Weight Management and a Healthier Lifestyle
Speaker 2: 00:09 Good day everyone. I want to wish everyone a happy and well new year. This is Justin Gomez with wake forest baptist health and we are recording our first ever best health podcast. So we're excited about the new year and some new ways that we're talking to our local community about wellness, uh, from the best health community team and from wake forest baptist health. We have a very special guests for our first ever podcast. Dr Jamy Ard. He's from our weight management clinic and he is going to be talking about um, a variety of topics around weight management getting healthier and um, you know, a lot of us were you just this Yo-yo, it's hard for us to lose weight for one reason or another. And I think Dr Ards gonna enlighten us on some really interesting information and facts and encouragement, um, about, um, the overall topic and, and some of the services that we offer here at wake forest baptist. So welcome Dr ARD. Thank you Justin. Glad to be here. Thanks. So, just to start off, tell us a little bit about yourself. Um, at what point in your life did you realize you wanted to be a doctor and, and take us from there?
Speaker 3: 01:30 Yeah. So, um, I grew up in Louisiana, small town in northern Louisiana called Grambling. Grambling state university is the, uh, you know, place that I grew up. Um, most people don't realize there is a town there. Um, it's not just the college. And, uh, I had the fortune of spending my formative years there. Um, but decided to leave once I went to a undergraduate school. I went to a Morehouse college in Atlanta and, uh, the matriculated at Duke for medical school. Don't hold that against me. I try not to. Um, but that's where I really sort of got interested in weight management because when I went to medical school, you know, I was really anxious to say, hey, I want to fix some stuff. Right. That's why I wanted to be a doctor. I thought I was gonna be a doctor all my life. So year it was, now I'm finally learning about what doctors do.
Speaker 3: 02:27 And, um, I was like, I want to be in the line where, you know, you get in there and you fix something and you're done and you see people, you know, do better as a result of the things that you've, uh, helped them with. Um, and so, you know, to me that was like, okay, I'm going to be a surgeon. Um, and then we started learning about, um, different things that, um, you know, chronic diseases like diabetes and high blood pressure and, uh, high cholesterol and heart disease, even cancer and those types of things that you learn about when you're doing your pathophysiology. And, um, the first thing that everybody was saying was, hey, you know, tell people that, you know, live a healthy lifestyle. Right? That's the first thing that you want to do to deal with any of those diseases or prevent them.
Speaker 3: 03:15 Sure. In this was, uh, in the early nineties, uh, where people were just starting to talk about obesity as an epidemic. Um, and really, you know, starting to think about, you know, more people are gaining weight and we're seeing more obesity. Um, and so that, that got me really interested in then, um, in a small group, a team that we had, uh, one of the clinicians who was the director of the Duke Rice Diet. Uh, Bob Rosati was his name. He took us to that clinic and, uh, let us talk to some of the patients there. And that was just eye opening for me to see with this type of intervention where they were helping people, you know, basically engage in an intensive lifestyle intervention, um, that these are folks who were coming in and wheelchairs and leaving, you know, walk in the mail, you know. Sure. Right. And doing that in a very short period of time, it wasn't that they, um, need a year's to do that.
Speaker 3: 04:15 That was something that was happening in, you know, a month or two months. Um, and that was just, that was really eye opening and it was inspiring. And, um, and I felt like, you know, of all the things that we've been learning about these, this is something that reaches across a number of different health conditions and affects everybody. Um, no one's immune from the challenges of having to manage your weight. Um, and so it went from there. And then that was very early in my medical school career and that's what I've been doing all my life now. So I'm a professional career. That's pretty cool. Yeah. So how long have you been at wake Forest Baptist health? Um, six and a half years. So my family and I, we came here in 2012. Um, yeah, so it's been, it's been a good run. So when, uh, you're not, uh, being a doctor for us, what do you like to do with your fam in the spare time?
