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Keeping the weight off after surgery

January 11, 2011 12:00:00 AM PST
In recent years, the number of people getting weight loss surgery has quadrupled, but doctors say it is not the simple fix that many people think it is. Once the procedure is complete, the hard work begins.So how do you make sure people don't slide back into their unhealthy ways? One local doctor says it takes a team effort.

We usually see doctors and patients talking in a medical office. But once a month, Dr. Ted Khalili, a bariatric surgeon, takes off his white coat and heads to the track with as many patients as he can get there.

Larry Kaltman, 66, always tries to make it.

"The doctors are there very willing and very happy to share information. They are very, very supportive," he said.

Before having gastric bypass surgery in September 2008, Kaltman was 317 pounds and he would yo-yo-diet. Now he's 221.

"I have gained and lost more people than I know over the years. I'd go up, I'd go down," said Kaltman.

The failure rate for obesity surgery is about 25 percent. And the reason why Kaltman thinks he is so successful is because of the approach that Dr. Khalili and his colleagues take with their patients.

"It's not a magic bullet. It's a wonderful tool," he said.

About 80 percent will also gain weight, what some experts call "creeping weight" gain.

"So we can deal with minor setbacks. What we don't want to see is a patient who's lost 100 pounds doesn't connect with us and comes back and has put on 80 pounds," said Dr. Khalili.

A Mayo Clinic study finds a multi-disciplinary approach gives people the best results. Dr. Khalili sets up regular support group meetings and monthly walks, plus doctors follow up with nutritional guidance and frequent testing.

"If you don't connect, if you don't come to support groups, if you don't change your lifestyle, you will regain the weight. You will defeat the purpose of the surgery," said Dr. Khalili.

Kaltman's goal is to lose five pounds a month for the rest of this year, and he feels he's got the support to make it stick. He wants to get down to 185 and stay there.

"We make the decision but the doctors give us that gift and then it's up to us to make sure that we use it properly," he said.

The Khalili Center's regular support group meetings are open to anyone, you don't have to be a patient.

This year, the FDA is considering whether to make LAP-BAND surgeries available to people with BMI measurements as low as 30.