Core Bariatrics
Welcome to Core Bariatrics, the podcast dedicated to walking your bariatric journey with you. Hosted by a bariatric surgeon and her very first bariatric patient. Their paths crossed as patient-doctor, but now they work and lead together. This podcast is your trusted source for valuable insights, expert advice, and inspiring stories that will empower you to make informed decisions about your health. In each episode, we explore the world of bariatric surgery, covering a wide range of topics such as different types of procedures, pre-surgery preparation, post-surgery care, nutrition, exercise, mental health and much much more.
But Core Bariatrics is more than just a podcast—it's a supportive community where you can connect with real people who have walked the same path you're on now. Listen to personal testimonials from individuals who have undergone bariatric surgery, sharing their challenges, triumphs, and the incredible impact it has had on their lives.
We will discuss the importance of post-surgery lifestyle changes, including healthy eating habits, regular exercise, and mental wellness strategies, ensuring your weight loss journey is sustainable and fulfilling.
Join us on Core Bariatrics as we foster a sense of community, providing a platform where you can find encouragement, motivation, and practical tips to navigate the challenges of obesity and achieve lasting weight loss success. Whether you're considering bariatric surgery, are in the post-surgery phase, or simply interested in learning more about this life-changing option, our podcast is here to support you every step of the way.
Remember, your path to a healthier, happier life starts here at Core Bariatrics. Subscribe now and embark on a transformative journey towards a better you.
Core Bariatrics
Episode 6: Bariatric Surgery, Easy Way Out?
Have you ever thought about the paradox of surgeries? Why would a life-saving procedure like bariatric surgery be shrouded in stigmas and misconceptions, while other complex surgeries, such as orthopedic ones, escape this judgment? This is the complex world we navigate in our latest episode, as we, your hosts Dr. Maria Iliakova and Tammie Lakose, challenge these misconceptions and strive to bring a better understanding of bariatric surgery to our listeners.
Bariatric surgery is far from an 'easy way out' for weight management. We converse about the extensive requirements, paperwork hurdles and potential risks that underscore the seriousness of this procedure. We also shed light on the often-overlooked psychological dimension of this surgery, as patients grapple with significant mental health challenges alongside physical transformations.
As we wrap up this enlightening journey, we'd like to invite you, our listeners, to be a part of our ongoing conversation. Share your thoughts, questions, or suggestions - your feedback is the catalyst that shapes our content and uncovers the topics you're keen to explore. Stay tuned for future episodes where we continue to delve into the multifaceted world of bariatric surgery. Until then, keep learning, keep questioning, and let empathy guide your understanding. Thank you for joining us, and we look forward to hearing from you.
Welcome to Core Bariatrics podcast, hosted by bariatric surgeon Dr Maria Iliakova and Tammie Lakose, bariatric coordinator and a patient herself. Our goal is building and elevating our community. The Core Bariatric podcast does not offer medical advice, diagnosis or treatment. On this podcast, we aim to share stories, support and insight into the world beyond the clinic. Let's get into it. Tammie, you know what I wish we had. What do you wish we had? I wish we had an easy way.
Speaker 2:You know why why?
Speaker 1:Because we'd use it For sure, for sure, and we'd be millionaires.
Speaker 2:Billionaires, yes, and we'd be billionaires, billionaires, maybe even trillionaires. But seriously, don't you think it'd be great if we had an easy way?
Speaker 1:Yes, 100%.
Speaker 2:So when people say surgery, well, that's the easy way out, what do you think?
Speaker 1:about that. Do you think people have not been through this process and do not understand actually how hard it is?
Speaker 2:You're absolutely right. I think that's true. It drives me crazy sometimes to hear that people think that surgery getting cut on and going through the whole process is easy. Would anybody ever say that about a different process?
Speaker 1:Oh, probably not Absolutely, and it infuriates me 100% after going through this process.
Speaker 2:Yeah, exactly. So if we had an easy way, I promise we would take it, I promise. I wouldn't put people through surgery if I had an easier way for people to manage their weight and get all the benefit out of it. But you know what?
Speaker 1:What.
Speaker 2:There sometimes isn't one.
Speaker 1:No no.
Speaker 2:No, yeah, and here's the thing that really this makes me think of. Let's think of some things that aren't easy, like getting on Google and looking for something that you want to buy, or grabbing your iPhone or your Android and using a map on there, or something like that. Yeah, finding directions Super easy. At this point, we can even remember using paper maps to get around.