Speaker 3: 05:05 Um, yeah, so I got a couple of teenagers, uh, twins that are 15 year old, 15 year olds now twins. Oh Man. Uh, I'm having a flashback now. Sorry. Uh, uh, those first few days are tough, but um, no, you're great. And uh, so you know, like everybody else and we were running around and at least we're still playing man to man, cause we only have two. Uh, there you go. Um, but you know, they're, they're into their ex extracurriculars. And my wife is a wonderful woman who takes care of all of us and, you know, make sure we are all organized. She's the coach on the team. Larry, go. Um, and then when I'm, when I've got some free time, I'm trying to play some cough. So that's pretty much it. There you go. There's lots of good courses around here. Yeah. So we're going to get into more details about the weight management center and medical weight management here in a few minutes. But I just kinda
Speaker 2: 05:58 want to get a response from you, first of all, um, just in more broad strokes. So we are inundated with so much information these days. And when I say we a as a consumer, as a potential patient or a patient, um, there's so much information coming at us from, you know, social media videos to late night infomercials and, um, there's so many, uh, quote unquote, uh, you know, lose weight fast. This will change your life. Just use this machine for eight minutes and it'll, the fat will melt off. And you know, [inaudible] pills that you can take that are wonderful, supposedly according to these commercials or videos we see. So just I guess speak broadly from just the, how that is a potential challenge for us, uh, as a consumer, as a human being, um, with all this different messaging, how is so much white noise and, and, and how, how does that present a challenge when you speak to potential patients coming in that they've heard all of this, this messaging, what is true, what is not true? If you could talk to that for a second. Yeah.
Speaker 3: 07:02 Yeah. So, so now this is going to take up the rest of the podcast, um, because you know, you're, you're right, right. I mean, we get, we get lots of information coming at us on a regular basis about, yeah, do this, don't do that, this recent bad diet that, um, you know, sort of new thing that people are avoiding now. Like you can't eat carbs or you can't, you know, eat fat or you only can eat Avocados, but on whole grain toast or, you know, I mean, who knows. Right. And so, um, and then the other challenge is everybody has an experience with food right in the end with physical activity and you know, with their own sort of story around, you know, healthy lifestyle endeavor. And so that, that means that everybody's got an opinion. Everybody's got their sorta perspective and take on it.
Speaker 3: 07:52 Um, which is, you know, totally different than any other area of medicine, right? I mean, you know, if you've got a knee that needs to be replaced, you don't go into the orthopedic surgeon and say, you know, hey, I want this model of knee, um, in, in this procedure. Um, you don't tell your cardiologists put this particular stent in, but when it comes to weight management, uh, you know, a lot of the care is really sort of in the patient's court. Um, and you know, there's some challenges to that because, um, you know, a lot of times in this space we have people who are well trained and been doing this a long time and have a lot of experience in terms of understanding the physiology of obesity and body weight and, um, the benefits and risk of pharmacotherapy and different dietary approaches and physical activity and how to integrate all of that, the behavioral health aspects of it.
Speaker 3: 08:50 So it's, it's a really complex sort of a set of behaviors. People tend to want to boil it down to just one thing. I want to lose weight, but it's a complex system of hundreds of different behaviors that people have to integrate in order to be successful. And so, um, because of a number of different things related to our health care system and people's experience with food and the individual components of the, uh, you know, treatment strategy that you have to apply, I think there's this sort of imbalance in terms of the role of a medical professional in helping to guide, uh, treatment strategies for individuals who are wanting to be successful with weight loss. Um, it's just like financial planning, right? You can do a lot of different things on your own. You can read some books, you can, you know, go to a friend.
Speaker 3: 09:44 Um, but you can always, you can also go all the way up to a professional who's been doing it for a long time and has got an established track record and you can trust your, you know, resources with that person. Um, weight management really is not very different than that. And some people will probably do just fine on their own or with a commercial program like weight watchers or Jenny Craig or something like that. But then there's a group of people who we deal with in the weight management center who we sort of see as a, you know, they crossed the line where medically they have more complications, they have more challenges with losing weight. Um, they need more resources, more support. Um, and maybe they've tried lots of times or maybe they've always had difficulty initiating weight loss or they've lost it, but unbeknownst uh, unable to keep it off. Um, those are folks who Dan benefit from this type of professional help and support. And that helps sort of cut through that clutter, um, because yeah, it's totally confusing in the marketplace. And, uh, I think even the best of us in terms of our who spend our time doing this on a regular basis, um, find, you know, yeah, this is really challenging. Yeah,
Speaker 2: 10:57 I could imagine. Um, so we'll talk a little bit more about, um, the weight management center here at Wake Forest Baptist. Now, um, I wonder if some people might think they're a initial, they jumped to when you start talking about medical weight loss or medical weight management, um, their first thought might be, oh, surgery. Um, so the, if I have doctors involved, there's going to be maybe some sort of surgery. So we have surgical options and solutions for patients, but then we have nonsurgical solutions and programs as well. So maybe just talk about, uh, both of those pillars, if you will for a minute. Yeah, so, so we think of, it really is a continuum of treatment, right? Um, again, I'll use another analogy. So cardiology or heart diseases
Speaker 3: 11:43 example. So you have cardiologists who um, use the tools that they have. They don't do surgery, they might do procedures, um, but they often deal with medication and management of medication to help treat or prevent heart disease. Um, but then you also have cardiothoracic surgeons who if disease progresses to a certain point can get in and sort of reroute the vessels and you know, sort of help take over management in their indications for when a surgeon would be involved. So obesity treatment is really not very much different than that in that there is a continuum of, of treatment options and that goes from um, what we could think of as medical or nonsurgical treatment where we're using lifestyle intervention. And that includes things like changing your diet and being more physically active in the right ways. Um, counseling with the behavioral specialists, using pharmacotherapy medications that can help people lose weight, um, and putting all of those pieces together, specialized diets.
