Resolving to stay fit in 2017

‘Weight management,’ not ‘weight loss,’ is the key to long-term health

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Franklin Square resident Stefanie Calise said it was her son, Landon, who was her inspiration to lose almost 300 pounds.

"I wanted to be around for my 9-year-old," she said. "I wanted to be healthy, to be able to see him grow up."

Calise's fiancé, Robert Destefano, also of Franklin Square, has also lost a similar amount of weight, and quality of living was his motivation.

"I was 528 pounds on Oct. 22, 2012, then I got the gastric bypass and got down to 250 pounds in 2014, in like a year and two months," Destefano said, recalling his surgery results. "Then I had the tummy tuck, which took off another 34 pounds, so then I was around 215-220 pounds."

Keeping the weight off, Destefano said, is a struggle, but he feels that his weight maintenance is succeeding. He's making sure to eat right and keep moving. "I actually gained back 50 pounds, but now I'm on a strict diet, trying to get back down," he said. "I still lost a huge amount of weight."

The key to maintaining weight loss is, first, understanding the individual's approach to it, said Dr. Rajeev Vohra, chief of laparoscopic and bariatric surgery at South Nassau Communities Hospital.

"I like to say it's about weight management or weight maintenance, not weight loss," he said. "Weight loss is just about taking the pounds away, where weight maintenance or management is long term. With management, you have learned what works for keeping your weight off forever and not just for the moment. Different methods work for different people, and it's important to know which ones work for you." 

Vohra said that the interest in weight management assistance is higher at certain times of the year. "No question, we do see a surge of enrollment in January and February every year," he said. "From Thanksgiving to New Year's Day, people may overindulge, but for the most part, patients aren't doing this for vanity. They want to do this for health reasons. There is just more motivation at this time of the year."

At Siege Athletics, gym owner Noah Siegel also sees an uptick in enrollment at this time of year until March, and again as the weather gets warmer. "Those seeking longevity in weight loss stay," he said. "They also tend to be healthy and body-conscious. I think it's the warm weather that motivates them as well. So many warm-weather sports are played, and they want to be ready to be active in them again, without injury due to being unprepared or out of shape."

At SNCH, weight management is a five-step approach. The first step involves working with a nutritionist. The second requires calorie restriction through use of special shakes and bars to eat, which may be used in tandem with step three, according to Vohra. The third step involves pharmacotherapy, where medication is used to suppress the appetite. 

In the fourth step, the patient undergoes an endoscopic procedure, and a gastric balloon is placed inside the stomach to aid in weight loss. Saline is injected into the balloon, which stays in place for six months, before being removed. The fifth step, used in the most exreme cases, offers three different options for surgery, a gastric sleeve, gastric bypass or a lap band. 

At all five program steps, a surgeon, bariatric physician, nutritionist, nurse practitioner, physical therapist, exercise physiologist, dietician, psychologist all work with the patients as support. In addition, weight management support groups are offered to help them work through their management issues. Diabetics see the most success with the surgery options, Vohra said.

"There is 80 percent resolution of diabetes within a four to six week time period, post-surgery," he said. "Surgery produces the most meaningful weight loss, with the obese and diabetic being the most successful. About 70 percent of those who get the surgery are successful long-term in maintaining their weight."

To sustain weight loss, Siegel said, it is important to trust the process."It's like anything else," he said. "With fitness, it's a marathon, not a sprint. Show up at the gym two or three times a week and give that your all, instead of pushing for six times a week. You don't want to burn out."

Siegel also stresses the importance of nutrition in weight maintenance.

"About 99 percent of my clients here make mistakes in food," he said. "It's the choices they make. You can't spend two or three hours here at the gym and then go outside and eat poorly, and expect to successfully maintain good health and weight loss. They have to control what they do all the time."

Destefano says he is so much happier with his weight maintenance. "Oh my God," he said. "It feels so good."