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 28: Managing Food Noise and Men and Weight Loss
Our conversation doesn't stop at food noise. Men, this one's for you too. We dive into the societal expectations and stigmas men face when it comes to weight management, and why it's crucial to overcome them. Discover the tangible health benefits weight loss can bring—from improved fertility to better sexual health—and hear inspiring stories of transformation that go beyond physical appearance. Whether you're considering bariatric surgery or simply looking for ways to manage your weight more effectively, this episode offers valuable insights and encouragement to support you on your journey.
Welcome to Core Bariatrics Podcast, hosted by bariatric surgeon Dr Maria Iliakova and Tami LaCose, bariatric coordinator and a patient herself. Our goal is building and elevating our community. The Core Bariatrics 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. Hello everybody, Before we get into the episode, I just want to apologize for the echo that happens throughout the episode. Hopefully you all can get through it without having to turn it off, though if you do, we understand. But thank you for continuing to listen and let's get into today. Okay, maria, here is another day of recording.
Speaker 2:we are so busy we're so busy.
Speaker 1:We're kind of um flying by the seat of our pants with episodes lately, just because we are so busy that sometimes it's hard to touch base with each other and record.
Speaker 2:So we're flying by the seat of our pants.
Speaker 1:I feel like we do that a lot anyways, so we've been successful so far.
Speaker 2:Let me tell our listeners one thing about flying by the seat of our pants. I think your version, maybe my version too flying by the seat of your pants is the most organized version of some people's lives.
Speaker 1:You know, you're probably not wrong. Actually, yeah, by flying by the seat of our pants, we do have an outline there's an outline.
Speaker 2:Not only is there an outline, but, like tammy, you created like a hundred outlines for this podcast and done a ton of background research and you've gotten interviews with all kinds of people. So I think your version of flying by the seat of your pants is my best day.
Speaker 1:Yeah, you're probably right. So on one of our last episodes we started doing fan mail, so I'm going to start with that and then we'll go on to. We're actually going to talk about men and bariatrics and surgery and whatnot.
Speaker 2:So, yeah, let's do it.
Speaker 1:All right, let's start with the fan mail here. We got a message saying can you talk about food noise, weight loss shots after surgery due to food noise? Um, we'll start with that, because then she also um discusses or asked and flavored water, such as crystal light, does it make you want sweets, versus having plain water? She struggles getting water in unless it's flavored, but I also. But she also seems to want sweets, so she battles with wanting sweets just to have them, but it doesn't actually want them, if that makes sense, which it does to me. So we'll start with the first thing of talking about food noise and the why people, or why physicians, use weight loss shots for the food noise.
Speaker 2:Sure, I'm gonna let you run away with that. Let me run away with that, because I actually will contradict that just a little bit, even to begin with. So uh there's actually some really great medications on the market that help with not just weight loss but specifically this food noise thing and food noise. Let me just explain like what that that is, if someone's wondering what that means, it's this constant need to be eating, this constant feeling and thought of like I want food, I want to be eating. What's the next thing I'm going to?
Speaker 1:eat. What am I going?
Speaker 2:to be making for dinner oh my gosh, I don't think I had enough earlier. And I have actually struggled with this because I have a history of an eating disorder and food becomes like one of the most, if not the most, important thought in your brain, to the point where it kind of disables you from doing other really important things in life sometimes like job or school or you know other things, and uh, it's really a mental, it's partially mental, it's partially physical.
Speaker 2:There's lots of things that go into that, but it's also behavioral, like how you, how you are trained or how you are raised or how your environment is structured. There's kind of a lot of factors there and, to be honest, the medication I prefer over all of them even over Ozempic and Majaro and all the GLP-1s is actually Contrave and I think people kind of forget sometimes that there's actually 10 FDA approved medications on the market for weight management and Comtree is one of them and it's a combination of two medications that were actually discovered for to help people quit smoking, because it helps with that kind of obsessive or overwhelming drive to do something, that kind of almost OCD or anxiety driven need to do something, and whether it affects smoking, it also actually affects that desire for food. So it actually is one of the most effective medications and things on the market to tackle food noise yeah, yeah, and now explain what contrave is.
Speaker 1:What medications are it? Because, if I'm not mistaken, there's two, and one of them. A lot of people tend to be on anyways.