Speaker 1:I do not, but yes, right.
Speaker 2:Well, maybe I'm aging myself a little bit, but when I was a kid, I remember my grandpa cranking out their maps and that's how we would get from place to place and his is suzu, which is the company that doesn't exist anymore, but anyway, so that's what I mean is, if we had a way to do what Google does or what map systems do, or any of these things, I promise we would use them, but we don't have Right, right, no, so that's what we're going to talk about today is that surgery is not so much of an easy way. If I had an easy way, I would totally use it and everybody would totally get it.
Speaker 1:Absolutely.
Speaker 2:No. So, Tammie, can you explain to me a little bit about why surgery isn't necessarily the easy way to manage weight?
Speaker 1:Well, for one. For the rest of my life I am going to have this stigma on me of you had bariatric surgery and you took the easy way out. Mentally that takes a toll on someone, and so me personally, I don't mind, I'm strong enough to handle that. I will tell someone on the street that I don't even know I've had bariatric surgery and I'm proud of that. So I'm willing to open up that conversation where some people might not be able to handle that judgment. So hopefully we can get away from that. But as of right now, not an easy way out because, guess what? You're going to deal with that mental aspect forever.
Speaker 2:Of other people judging you. It sounds like of other people having an opinion about what you did.
Speaker 1:Oh, absolutely, Even if they say they don't have an opinion you can most people can see right through your bull crap.
Speaker 2:I see. So even if people are saying that you're feeling like they're judging or they're having an opinion, they're just not necessarily expressing it Absolutely, absolutely, and I think everybody that has had bariatric surgery has felt that feeling and why do you think that is? Why do you think that other people sort of interject an opinion on this specific kind of treatment? Because it's not like we have opinions about people having, like, their gallbladders taken out or a hernia surgery, or if someone needs some kind of orthopedic surgery for their bones or something. But why do you think this is different?
Speaker 1:Well, I want to touch, based on the whole orthopedic thing that you just brought up, because, look, a person could live with their pain, their lack of mobility right, they could, but there is a surgery to help that. So you're absolutely right. Why is bariatric surgery considered the easy way out, when it gives you the tools, it gives you the opportunity to live a better life, where, if someone has a hip replacement and even gets metal put in their body, their knee, whatever, why is that same judgment not there, especially, you know.
Speaker 2:That's a broken good point. I really never thought of that, because, you're right, something like a hip replacement or a knee replacement or a scope or something like that is a quality of life surgery, right. You do it so that you can move better, so that your knees hurt less, your hips hurt less, and lots of people go through that, absolutely Right. Athletes go through them. A lot of older people go through them through normal wear and tear, and it's not like we have a judgment call to say, oh my gosh, you took the easy way out. We took it in Absolutely.
Speaker 1:And the healthiest person that who isn't obese or has always eaten, drank their milk, right, right. There's no way to predict if a person is gonna need a hip surgery, a knee replacement. There's nothing that they could have done differently to prevent most cases to need those things Right.
Speaker 2:Right, that's such a good point. I really have never thought of it that way and that's a good analogy.
Speaker 1:But to answer your question, about why I think people do have that judgment or that thought is honestly being uneducated. Being uneducated, that like what the surgery entails. What kind of lifestyle does this make a person have? Because, guess what, you can't put a person's stomach back, right, right?
Speaker 2:Well, and that's a good point, because I think a lot of people think of it as either or Like you have surgery and it's a magic bullet and all of a sudden, weight is not a problem for you anymore and it's always fit for forever, right, like? How many people say that? Even sometimes people who walk in and expect.
Speaker 1:Absolutely that happens.
Speaker 2:Come on, guys, as the rest of you do your best, and it's not an either or approach, it's very much a end, it's an end, so it's a half surgery, but there's I mean, you went through the process. There's so much education in preparation to make sure that people know how to take care of themselves and their bodies Afterwards, and that's a lifelong commitment.
Speaker 1:Absolutely, and so, as I told you previously that, as Educated as I truly am, I still Was learning things about this surgery that again made me realize, nope, this isn't necessarily the easy way out. This is the way that I had to take To get to where I felt better, and so the point that I'm getting to is that, like the sleeve, surgery is not a restrictive, just Restricted right to get you fuller faster and all of that that there's actually metabolic and hormonal changes happening. That Helps something that I couldn't help.
