Last month, we celebrated the second year
anniversary of Tidewater Bariatrics. In two years, we have treated
355 patients and they have lost over 11,000 lbs with medical
management of their obesity.
Obesity is a complex behavioral and physiological
disease. It takes highly structured intervention to make changes
that will have a life long impact. I began Tidewater Bariatrics
because I knew that obesity was treatable but that it was not
treatable in the typical outpatient model. As we all know, we
cannot have a substantial impact on behavioral illness without
the ability to see a patient with great frequency. As such,
Tidewater Bariatrics is a practice dedicated to providing our
patients with the greatest chance of success. The program is
intense; weekly commitments for visits, daily record keeping,
and a commitment to learning new skills. It is the greatest
complement when a patient tells me that “we were in their
head” when they were making food choices.
To manage and treat obesity, one has to
embrace not only “physiological medicine” but behavioral
medicine. Regulation of food intake is a tremendously hard job,
and the excesses that surround us make the challenge even more
difficult. Each of us make about 200 food related choices every
day (should I eat?, where should I sit?, what should I eat?,
should I have chicken baked or fried?, broccoli or string beans?,
how many calories do you think that is? Will I be able to exercise
later to day? take my lunch or eat out?, what restaurant? do
I want Cheerios or Special K? etc). If only half of these food
related choices are made poorly, one can gain a significant
amount of weight. Teaching planning and the importance of choice
making when it comes to food increases the likelihood that our
patients will want to make healthy food related choices. Weight
management and health management are skills; and just like any
other skill, they need to be practiced, practiced and over practiced.
If the skills are not practiced, the poor choices and prior
habits will once again become dominant and the weight will undoubtedly
return.
Bariatric surgery does not eliminate the
need for cognitive behavioral therapy in the treatment of obesity.
It delays it and it augments it but as many of my patients will
attest, without changing the “relationship with food”,
one cannot truly conquer the disease of obesity
A key behavioral concept we teach is controlling
one’s environment. If our environment is healthy, we do
not have to exercise “will power”. For example,
if I have donuts in my kitchen I must exercise tremendous “will
power” not to eat them. Most of us, will eventually eat
them, and if we dwell on it long enough, we eat more than we
would have if we had just had one to begin with. However, if
there are no donuts in the house, i.e. environmental control,
then I do not have to exercise any willpower to avoid them.
As you can see, we emphasize that this is a skill development
and less about “dieting”.
Most of my patients are very successful
in many spheres of their lives whether it be their careers,
education, families etc. Translating for them and showing them
that the same skills that they have used to build those careers,
families are the same skills that they have to use to negotiate
their health management. It is harder now because we all eat
out and the excesses are so great.
Action brings results. The 355 Tidewater
Bariatrics patients have become students of healthy eating habits
and have been taught the discipline and required skills to maintain
their weight loss in a supportive and highly structured program.
Each of these patients have taken on the challenge of being
accountable for their food consumption, their exercise output
and have proven that counting calories does matter.
Happy Anniversary TWB patients…..Your
hard work and acceptance of this challenge has shown that obesity
is treatable. We can stop this epidemic.
About Dr. Margaret MacKrell
Gaglione
Dr. Margaret MacKrell Gaglione is the Medical Director of Tidewater
Bariatrics in Chesapeake, a practice dedicated to the care of
overweight and obese patients. She is a board-certified internal
medicine physician and bariatric specialist. She can be reached
at (757) 644-6819 or www.tidewaterbariatrics.comnecessary for
lifelong success.
Margaret M. Gaglione, MD, FACP
757-644-6819
Email: doctor@twb4u.com
Always
Consult Your Physician before beginning any Diet or Exercise Program.