Speaker 2:Yeah, absolutely. So. People will be surprised that it actually. Yeah, it's a combination of two medications One is bupropion and one is naltrexone, and bupropion is also known as Welbutrin, which is used for anxiety and depression and many other mental health conditions and, yeah, also used for it to help people quit smoking. Even by itself, it is very, very effective to help people lose some weight if they've got extra weight, and to maintain weight. And that's actually pretty unusual in the sense of mental health medications, because most mental health medications cause people to gain weight.
Speaker 2:So you can only imagine what it was studied for, uh, to help people quit smoking. Typically, when people quit smoking, they actually gain weight because, um, there's there's kind of a transference of the, the, the food behavior with your mouth Also just wanting to do something in between doing other things or when you're bored or just having a habit of of some doing something, and instead it gets transferred to eating, Right? So typically people actually gain weight when they stop smoking. But when they stop smoking using this medication, Contrave specifically, they actually lost weight and so of course the company was like immediately on that and had a study for the purpose of weight management and weight loss and got it FDA approved and it's the only type of medication in its class.
Speaker 2:It's actually way less expensive than the shots, than Ozempic and the other GLP-1 medications, and it's super underused. And I am in no way sponsored or affiliated or anything like that with Contrave, but I will say that in my own practice that has been the number one medication because it is about equally effective. Definitely it's less expensive for most people, especially without insurance, and it super addresses that behavioral and mental aspect of food noise and with that I'm so sorry. I feel like I snuck all the air out of the room with that one, but no, no, you made a good point there.
Speaker 1:that I wanted to really emphasize is that I feel like food noise and even Dr Teresa Lemasters has talked on this that food noise really is a mental I don't want to say a mental health issue per se, I guess, but it's mental right, and so when you have a medication that's helping you with that mental aspect, it helps with that food noise honestly. So I have ADHD and my ADHD meds kind of helps with that food noise honestly. So I have ADHD and my ADHD meds kind of help with my food noise, because without my meds I'm kind of scatterbrained all over the place. One of those things is food, where when I do take my meds, I am very able to focus on work or stuff like that instead of worrying about what I'm going to eat next.
Speaker 2:Absolutely, absolutely. And actually Vyvanse is off label for weight management and weight loss in part because of that, because a lot of people, um, who have either food addiction or like over snack, over eat, uh have have kind of this food noise also going on, um, whether it leads to actually eating or not, but have the food noise actually have ADD or ADHD or features of that. So treating that can help with food noise. You're absolutely right there. So I wouldn't say food noise is in and of itself a mental health condition or issue, but it absolutely is tied to a lot of a lot of them. And then not only that, but I do think in the US especially, we havea very snacking based culture yeah, we do.
Speaker 1:Oh my gosh, there's so. My boss has so many snacks in our office. I mean chips galore, cookies galore.
Speaker 2:I'm like stop it but that's how she shows us her love.
Speaker 1:honestly, I feel like, yeah, is that she's like thank you so much for how much hard work you guys do.
Speaker 2:Here's all the snacks and I'm like oh, I think we just we come from very food driven cultures, even my family, you know, coming from Russia when I was a kid. We're a very food driven like. Food is love and sharing food is love and that's how we build community.
Speaker 1:Yeah, your Thanksgiving was bombcom.
Speaker 2:Thank you. I thought so too, thank you, but no. So food is really, really critical in our cultures and the the. When we compound that with how busy we are in our lives, it's really tough to eat healthy and to eat full meals necessarily that are full of like all the good things for you. So, uh, a snacking culture plus being busy plus food noise, that's just a really tough combo to do without support. Not to say that everyone needs medications for that, but routine definitely helps. Cutting back where you can on your schedule to give yourself space and time to actually eat properly or snack properly. Having other kind of go-tos to deal with anxiety stress, like working out or doing a meditating, doing other things you really like to do, can help, but definitely medications play a big role there too.
Speaker 1:I feel like us, as a society of we, are go, go go. We struggle with mindful eating like just mindlessly eating.
Speaker 1:Obviously, if I'm charting and of course there's chips next to me, I'm mind mindlessly eating. So so I think we kind of touch base on the food noise thing and you said you like using those the contrave, and some people use vivance and stuff. Um, because the weight loss shots? Now, let's try to touch base on that as quickly as we can, even though it's probably a whole episode in itself of why those shots might be used just for food noise.
Speaker 2:Because I actually want to know the answer.
