Hello, I am Dr. Samer Mattar, the Medical Director for the Clarian Bariatric
program. My interests include the comprehensive treatment of the diseases associated with morbid obesity and laparoscopic weight loss surgery. I was formerly assistant professor of surgery in the Mark Ravitch/Leon C. Hirsh Center for Minimally Invasive Surgery at the University of Pittsburgh School of Medicine before coming to Clarian Health. I completed my residency at Vanderbilt University Medical Center, and received additional special training in advanced laparoscopy as a clinical fellow and clinical instructor on the Endo-Surgery unit at Emory University Hospital. I received my medical degree from Cairo University, and I am a member of the faculty at the Indiana University School of Medicine. I look forward to blogging about the health benefits related to bariatric surgery and answering any questions readers may have about this life-changing surgery.
I received this e-mail earlier in the week from a former patient who will be participating in the Mini-Marathon this weekend:
Almost one year ago, you helped me change my life. Now I am inviting you and all of Clarian Bariatrics to join me for my next life changing event, as I finish JOGGING my first 1/2 marathon Saturday, May 2nd, with the Indianapolis Mini Marathon. Even if you are unable to be there as I cross the finish line, I wanted to say thank you for helping me, help myself.
Almost 100 pounds later, I couldn't have done it without you. Thank you.
Ms. C
Stories like this that make my job so fulfilling! If you are running this weekend, best of luck to you. If you have a story you would like to share with the Clarian Bariatrics family, I would love it hear it. I know that each of you has things to celebrate, and we want to share in that joy.
Best of luck, Ms. C!
Obese patients are about six times more likely to develop heart disease than those of normal weight. Increased levels of blood fats and the metabolic effects of obesity affect coronary disease.
An increased load on the heart leads to early development of congestive heart failure. Severely obese people are 40 times more likely to suffer sudden death, in many cases due to cardiac rhythm disturbances.
However, weight loss surgery can help elminate - or drastically improve - this health problem caused by obesity. If you would like to learn more then consider joining us at a FREE informational seminar.
At the seminar you can ask questions of Indiana Weight Loss Surgeons and find out more information about bariatric surgery costs and Indiana Bariatric Centers. Click on the image at the top right of this page to learn about upcoming dates.
Bariatric surgery is a serious solution to a very dangerous disease. It is a form of behavior modification that uses a surgical treatment to control hunger - one of the strongest stimuli in nature.
As a result of technological advancements, most bariatric surgery can be performed via a laparoscopic access, in which a small camera and long thin instruments are inserted through very small incisions in the abdominal wall.
Although laparoscopic surgery offers many health benefits including shorter recovery times, reduced incidence of infections, and the aesthetic benefits of a much smaller surgical scar, it is the reduction of pain that is the most beneficial. Less pain allows patients to get out of bed and walk on the same day of surgery, and thereby reducing the incidence of serious complications such as blood clots and chest infections.
When you are ready to speak with a medical professional and learn more about bariatric procedures, Clarian Bariatrics offers a variety of ways to get more information. We conduct regularly scheduled seminars that give you the chance to ask questions, talk with the medical team and even talk with patients who have had bariatric surgery.
Learn more by clicking on the image at the top right of this page.
Here are some additional tips created by one of my former patients, Judi. Great advice for those individuals that are pre-operative. DO NOT, I REPEAT, DO NOT SUCCUMB TO PEER PRESSURE about what to order or eat. Those that repeatedly try to tempt you with those foods you know you should not sample fall into two categories: those that are just
truly ignorant about what is appropriate for you and are just trying to make you feel included, and those that are out to sabotage you.
Stick to your guns! I finally told a co-worker who repeatedly offered me desserts with the “surely one bite won’t hurt you” line, that “Yes, one bite will seriously hurt me. If I told you I was allergic to shellfish would you continually offer me crab legs? Please, don’t offer me that anymore. I will never take it, and I’m perfectly okay not having any. It doesn’t bother me at all if you eat that in front of me.” He finally got the message. My health is more important than his feelings about a dessert.
