Specialty Care for Obesity

What is obesity?

Obesity is currently an epidemic in the United States, with over two thirds of our population’s adults suffering from overweight or obesity problems. Over a third of adults in the U.S. are obese, as well as another third of children. Unfortunately, being overweight or obese poses serious health risks, contributing to the development of a wide array of health conditions. Some of the many health problems that are linked to obesity include:

  •  Hypertension
  • Heart disease
  • Hyperlipidemia
  • Liver disease
  • Diabetes
  • Certain cancers

Non-alcoholic fatty liver disease

Non-alcoholic fatty liver disease (NAFLD) is similar to alcoholic liver disease, however it occurs in the absence of heavy alcohol consumption. It occurs when fat accumulates in the liver over time, causing serious health problems, including inflammation, liver scarring, and eventually, fibrosis and cirrhosis. Cirrhosis can cause several life-threatening complications, like gastrointestinal bleading, fluid accumulation, and liver cancer. The best way to prevent these serious health issues is by losing weight and maintaining a healthy weight long-term.

How is obesity diagnosed?

Obesity can be diagnosed in a few ways, most commonly through calculating a person’s body mass index (BMI). The calculation divides a person’s weight by height. The number created using the BMI calculation should fall within a certain range to be considered “healthy.” Patients with a BMI of 30 or greater are generally diagnosed with obesity.

Weight BMI

Underweight

<18.5

Healthy weight

18.5-24.9

Overweight

25-29.9

Obesity (I)

30-34.9

Obesity (II)

35-39.9

Obesity (III)

≥40

How is obesity treated?

Weight loss management can be treated in a number of ways, varying based on several different factors, which include the severity of obesity, past medical problems, and the patient’s personal needs. Treatment may include one or more of the following:

1. Lifestyle Intervention
Changes to a person’s lifestyle and everyday routine is the most important aspect of weight loss, which begins with changes to diet and exercise routines. There are a number of diets available today, which can be overwhelming for a person trying to decide which weight loss method is best for them. The success of any diet relies on the practicality of the diet as well as the patient’s ability to follow its guidelines. It is important to get a professional’s opinion before choosing a diet, to ensure that you are picking a diet that will work in the long-run.

Resting Metabolic Rate

At Gotham Medical Associates, we believe each patient is unique and so is every patient’s metabolism. That means that even when two people share the same weight or height, they may not have the same metabolic rate, which can cause different responses to the same diet or exercise changes. To analyze a person’s resting metabolic rate (RMI), your doctor will use an indirect calorimeter, which allows us to prescribe the best diet and exercise regimen for your personal needs.

Depending on your BMI and specific medical concerns, further weight loss therapies may be considered. However, it is important to note that successful weight loss will always require a level of lifestyle changes.

2. Pharmacologic Intervention
There are numerous drugs on the market that help with weight loss when used correctly. Some medicine requires a prescription while others do not, and it is important to note that some of these drugs are not yet FDA approved. There are potential side effects that go along with some weight loss drugs, and we urge patients to discuss any use of weight loss medication with one of our experts before using them. Any weight loss medication should only be used after speaking with a healthcare provider to ensure patient safety and proper monitoring.

3. Endoscopic Intervention
Endoscopic bariatric therapy is the latest route for weight loss, involving inserting a balloon into the stomach. This may be a good option for some patients, however it is only intended to be used for a temporary amount of time (usually around six months), and must be removed. This means that a comprehensive weight loss program, including diet and lifestyle changes, must be used before, during, and after the procedure to promote successful weight loss and weight management. The best candidates for endscopic intervention are those who have tried conservative treatment options without success and who are not good candidates for surgical intervention.

4. Gastric Balloon Intervention
A soft, silicone balloon can be inserted into the stomach using a gastroscope, which is passed through the mouth. The balloon is then filled with saline until it is roughly the size of a grapefruit. After the balloon has been in place for about six months, it is removed and patients return to a healthy lifestyle to maintain weight loss.

5. Surgical Intervention
Patients who have a BMI of 40 or above, or patients who have a BMI of 35 or above and have a medical problem related to obesity are good candidates for surgical intervention when other conservative options have failed. There are different types of surgery that can result in weight loss, including:

  • Gastric Bypass Surgery: Also known as roux-en-y gastric bypass (RYGB), this surgery involves creating a very small pouch in the stomach and then bypassing a portion of the small intestine. This resricts the amount of food that is consumed and absorbed into the body.
  • Lap Band Surgery: This procedure, sometimes referred to as laparoscopic adjustable gastric band surgery, is performed by placing an adjustable ring around the upper part of the stomach, creating a small pouch. Then, a saline solution is injected into the pouch, which inflates. This causes the patient to feel full more quickly and restricts the amount of food consumed.
  • Sleeve Gastrectomy: This surgery is performed by removing a section of the stomach, leaving only a small portion behind. This causes the patient to feel full very quickly and limits the amount of food the person is able to intake.

Every surgery has certain risks and requires a patient to comply with other diet and lifestyle changes. It is important to continue regular check-ins with your doctor after surgery to ensure your successful weight loss and weight management.

Locate Us

Downtown

123 William Street, 15th Floor
New York, NY 10038

212.227.3688

Midtown – 5th Ave.

535 Fifth Avenue, Suite 611
New York, NY 10017

212.227.3688

Midtown – 56th St.

60 East 56th Street, 7th Floor
New York, NY 10022

646.329.7259