Obesity is a chronic disease and a major health care issue. Approximately 61 percent of American adults are overweight and are at an increased risk of an array of medical problems and life-threatening diseases including:
- Diabetes
- High blood pressure
- Elevated blood cholesterol
- Heart disease
- Lung disease
- Stroke
- Gallbladder disease
- Liver disease
- Joint disease
- Sleep disorders
- Cancer
In addition, obesity contributes to impaired quality of life.
Treatment Approach
Treatment of obesity presents a difficult problem because each person's genetics, diet, lifestyle behaviors and level of physical activity are different.
The Weight Management Center is dedicated to the medical and surgical management of obesity. The multidisciplinary program involves physicians, psychologists, registered dietitians and physical therapists.
Because it's important for patients to be comfortable with any weight management program and those who administer it, the Weight Management Center offers a free orientation. The orientation allows interested persons to get a complete overview of the program. Additional screenings and assessments are conducted, if an individual wants to proceed with the program.
Weight Management Center Staff
The Weight Management Center staff are leaders in their field and collectively represent the area's leading experts in all areas of managing obesity. To speak to one of the staff members, please call 314-286-2080.
Providing diagnosis and leading-edge treatment of medically significant obesity and applying the most current research on weight loss, the program helps patients manage their weight safely and successfully, and reduce their risk for long-term complications of obesity.
Medically significant obesity is defined as a body mass index (BMI) of 30 and above - or 27 and above, if the individual has medical complications of obesity such as diabetes or heart disease.
Services
Medical monitoring and physician supervision
Behavioral modification sessions within a closed group setting to help form life-long healthy eating habits and lifestyle changes
Emotional support and encouragement from group members
Nutrition seminars to educate members about healthy grocery shopping, menu planning, portion size and nutrient content
Physical activity seminars to explain all aspects of exercise and to tailor programs for each patient
Meal plans and meal replacements
Individual counseling sessions
A long-term maintenance program
Drug therapy, supervised by experienced physicians, for those unable to achieve their weight management goals
When a patient is referred to the Weight Management Center, an initial screening is scheduled. Prior to that visit, the patient will be asked to complete a food diary, food frequency form and a three-part psychological assessment, which is mailed in advance. The initial screening takes approximately three hours and involves a medical examination with blood tests and EKG, a psychological assessment, and a detailed nutritional evaluation.
Many people who lose weight tend to regain it over time. For this reason, the ability to sustain that loss is just as important as the initial weight loss itself. Staff members teach the skills necessary to help maintain weight loss and achieve realistic goals. Even moderate long-term decreases in body weight -- five to 10 percent of initial body weight -- can result in considerable health benefits.
Specialized Procedures
Gastric bypass surgery is available for those who are severely obese, (severely obese is one or more of the following):
- having a BMI (calculate your risk) of 40 or greater
- being roughly 100 pounds or more above ideal body weight
- BMI greater than 35 with serious obesity-related complications such as diabetes, hypertension, sleep apnea or other medical conditions.
Gastric bypass surgery involves stapling part of the stomach to make a small stomach pouch. A part of the small intestine is attached to this pouch which will bypass a portion of the digestive tract. After surgery, patients are not as hungry and when they do eat, less food can be eaten because the stomach pouch is very small. For appropriate patients, gastric bypass surgery is safe and highly effective for producing long-term weight loss.
Immediately after surgery, a patient cannot eat or drink. The physician determines when the patient can begin clear liquids. If these are tolerated, the patient progresses to a full liquid diet. The next step is a pureed diet. The patient will be consuming the pureed diet upon discharge from the hospital, usually on the fourth or fifth day after surgery.
Four weeks after surgery, a soft diet will be introduced. Six weeks after surgery, if the diet is going well, the patient will begin to eat solid foods. In the first month after surgery, the patient's new stomach will only be able to hold two to three ounces of pureed food at each meal. This will gradually increase to four to six ounces of solid food per meal.
Patients are counseled about their diet and physical activity. Follow-up appointments are scheduled to ensure the highest possible success for each patient.
Unique Aspects of the Facility:
The Washington University Weight Management Program, in affiliation with Barnes-Jewish Hospital, is the only center in the metropolitan St. Louis area that offers medical and surgical specialists collaborating to treat people who are obese.
The Weight Management Program's unique physical activity program - On the Move - is designed to encourage a long-term commitment for a physically active lifestyle. On the Move emphasizes physical conditioning, proper body mechanics, strength, endurance, flexibility, balance and coordination. Pre-tests and post-tests are conducted to individualize the program based on each participant's capability, medical condition and lifestyle.
It is our philosophy that patients need to be fully informed of the risks and benefits of both the surgical and medical treatments for obesity to make informed decisions. Patients referred to the Center are thoroughly evaluated to ensure that the most appropriate weight management approach is selected for them.
Research and Clinical Trials
While enrolled in the program, patients can choose to help increase knowledge of obesity by participating in federally funded studies. Using the most sophisticated techniques, researchers hope to gain a better understanding of why people are overweight and use these insights to develop better management for those who want to lose and maintain long-term weight loss.
The Gastroenterology Department is one of two centers in the country to have been awarded a Digestive Disease Research Core Center and a Clinical Nutrition Research Unit by the National Institutes of Health.
For more information on current clinical trials sponsored by Washington University School of Medicine, go to Volunteer for Health.
To make an appointment with a Barnes-Jewish Hospital physician, call 314-TOP-DOCS (314-867-3627) or toll free 866-867-3627.
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