And finally, most importantly,
DO NOT, TRIPLE REPEAT, DO NOT TEST TO SEE IF YOU DO INDEED DUMP! I cannot stress this strongly or urgently enough. Assume you do. Assume you do so VIOLENTLY. All post-op patients that I have spoken to that have tested this with a forbidden sugar-laden item, and have found out that they don’t dump have lived to regret it.
Once you open the door to cake and ice cream you will NEVER be able to shut it again. This puts you at EXTREME risk of going back to your old eating habits at warp speed and this is a near guarantee of gaining all of your weight back, plus some, and most dangerously, requiring the co-morbidities that got you into your surgeon’s office in the first place. I know it’s not easy, especially given the relationship most of us had with food like that in the past, but it just simply is not worth it. When you feel tempted, ask yourself if you’re really willing to go back to your pre-op life for one piece of cake... (And then yell “NO!” and step away from the cake!)
Keep these strategies in mind to help you stay on the right track and stick to the 10 Rules!
The following article was written by a former patient of mine, Judi. She read one of my blog posts about proper eating, and thought she would share some of her own wisdom with you! These are great tips, and I will share them over the next few weeks. Thanks, Judi!On December 12, Dr. Mattar posted a blog entitled “Pay Attention” with 10 rules of proper eating for post-op patients. This was an excellent reminder for me, as I am now a year and a half post-op and a reminder of these rules is always a good refresher.
After reading this blog, I thought it might be helpful to share my concerns
about dining with non-bariatric patients, especially those that have unhealthy eating habits, as this is a prime situation in which we are likely to abandon those 10 Rules. I liken it to “keeping up with the Joneses (as they clean their plate at too fast a rate and of food you’re likely better without).
So – in addition to the 10 Rules from Dr. Mattar, I’ve listed a few more that you might find helpful:
DON’T PAY ATTENTION TO WHAT OTHERS ARE ORDERING OR EATING. If your dinner mate has an overloaded plate, your eyes tend to get bigger and you could be prompted or order more or to put more on your plate too. Keep your thoughts to your own plate and order or take appropriate items and quantities. Ask if you can have a half order or a child’s portion - if the child’s menu actually has something worthwhile on it. (By that I mean something more appropriate than chicken fingers and hot dogs! No wonder we have an exploding epidemic in childhood obesity!)
DON’T TRY TO KEEP PACE with your dinner mate. People who have not had the surgery can eat much larger quantities of food at a much quicker pace than us post-op patients. If they’re a fast eater, you could be prone to pick up your pace without realizing it and that’s something you’re likely to regret rather quickly. Eat at your own pace and follow the 10 Rules. It’s okay if you’re slower. They won’t abandon you at the restaurant if it takes you longer to eat less.
A momentous occasion will take place next week when President-elect Obama will raise his right hand and solemnly promise to change the course of our nation. He has repeatedly indicated that he will propose, and oversee, change in many sectors of government. 
One of the most important areas that he will focus on will be health care, including the provision of services to every American. He has also expressed a commitment to fight obesity through programs that improve nutrition through changes in school menus and through enhanced public education.
Both obesity and morbid obesity are wide-ranging epidemics that continue to spread like wildfire across America. Diabetes, high blood pressure, sleep apnea, and numerous other diseases severely affect quality of life and even curtail patients’ life span; thereby eroding our potential for sustained growth and success as a nation.
The Obesity Action Coalition (OAC) has assumed a leadership role in supporting the fight against obesity and in protecting the interests of obese individuals. I would encourage you to visit their Web site to learn more about how the OAC can assist and support you and how you can support their noble mission. Also, please take a moment to sign up to their open letter to President-elect Obama, urging him to hold on to his promise to create change, reduce the spread of obesity, and protect those who are obese.
Below are a few more commonly asked questions about weight loss surgery and bariatric weight loss. Please join us at a FREE information session if you have additional questions about bariatric surgery costs, causes of obesity and Indiana Hospitals. Information on these sessions can be found by clicking on the image at the top right of this page.
Q: Are all low-fat foods healthy?
