Like many people who suffer with obesity, being extremely overweight since his youth robbed Richard Tremblay – Rick - of a life he could have been enjoying, that is, until he underwent gastric bypass surgery at Baystate Medical Center.
“I’ve struggled with my weight since the third grade. Over the years, trying different diets resulted in losing some weight, which I would eventually gain back. At my heaviest, I weighed 409 pounds in 2019,” Rick said.
According to the Centers for Disease Control and Prevention (CDC), obesity in America affects 100.1 million (41.9%) adults. If left untreated, obesity increases the risk for a number of health conditions including high blood pressure and high cholesterol, type 2 diabetes, asthma, sleep apnea, joint problems, and gallstones and gallbladder disease.
WHY HE OVERATE
Obesity was a constant battle for Rick, driven by a combination of stress eating, not exercising, and poor eating habits from growing up in a military household where “you couldn’t leave the dinner table without eating everything on your plate.”
“I had a sweet tooth, especially for chocolate, and would tackle anybody for a Snickers bar. I also gravitated toward junk food and all the stuff you shouldn’t be eating. If only I had known then what I know now, I probably could have prevented my obesity in my early youth,” Rick, 49, said.
“I was overeating from boredom. It’s a catch-22. You are overweight and don’t have the energy or strength to find that motivation needed to get outdoors and do things. I became a prisoner in my own body, depressed at times and reclusive. I couldn’t do what others were doing, sitting in a booth at a restaurant, going on hikes, bicycling, hiking, swimming, let alone taking my shirt off in public,” the Chicopee resident added.
A SERIOUS DISCUSSION
Eventually, Rick’s primary care physician had a heart-to-heart talk with him saying the time had come to think about weight loss surgery, that it was “the only option left” for him.
“I began to do my research on who offered the best program in the area and that led me to Baystate Medical Center. It was important for me to find a program with an excellent success rate. If I was going to invest my time and money in finally losing weight, I wanted to be successful at it. Baystate definitely has a more structured program with plenty of clinical support from dietitians to psychologists on site, and I needed that,” he said.
HIS BIGGEST SUPPORTER
Tremblay noted his “best cheerleader” throughout the process was Kimberly Estremera, MS, RD, LDN, CSOWM, one of the program’s bariatric dietitians.
“I still see and talk with her today. I don’t think I would have been as successful without her constant support and encouragement, which I really needed, especially in the initial months when you begin to restrict your diet to lose some weight before surgery. She helped me to look at the calories I was eating and made sure I got just the right amount of protein, carbs, and fats in my diet, as well as guiding me to just eat smarter. And it wasn’t just about calories, but tips on knowing what kinds of food to eat to help curb my cravings, how to read the labels in a grocery store, the importance of exercise, and so much more," Rick said.
“The psychologists I saw were also helpful and spoke with me about my expectations, my home life and any struggles or past traumas that might have served as a trigger to gaining weight,” he added.
A TEAM EFFORT
Working with Rick was a team journey, Estremera noted.
“We both were able to listen and reflect the goals Rick had for himself and his health. It was a pleasure to support Rick in his learning and evolving as he prepared for bariatric surgery. It is a lifetime pursuit and I look forward to seeing Rick as he continues to progress, make strides, and change his health,” she said.
The program’s dietitian also noted that when pursuing bariatric surgery, it is very important to understand how food choices and eating behaviors affect your health. The Baystate Bariatric program works on building a strong foundation of healthy eating patterns, so patients can continue to improve on habits that move them towards their health goals. Patients are taught how to create individualized nutrition plans that reflect their lifestyle, culture, and goals.
SELECTING THE RIGHT SURGEON
Since Rick wanted gastric bypass and a surgeon who could perform minimally-invasive surgery, that led him to Dr. John Romanelli, Chief of General Surgery and Director of Bariatric Surgery at Baystate Health.
Dr. Romanelli is one of the surgeons in the Bariatric Surgery program alongside Dr. Jay Kuhn and Dr. Alicja Zalewski, who have a total of 37 years combined in their consistent efforts to bring the best in bariatric surgery to western Massachusetts.
“Ours is a comprehensive program that will take patients anywhere from six months to one year to complete. Patients need to know that this is not something that can be done overnight. Weight loss surgery is a tool that can be very helpful when employed the right way and only works well in coordination with calorie burning exercise, substantial behavioral changes, and a firm commitment to eating a better diet,” Dr. Romanelli said.
WHO QUALIFIES FOR SURGERY
Weight loss surgery is an option for people who are severely obese (about 100 lbs. over your ideal body weight and a BMI – body mass index - of 35 and above) and cannot lose weight with diet and exercise alone. Improving your lifestyle, eating right, and staying active is still important.
