Episode Transcript
[00:00:00] Speaker A: Welcome to True north, your destination for better health, brought to you by North Mississippi Health Services.
Each episode, we sit down with experts from across our health system to explore the topics that matter most to you and your family.
From prevention and wellness to the latest treatments and healthcare innovations. We're here to provide trusted information that helps you make informed decisions and live a healthier life.
[00:00:34] Speaker B: Welcome back to North Mississippi Health Services podcast as we talk about bariatric surgery and weight loss.
Joining me today is Dr. Terry Pinson and Dr. Will Cauthen. I'm your host, TJ Adams. So, guys, from our previous podcast, we left it and where we would have the discussion around why weight loss is so difficult in patients.
And another topic was when to seek medical help.
So, Dr. Cauthen, would you lead into this one?
[00:01:04] Speaker C: Yeah, you know, I mean, everybody out there has probably tried to lose weight at some time, right? And so, and you know, you know, this is a conversation we have with our patients. You can break weight loss down into several different ways. It can be, you know, really, really complicated, or you can make it really simple.
[00:01:20] Speaker B: All right?
[00:01:21] Speaker C: I mean, if you wanted to get really complicated, you can talk about the pathophysiology and, you know, feedback mechanisms and all this kind of stuff, which I don't think most people want to get to a long discussion about. On the simple side, you know, it's really just kind of a math equation. I've got to burn more calories than I take in.
[00:01:36] Speaker D: Okay.
[00:01:37] Speaker C: But that's more difficult than said.
[00:01:40] Speaker D: So,
[00:01:42] Speaker C: you know, what most people don't realize is, you know, once you start to lose weight, your body will actually make certain physiological changes would make which make it more difficult to lose weight.
Your metabolism slows down, you store fat at an easier rate, things like that.
So, you know, people always come in and they say, hey, you know, I lost, you know, I lost 10 or 15 pounds. And then I kind of got back into some old habits and I put on 20. Okay, well, there's a reason for that. Because your metabolism slowed down. You went back to taking the same number of calories as you were before, but now you were in a calorie positive versus even. And so you gained weight pretty rapidly.
[00:02:20] Speaker D: So,
[00:02:22] Speaker C: you know, we hear this all the time and people just. It's just really hard to be successful long term if you need to lose more than, you know, 15 or 20 pounds.
[00:02:30] Speaker D: It's elaborate on what Dr. Cauthen saying your body has. It says, okay, you're supposed to weigh 240 pounds.
That's. It's an abnormal set point. Okay, so it's set at an abnormal point. You have all these people that are not obese, and theirs is at a normal level, and you have somebody that's obese and theirs is set at this high level. They try to lose weight. You know, their body's saying, no, I can't. It's supposed to be 240. That's one of the great things about bariatric surgery. It actually resets that set point back to a more normal weight. And that's.
[00:03:00] Speaker C: That's kind of how it works a little bit. Yeah. It's like it's a survival mechanism. Right. Your body. You start to lose a significant amount of weight, you know, internally, your body thinks something's wrong. All right, so it goes into survival mode. It makes it difficult to lose that weight.
[00:03:15] Speaker B: So basically, storage mode.
[00:03:17] Speaker C: Exactly.
[00:03:17] Speaker D: That's it.
[00:03:18] Speaker C: Survival.
[00:03:18] Speaker B: Yeah.
So as a patient, patient comes, you know, they're dealing with obesity, maybe chronic obesity. Over time.
How do they seek help to one of you guys? What is the process? What do you guys offer from a clinic standpoint?
[00:03:36] Speaker D: Yeah, so. So first, you can just contact the office, and we'll see them in consultation. Patients in consultation, they will go over the patient's body mass index, and if they qualify for bariatric surgery or if they just need to come in, we'll see them in consultation and we evaluate the patients to really have the most effective course for that patient. What do they really need?
If you look at it from a standpoint of. And Dr. Cawthon has a good way of addressing this, is that if you need to lose 0 to about £20, you can do a diet, exercise, and manipulation. From that standpoint, if you need to lose from 20 to about 60 pounds, sometimes you can do that with medications, GLP1 therapy, and we'll talk a little more about that as we go. Beyond that, though, is bariatric surgery. And that's really the mainstay. And we will do a consultation. We'll talk to you and go over all aspects of that if you contact the office.
[00:04:32] Speaker B: So if I'm a patient seeking help, they come to your bariatric surgery weight loss clinic. You can give me, as the patient, a plan.
I can, as a patient, explain to you what I would like, the help I need, and your comprehensive center can provide a plan for me to help get me on the right path of weight loss.
[00:04:54] Speaker C: Yeah, for sure.
[00:04:55] Speaker D: Yeah.
[00:04:55] Speaker C: Let me. Let me backtrack just a little bit. And this is what a lot of times I will tell patients or tell people if, if you've got to a point where your weight is significantly impacting your quality of life or medical conditions, you know, sleep apnea, diabetes, you're having to spend hundreds of dollars a month on medications. You probably need to consider weight loss surgery or weight loss in general.
[00:05:17] Speaker B: Right.
[00:05:18] Speaker C: So fast forward. Yes, we can create a plan for each patient. You know, we have, we mentioned in the first episode, but we have a very comprehensive program where we have our own dietitians, we have nurse practitioners that run a medical weight loss clinic, we have access to the wellness center and exercise physiologist. So we can create a plan for each patient which includes, will always include lifestyle modifications. Okay. If we don't start with lifestyle modifications, everything else is going to be obsolete. So that's always step one and that may be all the patient needs. And then we can move on into things like GLP, GLP1 receptor agonist and. Or surgery. So, yeah, I mean, some of the most common medical conditions that we're going to see.
