This is a presentation Dr. beck and Dr. Eakin give at the bariatric information sessions at Jordan Valley Medical Center, in Salt Lake City, Utah. It provides strategies fro medical weight loss, an it discusses the pros and cons of common bariatric operations.

1. Weight Loss Surgery
Catherine Beck M.D. and Jeffrey Eakin M.D.

2. ABOUT US
Dr. Catherine Beck
Dr. Jeffrey Eakin
Center for Minimally Invasive and
Bariatric Surgery
Jordan Valley Medical Center
www.cmibs.com
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3. FOR STARTERS
Dr. Catherine Beck
Dr. Jeffrey Eakin
Center for Minimally Invasive and
Bariatric Surgery
Jordan Valley Medical Center
www.cmibs.com
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4. Section 1
Taking the first step
Congratulations...because reading or hearing this
material is the first step toward loosing weight and
changing your life!
Commitment is necessary for such a big change, and it
starts with small steps and the decision to change.
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5. Section 2
Why loose weight
•Not just for appearances
•Everyone has their own reason
•Often people do it to:
•feel better
•be able to be more active with kids
•have more energy
•be healthier
•respond and fix a new medical problem
•live longer
•stop taking medications
•decrease the need for so many doctor’s appointment
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6. BMI
Dr. Catherine Beck
Dr. Jeffrey Eakin
Center for Minimally Invasive and
Bariatric Surgery
Jordan Valley Medical Center
www.cmibs.com
5

7. Section 1
What is BMI?
BMI is short for body mass index
Basically...it is your weight divided by your height
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8. Section 2
Sample BMI calculation
Example Calculation
If a patient is 5’5” tall and
they weigh 275 lbs
BMI = 45.8
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9. Section 3
What is my BMI?
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10. Section 4
Same for definitions men and women
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11. WEIGHT LOSS OPTIONS
Dr. Catherine Beck
Dr. Jeffrey Eakin
Center for Minimally Invasive and
Bariatric Surgery
Jordan Valley Medical Center
www.cmibs.com
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12. Section 1
4 Main Options
•Diet
•Exercise
•Medically supervised weight loss
•Weight loss (bariatric) surgery
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13. Section 2
Diets
•Diets don’t work
•“Diet” implies a transient state of being = short term fix
•Need complete change of lifestyle
•Many people have medical illnesses limiting their abil-
ity to exercise - like arthritis
•Overweight individuals often embarrassed to exercise
of join a gym
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14. Section 3
Motivation and Habits
Motivation
is what gets you started;
Habit
is what keeps you going
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15. Section 4
Diets
•Studies show high rate of weight regain
•no singular diet has been proven to be be best
•Diets (on average) only produce an 8 pound weight
loss
•Only sustained over a 2 year period
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16. Section 5
Diets and exercise
•Successful diets and exercise are done in tandem
•Should lose of one pound per week
•Thus, over 3 months = 12 pound weight loss
•That is successful!
•But...usually frustrates patients because it’s slow
•Almost doesn’t feel worth the hard work
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17. Section 6
4 Main Options copy
•Diet
•Exercise
•Medically supervised weight loss
•Weight loss (bariatric) surgery
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18. Section 7
Medically supervised weight loss
•Regular appointment with:
•medical weight loss physician
•registered dietitian
•Techniques used:
•behavioral changes
•prescriptions medications
•
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19. Section 8
Medically supervised weight loss
•Treatment focuses on:
•educations...what to eat and how to exercise
•stimulus control...break old habits
•cognitive restructuring...retraining the brain
•goal setting...where are you going...1 lb. a week
•self monitoring...keeping a journal...or mobile app
•contracting...commitment
•social support...family, friends and other patients
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20. Section 9
Medically supervised weight loss
•Can achieve:
•10% weight loss (400 lbs = 40 lbs)
•25% excess body weight loss (400 lbs = 50 lbs)
•duration loss depends on duration of treatment
•Weight loss of merely 5% can improvement illnesses
•So if 100 pounds overweight...losing 5 pounds can im-
prove some of your medical problems!
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21. Section 10
Bariatric surgery
•Diet
•Exercise
•Medically supervised weight loss
•Weight loss (bariatric) surgery
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22. Section 11
Surgical weight loss for Obesity realted illnesses
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Diabetes
Hypertension
Coronary artery
disease
Heart
Disease
Arthritis
Daytime
tiredness from
sleep apnea

23. Section 12
Weight loss (bariatric) surgery results
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weight loss of 50-60% excess body weight
Reduction in death from cancers (especially
colon and breast cancers)
60%
Reduction death from heart disease 60%
Reduction in death from diabetes 90%

24. Section 13
Weight loss (bariatric) surgery results
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diabetes gone and off meds 75%
No longer have high blood pressure 60%
No longer have sleep apnea 80%
No longer have high cholesterol 60%