Speaker 2:Yeah, we don't know exactly. Again, we don't really know the mechanism in terms of our brains and the true like what parts of the brain, what parts of the body are interacting for food noise? It's probably more complex than just one pathway. We do have an episode where we talk a little bit more about the shots, which are also called the OP ones like Ozempic. So I do recommend, if anyone's interested in that, that you kind of go to that episode for more details.
Speaker 2:But in the same way that Contrave and other medications hit that pathway, it seems like these shots also address that pathway. That's not the primary way that they work, but that's definitely one of the ways that they seem to work. And I will say, actually for many people, surgery itself also addresses that pathway. It doesn't for everybody, but it does for a majority of people. So the combination, especially of like surgery plus one of the medications if you still need it afterwards, can be even more powerful. So there's really all, all options on the table and if it's something that you're dealing with, I really would recommend talking to a specialist, because I don't think this is something a lot of primary care doctors or generalist doctors or, you know, just medical professionals really know about or know what to do about, unless you're talking to someone specifically in this industry.
Speaker 1:We're trying to get the word out, but it's not so quick question with that. If you knew, if you knew, if you had one. Let's say I came to you as a patient, obviously saying I have all this food noise and I'm clearly gaining weight and but you know, my insurance covers the weight loss injections and I can get it super cheap. Would you go towards the injections or would you still start with the?
Speaker 2:No, I would still start with Contrave, and actually we did that. So, even if people have diabetes, even if people have conditions like now uh, now, glp ones and the other injectable, the shot medications are covered in some insurance policies, even for, like heart conditions and some other things like Nash um, which is liver, fatty liver disease Uh, even if it's covered for the majority of people, I will actually still pick contrave, and there's a couple of reasons for that. It's a pill. It's tolerated better by most people. It doesn't have some of the side effects that the injectables do.
Speaker 2:It doesn't slow down the function of your gut, which can be a really big side effect for people, especially after surgery, when the function of your gut is already a little bit altered. So it really yeah, and there's definitely a subset of people who have really bad nausea, diarrhea and other GI symptoms that go along with the shots. That's just super uncommon to contrave. So for all of those reasons, I still stick with that medication as my go-to not for everybody.
Speaker 2:Everybody is still an individual and this is not advice for any one individual. I have to stress that this is a podcast for anyone listening, so we do not give any individual medical advice on this podcast, nor could we.
Speaker 2:And all providers are different too, and all providers are different too, and all providers are different, and so it also depends on what are people comfortable with? What do people know about? Some people who prescribe weight management medications don't necessarily know as as much as others do, or don't have a have a practice of including things like contrave in it. So, um, I do encourage people to look into it, to become as educated as they can, and it's also kind of nice that there's not just one possible treatment for this. There's more than one, especially if people have insurance coverage or the luxury of being able to afford things out of pocket. So, in a way, like I'm actually really glad that there's not just a one size fits all solution.
Speaker 2:There's multiple options.
Speaker 1:Absolutely, and I think we have touched base on this before about the flavored water thing, because I told you that previously I've been able to drink just plain water and now, good luck, unless I am literally dying of thirst, I need to have crystal light in my water. In my water, um, now this lady, that or person that wrote in I don't know if it's lady but um, does it ask if? Does it make you want sweets more? Yeah, and I have said that some of the I don't think that the crystal light does specifically, but if I overdo the fake sugars, I do find myself wanting sugar more or sweets more but not just my flavored water.
Speaker 2:Yeah, you know, and I think it's a matter of a little bit of a threshold, Like if you like.
Speaker 2:You said like it's not any amount, it's kind of like if you overdo it a little bit, I will say, um, and this is only because, like, I grew up eating food different than the average American diet. I grew up eating food that we cooked at home. That was kind of part of our culture. And I will say Russian food in general, or the stuff that I ate as a kid, is a lot less sweet than than what's typical in American culture. So I think it's a little bit of like what your palate is used to. If you're used to things that are sweet, you're going to continue craving things that are sweet.
Speaker 1:If you're used to things that are salty.
Speaker 2:You're going to continue craving things that are salty, even if your body has changed. And then there's also we know that this happens again. We don't know a hundred percent why or how or like how to predict it, but people's taste changes after surgery. Um, it can actually change after any surgery that affects the gut, but it really can change after bariatric surgery, after weight loss surgery. So there's when you say that, like you used to drink water plain and that was great and that was fine, and now you can't stomach it. There's actually some science and some truth to that, but we just don't know why.
