A Personal Perspective on Obesity and Bariatric Care
In My Own Words                                   
by Tim Gieseke MD, CMD

In my PA / LTC practice I have been admitting more young patients with complications of serious obesity.  In recognition of this emerging consequence of our obesity epidemic, our CALTCM Education committee has designed a half-day workshop for our 2017 annual meeting on Bariatric Care.  One exciting aspect of this workshop will be the emphasis on improving the health and wellness of not only our patients with obesity, but also our staff and ourselves.  A number of years ago, I had the privilege of learning motivational interviewing at an AMDA annual meeting under the instruction of Drs. Daniel Bluestein and Patricia Bach.  This has revolutionized how I approach difficult lifestyle problems integral to successful self-management of many chronic health problems like obesity, drug misuse disorders, diabetes, and most chronic diseases.

In my own case, I began to have warnings of excessive weight last summer that were becoming hard to not notice.  Things like my heaviest weight, inability to button the top button on some of my dress shirts (another reason to avoid ties), and finding multiple pants and shorts “too tight”, could no longer be ignored.  From a health perspective, I felt older with less energy and my nocturnal heartburn and nasal congestion (dry mouth with snoring) were getting worse.

As a health professional, I was aware of multiple studies showing the weight loss value of portion control and low processed carbohydrate diet (including beverages).  My basic strategy of bicycling was no longer working to control my weight and my childhood ingrained food principles (clean your plate, no leftovers) had further sabotaged my efforts to improve this area of health.  In addition, I had become too busy to make a lunch and ate late dinners when I had a voracious appetite.

In motivational science, the first step is to realize you have a problem.  The next is to want to change and to see the next steps to take to address the problem.  Then you need to celebrate success and set new targets.  In my situation, I realized my weight reflected an unhealthy lifestyle that would threaten my “golden years” and also wasn’t a good example to my patients, friends, or grandkids (10).  I also saw that I could change my attitude about food from eating as a duty or reward, to eating to live well.  I also had hope that I could make the above evidenced based dietary changes.

I am pleased to report that I can now button the top button on all my dress shirts, wear all my pants, have much less heartburn, and have improved energy and mental clarity.  My wife reports I’m snoring less.  I’m not yet where I want to be, but I’m encouraged by these results.

I hope these reflections encourage you to partner with CALTCM to take on the hard clinical problems of our patients with renewed optimism.  Please encourage your colleagues to attend this session and take the bariatric challenge. Remember, the "times are a changin".

Here is to a healthier 2017 for our patients, staff, and community.