25. Section 14
What to expect after deciding to pursue surgery
Team Approach
Two Bariatric Surgeons
•Dr. Catherine Beck
•Dr. Jeffrey Eakin
Medical Weight loss Specialist
•Dr. Gayle Stewart
Registered Dietitian
• Ariel Miller RD
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26. Section 15
Process before weight loss surgery
•Insurance Verification
•Initial visit with the surgeon...best operation
•Psychologic assessment
•3 - 6 month medically supervised weight loss
•Insurance approval, pre-op diet, surgery scheduling
•1 - 2 day hospital stay
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27. Section 16
Process before weight loss surgery
•Follow-up schedule after surgery:
•2 weeks
•4 weeks
•Every 3 month for 2 years
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28. Section 17
Psychological asessment before surgery
•Why the psychology assessment?
•Insurances require it
•It ensures you resources available to make a com-
plete change in lifestyle
•Ensures you can handle major changes after surgery
•Rule out illness (e.g. drug and alcohol abuse
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29. Section 18
Why the 3 - 6 month period of weight loss?
•Most insurances require a trial period of weight loss
•It ensures you have the education and tools to have
successful weight loss.
•Unfortunately everyone can “eat through any surgery.”
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30. Section 19
Visits before surgery
•Visit with surgeon
•Dietitian evaluation
•Psychology evaluation
•Physical therapy evaluation
•Medical weight loss counseling
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31. Section 20
Scopes before surgery
•Possible colonoscopy
•Upper endoscopy
•Possible reflux and acid testing
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32. Section 21
Tests before surgery
•Chest x ray
•X-ray of esophagus and stomach
•Blood draws
•EKG
•Study of esophagus and how it works
•Possibly mammogram
•Ultrasound to look for gallstones
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33. Section 22
Things to stop before surgery
•Smoking cessation...never again!
•Cessation of hormonal birth control
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34. Section 23
Things to stop before surgery
Did we mention smoking cessation?
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35. Section 24
You can do it for a new “me”
•Feels like:
•A lot of work
•Enormous commitment and
•A lot of appointments
•...It is
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36. Section 25
You can do it for a new “me”
•We want you to be safe and be successful!
•Guide you through each step so its not overwhelming
•Your heaviest weight will be at your first appointment
•You can do it!
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37. WHO QUALIFIES FOR WEIGHT LOSS
(BARIATRIC) SURGERY
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38. Section 1
Am I a candidate for weight loss surgery
If you make the decision to go with surgical
solutions...how do you know if you qualify?
Requirements to Qualify for Bariatric Surgery
•BMI > 35 with 2 or obesity related illnesses
•BMI >40 with or without obesity related illness
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39. Section 2
Obesity realted illnesses
High blood pressure
Diabetes
Weight bearing arthritis
Cardiovascular disease
Obstructive sleep apnea
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40. Section 3
Obesity realted illnesses
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Diabetes
Hypertension
Coronary artery
disease
Heart
Disease
Arthritis
Daytime
tiredness from
sleep apnea

41. Section 4
Other illnesses related to obesity
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high blood pressure high cholesterol
Diabetes Sleep apnea
pulmonary hypertension Thyroid Disease
Heart Disease Back Pain
Osteoarthritis depression
infertility/PCOS gallstones
uterine cancer breast cancer
esophageal cancer cancer gallbladder cancer cancer
colon and rectum cancer kidney cancer
thyroid cancer liver disease

42. Section 5
Same for definitions men and women
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43. Section 6
Cost for weight loss surgery
•Different plans = different coverage and requirements
•Some say...“one surgery per lifetime” limitations
•There are self pay options
•Our team will takes care of all of this
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44. Types of weight loss (bariatric) surgery
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45. Section 1
Laparoscopic Gastric Banding
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46. Section 2
Advantages of laparoscopic Gastric Banding
•Excess body weight loss 40%
•Stomach is not cut or stapled
•No new connections ( e.g. between stomach and bowel)
•Short hospital stay
•Reversible and adjustable
•Low risk of vitamin deficiencies
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47. Section 3
What is laparoscopic Gastric Banding
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48. Section 4
Disadvantages of Laparoscopic Gastric Banding
•Slower weight loss
•Foreign body implantation (chance for infection)
•Band can slip and erode into stomach
•May cause damage to (hole in) esophagus
•Requires strict compliance
•Requires constant follow-up
•Highest rate of reoperation
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49. Section 5
Laparoscopic sleeve gastrectomy
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50. Section 6
Advantages of laparoscopic sleeve gastrectomy
•Decreased the amount of food that can be eaten
•Helps brain response to hunger
•Helps hormonal response to hunger
•Weight loss similar to gastric bypass
•No foreign body
•No new connections (like in gastric bypass)
•Short 1 Day Hospital Stay
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51. Section 7
What is a laparoscopic sleeve gastrectomy
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52. Section 8
Disadvantages of Laparoscopic Sleeve Gastrectomy
•Not reversible
•Potential for vitamin deficiencies
•Unknown effect of reflux disease
•Possibility for a leak after surgery
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53. Section 9
Laparoscopic (roux-en-y) gastric bypass
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54. Section 10
Advantages of laparoscopic gastric bypass
•Decreases the amount of food that can be eaten
•Decreases absorption of fats and carbs
•No foreign bodies
•Treats (usually cures) reflux disease
•Can be done on patients with
gastroparesis
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55. Section 11
What is a laparoscopic gastric bypass
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56. Section 12
Disadvantages of Gastric Bypass
•Vitamin deficiencies
•Not reversible
•Life-long compliance is essential - with all operations ;)
•Potential for:
•obstruction of the intestines
•hernias inside
•ulcers in the pouch
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57. Section 13
Key to success!
•Support Groups
•Meet with people who are in your same situtation
•Meet with someone who has been through the pro-
gram and been successful
•Share your tips for success with
others and be their inspiration
•Follow up (surgeon, dietary)
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58. Section 14
Support group topics
•Support Groups
•dietary changes
•exercise and fitness
•common concerns and questions
•open forums
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59. Section 15
Exercise support
•Once a month s @ Jordan Valley Physical therapy gym
•Third Wednesday of every month
•Once a week open gym time for patients
•Every Thursday from 6-7pm
•Options to join the gym for patient
•Options for one on one training for
patients
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60. Section 16
Where is exercise support
Jordan Valley Physical therapy gym
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61. Section 17
How do I start making instant changes?
Call the number below to set up your initial evaluation
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Click to call us from
website

62. Section 18
Where can I see the doctors?
Jordan Valley Medical Center West Valley Campus
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63. Section 19
Thank you for sharing your time with us!
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www.cmibs.com