Speaker 1:Why? Yeah, and I will say that. So Light packet usually goes in like a 16-ounce bottle. I'm putting it in a 40-ounce Stanley cup, so maybe this person is putting it in the 16-ounce, where it is much sweeter. So you could try to water it down a little more and wean your way to less sweet. You don't have to get rid of it per se, but trying to get it less sweet maybe.
Speaker 2:And the weaning thing is actually really important.
Speaker 2:Very little, very few changes happen overnight successfully, and when we're trying to change our behavior, when we're trying to change like our habits and what we eat, what we drink, how we go about our day, change like our habits and what we eat, what we drink, how we, how we go about our day, it I would recommend taking a slow approach to those things.
Speaker 2:So, let's say you're trying to add a little bit of plain water, don't start by, like you know, five extra glasses a day. You're probably going to be miserable and be stuck in the bathroom all day and a lot of other things. Instead, try one extra glass and see how it goes for a week or two, and the same thing with this. If you're trying to decrease how sweet you drink things, maybe take it down a notch a little bit and take it down for a week and see how you feel, and then take it down another notch for another week and see how you feel, because you know how do you eat an elephant One bite at a time, right, right, absolutely. I wouldn't recommend approaching really any change in a drastic way, because that is going to be a likely setup for not being able to do it long term.
Speaker 1:Yeah, I know people that just start drinking a gallon of water after one day and they're like never mind, I can't do that. I'm in the bathroom constantly and it's like, well, if you gradually work up to that gallon, your body knows what to do with it, but if you just start throwing water at it, it's like what is this? We need to get this out Totally, Totally.
Speaker 2:I mean, like, think of it like almost like a new job. Right, If you were supposed to, if you were at the expectation where that you knew absolutely how to do everything in your new job the first day that you got there and you were going to be perfect at it, then maybe you should have a different job and maybe you should be your boss at that job, so right. So think of it that way when you're making changes, there's a transition period. So take it, take it slow and take it over time. And that's hard to do because it's not like, woohoo, I changed something overnight, but at the same time, it'll probably give you a likelier chance that that change sticks.
Speaker 1:You're absolutely right, all right. So I hope that answered that person's question. So let's move into men and bariatrics. Yes, do you know what the percentage of men actually getting bariatric surgery is?
Speaker 2:I do. Do you know? Do you want to guess?
Speaker 1:Honestly, in the year I was in the clinic there was honestly only five, I think, so I'm going to say 3%.
Speaker 2:Actually it's higher than that. So it is about 20% overall, but it varies by region.
Speaker 1:And I think that's where this might have been is because we're in the Midwest or at least our practice was and try and get these, Nevermind.
Speaker 2:Yes, well, yes, exactly, exactly. So one is. That's pretty shocking to me because, even though men are just as likely to be overweight as women, in this country and globally, like all over the world, only our patient population that actually gets surgery is only 20% men, so that's basically the 80%, four and five of the people getting this kind of care are women and only one in five is a guy, even though the numbers are the same in terms of who actually deals with these medical problems, and there's actually some really good data that shows that men who have diabetes or men who have heart problems or men who have high blood pressure things that can be related to weight, especially extra weight they actually suffer more long-term. They have higher rates of dying younger. They have higher rates of dying younger. They have higher rates of having complications. They have higher rates of having higher costs associated with it and even experiencing like bad complications, like amputations, losing a leg.
Speaker 1:You know you're right Now that I'm thinking about my inpatient population.
Speaker 2:Yes, yes and so, and it's also in part because, like, men are slightly likelier to smoke, Men are slightly likelier to smoke, men are slightly likelier to have like lower socio, like social support, which also is a big factor.
Speaker 1:So all these, things.
Speaker 2:It's not just like yeah, and it's not just to say that, like weight affects men more, right. But given the overall picture of like how men age a little bit differently than women do, typically the outcomes for men are worse when they're overweight than they are for women.
Speaker 1:I did not know that.
Speaker 2:So that's all to say. Where are the guys? Where are the guys? What do you think is going on here, Tammy?
Speaker 1:Well, I was actually just gonna think or just gonna say do you think some of it has to do with how and we've touched, based on this, on an episode two of how dad bods are more accepted than a mom bod per se, or maybe us women just don't like them as much, I don't know I don't know, I think there's.