Speaker 2:Oh, yeah, absolutely, because there's only so much that diet and exercise can do or medications can do, which is why surgery is ultimately so much more effective for most people who have extra weight, and that's that's kind of the stereotype that we really have to break is. A lot of people who aren't in medicine, but even a lot of people who are, think of surgery as like a cheat code because it fast-forward the processor and achieves more. But that's kind of the point, exactly more effective. It's a more effective treatment and we shouldn't punish people for using a more effective treatment. It's sort of like yeah, you're right Like if you had knee pain or something like that and you could either use a brace or you could get surgery. Sometimes a brace isn't enough, or sometimes physical therapy isn't enough, so you progress to having surgery and then surgery can definitely be enough for some people to treat their pain or to treat their Immobility or other problems. Yeah, yeah, and I definitely think of this kind of surgery as the same, it's not for everyone, but for the people who can benefit from it it's a massive change that can't be Accomplished any other way. There's no other way to reset that thermostat through medications or without surgery, absolutely. Do you think that there's an element of fear involved in how people perceive this and in people thinking that this is the easy way?
Speaker 1:Absolutely so. I think that some people and I'm gonna say from experience I was very on a uneducated judgmental. I was Tammie shame on you I was not very confident, whatever, whatever, I had that same judgment at some point, and so there is yes, I think fear has a lot to do with it that, um, someone is going to fear that there, they may not make it out of surgery, be, they're going to have issues.
Speaker 2:And judgment.
Speaker 1:Right and right that they're gonna have to change.
Speaker 2:Yeah, yeah, because there's definitely an accountability aspect to this. Right, because it's sort of like I Don't know if you get a gym membership or something like that and if you don't go, it's like whatever. But if you do something that alters your body, like Physically changes your body and puts you at some level of risk, potentially right, because these things can have complications associated with them. Sometimes it's a totally different level of commitment and it's not reversible, right, like you can go back and, like you said, put, put that stomach back in. Right, who are? I knew a bypass, really. There's not really a good way to do that or a safe way to do that. So, yeah, you're right, these are not reversible changes, they're not things you can go take back if you don't feel like it later on.
Speaker 1:Yeah, yeah, and so I just think that People that are thinking this is the easy way out truly just aren't educated on the whole Whole process and why people do this. Maybe they're scared of they don't want to have that judgment on them or scared of surgery.
Speaker 2:Yeah, yeah yeah, I would you're if also kind of cost is associated with this too, because a lot I mean you're, you're a coordinator of the program and You've seen this there's people who don't qualify based on their health insurance, or they don't have health insurance that covers this, even if they would normally qualify under guidelines and things like that. So do you think that cost is an element here too, and how people perceive this?
Speaker 1:Yeah, and that costs not even for surgery but cost post-op. Right, there's a little. Oh, that I feel like there is a little extra cost there because you are gonna have to take vitamins and stuff. But yeah, this surgery, like in our program, you see us minimum of four times. And each of those office visits are probably $300, and then you also see a dietitian. That is another hundred dollars or so just giving up roundabout price. I don't know the exact price, but so right, with very that times four. And Then we usually require a scope, which is a whole procedure in itself. And then we may require you to see a sleep specialist, get a sleep study, see a pulmonologist, so, and also mental health evals, and some insurances do not cover these mental health evals. So, that's an autopilot pocket cost as well. So there's a lot of cost preoperatively alone and not everybody can afford that.
Speaker 2:Yeah, I wonder if that is a big element here, because the more we talk about it, I think, the more it becomes obvious. This is kind of the hard way. That's a easy way. Yeah good, like you're saying it's. There's cost associated, there's time, there's preparation, there's potentially making yourself vulnerable because you're undergoing a lot of scrutiny. Really, you're being put under a magnifying glass through this process quite a bit and I wonder if some of this Thought that this is the easy way is kind of a defense mechanism so that people don't have to consider this option or so that people like really can, can make it out to be more negative than it is.
Speaker 1:Yeah, I think you're. You're totally onto something because, as I've said in the past, that I have been a negative person and now looking at being or I'm positive, more positive, you know, looking back, absolutely I was a negative person and shed negatives Right Light on surgery per se.
