Jonathan Lutz recalls one of the moments that made him want to get weight loss surgery. In 2014, he took a train to New York City to see Neil Patrick Harris in Broadway’s Hedwig and the Angry Inch. His hotel was a 14-block walk from the train station. “Walking through New York City with one suitcase, one overnight bag and my CPAP machine was absolutely miserable,” he says.
The South Riding resident had been overweight since his early teens. He had tried dieting but never kept the weight off for long. At 33, he began having severe medical problems: a blocked artery, sleep apnea and high blood pressure, just to name a few. His mother had recently had a successful sleeve gastrectomy, where a portion of the stomach is removed, allowing patients to feel fuller faster. “I was tired of being so unhealthy,” he says. “I decided it was my turn to look into [surgery].”
Lutz went to Virginia Hospital Center in Arlington and had the sleeve gastrectomy in December 2014. After starting an exercise routine a few months after his surgery, he decided to take up running, starting with a 5K. Within a couple of months, he completed a 20K, then a half marathon. Ten months after the surgery, he ran his first full marathon. He has lost 111 pounds and has been able to keep the weight off.
This year he has already run two marathons—one in New Orleans and another in Paris—and he is training for October’s Chicago Marathon. “I believe the gastric sleeve surgery was a tool to help me improve my life,” Lutz says. “It helped me start living the life I always wanted to live.”
More than one-third of United States adults are obese, according to the Centers for Disease Control and Prevention. Virginia’s obesity rate ranges between 25 and less than 30 percent. The estimated annual medical cost of obesity in the U.S. was $147 billion in 2008, and obese individuals paid $1,429 more in medical bills than those at normal weight.
In order to help this at-risk population, many area hospitals offer weight loss surgeries and programs designed to get participants to a healthy scale number they can maintain over their lifetime.
Weight Loss Surgeries and Procedures
Besides the sleeve gastrectomy, there are a number of surgical procedures hospitals may perform to help patients who have a body mass index of 40 or more lose weight. One of the most famous is gastric bypass, where surgeons use staples to divide the stomach into two sections and connect the small intestine to the smaller pouch. Laparoscopic gastric banding also involves separating the stomach into a smaller and larger section using a band rather than staples. There are also nonsurgical procedures like the intragastric balloon, which fills up a third of the stomach and makes patients feel fuller faster.
“By addressing the weight, we can prevent medical problems, and we can also treat problems that patients currently have,” says Dr. J.R. Salameh, medical director of the Bariatric Surgery Center at Virginia Hospital Center. “We just go to the core issue in dealing with the weight itself. Once they lose the weight, they become healthier, and whatever [health] problems they have, a lot of them improve or resolve. Life expectancy improves. Their quality of life improves dramatically.”
Most area hospitals offer free weight loss seminars to introduce patients to the many options they offer. Programs aim to provide an individualized approach for patients—not one size fits all. “For some patients, surgery is not the right option,” Salameh says. “For some patients, surgery is the right option. Within surgery we have to decide what is the best option for each patient.”
Azra Kukic, bariatric surgery coordinator at Reston Hospital Center, says much planning goes into deciding which surgery is right for each patient. Staff members go over medical and surgical history, current eating habits, lifestyle and family history.
Surgery itself is a small part of the whole picture. Even before a scalpel touches their skin, patients must be medically cleared and must meet with dietitians and psychologists who give them the tools they need to be successful post-surgery. Area hospital staffs aim to teach patients how to develop a different relationship with food. “Food is not comfort,” Kukic says. “They learn to see food as fuel for their body. It is a very different relationship that they develop when it comes to food.”
Patients who choose surgery, on average, lose about 75 percent of their excess weight, so if an individual is 100 pounds overweight, they are going to lose 70 to 75 pounds. “Of all the surgeries we do and I’ve done, this is the most rewarding operation we do because it really is amazing how impactful it is on people’s lives, on their health and also on their quality of life,” Salameh says. “Invariably what I hear is ‘I wish I had done this sooner.’”
Fredericksburg resident Sheilah Engleson is one of those patients. She says she wasted “a lot of years overweight when I think that [surgery] was probably the direction I wish I had gone a long time ago.”
