps a day, it’s 10,000 steps a week, and everybody is gaining weight.
Mark Neff

 

On why diets don’t work…

Everything is a quick fix. There are diets with names like the 17-day diet, which both my parents did. They were successful – until they stopped doing it. Then they went right back to the way they were before the diet.
Cristin Polizzi

People are often unaware they’re damaging their metabolism in the process of dieting, and they’re creating a system that becomes weight-loss resistant. Nobody tells you that when they’re selling you the 17-day diet.
Michelle Hunt

A study that compared different diets, including Weight Watchers, found what’s most important to achieving long-lasting results is eating food that you like. If you don’t like the food, the diet is a bad diet. It’s a band-aid.
Adarsh Gupta

 

On good eating habits…

I take a bite, chew 30 times and wait 42 seconds to take the next bite. Before, I just wolfed everything down and ate as quickly as I could.
Nicolas Fantazzi

I’ll have everything made ahead. Snacks will be something simple, like celery with nut butter or fruit and yogurt. If I know what I’m eating, I won’t have to think about it and then start wanting something different. It’s much easier to make a decision when it’s made in advance and you’re not already hungry wondering what to eat.
Cristin Polizzi

To be successful with bariatric surgery long-term, you can’t go back to the same destructive eating habits that brought you into the doctor’s office in the first place.
Marc Neff

 

On when weight loss surgery fails…

It’s really exciting and motivating to follow the diet plan and all the behavioral and lifestyle changes when the weight is coming off. But once you’ve achieved your weight-loss goal and now you have to continue to do all those things in order to maintain it, it’s way less exciting to do that. That’s when old habits will sneak back in.
Michelle Hunt

I’ve had patients who have said that surgery was a mistake, and usually, those are the patients who didn’t go through the proper preoperative education, screening and counseling, both before and after the surgery. To them, food is a companion. So now they’re miserable because they can’t eat what they want. They have more anxiety and depression that they can’t treat with food. I can’t fix what’s wrong with them with a knife.
Marc Neff

 

On memorable patients…

This gentleman was 617 pounds when he first came to see me. We had a discussion that he needed to be under 600 pounds. He came back 2 years later and was 657 pounds. He was one of the few men I really made cry in my office because I said I couldn’t do his surgery. My staff gave him a very specific plan and he got down to 595 pounds. Then I did his surgery. He ended up getting a portfolio spread in a men’s magazine because of how well he did with his weight loss.
Marc Neff

Oftentimes you’ll treat families, like the husband and wife might both have surgery and then their daughter might have surgery. I really appreciate the pictures when they share special moments in their lives.
Diana Wind

One patient had a little sports car that he couldn’t fit into when he bought it, and the day he was able to sit in the driver’s seat and buckle his seat belt, he got really emotional. It was his non-scale victory. I remember hearing about it, and I cried.
Cristin Polizzi

 

On life after weight loss surgery…

You have to have smaller, more frequent meals so you never are super hungry. Once you start skipping meals and you reach a point of being super hungry, you can’t control it. You see whatever is in front of you and then it is in your mouth, even if your mind tells you no.
Adarsh Gupta

One of the hardest parts of post-op life is slowing down. I was so used to eating on the run. Now I have breakfast time. I have lunchtime. I have dinnertime. I have to sit, and I have to put my fork down in between every single bite I take because otherwise, I will eat way too fast.
Cristin Polizzi

When I see a patient post-op who has come back with either weight regain or is struggling, I have to decide if it’s a change in medication, a disease process like low thyroid that’s affecting their metabolism, or if it’s something psychological. Is there anxiety that wasn’t there before but maybe now there’s a new relationship with food? Or did they start binge-watching “Game of Thrones” again and guess what, the chips are out, and these are things they’re not paying attention to.
Rohit Patel

There’s a stigma with coming back for help after surgery. I often hear people saying, “Well, I should have come in sooner but then someone would be disappointed in me.” It’s not going to go perfectly. You’re going to struggle, because everybody does.
Michelle Hunt

January 2021
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