We mentioned BMI earlier too, before, but medical conditions, probably the most common things we're going to see, type 2 diabetes, hypertension, sleep apnea, fatty liver disease, coronary artery disease, but a lot of things. Another one we see pretty common is infertility associated with possible pcos.
So used to be one of our largest referral bases was ob. Gyns in our area would send us patients over, they needed to lose a significant amount of weight because they were trying to have children and could not.
[00:06:33] Speaker D: Yeah, we've had, we've had a multitude of patients that have come through the program, have had bariatric surgery, couldn't have children ahead of time, have had children after they've had bariatric surgery. Very healthy pregnancies is very exciting. I mean, because that is the most common cause in our region of infertility is morbid obesity.
And we've seen that.
[00:06:52] Speaker C: Yeah. And I always tell my female patients that are of reproductive age, I tell every single one of them, okay, you're about to have surgery, you're about to lose a significant amount of weight. We would like for you not to get pregnant for the first year.
And you know, these women look at me like maybe they've been trying to get pregnant for three or four years and they're like, you're crazy. What are you talking about? I'm saying just trust me, okay? It happens every single year, year after year after year. So, you know, which, you know, it's not the end of the world. Obviously. We're happy for them. Right. And we have some really good OBGYNs in our area that are luckily or, you know, familiar with dealing with patients that are undergoing weight loss and pregnancy at the same time, which can be very complicated.
[00:07:35] Speaker B: Right.
[00:07:35] Speaker C: But we have people that we can refer them to that'll manage that for them.
[00:07:38] Speaker B: So.
[00:07:38] Speaker C: Yeah, very common scenario.
[00:07:40] Speaker D: Yeah, it's, you know, I always like to tell a story out of a lady and her and her husband had been trying to get pregnant for like seven or eight years. They spent a fortune and she underwent a bariatric procedure and she came back two months post operatively, which is very early, and she was pregnant. She, she was pregnant at that time, you know, and at one year she had a healthy baby boy. Her body mass index was 20, 25, an ideal weight. All the medical conditions were resolved.
But we do like for patients to wait. Yeah.
[00:08:10] Speaker C: 12 to 18 months if possible.
[00:08:11] Speaker D: That's ideal because your nutritional consequences are your, your body's all equaled out at that time.
[00:08:17] Speaker C: Yeah, yeah. It's just complicated. Right. You're losing weight, but then you're gaining weight and you're, you know, you're growing a child. I mean, this is a very. It's hard. So I had one a couple months ago. She showed up and I was like, where have you been? I'd seen you in like, you know, a year. She's like, oh, I got pregnant again.
Happens all the time.
[00:08:35] Speaker B: So when things come up, such as pregnant two months after surgery or six months after surgery, I know you don't. That's not what you would like to see from your patient. But if it happens, the program's there to help.
[00:08:48] Speaker A: Yes.
[00:08:48] Speaker B: You have the resources and help navigate a patient through whatever's going on as they go through the process of surgery.
[00:08:55] Speaker D: Absolutely. And you have just, like we mentioned last podcast, is a phone call away. When you're still in a small community where you call and you talk to the OB gyn, you talk to that person, hey, can you get them in? They're having this issue and you talk to them. And usually it's, it's. I send them over. It's usually that day or within a couple of days.
[00:09:14] Speaker C: Yeah, I mean, luckily, you know, we've done enough procedures in this, in our, in our area that we've had a lot of women that have had bariatric surgery that have gone on and gotten pregnant. So the, the OB GYNs in our area, they're, you know, they're pretty used to dealing with these patients, taking care of them. So for them, it's really nothing new. And if you have kind of that unusual situation where it's a patient that's really early on in surgery and they're having some issues, you know, we also have maternal fetal medicine specialist too, that we can reach out to. And once again, I mean, these are people that we know personally. I mean, all I got to do is pick up the phone and call them. Yeah.
[00:09:49] Speaker B: So me as a patient, that gives me comfort because I know I'm going to a one stop shop to provide my bariatric and weight loss therapy and surgery and know that I can be taken care of in this area and taking care of the region. Also, as a patient, we have local patients come and have surgery. But also you have patients travel great distance as well, right?
[00:10:11] Speaker D: Yes, that's correct.
Yeah.
[00:10:15] Speaker C: I mean, once you develop a good reputation, I mean, people will come see, you know, like I've always said, if you provide a good service or a fair price, you'll always be busy. Right.
So, you know, I remind people all the time. I mean, you know, we sell a service. Right. You know, most people, their job either sell a product or a service. We sell a service. It just happens to be that we're physicians and, you know, the service we sell is surgery. So once you get a good reputation, people don't mind traveling for that because
[00:10:42] Speaker B: the patients know they're going to be cared for.
[00:10:44] Speaker C: Exactly.
[00:10:48] Speaker B: So as we go back when to seek medical help, we want to make sure that we encourage our patients, if they have questions, to contact the clinic. They can help navigate through the process, get you on your schedule, have a visitation, have a clinic visit and start the pathway.
In the next few episodes, we're going to discuss bariatric surgery, the qualifications, the process and the recovery time.
Thank you for joining us today on North Mississippi Health Services Podcast.
[00:11:17] Speaker A: Thanks for listening to True north, your destination for better health. For more information and resources related to today's episode, visit the links in our show notes. Until next time, stay healthy, stay informed, and remember, you are our true North.