Speaker 2:Right. Right, because it's kind of easy to poo-poo something and then, as a result, be not, you know, not encouraging of other people about it. And it's easy to poo-poo things you don't know Right, and typically that happens it's out of misunderstanding or fear, or. But I will say one thing I do actually think that it is important to know and be really transparent about the fact that these procedures do have risk associated with them, and that's one another reason that they're not really the easy way out by any means, because both sleeves and bypasses, and then the other kinds of surgeries, even bands, which aren't done very often anymore but are still done sometimes. Well, actually, the reason that they're not done very more is, one, they didn't work. They don't work as well as other surgeries. But two, they actually have higher complication rates. So bands, for instance, can slip, bars can get into the tissue of the stomach or the esophagus, the tube that's between the mouth and the stomach, and can cause really bad problems if that's the case. And so, yeah, like, all of these procedures require people to go under the knife right and fleet for surgery, have anesthesia and have recovery periods and all of that. And actually bariatric surgeries are some of the safest surgeries in all of the surgical field, because there's so many rules and regulations and standards and all of that, which is good, but at the same time it's still surgery, absolutely Right. Yes, still something that either can have a complication but at a minimum is something we can't go back and undo after it's done Exactly Yep, and so I kind of want to.
Speaker 1:This popped in my head too, because I myself have like ADHD and people with that are medicated for ADHD. Again, some people look at it as the easy way out, or even medicating children. Again, this is all parents, whatever you want to do, for I shouldn't even have brought kids into this, but some people may look at me and be like, wow, you're taking the easy way out of your ADHD. There's a ton of things that you can do to prevent some of your sporadic brain or whatever you want to say, but at the end of the day, there is a chemical imbalance in my brain that sure I can do things to ease some of the symptoms, but there's nothing that'll help me as well as my medication does. So, again, that's a really good point. Dying and exercise can help Absolutely, but at the end of the day, for most people it's not the end of the wall.
Speaker 2:Yeah. Yeah that's so true Because, right, it's not an either or and that's the tough part I think about everything is a man. Believe me, if I had a pill for this, if I had a way to wave a magic wand or a magic pill, oh my goodness, would we use it, right? The hard reality of it is, and the reason why I say that is because I personally and I think you agree too I don't have any morality tied up with weight. I don't think it's a morality-based problem. I don't think people did it to themselves and I just don't believe that, and science backs that up. So if we had an easy way to treat this and to manage this that avoided all of these risky things that could be risky, why wouldn't we? You know what I mean. That's the thing that really strikes me sometimes is why do we want this process to be hard? Yeah, right, what does that say about us as individuals or us as a society? That we want the process to be difficult? That doesn't make any sense to me. It doesn't.
Speaker 1:It's just like I've had people say an epidole for having a baby. Even my doctor is like look, yes, there's risk to that right, there's risk to surgery, there's risk to an epidural, there's risk to everything you do, but why not suffer?
Speaker 2:Yeah, why suffer if you don't have to? And that's again personal choice there. People can have any kind of birthday watch or any kind of you know, like that's nobody's choice but theirs. But to say that somebody deserves to have a more difficult time of it than they want to, or that they have to, like that's just. I don't understand why we want to punish people because it feels sometimes certainly being a provider in this field that we expect people to be punished for their rights or punished for the ways that we treat them. And that, to me, is really the thing that bugs me about this approach that we make people full guilty for whatever choice they make and there's no right choice they can possibly make.
Speaker 1:Right, and nobody else should have a say in what choice or an opinion about which choice you make.
Speaker 2:Exactly, exactly, exactly. So that's anyway. I really hope that that is something that more people here, that we have more providers here, because this same approach is just as bad from people who provide medical care as it is from people who receive this affair.
Speaker 1:Absolutely. When I told my primary care doctor that I needed his notes for insurance purposes, that we have tried, you know, wait, you know other things. He's kind of like, are you sure that's what you want to do? But I think at the end of the day he's just not as educated about this specific specialty, Right?
Speaker 2:Right, right, and I don't think there's any shame in that. This is a field that's pretty new. You know all things told. The bypass surgery has existed for decades, but it was actually used as an anti-reflex surgery before it was used as a weight management surgery. So that switched because people were getting it done to prevent ulcers and they were getting it done for reflux and heartburn basically. And then I was noticed that people were losing weight and that became an indication for doing a bypass by insurance codes and things like that. But the sleeve surgery, where we take out about 70 to 80% of the stomach, didn't actually get approved as a bariatric surgery until 2011 by the first insurance company. So it's really not that old of a procedure in terms of like insurance coverage or even being available for people for the purpose of weight management. So the industry is definitely catching up still a lot, because anyone who was trained before that time really didn't have exposure to bariatric surgery being an option for people. And even the ways that we do these surgeries has really, really changed and the way that we support people, educate people all of that, what we know about these surgeries and how they work, has changed really drastically over the past 10, 20 years and a lot of the, like you said, there's still a lot of skepticism from primary care, from other surgeons, from cardiologists, from everyone. Really, I don't think it's any one particular feel.