Speaker 2:I mean, it's so complex, right? Because like we want and as a culture, I feel like we prize like big, strong, burly dudes.
Speaker 2:And some of that is actually extra weight, Like it's not necessarily extra health, it's not necessarily like extra like muscle mass. It's just people being big. And if people are functional, if people you know are not having a lot of other health problems, and if people are overall healthy and they like how they look and they like how they function, they like how they work, that's great. That's not who I'm talking about. What I'm talking about is, um, you're right, Like I don't think body image is any less bad than in men, than it is in women. I think there is just different. And so the body type of we want women to all be skinny and you know have have looked like supermodels on billboards.
Speaker 2:And for guys, we want them all to look like lumberjacks, Like that's kind of the you're not wrong, and lumberjacks is typically not what you associate with weight loss or weight loss surgery, so I do think that is a big part of it that I will. I think that men especially are worried that if they go into a weight loss clinic or a weight management clinic and definitely if they're discussing surgery or medications that one they're going to potentially lose too much weight, they're going to end up looking a way they don't want to look, oh, maybe. Two, that it's not going to work. Or three, that they don't want to be there in the first place. Right, because there's some really good stats and data on this that men in general go get care less than women do.
Speaker 1:Absolutely, and they wait until it is the last resort.
Speaker 2:Yes, yes. So I think that and we've all experienced that, like I've had guys in my life family and otherwise I won't call anyone out specifically who you basically have to drag on their deathbed to a clinic or the hospital. So there's already some resistance to getting medical care. That's more in men than it is in women. And then on top of it you put something like weight loss, which has a lot of stigma and has a lot of uncertainty and may be expensive, may be painful, may change your life in ways you don't necessarily want it to. So you know, all those things combined, I think, make it really tough for men to feel supported and encouraged maybe even by other men to go get this kind of care, which most providers are men.
Speaker 1:right, like you are in a man field, right?
Speaker 2:I'm always in a man field.
Speaker 1:So honestly, I feel like a lot of our men patients did like seeing you as a woman provider because maybe there was less judgment there or not, that they felt like there was less judgment.
Speaker 2:I never thought of that. Yeah, no, that's actually. That's pretty insightful of you and I actually had some of our male patients say that to me specifically. They said I'm so glad you're a woman, I'm so glad that you're taking care of me, I feel more comfortable with you than if you were a guy, which I did not. Those were not comments I ever solicited or encouraged or asked people for. But I will say, almost every single one of the male patients I had did say that out loud, even though we didn't prompt that or anything.
Speaker 2:So, there is maybe something to that, that I think there's this perception that women who are doctors or women in healthcare in general, are just going to be a little bit, maybe, kinder or gentler or more accepting Maybe. Maybe that's part of it. I do think there's something there, because definitely yeah.
Speaker 1:I said we had the best of both worlds in our program. We had you and another provider that were just polar opposites and there was nothing wrong with it. I really said this is like the dream team, because some patients need a provider that gives them a little extra TLC and attention and just caring Right. But then there are some patients, women and men that just need to be told this is what you're doing, this is what, and just be harsh and blunt and to the point.
Speaker 2:Yeah, and I think you're absolutely right. You know there's circumstances in which harsh and blunt works well and there's people with whom that works well. In general, that doesn't work well for me because as a woman, that's just perceived totally differently when you do it than when men do it on average. So I try not to take that, that um. It doesn't come naturally for me with patients at all, so I don't do that Um.
Speaker 2:I will say, though I think that some, you know, what's interesting too is, even though 80% of the patients in this field are women, uh, about 70 to 80% of the doctors and the healthcare providers are men in this field. So there's absolutely a flip-flop and that's changing. So, like in my class, we had more, we started to have more women that were becoming bariatric surgeons, and that number is only increasing, but we still have a long ways to go there. There's a lot of the huge majority of people that are in minimally invasive or bariatric or um anti-reflex surgery or robotic surgery are men still. So it's much more likely if you go to get this kind of care, that you are going to interact with a, with a male surgeon, and I do think that there's some barriers there with men going to see a male doctor about something as personal and stigmatized as weight.
Speaker 1:Right.
Speaker 2:Um, but let me throw this in there. So I think one of the things that people don't know but may change some people's minds is that weight loss, especially through bariatric surgery, can improve your sex life and can improve fertility.