Speaker 3: 12:48 Um, and then if those things aren't working for the person to get the type of treatment effect that we want, then we can escalate two different options. And that can include devices, implantation of devices like a balloon, um, or surgical treatment. Um, where here at Baptist we do sleeve gastrectomy, ruined. Why gastric bypass and the duodenal switch. So those are the three primary procedures that our surgeons do. But those, those surgeries, um, are really tools that, um, you're using to help make the lifestyle components stick. Right? It's just the, the whole idea is less come up with a plan that makes it easier for you to implement the dietary plan that we want to implement. I wish we had a surgery for exercise cause then man, we'd be killing it. Right? But there's nothing that can make you exercise, right? There's no appeal that makes you exercise. Most of that is gonna be, you know, giving you some better tools that help you enjoy that more or given you some time management strategies so that you, you know, put that into your schedule. But, but that's how medical and surgical programming works together. Right. It's really both the, both of our teams are really sort of working in conjunction and often we're, you know, working with the same patient in a coordinated plan.
Speaker 2: 14:10 Sure. Um, well talking about the, the medical weight management, the nonsurgical options. I, uh, I visited the weight management center, uh, in Winston Salem this week and I was really impressed, got to hear from one of the nurse practitioners and, um, she did a great job explaining the different options, um, to the group that was there. And, um, the, the nonsurgical options, uh, the, I think two of the more popular programs are the by design Optifast and by design essentials. And if you could just briefly explain those two programs and then, uh, maybe talk about, um, also the four different pillars. Right. So it's not just a medical professional, it's not just an exercise guy, it's you, y'all really approach it from a holistic, integrated, comprehensive standpoint with the four different pillars. So if you want to talk about that for a minute, I think that'd be real helpful to the listeners. Yeah.
Speaker 3: 15:06 Um, I usually sort of describe our two programs as sort of base models of a car, right? Um, everything that we do is going to be individualized and tailored. So, um, you would have heard that that person that you know, introduced those programs to you talk about the idea that we're going to do a full assessment and then take the things that we learned about you, uh, both medically, behaviorally, your background, your goals, put all that together to come up with a specific treatment plan. But we start out with, um, two types of programs that, um, we use to then customize. And so those two types of programs, as you mentioned, our, our essentials program, our Optifast program, the essentials plan is really designed for those individuals who need to lose about, uh, one to two pounds per week over a six month period of time.
Speaker 3: 15:56 Usually that's gonna lead to somewhere around 24 to 40 pounds of weight loss for the average person. Um, and the idea is that we're starting with, um, some basic skills around food and, and being able to engage with food. Um, you're going to be doing some meal preparation and meal planning with the help of the dietician. Um, you're ready to shop for your groceries and, and put together, you know, those types of things. Um, we're really focused on disease management and Resolution of disease. So if you come in with high blood pressure or diabetes, we're going to focus the dietary plan so that it's specific for those particular disease issues. So, you know, even before you started losing a lot of weight, you're already starting to see improvements in those numbers. So, so a lot of what we want to focus on is not just the weight, but you know, making you healthier overall, getting rid of disease.
Speaker 3: 16:51 Um, so the essentials plan is really sort of designed to, to focus in on that. Um, it's good, it's good for that person who's ready to engage with food. It's not so good for that person who hasn't, you know, turned on their stove in the past six months. Right. If you're eating out every meal, if, uh, you're, you've got no skills around food, you know, we're not gonna turn you into Betty Crocker right away. Right. Um, that's, that's gonna take some time to sort of learn those skills and, and get comfortable with that. The Optifast plan by contrast is really a, um, more intensive type of treatment strategy designed to help people lose at least 50 pounds or more. Um, and it starts out with the use of meal replacements and you use a meal replacement as a substitute for food. It's, um, like we call it a vacation from food.