Anyone interested in weight loss surgery at Baystate – whether choosing laparoscopic gastric bypass or laparoscopic sleeve gastrectomy - will go through an in-depth screening process to make sure they are a good candidate for weight loss surgery and that they know what to expect. The screening process starts with a general information session. Then, patients will have appointments with a physician assistant, dietitian, surgeon, and mental health professionals, and will also be required to attend at least three support group meetings before surgery.
“Patients will need to talk with their primary care provider about whether or not bariatric surgery is right for them,” Dr. Romanelli said.
BARIATRIC SURGERY OPTIONS
During laparoscopic gastric bypass, which Rick opted for, the surgeon makes small incisions, or cuts, in your abdomen. A small camera and the tools needed to perform the operation are inserted through these cuts. Then, the surgeon creates a small pouch from your stomach and connects this pouch directly to your small intestine.
After your surgery, any food you swallow will go into this small pouch of stomach and then directly into the small intestine. Food then goes around - or “bypasses” - a part of your original stomach and small intestine so that a portion of calories and nutrition are not absorbed. You can expect to lose up to 60% of your excess weight in the first two years after gastric bypass.
During a laparoscopic sleeve gastrectomy, about two-thirds of the stomach is removed leaving a thin, tube-shaped or “sleeve” shaped - stomach. After surgery, food enters the sleeve and patients feel full after less food and will consume fewer calories. You can expect to lose up to 55% of your excess weight during the first two years.
AFTER THE SURGERY
Carrying all that excessive weight for so many years - left Rick feeling “generally sick with constant aches and pains” on top of being diagnosed with high blood pressure, arthritis, and sleep apnea. However, since his gastric bypass surgery in September 2019, all three have been vanquished. Rick now weighs about 190 pounds and consumes approximately 1,300 to 1,500 calories per day depending on the number of calories burned with exercise.
“I was burning so many calories working out with my physical trainer that I wasn’t consuming enough calories throughout the day to maintain energy. Dietician Kim Estremera recommended that I find a sports nutritionist and I found one who could do virtual sessions with me. This was critically important to me so I wouldn’t lose steam through the day or get unnecessarily sick,” Rick said about his aggressive workout routines.
The benefits Rick now enjoys go far beyond health.
“The surgery changed my life. It’s like a whole new world for me and I’m doing things I never would have imagined doing - ziplining and hiking the Appalachian Trail and traveling to Europe. It’s the small things you don’t think of now like being able to fit into a seat on a roller coaster or not having to book an extra seat on an airplane along with a bigger seat belt. And I have so much more energy to be able to do things like going to the gym to exercise, being able to get on a treadmill, and enjoying a healthy hike,” Rick said.
A NEW SOCIAL LIFE
His newfound weight and health have also made a difference in his social life.
“I feel more respected as an individual and my inner circle has grown. There is definitely bias out there. Kids can be cruel as I soon learned in school. And even my own family would occasionally give me a jab about my weight. One time I was on a bus and a man came up to me suggesting that I lose weight,” Rick said.
Rick noted he would “highly recommend” bariatric surgery for anyone facing similar challenges to his in attempting to overcome obesity.
“The Baystate Bariatric program is the only structured program that worked for me. In addition to my weight loss and its positive effects on my health, the surgery resulted in opening more doors and opportunities for me than I ever dreamed of,” he said.
SOME GOOD ADVICE
Rick offered advice to anyone considering bariatric surgery.
“You need to be mindful and mentally prepared to begin this lengthy journey. If you are doing this just to look good, that is not the best mindset. You must consider not just how you look, but really look at the reasons you are doing this. And for me it was wanting to live past 50 and being healthier and to feel good about myself. Looks are just a bonus,” Rick said.
“This has been an incredible journey that is not over. I still must be mindful of eating right and exercising. And that is what I appreciated about the Baystate program - that it sets you up with the skills and resources needed to succeed,” he added.
Dr. Romanelli had nothing but praise for his patient.
“Rick embodies what is possible if you set your mind on achieving your goal. His success was the result of a lot of hard work on his part, which involved behavioral changes in his eating habits and the need to exercise,” he said.
AN ACCREDITED PROGRAM
Patients can choose to have their bariatric surgery at Baystate Medical Center in Springfield or at Baystate Franklin Medical Center in Greenfield. However, gastric bypass is not available at Baystate Franklin Medical Center.
Both hospitals are accredited centers for weight loss surgery by the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP), which involves a strict review of our procedures, staff, and facilities.
To learn more about Baystate Health’s Bariatric Surgery program, call 413-794-7020 in Springfield or 413-773-2626 in Greenfield.