Speaker 1:Right. Yes, we have talked about this.
Speaker 2:Yes, we have a whole episode on this, because it's one of my favorite things to talk about, because so few people know about it and no urologist knows about it. No OB guy knows about it. Very few primary care docs know about it and definitely like very little of the public knows about it.
Speaker 2:But even though we know, like PCOS, which is polycystic ovarian syndrome for women can be treated with this. For women who have extra weight, it can be treated with bariatric surgery or with meds medications for weight loss. The same thing applies to men If you have hormonal causes for extra weight and that those hormonal causes can also impact your fertility or your sexual health your ability to even get it up, have an erection have good sex, and so 201, essentially patients who go through this, male men who go through this, see an improvement.
Speaker 1:Yeah, that's nothing. That's something that most men are not thinking about when it comes to losing weight.
Speaker 2:No, you're right and that and I know you think they should because you say it as much as you- can yeah, because like think about how much of a self-confidence boost that is, how much of a again, like if you're struggling with fertility, if you're struggling to have a child with your partner and not even being like, not even realizing that weight and your metabolism could be a factor right it's a factor that can be treated and cured potentially.
Speaker 1:Yeah, like that's, I think, a really important takeaway and I think that just makes me think that you know, if a doctor had two obese, an obese couple, come in. You know both, both heavy, who are, and they're struggling to get pregnant. Who are they looking at first? Yes, it ain't the man. They're saying oh, the woman needs to lose weight.
Speaker 2:Oh, the woman needs, yeah exactly, exactly, and so I I think that, in general, the health care system is, in a way, almost built to help women and help like focus on women in a way differently than men Maybe not better, but differently and so we see weight as a problem more for women than for men. I think we judge women more for having extra weight than we do men on average not everyone, but on average and I think we, we dictate to women that they have to do something about it more than we do for men. Yeah, and all of those factors, I think is also like, because of all of that, uh, there's a lot of marketing that goes out to women, there's a lot of education that goes out to women, there's a lot of um, even insurance policy that goes out to cover women.
Speaker 2:There's a lot of education that goes out to women. There's a lot of um, even insurance policy that goes out to cover women, even though the benefits are arguably greater for men, because the complications of the extra weight are higher for men than they are for women. And uh, yeah, so, and especially for younger men, because the longer you have heart problems, the longer you have diabetes, the longer you have high blood pressure, the longer you have hormonal problems that affect your fertility, the worse your outcomes will be over time. And we also yeah, we do see men developing these problems at earlier ages than women do.
Speaker 1:And I just feel like men are not scared or approached about weight and stuff as much as women are. We go to our appointment and, honestly, at any time our BMI is higher than what it should be, they'll say we should lose weight. I don't know if that's the case when it comes to men as much, so that's where I feel like men need to get to the point of having a heart attack or having extreme diabetes before a doctor is like oh, maybe we should look into losing weight.
Speaker 2:Yeah, and you know that's actually. That brings up a really interesting point, because I have a personal, personal connection, personal somebody in my life who recently had a heart scare, a heart problem, and it really caused them you bring that up. It caused them to focus on their weight and to actually start asking about what are the options. Do I consider surgery? Do I consider medications? They got on medications and they did lose some weight and they feel a lot better. Um, they may or may not have to stay on their heart medications, but they're at the point where actually one of them could be taken off because they've lost enough weight and the lost weight also enabled them to be more active, which enabled them to be their their heart health to get even better.
Speaker 2:So, that's the other thing to think about is, when you lose weight, you're not just losing weight in a vacuum. You're also losing weight and therefore sometimes able to move your body differently, sometimes able to exercise better, sometimes able to come off of other medications, sometimes you're improving things in a way that's not necessarily like one plus one equals two, but even more, and that's really really important to realize. And, um, yeah, so I think there's there's a lot to be said, for it doesn't have to be an emergency or a crisis for someone to really consider weight as something to tackle whether you're a man or a woman.
Speaker 1:And, believe me, we welcomed men the same.
Speaker 2:We welcomed men, absolutely the same, and I don't think we had a single guy who regretted being there, regretted going through their process, regretted going through the procedures. All of them 201, were like. I had several cry in my office afterwards because of the results that they were seeing and how it was changing their lives. So the impact is really massive, can be really massive.