A: Not necessarily. Often, low-fat foods contain a high concentration of sugar, and when the body consumes sugars, they are converted and stored as fat.
Q: Is there a chance that bariatric surgery won't work for me?
A: The failure rate for bariatric surgery is approximately 10-15%. In those patients who regain some or all of their weight following surgery, it is almost always because they fail to follow the guidelines and lifestyle changes required. Most patients who realize true "success" through bariatric surgery do so because they follow-up their surgery on a regular basis, and pay close attention to what and how much they eat. When you do that, you can almost be certain of long, lasting weight loss.
Q: Why do they ask me to lose weight prior to surgery?
A: There are two reasons for this. First, weight loss tends to shrink internal organs, which makes the surgical procedure easier and less risky. Second, this helps show the surgeons that you are committed to doing what it takes to lose weight and become healthy. While you aren't expected to lose major amounts of weight, if you can lose some weight prior to your surgery, the doctors know that you are serious about the procedure.
Q: How important is family to the process?
A: Family and friends are INCREDIBLY important to the process, especially in the first year following the surgical procedure. A strong support group that understands the lifestyle changes and effort required will make the transition back to a normal life much easier.
Those of you who read the December issue of Indianapolis Monthly magazine may have a seen a brief question and answer with me that addresses some frequently asked questions about bariatric surgery. I wanted to post a few of the questions to help you better understand bariatric weight loss and causes of obesity.
Q: Are men or women more likely to suffer from obesity?
A: Actually, both genders suffer equally. But women tend to seek out and undergo bariatric surgery at a much higher rate than men. This might be a result of women having a more pronounced physical awareness, and a better understanding of the need for weight management.
Q: For people suffering from obesity, is bariatric surgery the only option?
A: No. There are a great deal of non-surgical treatments and weight management programs available. The key is to seek professional help, and to let those professionals assess the best approach for weight management and improved health.
Q: How common is morbid obesity in Indiana?
A: It is estimated that 5% of the population, about 300,000 Hoosiers, are considered "morbidly obese" and only a small percentage of those people recognize it. It is very important for these people to understand the dangers of being overweight or obese, and to seek medical help.
Q: Why is obesity so prevalent?
A: For the most part, it is a function of the society we live in. First, we have easy access to an abundance of high-calorie, low-nutrition food. In addition, our society does not place enough emphasis on physical activity and exercise. Children who engage in relatively little physical activity tend to grow into adults who engage in less physical activity.
Today, I would like to address the important topic of adopting, and maintaining, correct eating habits after weight loss surgery.
As I see more patients who are farther out from weight loss procedures, I often notice that some unwelcome habits are taken up while eating; primarily not paying attention, and reverting to the “old days” of mindless eating. I hear many patients tell me that they eat their meals in front of the television, or engage in reading a newspaper or magazine or computer work.
Obviously what then often happens is that patients forget to take small bites, chew adequately and swallow slowly. This leads to either eating too much, or food getting stuck, which then results in either drinking water to “push” it down, or leaving the table to regurgitate the offending morsel.
It is important to remember the rules of proper eating and stick to them forever.
1. Never skip meals.
2. Eat by the clock; do not rely on appetite.
3. Stop whatever you are doing when meal time arrives.
4. Sit and eat at the table, not in the den or at your office desk.
5. Stick to the healthy portions, and always eat protein first.
6. Minimize snacking between meals.
7. Do not drink at mealtime.
8. Once full, leave the table, or if at a restaurant, ask food to be removed.
9. Pay attention to how you are eating, enjoy the food.
10. Meals should be formal events.
I am confident that following these rules will help continued weight loss, and prevent anxiety about increased food capacity, and discomfort with eating.
Most importantly, please remember to pay attention!
It is in these times of financial worry and gloom that we all take stock of what we possess and look at the future with an uncertain eye. The tumultuous events of the last few weeks have sent waves of panic in markets across the globe and in our own streets.
People in all walks of life, are either repeatedly checking their financial statements or are too scared to open the envelopes or Web sites. We start to recalculate our plans and postpone non-essential trips or items. And we worry.