Speaker 3: 17:40 So I'm think about it like this, if, if from food. Yeah. Yeah. Because a lot of times what ended up ends up happening is, um, are struggling with the substance that they're then supposed to use to help them get better. Right? So think about it. If I'm one on one patient, I, um, heard do a testimonial once. Um, he talked about how his life revolved around food and, um, he, you know, would go to a restaurant order two or three entrees and his wife would say, hey, if you just ate a little less of that, right, you just order one entree in instead of two or three, you start losing weight. And to him that was just sort of a foreign concept that was like telling a crack addict like, hey, just have a little bit of that crack. Right? And then, and then you'll get better.
Speaker 3: 18:29 And so for a lot of people, it's an all or nothing proposition, right? If I'm going to have one donut, I'm going to have the whole desert, right. You know, it's, if it's there, I'm going to eat it. Sure. And so, um, this notion of moderation and trying to make these small changes, for some people it's very difficult. Um, and so, you know, we, we, we say this is again an individualized approach and it's not going to be for everyone, but a lot of people will find, you know, will resonate with them when they, when we say, look, you won't have to make choices. You won't have to deal with, you know, cooking, you won't have to deal with. Um, though that, that planning aspect of this process right up front, we're going to give you some time to at least get the momentum going in terms of weight loss and then using the meal replacements. And then over time we're going to gradually rebuild your diet by adding back food, um, in a, you know, very systematic and thoughtful way with the support of our, of our team to help you continue that weight loss. And now at the end of this, you've, you know, essentially rebuilt your diet to be more specific for you and allow you to maintain your weight loss.
Speaker 2: 19:38 Sure. And I really, I thought it was really, uh, helpful and I haven't gone through the program myself, but I'm assuming just having the four different disciplines there to help you. Um, and it sounds like they're really, they're in a strong support system kind of way with, you know, you're, you're touching base with them on a weekly basis. There's, you know, there's an app that you're logging your food and your exercise on that your support providers w at the weight management center are going to be talking to you about an offer new encouragement or um, some, some medical advice on, on how to keep it going or if there's ways to improve it as you go through this, this journey, um, in the program. And I liked that. That's not just, um, you know, you're going to see a, a doctor or a nurse practitioner, you're put, you're also gonna see a registered dietician. You're going to see a behavioralist, which I think is a really key component. And as well as a exercise specialist, um, in, in, I like the behavioralists cause you hear a lot about, you know, stress eating or once you get in there and start unpacking, you know, there's, there's mindful
Speaker 3: 20:48 eating but then there's mindless eating and yeah. And you know, some of the different ways of, of why people make the decisions they do. So I like how the behavioralist is a part of, of the program. Yeah. I think the key to our success and really what differentiates us, um, compared to anything else that you can find out there is the fact that we do have this team approach with covering all those bases in terms of understanding that not just what to eat, but how to put the plan together, how to exercise properly for weight loss, um, and getting the medical advice and support to help manage chronic disease, uh, with the potential for medication treatment and so forth. Um, if you think about it, what most people end up doing when they're, when they sort of set this resolution at the beginning of year now to go out and loosen weight, they, you know, 90% of people are start off with, okay, I'm going to get a gym membership.
Speaker 3: 21:46 Right? And right. Unfortunately I'm gonna really hurt a lot of people's feelings now. You just don't lose a lot of weight with exercise alone. Right. Me Can do a little bit. Women generally not much. Sorry. Um, so it's just, it's just, yes, it's good to exercise cause it's good for your heart and it's lots of other healthful benefits, like your mood and so forth. But if you just go get a gym membership alone, probably not going to lose a lot of weight on average. Um, and then so then a lot of people will say, okay, well maybe I'll, you know, meet with the nutritionist or get something online or pick up a book to help me sort of figuring out what diet plan to do. Right. So now you, you're trying to piece something else together. Um, very few people talk to their physician, um, or healthcare provider about, you know, the idea of losing weight.
Speaker 3: 22:38 Sometimes I think a lot of people don't realize like, oh my, you know, healthcare provider might be able to help me. Um, and sometimes that's true, right? They may not be able to, they may not be equipped to help you, but they can at least refer you into a center like ours. Um, if you're interested in that kind of support. Um, and then, you know, as you said, from a behavioral standpoint, you know, very few, if any people are really sort of, uh, attending to, yeah, I know what to do. Right. I know I should, when I go to Panera, I should get the, you know, apple instead of the chips. Right. But how many times out of 10 do I get the apple? Right. Right. And does that depend on my mood that day? There's that being done, whether I want those chips as a reward or a just fiending for some salty, crunchy. Yeah, they do. And you know, if you could get a second bag, you might, uh, so, you know, it's, it's trying to figure out how to implement the plan or the thing that you know to do. Um, and that's where our behavioral team really sort of comes in there to really kind of help us connect those dots. So I
Speaker 2: 23:46 can't imagine it doing any other way cause it's, it's already hard enough as it is. And if you don't have all that expertise and support to really help you figure it out, um, then I know why it's so terribly difficult for people. Um, and they feel frustrated and they feel like, oh, you know, nothing's worked for me. Well sometimes you just haven't had the right treatment. Sure. Well, um, as we wrap up here in a minute, I do want to say, I just encourage, if there's someone that's listening to this podcast, you know, it's not, um, I think for some people it could be daunting if I have to, if I have to take the step to have medical weight management or weight management, you know, as supervised by doctors. I don't, I just, I just want to encourage people, that's, it's, y'all are nice. You don't bite, go, just go by and listen to, uh, you have info sessions that you do regularly.