Speaker 1:How do we get them more comfortable of coming in? Okay, not even just to a bariatric program, but to the doctor in general I think that's something we're not going to be able to figure out in our lifetime to talk to some guys. Yeah, you're not wrong yeah, so we'll.
Speaker 2:we uh, we actually have a couple of folks lined up to interview for this in the future, um, so that we can truly talk to some people who, I think, have some good ideas about how we get more men in the door and how we get more guys thinking about this, cause I think really, like sex is going to be a driver, right? Who?
Speaker 2:doesn't want to have better sex in their life and maybe fertility for some, for some of them, um, having babies is a big driver for younger guys for sure. Uh, and then overall, just being able to like move your body better and being there for the people in your life and being able to do your work and you know, rocket, be confident, be satisfied, not have to spend a lot of money on medications, not have to worry about having a heart attack soon or down the road. I mean, I think it's, yes, I think there's a lot of reasons that people could walk in the door or could want to, that people could walk in the door or could want to, but this is not a yeah, this isn't, this is not an easy issue.
Speaker 1:No, yeah, those men are not easy.
Speaker 1:No, just kidding Us women are not easy either, but I know, I know my husband like he doesn't want to take a day off of work Right, because he knows he has to. Okay, I have a very well-paying job too, but he knows he needs to provide for his family and he is also very, very wanting to make sure he is there for his work as well, so he doesn't want to let anybody down. So that's when I'm just like if you don't go to the doctor, I'm going to drag you there.
Speaker 2:I love it Well, and it's one of those like put your oxygen mask on first kind of situation.
Speaker 2:Before, like put your oxygen mask on first, kind of situation. Yeah, I mean like I've seen this with a lot of guys in my life a lot of women in my life too, but a lot of guys especially where you just drive yourself until exhaustion and then at the point of exhaustion you're not really useful to anyone, you're not useful to other people, you certainly aren't useful to yourself, and getting to that point is kind of awful in a lot of ways. So, taking a day, taking a minute to really think about you know what, what if I fill my tank up now so that I can prevent becoming a big healthcare burden on, do the things I love and avoid mental health issues, oh yeah.
Speaker 1:Because, if I'm not mistaken, the statistics are more men commit suicide than women, I believe, because you know they bury it so much and like they have to be strong and all of that. So that's something to think about too. I don't know. I know that if there is any man that's listening to this, you know I obviously put myself in front of all of our patients at the checkout area, any man that came in. I'm just like I am so proud of you that you're here, because, yeah, not a lot of men do come through and they were like it did take a lot for me to get here, but now I am happy that I am here. Or the ones that have gone through there, like that I am here, or the ones that have gone through, they're like I can't tell you how much happier I am and I actually my husband's two coworkers have had surgery and they're just totally different people and they can work so much better.
Speaker 2:And yeah, and a lot of people and like you've mentioned this before. But you don't even know how good it can get until you do it. You don't even know what the benefits can be until your body is doing it and it's not hard for you right, yes, like me taking a two and a half mile run, or walk, not run jog.
Speaker 1:Um, when I'm on call now, I, as long as it's somewhat nice out um, I'm taking at least a two mile walk around the hospital and it's like nothing to me. I could keep going if it wasn't eight, nine o'clock at night, but it's just something that is so hard to explain that even walking up the stairs into work previously was hard.
Speaker 2:Absolutely, and that's like again. It's hard to like know what you don't know if that makes sense.
Speaker 2:And I've experienced this too, where, like it's almost like learning something right, like you learn something and then all of a sudden it reframes everything that came before and this process really for people like I've seen, people who didn't think that they could yeah like run a mile or um do, oh my gosh, what was one thing there's, I mean, or apply for a job they didn't think that they would be able to get, and like, within a year of doing surgery, they're doing things they just never thought.
Speaker 1:Just more confident. I've experienced that. I'm okay with putting myself out there.
Speaker 2:Absolutely. Or like we've had patients who said they were able to take care of a family emergency in a way that they absolutely would not have been a year before or six months before surgery. Yes, yes. At the same time, I do want to just one big, big, big like stop sign, caveat, red flag, whatever. I never want to be in the position of. I never want people to be shamed about their weight and I don't think it is okay for anybody myself, any other, any primary doc, anything like that to bring up weight in a shaming way for a guy to visit. So that's not what we're encouraging.
