We all know being overweight is not good for our health, our job hunts, even our love lives.
"There is an epidemic of people weighing more than is healthy for them," agrees Dr. Joe Colella, a leading robotic bariatric surgeon in Pittsburgh, Penn.
"There is a disproportionate growth of the super-obese and an even bigger growth among that segment of the population not even thinking of losing weight. Hospitals – hospital beds, for example – are not prepared to serve people who weigh too much," he says.
Colella is one of fewer than 16 bariatric surgeons nationally performing robot-assisted bariatric surgery, which its advocates say is less invasive than traditional bariatric surgery.
In the following interview, he discusses weight loss through dieting as well as through bariatric surgery – both the stomach-constricting Lap Band, made by Irvine-based Allergan, and the stomach-detouring gastric bypass.
Q. You are talking about the really obese, right? How much "overweight" can people be without feeling obese?
A. People with a body mass index of 30 – about 30 pounds overweight – should have the option of weight-reduction means such as the Lap Band. Over time, as you get older, without aids that weight can increase.
The means medical problems start to mount. Diabetes becomes unmanageable. And there's not much choice when you also can't get out of a wheel chair or are bed ridden.
Q. You are a specialist in gastric bypass. Isn't that an operation used by younger people?
A. We do them for people in their 60s today.
Gastric bypass changes your diet. What you eat determines what you weigh and how healthy you are. So if you can make adjustments and get yourself used to appropriate food choices, you may be able to take care of the weight problem yourself. But you will go to what is an appropriate weight for your genetic makeup.
Q. Now you are talking about "big" people versus "little" people?
A. We're talking about body mass index, which is a broad-based way of looking at individual weight.
Who are the best odds players in the country? The insurance industry. And life insurance will assess your risk for x y z disease based on body mass index. Which tells you a lot when you read between the lines.
Q. So I diet until my BMI is around 30 pounds overweight and I'm OK?
A. The problem is we know that once your reach a certain BMI, you can lose the weight but you can't seem to keep it off. We know people with a BMI of 40 or more cannot seem to lose a significant amount of weight and keep it off. We think the magic number [for a BMI] is somewhere in the low 30s for successful diet results.
Q. What medical problems do people with a higher BMI face?
A. The big things are vascular disease and stroke, type two diabetes, various cancers, high blood pressure, high cholesterol and sleep apnea.
And type 2 diabetes has a whole trainload of problems associated with it, which is why it should be avoided.
Q. I write primarily for people 50 plus.
A. Ah, if you are overweight at 50, the odds are stacked against you losing enough and maintaining it on your own.
Essentially, you need to overwhelm your body with lean protein and complex carbohydrates. Then your body has to learn to use the energy and thus extract the calories from those types of foods.
There is another important reason to change.
Many people don't realize they are in a carbohydrate coma. Just changing their diet may not make a great weight impact but could help them sleep and think better.
I'm talking primarily about eliminating white sugar and starch.
Your diet doesn't need to be calorie-free. But complex carbohydrates – fruits and vegetables – suppress the appetite because your body has to work harder to get at the calories in those foods.
You should not eat a lot of cheese and dairy because the fat content can be high.
You should eat meat, fish and chicken. If cheese is your only source of protein, it can be a problem.
Frankly, I don't know a better food to eat than salmon.