Speaker 2: 24:34 Correct. That's right. And listen to what they have to say that really encouraging and supportive. Um, so there's, uh, there's just great information just by going into the initial info session and um, of course very well equipped to answer, um, questions and, and talk about your specific situation, whatever that might be. Um, I do want to go into, I guess a little bit of the shameless plug, uh, portion of our podcast. Um, there is a, a really easy way to get ahold of y'all at the wake Forest Baptist Weight Management Center. You can give them a call at three, three, six, seven one six, six zero nine, nine. I'm also encourage everyone, if you go to the wakehealth.edu website, you can just search weight management and that page will come up. There's a really great testimonial video from a gentleman named Chris and I, uh, you know, working in the health system, I see a fair amount of, of, of videos or here patient testimonials, but I was really struck by his, uh, authenticity and just how it just really transformed his life for him and his family. Um, so it's a great video to go check out. I encourage everyone to do that. Um, also, uh, want to point out, so it's not just once in Salem, we have an office in Winston Salem, but office in Greensboro as well. Correct? That's right. Um, so feel free, uh, if your age just in different locations across the triad to check us out. So, uh, Dr ARD, uh, what are, what are some, what's a closing thought you have for us? A nugget of inspiration or just something random and funny.
Speaker 2: 26:11 Um, you know, I, I will add to that around the location and made me think about the idea that, you know, people really busy these days and, and you know, you got lots of obligations in, in trying to make your lifestyle change and be healthy and get engaged with, um, our program is definitely going to require some time in effort. Um, but we do everything we can to make it easy for you. We even have a virtual versions of our program, so basically you can do 70% of what you need to do by
Speaker 3: 26:44 video. Oh Wow. Okay. All right. So even if you're not in Winston Salem or Greensboro, um, but you're coming from somewhere in north and south or east or west of here. Um, and you want to participate, I'm totally able to do that. All you need is a smartphone or a tablet or a computer. Um, so I can just jump on and do video chat with one of my providers. That's right. That's right. Yeah. So we, we, um, we've got a lot of people who engage in the program that way and, and I think they find it terribly useful. And even for people who are local, just knowing that, you know, I've got a 20 minute visit but I don't have to spend 40 minutes in the car, you know, going back and forth, um, is a real timesaver. Uh, and so that makes a big difference in terms of thinking about engagement.
Speaker 3: 27:33 So I would encourage people who are, you know, sort of listening and wondering like, yeah, I don't know if this could be useful for me or not. Like you say a check us out, come to an information session. It's no obligation. Sure. You at least get, you know, entertaining for 45 minutes. Um, and uh, we'd be happy to, you know, answer any questions at the time you get to meet the providers. We're, we're the ones who are doing the information session so you can, you can ask us directly any questions that you have, be more than happy to talk to you. That's great. That's awesome. Uh, Dr Art, I really appreciate you taking the time and talking to us today. Um, I know, you know, getting healthy or losing weight, that's on a lot of people's minds, uh, at the beginning of the year. So, um, this was great information that you provided to us.
Speaker 3: 28:19 I appreciate it. Yeah, thank you for having me. All right, well, um, once again, uh, this is our first best health podcasts and it will be doing one each month. So encourage you all to come back and check us out again next month, uh, with our next uh, special guests talking about, uh, heart-healthy for February. So, um, I mean really appreciate you guys taking the time to listen to us. And, uh, once again, don't forget to go to wakehealth.edu and check out the weight management center. Also, you, there's a lot of other community wellness resources with wakehealth.edu/besthealth with our best health wellness program. So feel free to check us out on the Internet. Um, help you guys have a great
Speaker 1: 29:04 a week, month and we'll talk to you guys again soon. This is Justin Gomez with best health and wake forest baptist health. Thanks for listening to this episode of the best health podcast brought to you by wake forest baptist health. For more wellness info, check out wakehealth.edu and follow us on social media. Wake Forest Baptist health, the gold standard of healthcare.