She had tried diets like Atkins and Weight Watchers in the past. She would lose 20 to 30 pounds but then gain it back and more. In February 2015, she was 4 feet 11 inches tall and weighed just under 250 pounds. Engleson ended up having a gastric sleeve procedure in July 2016 at Sentara Northern Virginia Medical Center in Woodbridge. As of late May, she had lost 100 pounds and was able to stop taking her blood pressure medicine. No longer a size 22, she can go to regular clothing stores now to shop. Her grandchildren, ages 2 and 4, can no longer outrun her when she is watching them.
During her journey, Engleson would often call Chris Potito, Sentara’s metabolic and bariatric surgery program coordinator. Each patient gets the registered nurse’s cell phone number. “They can contact me anytime, anywhere through the venture,” Potito says. “It offers a level of reassurance that there really is somebody out there who cares, is committed to the program and collaborates with their doctors. They know that if there is a concern, that issue is going to be pushed forward” and dealt with appropriately.
Sentara, as well as Inova Fair Oaks Hospital in Fairfax and some others in the region, offers both surgical and nonsurgical weight loss options for patients. “We are trying to meet all of our community needs,” says Carmen Spencer, Inova’s clinical program coordinator for weight loss services. “For some people, surgery is a better option for them versus other people [who] really want to try the medical route before they do surgery. Surgery is a more drastic approach. We want to make sure there is something for everybody.”
Nonsurgical Weight Loss Programs
Fairfax City resident Jason Reis had never really been a breakfast person. He’d also rarely eat lunch, but he would feast at dinner—sometimes scarfing down an entire pizza by himself. “I had settled into some pretty bad habits and mindless eating,” he recalls. His parents and wife sat him down to voice their concerns about his habits, yet he was still resistant to any weight loss programs.
A few months later, Reis saw his primary care physician for an annual physical. His doctor told him he would now need a trifecta of medications to treat blood pressure, cholesterol and diabetes. His doctor suggested he try Inova’s 12-week medical weight loss program. Participants are put on a low-calorie diet using powders and bars as meal replacements and work with physicians, dietitians, nutritionists and exercise specialists to develop an individualized plan for success. “Dietitians teach them how to eat after they are off meal replacements, incorporating food slowly while they are in the program so that once they are on all foods they can make the right choices,” Spencer says.
Reis joined the program last year right after Thanksgiving. In late May, he was doing the program for the third time and had lost 80 pounds. “By changing my habits [and] eating earlier in the day, it was kind of like magic,” he says. “I wasn’t chowing down 1,000 calories before I went to sleep. It’s being mindful of what you are eating and when you are eating and giving your body what it needs instead of necessarily what you want. The mindset change for me has been the biggest thing, the shift in how I think about food and my habits.”
When Reis goes to work, he now takes the eight flights of stairs instead of the elevator. He’ll even park his car in the farthest parking spot just to get more steps in. “[The weight loss program has] been a godsend for me,” he says.
Many hospitals offer support groups for surgical patients at different stages of their journey. Some are considering the surgery, others are a few months post-operation, and some are several years removed.
Engleson attends Sentara’s support group, which also offers a clothing exchange and an annual reunion to celebrate patients’ successes. “I think it is motivating to listen to other people and listen to their stories,” she says. Potito says group members form bonds and friendships including going to help one member pick out a new wedding dress because she had lost so much weight. “People who attend some kind of support group are much more successful than people who just try to do it on their own,” Potito says.
Lutz attends VHC’s group every other month. “I try to share my experience and show people that there are other options to being unhealthy and overweight,” he says. “I do like talking to people who haven’t had the surgery yet and are deciding.” The group also provides accountability to Lutz and the ability to see others progress. “I’m really lucky that I get to see all these amazing transformations and how successful people are if they know how to use the tools they are receiving.”
Lutz ended up going back to New York in December. He had never been there during Christmas time. “I just noticed how different [the trip] was,” he says. “I was able to walk around the city all day long. I had my book bag. I had my suitcase with me, and it wasn’t a challenge. I got pretty emotional because I have come so far. I’m a completely different person from the time I was in New York City from 2014 to the time 2016 rolled around. I’m amazed at doing simple things such as walking around all day or playing with my nieces and nephews. It doesn’t have to be challenging, and it doesn’t have to make me tired and winded.”