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How Being a Physician Living with a Chronic Disease Impacts my Work with Bariatric Patients



“You can make $20 per stool sample?” You would have thought I had won the jackpot! I just thought my colleagues and I were getting one over on the “Diarrhea Clinic” in Guadalajara, Mexico. I attended medical school there and was making a habit of “donating” regularly. What I did not realize was that I wasn’t just suffering from “Montezuma’s Revenge.” It wasn’t until I returned home that I learned I had Crohn’s Colitis, an often debilitating inflammatory condition of the GI tract characterized by abdominal pain, diarrhea, and rectal bleeding. It can often result in multiple surgeries to remove diseased colon and worse, colon cancer.

I spent the next several years on different medications including monthly infusions and weekly injections, all of which had many side effects. During my residency, I spent 10 days in the hospital due to a flare that resulted in over 20 abnormal stools per day, anemia, and almost constant pain. Despite this, I returned to my career determined to not let this disease slow me down.

I became a family doctor and practiced in the primary care setting for nine years. During that time, I discovered a passion for bariatric medicine. This evolved out of a desire to keep myself healthy which required changes in my diet. I found that eliminating processed foods and added sugars, except those naturally occurring in fruits and vegetables, helped me to keep my colitis at bay. With the help of an excellent gastroenterologist, I healed and continued to enjoy excellent health for many years. However, this hasn’t always been easy and this is where bariatrics comes back into the picture.

Taking care of myself every moment of every day requires a lot of work. It means pushing myself to exercise even when I am exhausted. It requires eating salads and protein when others are enjoying pizza or ice cream. It requires actively engaging in positive thinking and using tools like meditation, cognitive behavioral therapy and affirmations to manage stress levels. And I don’t always feel like doing these things. These are exactly the same challenges that, on a day to day basis, my bariatric patients experience.

I find that using these tools myself adds an additional layer of empathy and relatability to counseling my patients that otherwise wouldn’t be there. They often greatly appreciate this and find that I am able to help in a very unique way because I “get it.” I share my story with patients because when a doctor is able to be vulnerable, they realize they are not alone and that anything is possible.

Every day, I continue to discover new and powerful ways to care for myself, mind, body, and spirit. As my practice continues to evolve, I incorporate as many of these amazing modalities as possible. I hired a mind-body medicine physician to teach yoga, meditation and other skills who has inspired many of my patients. I have a behavioral counselor who keeps us all on track. But most of all, my patients, staff and I are all just trying to be the best version of ourselves on this human journey. I still struggle regularly — as do my patients — but we all have found better ways to be in this world. And because of that, I have found this work far more gratifying than anything I could have imagined and I believe my patients are better for it.



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You Can’t Afford to Ignore Obesity: How Obesity Treatment Saves Time, Money and Lives



Why should a busy healthcare provider take time out of their day to treat obesity when their patients are dealing with so many other health issues? This seems to be the prevailing question among many providers, despite obesity’s 2013 designation as a disease. There are so many other diseases and ailments that need to be treated, so why obesity?

The answer: Because we can’t afford not to! And that applies to time, money and the health of your patients.

It’s true that chronic diseases suck up the majority of healthcare resources; 75 percent of all health care costs are linked to chronic conditions. People with chronic conditions are the most frequent users of health care in the U.S., and they account for 81 percent of hospital admissions; 91 percent of all prescriptions filled; and 76 percent of all physician visits. Chronic disease is widespread, and it’s only getting worse. By 2025, chronic diseases will affect an estimated 164 million Americans — nearly half (49 percent) of the population

In response to the growing concern over chronic disease, many healthcare providers and hospitals are investing thousands of dollars in resources and time to implement multi-level treatment plans targeting chronic conditions. But the question many advocates are forgetting to ask is: What is one of the most common links between many chronic conditions?

The answer: OBESITY.

