Weight Loss Resources on East Tennessee Medical News

Weight Loss Resources

By: JAN HAMILTON POWELL

Chattanooga Area Hospitals Offer Support for Physicians

With obesity reaching epidemic levels, physicians are searching for additional help for their adult and pediatric patients. Local resources include a new book on raising fit children and several medically-supervised weight management programs offered to adults by area hospitals.

"Physicians often feel helpless in the face of the complexities of the obesity issue," said Joani Jack, MD, a Chattanooga pediatrician who has co-authored a book, Raising Fit Kids in a Fat World, with Judy Halliday, RN.

After 12 years in private practice, Jack treats patients at T.C. Thompson Children's Hospital where she also teaches pediatric residents through the University of Tennessee College of Medicine Chattanooga.

"Physician advice and recommendations alone don't meet with a lot of success with obesity," said Jack. "It's tough to admit, but we don't yet have the best treatment."

Jack said parents are obviously the vessels through which children have to be reached, and "Unfortunately, in my experience, the majority of parents are not interested in addressing the issue."

Obesity is often a multi-generational problem, Jack said. "And overweight children whose parents are overweight have two strikes against them."

She believes the most progress is seen with parents who begin making positive changes–for themselves and their families–when their children are young.

One of her reasons for writing the book was to reach a broader audience of motivated parents seeking real lifestyle changes for their families.

According to Jack, "Someone willing to buy a book is really looking for answers. It makes me feel I'm having a greater impact."

Jack said the book carries a strong spiritual message about meeting emotional needs and life's stresses with healthy, nonfood-related choices.

"Too often people eat, not because they are hungry, but because they are worried or excited, happy or sad," said Jack. "We must educate new generations to feed these feelings in healthier ways, through faith and other activities."

"Education is the basis of lasting lifestyle change," agreed Sandi Brown, RN, BS, director of surgical and ambulatory planning at Memorial Healthcare System. Even after years in the weight management field, Brown said she is still surprised at the lack of knowledge many adults have about nutrition.

The Memorial Weight Management Center grew from Memorial's bariatric surgical program, which is certified as an American Society for Metabolic and Bariatric Surgery Center of Excellence, a Blue Cross/Blue Shield Blue Distinction Center and by United Healthcare and Cigna. By 2004, Memorial's program had expanded to include a non-surgical track.

"The standard now for bariatric surgical patients is a six to twelve-month weight management program before their procedure," Brown stated. She said these patients need to reach an optimum weight before surgery and also learn healthy habits to aid them later.

The Memorial program is not just for patients preparing for surgery, and Brown said they have had some patients who have done so well they have elected to forego the surgery.

Running in six-month increments, Memorial's program begins with lab work and a complete health history to determine health issues such as diabetes or cholesterol. Patients meet with a physician or nurse practitioner each month. Provider fees are often covered by insurance, Brown said.

A $65 monthly fee, not covered by insurance, is required for the program's additional services. This includes a classroom-style nutrition class, four one-on-one sessions with a dietitian to tailor an individualized food program, and two meetings with social workers and weekly support groups to explore the emotional issues associated with weight management.

While exercise is encouraged, Memorial does not offer an exercise facility as part of the program.

The Memorial Weight Management Center is located near their downtown facility, at the corner of Derby and Citico, next to the Chattanooga Heart Institute and the Memorial Diabetes and Nutrition Center.

"Memorial's goal is to help our patients incorporate healthy eating and exercise into their everyday lives," said Brown. "Food isn't bad, and diets aren't the answer. We aim to educate people on ways to make healthy choices."

Choice is very important for individuals seeking weight management solutions, according to Brenda Ross, RN, MSS, manager of rehab and wellness for Erlanger Health System. She said, "We meet highly-individualized needs through numerous options."

Ross stated that Erlanger has been offering weight management programs since 1985. In 1991, the hospital opened the Chattanooga Lifestyle Center on Market Street next to the Sports Barn. The center offers cardiac and pulmonary rehabilitation and a choice of medically-supervised weight management programs with a fully-equipped gym and a team that includes a physician, nurse, psychologist, exercise physiologist and dietitian.

According to Ross, the Erlanger program begins with a complimentary consultation with a dietitian where all the options are examined.

Erlanger's first option is one-on-one nutritional consultation with a dietitian to determine a meal plan and exercise program. A follow-up is included in the $75 per hour price.

Pro-fit Plus is an individualized, eight-week, medically-supervised program including a personalized food plan and nutritional education developed by a dietitian, exploration of the psychological issues associated with weight management and use of the gym for a fitness program with an exercise physiologist. Ross reported the cost as $400.

Opti-Fast is a meal replacement program that include shakes, bars and soups. Ross said, "We call this stimuli narrowing. Food choices are limited so that patients can focus and become encouraged by success."

The Opti-Fast program can be 5, 14, or 21 weeks or an individualized length, and Ross reported that costs vary depending on a patient's needs.

Opti-Fast includes a strong educational component and the support of the full team. Ross said, "The goal is helping the patient understand why they may overeat and giving them tools for long-term success in an everyday world where meals are not pre-packaged."

Most insurance does not provide reimbursement, Ross said, although provider fees and some counseling related to underlying health concerns such as diabetes or cholesterol may be covered.

Ross said Erlanger opened bariatric surgical services in 2007, and the programs in place at the Chattanooga Lifestyle Center also support patients who are planning for the surgery.

Jack said that she deliberately chose the words "Fit Kids" instead of "Thin Kids" for the title of her book. She said, "People come in all shapes and sizes. This isn't about looking a certain way or being a certain size. This is about long-term health benefits."

Brown of Memorial echoed those thoughts and said, "For adults, who may have obesity-related health issues, there are distinct advantages to a medically-supervised weight management program."

Ross of Erlanger added, "Physicians can refer to us knowing that our program is designed to keep a patient's overall health needs in mind as the choices are made."