Speaker 2:I don't want anybody to go out there and say, hey, we heard on this podcast that we should be like telling every guy who has extra weight that he's a problem and something needs to be done about it. Absolutely not. What I am saying is this topic should not just be a woman's topic or a female centered topic, because men benefit from treatment when, when they have extra weight. That causes issues just as much potentially even more than women do. So don't avoid the conversation for men if you have it for women, and try to be really mindful and humble about how you have it.
Speaker 1:And this is just something for a man to think about as we're closing this out. You know, us women think about this. What happens if I'm not able to take care of my kids, or take care of my spouse, or take care of my parent, or just what happens if I'm not able to work? What's going to happen to my home, my car? So I know obviously most women think about these things daily. They worry about those things. So it's just something I want to put in a man's mind that might be listening to this of you don't want to get to the point of you can't take care of yourself, can't take care of your family, you know, can't provide. So just something to think about that you don't want to get to the point of not being able to do it, and then it's a last resort.
Speaker 2:Absolutely, yeah, absolutely. So the other, the only other thing that I'll mention that we haven't touched on yet is reflux, because reflux is really really common. It's heartburn, right? So, like people have heartburn from eating spicy, foods or laying down and sometimes can't sleep, or they have coughing, or you know lots of different symptoms. Guess what can make reflux better if you have extra weight right Losing, weight losing the weight.
Speaker 2:So and specifically bariatric surgery, because you can actually go in and fix the reasons that are causing reflux sometimes and definitely the weight loss itself can help with those symptoms too, and reflux is more common in men than in women. So if you have extra weight and you have reflux, guess what? You basically bought yourself a ticket to having a bariatric surgery. That can help with two for like a two for one.
Speaker 1:And I also want to say because I see this all the time that someone says I have acid reflux, I have to do a bypass. And I want to. Just I've had to step back and not write novels on Facebook groups of just the knowledge I do have from you and other surgeons. But for all of those that are thinking that I have to have a bypass if I have any type of reflux, it's not necessarily true. Yes, if you have a sleeve it's going to create more pressure that can cause reflux. But you've got to think about the weight that you're losing. That causes the reflux. So obviously the providers know best of if you do have moderate or severe acid reflux or anything on a scope or whatever. They're going to push you towards that bypass. But just because you have acid reflux every once in a while doesn't mean a sleeve is completely out of the whatever.
Speaker 2:Absolutely. You're totally right, and that's kind of um, that's been something that's been hotly debated, I would say, in our communities and our profession, of whether or not somebody with reflux can have a sleeve. The answer is yes. The answer isn't always the answer is it depends. It depends absolutely, because if you have mild to moderate reflux and you don't have a hyaluronic or you have a small one, then a sleeve can absolutely be a good surgery and potentially a good first surgery. In the case of, you know, borderline cases, sometimes people have to be converted to bypasses down the road or other options, but the weight like you said, losing the weight and the metabolic changes that happen even with a sleeve, absolutely can help people to treat and reduce reflux. In some people, though, you're absolutely right, sleeves can actually cause reflux or can make it worse. So that is not a one-size-fits-all approach. That is a you treat the patient that you've got with the options at hand, and that's a discussion to have with your provider or for the provider to have with the patient, right.
Speaker 1:I just wanted people to know that toast because I have acid reflux means that a sleeve is not acceptable. Nope, not necessarily the case, but yes, case by case.
Speaker 2:Absolutely so. No, that's a really good point so.
Speaker 1:I think just to kind of wrap it up is.
Speaker 2:I would love for people to be kind of aware of bariatric surgery and medications as a treatment for weight, especially guys, guys, it really, really helps with a lot of things and it helps you more than women in many cases consider. And I, you know, I don't expect overnight that everyone will either know about this or support it or make it available. But if you're interested, reach out to us, reach out to your local programs and see what it can do for you, because you might be really surprised.
Speaker 1:Absolutely. I'm glad we touched base on this because I think a lot of women might be forwarding this to their significant others or family member or whatnot, because it is a lot of good information that this is not just for women. So thanks for talking about all of this stuff and, like every day I'm talking to you, I learned something new. So thank you for all of your information.
Speaker 2:Oh, my goodness, same my love. All right, you guys. You guys all have a great rest of your day, and it was great to talk with you, tammy.
Speaker 1:Yes, goodbye, love you.