Obesity is associated with significantly increased risk of more than 20 chronic diseases and health conditions that cause devastating consequences and increased mortality. Consider the following statistics:

• In the often-cited Framingham Offspring Study, obesity was responsible for 78 percent of cases of hypertension in men and 64 percent in women
• The well-known Nurses’ Health Study of more than 44,000 women found high waist circumference resulted in a two-fold increase in coronary heart disease
More than 85 percent of people who have type 2 diabetes are overweight, and more than 50 percent are obese
• Overweight and obesity are associated with increased mortality from diabetes and kidney disease, resulting in over 60,000 excess deaths per year

And this is just the tip of the iceberg. Obesity, in many cases, is the direct cause of many of the chronic conditions that we are spending so much time and money treating. Many of these conditions can be prevented, delayed, or alleviated by simply treating the cause, not just the symptoms. Research shows that modest weight loss (five to 10 percent of body weight) can reduce the risk of developing chronic conditions dramatically, and this amount of weight loss is achievable through various evidence-based medical obesity treatment models.

Not only can obesity treatment save physicians time and money by decreasing healthcare costs associated with comorbid chronic conditions, it has also been shown to be a proven revenue generating model, with real financial benefits. In a climate when we’re unsure about where we will stand with insurance and Medicare, it is imperative for healthcare providers to proactively look for new and innovative models to save time and money, and ultimately, to save lives.

Are you still asking yourself, “Why treat obesity?”


Sources: Partnership to Fight Chronic Disease, Hospitals & Health Networks, Stop Obesity Alliance

Blog written by Vanessa Ramalho/Robard Corporation


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Another Approach to Reduce Job Absenteeism



With obesity recognized as a chronic disease, the cost of obesity on one’s health, longevity, and medical expenses with comorbid conditions is slowly becoming more widely recognized. Nationally, it is estimated that obesity costs employers more than $73 billion annually in higher healthcare costs.

However, obesity carries with it additional costs that are not always publically addressed — costs that affect the day-to-day of people’s lives, as well as their livelihood. One of the lesser recognized is absenteeism and its overall impact on productivity at work.

The total economic cost of obesity in the U.S. includes indirect costs, such as missed time from work, lost productivity at work, and premature death due to obesity-related health problems. Obesity can cause exhaustion, inability to focus, decreased confidence, and an increase in stress. Comorbid conditions caused by obesity can also result in unscheduled call outs and extended medical leave, leading to low morale, disciplinary action, and even the loss of one’s job.

While there are limited studies that have looked closely at this issue, one group of researchers at the University of Michigan Weight Management Program tackled this issue head on with a study they recently presented at Endocrine Society's 99th annual meeting in Orlando. The study revealed compelling evidence that participation in a weight management program can reduce job absenteeism.

The weight management program in the study utilized a Very Low Calorie Diet (VLCD) and followed participants through a six-month time period. The participants lost an average of 41 pounds through the program. Before the program, participants reported that they worked, on average, 5.2 fewer hours per month than what their employers expected. After six months in the program, they described working 6.4 hours more than expected.

According to Jennifer Iyengar, M.D., the study's lead author and an endocrinology fellow at the University of Michigan, the findings “suggest that, through favorable effects on work attendance, participation in a weight management program may be mutually beneficial for workers and their employers.”

While more research needs to be done on what impact medical weight management programs can have on work productivity, the hidden cost of obesity is still fairly clear, and it takes a toll. Obese workers on average are absent one more week each year than other employees. While concern for health should of course be a prime focus, concern for the livelihoods of job security of obese individuals should also be taken into consideration.

With Robard Corporation’s evidence-based weight management programs and products, you can launch or enhance a current wellness program by providing your employees with an effective weight management solution that helps them achieve their health and lifestyle goals. Our time-tested, multidisciplinary programs can help alleviate unscheduled absenteeism, increase productivity and reduce employee turnover. Click here to get some free information today.

Sources: Science Daily


Blog written by Vanessa Ramalho/Robard Corporation

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