Speaker 1:Right, and I think this is again just the beginning of education and support, like building all of those things. We can only get better. We can only educate more.
Speaker 2:Exactly, exactly, exactly. Yeah, because I think that there's kind of like a couple of things here that we're hitting on One, which is you know, if there were an easy way, why wouldn't?
Speaker 1:we.
Speaker 2:And that's very truly. Why wouldn't we? Right? And two, you know there's definitely reasons that people either don't think of bariatric surgery as an option or have built-in preconceived notions of it or judgments of it, and so trying to sort of break those down person by person or by crew, Absolutely yeah, and so, yeah, you touched base on time.
Speaker 1:I mean, I had to be in the program for six months. That is one appointment a month. Each appointment is about an hour or so long and that's if your provider is running on time and not chatting too much, Right? Or if you even you can just know you're running usually on time, or even if you a lot of the time, me and the dietitian. Really I had a lot of questions and there's just not enough time. But my insurance required six months. Some insurances required 12 months. Some insurances require 36 months of documented obesity or trying to help lose weight. All of that so yeah.
Speaker 2:Yeah, we actually had. I think you were involved with both of those patients, but we had two patients this year that were denied their surgeries because Initially there wasn't documentation going back three years, and it wasn't just three years of documentation. The insurance company wanted photos and documented notes from that per those. Those individuals had to have primary care notes as well and I'm like who on earth goes to their primary care doctor at this point, like once a year, on a regular basis? Who provides Photos in that documentation? We don't take photos in our documentation on a regular basis. I was like what?
Speaker 1:Yeah, that was. That was crazy. That's required. That was crazy and we did. We went above and beyond to like yo Insurance. This is not right.
Speaker 2:Oh yeah, we filed right, we filed appeals and things like that, but one of those actually we did not win because that patient did not have a BMI that was over 35 for three years and that was their requirement that she had to meet criteria, not just now, not just within the time she was in the program, but for three years prior three years. That's me just, you know that kind having to jump that kind of poop and making the poop be in the stratosphere instead of on earth. It's just, it's discrimination, honestly. I think that that's just plain discrimination. It's not based on science, it's not based on good patient care, it's not based on having, you know, supports that allow people to live high quality lives and be present for their families and their work, and you know everything.
Speaker 1:That's just straight up this, this mentality that we don't want people to access this care because we don't believe it just like medical weight loss, were struggling to get things approved and Some insurances allow it, some don't and some have and decided right not to right at the beginning of the year. A lot of patients I've been getting Forms saying we are not going to be covering this medication.
Speaker 2:So Exactly exactly and with a lot of things. I mean, I do think we touched on cost a little bit earlier and you're right, there's a lot of upfront cost but there's actually really good. There was a study that was done a few years ago that that followed people for years and years after surgery and it showed that the return on investment was basically realized in about two to three years, right, so what you're investing now, or what an insurance company is investing now, decreases the risk of future health problems. There's even one study this is kind of interesting, or actually, I think, two studies that show the people's salaries, like their incomes, go up after surgery, which is kind of interesting, and there's a lot of factors that were like how, how fascinating, you know, because people's lives change, not just in what medications they take and like what their health outcomes are, but way bigger picture than than just this one, and I can touch based on the salary thing of if I didn't have surgery, I would have never stepped out my comfort zone and applied to be a bariatric coordinator, which was Quite more pay than being a respiratory therapist in my case.
Speaker 1:So I think people you know having the confidence and all of that, that's why their salaries go up is because they're willing to step out of their comfort zone.
Speaker 2:That's fascinating. That's so fascinating and I think that's that's kind of a silver lining. I don't think anybody goes into surgery saying, oh, I'm gonna make 20% more neck first, maybe we should maybe that would be a good way to, you know, promote this.
