Robert Woodbury, MD
Fellow American College of Surgeons
Fellow American Society of Metabolic and Bariatric Surgeons
At Healthy Steps we have always believed that the treatment of obesity should be approached in a comprehensive manner. I have been providing this level of care for more than 25 years. Our bariatric surgery patients go through an intensive program of education in lifestyle, nutrition, exercise, and psychologic preparation. We have had patients lose 20 pounds, 50 pounds, and even 80 or more pounds prior to surgery. Friends and loved ones have seen these benefits and have repeatedly asked us if they could go through the Healthy Steps program without the surgery. For patients with
obesity and metabolic syndrome, we are proud to now offer a non-surgical program!
Obesity is now an epidemic in our society. It is estimated that 1/3 of adults in the U.S. are overweight, and an additional 1/3 are obese. Even more alarming is the rise in childhood obesity. Patients who have a body mass index over 30 have a 70% increase in coronary artery disease, a 75% increase in stroke, a 400% increase in diabetes, and up to 55% increase in mortality. Historically, treatment of obesity has been mostly focused on limiting food intake using plans that may work in the short term, but are completely unsustainable in the long term. Under most circumstances, losing weight with various low-calorie liquids and other crash diets is only transiently successful. Even worse is the fact that total “weight” may be lost, but it often includes loss of lean muscle mass more than actual fat. After the diet plan is stopped most people re-gain weight, but they re-gain it as even more fat than they started with.
Metabolic syndrome is an especially harmful combination of large waist circumference, high blood pressure, diabetes or “pre” diabetes, and poor cholesterol profile in the blood. Part of the cause is the inability of the body to use insulin effectively, and the hallmark is abdominal fat. It is estimated that one in four adults is afflicted. In a study of 2 million prescription records it was found that the annual prescription cost to treat the disease was over $4000 per year, per patient. In addition to the financial costs, people with metabolic syndrome are also twice as likely to suffer a heart attack or stroke, and three times as likely to die early from those causes.
The Healthy Steps team offers an intensive lifestyle program to help people who suffer from being overweight, and/or metabolic syndrome, as recommended by the National Institute of Health. It is based on sound principles published in respected medical and biologic scientific literature. It incorporates principles of low glycemic Mediterranean style eating, and exercise that are sustainable in the long term. Judicious use of medical foods and anorexic medications are incorporated when needed. Each patient undergoes individual coaching and counseling to help them understand how their own metabolism
functions, and thereby realize their goals.
Our 12-week Therapeutic Lifestyle Program is focused on the following:
- Nutritional assessment and counseling: we will help you develop a food plan, right down to recipes, restaurant alternatives, and shopping ideas.
- Exercise education: we will help you develop a program that will work in the “real-world”, and sustainable for life.
- Body composition measurement: we are less concerned with simple weight loss, and more concerned with losing fat and preserving muscle.
- Medical foods in the forms of powder or bars to help stabilize sugar and fat in the blood. Patients tell us that this curbs hunger and allows them to adjust to the new, lower calorie eating.
- In some cases short term use of medications that can also help curb hunger.
- Medical assessment and oversight: our medical director and nurse practitioner will monitor progress and work with your regular physician.
Obesity and the metabolic syndrome are epidemic, and deadly. Treatment is not as simple as calorie restriction and pills. In fact, long term studies attest to the utter and consistent failure of this approach. Healthy Steps is the only institution in the North bay that brings together medical treatment, surgical treatment, and lifestyle treatment, all in one place.
Definitions:
overweight = body mass index over 25
obesity = BMI over 30
severe obesity = BMI over 35
morbid obesity = BMI over 40
Diagnosis of Metabolic Syndrome
If you have three out of the following five criteria.
- Large abdominal fat (waist circumference of 40 inches in men, 35 inches in women)
- Fasting blood sugar of 100 mg/dL or more
- Triglyceride level of 150 mg/dL or more
- Low level of HDL (protective cholesterol) for men less than 40mg/dL or women less than 50 mg/dL
- Blood pressure greater than 130/85