We worry whether we will make the payments, we worry whether we will keep our jobs, or we worry whether the assets that we have will maintain their value. And so, we search for “assets” that are “guaranteed” to hold their value.
Of course, we have loved ones, our friends, our “credit” of good deeds, but hands-down, the most valuable, highest yield-returning investment we could ever make is in our health. Both as a nation, and as individuals, protecting and strengthening our health pays huge dividends.
For those of us whose health is still untarnished, maintaining good health should be a priority. For those whose health has deteriorated, then, like any major investment, it should be repaired and refurbished and brought back to its former glory.
Morbid obesity damages our health, and robs us of our future. It limits our abilities, our activities, and imposes an enormous drain on our spiritual and physical energy. But, there is an antidote.
Bariatric surgery, does, indeed, reverse many of these illnesses and limitations. To this day, I remain truly astounded when I see the radiant beams that shine from my patients, their inability to sit still because of their unharnessed energy, and their optimistic and fresh outlook on life. I know that these patients are just itching to get out there and make their mark.
So please, take care of your health. Keep an eye on your weight, and live in moderation. Good health is as good as gold in the bank.
As you all know, what we strive to achieve at Clarian Bariatrics is not only dramatic weight loss, but weight loss that is durable and sustained. Anyone can promise (and indeed, many do) profound weight loss, but if you carefully read or listen to these ads, you will see that nobody mentions how long this effect lasts. That is because all of these fad marketers are fully aware that their treatments are temporary at best.
Over the years, I have come to realize that one of the most important predictors of long-term success is the enthusiastic and whole-hearted attendance at follow-up appointments by the patient. Patients who adhere to the follow-up schedule have better results than those who miss out on appointments.
I don’t think there is anything magical about following up, there is no special mystical or secretive service that we offer our patients; but we do listen very well, and learn from what we hear. We have come to recognize many of the challenges that our weight-losing patients face and we have identified effective ways of helping our patients overcome these problems.
Whether your treatment was covered by insurance or you derived the required funds privately, the fact is that you invested a large sum of money, time and effort for this therapy. And just like you would be careful to maintain such a big purchase item (a new car, for example), you should strive to protect and appreciate your weight loss surgery.
Like a luxury automobile, you should regularly visit with your engineers (bariatric staff), get a maintenance check (vital signs, weight reading, overall physical and mental health, and blood work) and get a tune-up if needed. This way, potential problems are diagnosed early and any difficulties that you might have, whether medical, mental, social, financial, domestic, spiritual, can all be addressed and hopefully nipped in the bud.
So keep coming back to home base! We are always here for you!
At first glance, the formula appears straightforward: if you consume more calories than you burn, they will be stored as fat. You would think the reverse is also simple: if you consume less food, you will lose weight. Yet, many individuals struggle all their lives trying to achieve this simple equation.
Severely overweight individuals suffer through numerous diets, losing weight temporarily, only to regain all their lost weight, and then some more. Over the years, the pounds relentlessly add up, resulting in the emergence of various diseases, severe limitation of activities, and an overall deterioration in the quality of life.
As a bariatric surgeon, I am familiar with the limitations imposed by being overweight. I know how obesity affects every aspect of life. I know that it is associated with numerous medical diseases, and that it robs individuals of the ability to enjoy many daily activities. But I also understand the challenges of achieving and maintaining dramatic weight loss.
Through patient education, various treatment methods, intensive individualized and group support, and numerous other activities, weight loss surgery can be an effective way for a person to achieve his or her weight loss objectives. However, it is not an easy way out.
Long-term success depends on an individual’s full participation in the program. The patient must assume the role of a team player. Experience has taught me that the most successful patients, those who lose a large amount of weight, and keep it off, are the ones who actively seek to understand how the surgery works, the associated risks and benefits of the operations, and recognize the importance of following nutritional and lifestyle guidelines.
I hope that this post has given you a better understanding of how professional and family support and a “can do” attitude relates directly to successful outcomes in weight loss surgery. Please continue to use this blog as a resource to learn even more about bariatric surgery and weight loss support.
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