Speaker 1:Yeah, but there's just so many silver linings to this process but that does not make it easy and that doesn't make it not have challenges, and that's, that's the approach that I wish more people understand and I want to touch base on another aspect that people don't think about, and Sure, if they want to think that getting to surgery is easy, but, like postoperatively, again, you have vitamins that you have to take every day, guilty of forgetting to take those, you know can't indulge in things which, mentally, let's talk about. Mentally, the yes, anxiety and depression can get worse. That's why we Require mental evaluations, just to make sure there's no underlining stuff that can really Come to surface after surgery. But me myself, I feel like I am very self-aware of my anxiety, my depression. I'm really good at keying in on that and, you know, treating it how I need to. But that still doesn't take away the fact that Some of my mental health has been a little worse. My anxiety has gotten a little worse and I I think that anxiety has to do with yeah, do people think that this was the easy way out and what are they thinking about me, like you know.
Speaker 2:So yeah mental health has a big play in the aftermath and Because you take away that comfort of eating when you're emotional and you got to figure out a new way to cope Right, and that's a good point, because it's sort of it changes so many things about what is normal in your life, because your, your normal, becomes different in all the way absolutely. Great. We've heard people say, and I think you've even said like you run circles around family members and that can cause that's great in some ways, but it can cause some annoyance or, you know, frustration and some rifts. What you find to be an interesting thing to do is different, because you you've mentioned yourself like going out more or Wanting to go out more, and that sometimes isn't what everybody else in the family Expects or wants to do, yeah, yeah.
Speaker 1:My husband, you know we've always gone out, but he said he never expected that I would do just a complete 180. And how I used to say, no, I don't want to go out anymore, I can't find anything to wear, or just didn't feel in the mood to go out Probably anxiety, depression. And now I'm just like, yes, let's go out, let's go out, let's go out. And so that's a relationship change that we're. We are Figuring out as well that we are navigating and absolutely it's not easy.
Speaker 2:And would you say that it was easy to meet all of the expectations that you had, or even know what to expect for after surgery?
Speaker 1:You have no idea what to expect after surgery, because everybody's different, right? People always ask me what was your pain level? What level, like all the things that I'm like? Well, here was my experience but you could have a totally different experience.
Speaker 2:Right, exactly. Yeah, because you're absolutely right. There's a few things that are standard for everyone. Like you said, there's vitamins. You have to drink 64 ounces of fluids a day. We want you to stay active every day, like there's some basic tenants that apply to everyone, but how people experience everything is going to be unique, absolutely.
Speaker 1:And how much weight you lose, how it looks coming off. And that's another thing. That's not easy is looking at your body. So looking at my body obese, it was hard, but I feel like now it's almost harder because of loose skin and stuff like that.
Speaker 2:So a lot of mental it's just a lot of mental, a lot of mental, a lot of physical changes and changes are never easy, especially all at once, and it is that way, isn't it? It's kind of like drinking from a fountain.
Speaker 1:Yeah, hmm.
Speaker 2:Well, you know, I do want to just say that I really do wish that we had easier ways for people to do well after surgery. Even in the current state, I wish there were easier ways to treat and help people that weren't surgery, and I think we're starting to see a lot more movement in that area and I'm really, really proud to be creating some things with you, tammy, and you leading the way to creating some things that really support people after surgery, because I think this is a way that we make people's lives just a little bit easier.
Speaker 1:Absolutely, absolutely, because having people in your court makes life better, definitely. And people that understand and truly are not judging you, and you know that for a fact. So I'm selfishly doing this. We're building this community for me so I can have friends.
Speaker 2:No, oh my gosh, I love it, but also for me, I feel kind of selfish about this too, because these are the kinds of things that make it so rewarding to see people do well and to see people really thrive and be able to do all the fantastic things that they walk in wanting at the end of the day, all the goals and things like that, and long term, it's really really hard to do on your own, and so maybe creating some easy paths for people that would be cool. That would be great.
Speaker 1:Add another thing to the list, right.
Speaker 2:Right. Well, thank you so much for being willing to talk to me today team about this, because I know the easy way is something we have talked about a lot and is out in the world as a discussion point for Bariatric Surgery a lot. But I'm glad we kind of tackled this and hopefully have helped other folks just feel maybe a little better, a little easier today. How about?
Speaker 1:their decision, absolutely so make sure. Thank you all for listening, make sure you follow our podcast here so you get notified that we uploaded another episode. And again, feel free to leave comments to let us know what you want to hear, what you want to talk about, because we are listening. This is not only my platform to help other people, but your platform to tell us how we can help you.
Speaker 2:That's right. Thanks so much, guys, see you next time. Bye.