Bariatrics Takes Aim At Obesity Through

 Weight Control And Management

By Kaaren Valenta

Obesity has become epidemic in the United States. Nearly one third of all adults are now classified as obese, according to the US Department of Health and Human Services (HHS).

Obesity is a major health care issue with annual costs expected to exceed $200 billion in the United States alone. Obesity is responsible for more than 280,000 deaths annually in the United States and will soon overtake smoking as the primary preventable cause of death if current trends continue. Obese individuals have a 50–100 percent increased risk of morbidity and mortality as compared to normal weight individuals.

“The problem keeps getting worse,” said HHS Secretary Tommy G. Thompson. “We’ve seen virtually a doubling in the number of obese persons over the past two decades and this has profound health implications. Obesity increases a person’s risk for a number of serious conditions, including diabetes, heart disease, stroke, high blood pressure, and some types of cancer.”

The problem is not just in adults.

“Twenty-five percent of children are overweight or obese,” said Theresa Piotrowski, MD, a Newtown physician who recently opened a new multidisciplinary bariatric practice with offices in Sandy Hook and Bridgeport.

Dr Piotrowski has been a board-certified family practitioner for more than 15 years, with special interest in the areas of the areas of pediatrics, newborn care, and women’s health. This fall she completed her written and oral exams to become board-eligible for certification as a bariatric physician and to open Spectrum Bariatric at 5 Riverside Road in Sandy Hook and 4775 Main Street in Bridgeport.

“Bariatrics is a relatively new field,” Dr Piotrowski said. “The American Society of Bariatric Physicians is only ten years old.”

Dr Piotrowski was attending an American Board of Family Practice medical conference in San Diego, Calif., in September 2002 when she picked up some information about bariatrics.

“Months later I was going through the material and it fascinated me,” she said. “I never knew about the practice of bariatrics. I always assumed they were surgeons.”

Bariatric surgery, during which procedures such as gastric bypass, gastric banding, or stomach stapling are performed, has been widely publicized but it is not an answer for most people who are overweight. The surgery is limited to those who are considered morbidly obese.

The patient must be 120 percent overweight (usually at least 100 pounds overweight), have a body mass index of 40, or 35–40 combined with other medical problems, and have been treated by a physician for a year before surgery can even be considered.

“What many people don’t realize is that this kind of surgery requires a major lifestyle change,” Dr Piotrowski said. “It is major surgery. One in 200 patients don’t survive this surgery.”

Dr Piotrowski’s practice is focused on helping patients avoid the need to have surgery. Spectrum will be devoted to weight control and management and will offer the latest in innovative medical technology for health and wellness. Dr Piotrowski believes that being overweight is a serious medical issue and that patients with this problem deserve the very best care that modern medical science can provide.

“Conditions like diabetes, hypertension, sleep apnea, and asthma are often linked to obesity,” Dr Piotrowski said. “Ninety percent of the people with Type II diabetes are overweight. It has reached the point where patients take an average of one drug for each ten years of age when they are obese. That means five drugs for a 50-year-old, six for a 60-year-old.”

But for each 15-pound weight loss, a patient has the potential to eliminate one medication, she said.

Dr Piotrowski has always been interested in working with patients who need help developing healthy lifestyles and eating habits. Treatment involves a great deal more than the “dieting” that most patients have tried on their own and failed.

“You can go on a weight loss program but then what?” she said. “There has to be lifestyle changes to maintain the weight loss. Yo-yo dieting is detrimental, causing more of a stress on the body than if the overweight condition is maintained.

“You can’t treat a patient without looking at the psychological issues for eating, so I have access to a psychologist as well as a personal trainer. A person that weighs 300 pounds won’t go to a gym, but a personal trainer could come to the home,” she said. “It is important to increase the activity level. Just to get up and moving is an accomplishment for many overweight people.”

When treating adolescents, the situation is even more complex.

“With adolescents, you are not just treating the kid, you are treating the family,” Dr Piotrowski said. “Doctors have found abnormal elevated liver function in kids caused by the high fructose corn syrup that is in so many products that appeals to that age group. It’s in nearly every kid product.”

The diet aid aspartame also causes elevated liver function and visual problems in some children, she said.

“About one year ago, my family significantly changed the way we shop. We cut out all processed food,” she said. “When I changed the way I eat, I lost ten pounds without even trying to. I did it because it is healthier.”

Dr Piotrowski’s family includes her husband Eric Sjoblom, a pilot for American Airlines, and their two children, Brian, 9, and Sara, 11.

“When I was a kid growing up in Chicago, I rode my bike everywhere and got plenty of exercise,” Mr Sjoblom said. “Children in Newtown can’t do that because most of the roads aren’t safe for bicycles. That’s why organized sports like soccer have become so important.”

Dr Piotrowski completed her undergraduate work with cum laude honors at Assumption College and earned her medical degree at the Georgetown University School of Medicine, followed by residency in family practice at Pendleton Naval Hospital in San Diego.

“That’s where my husband and I got married, and where I was attending a ten-year reunion of the [hospital] residents when I learned the board and society of bariatric physicians. I never knew they existed,” she said.

Having completed the 500-question exam and the oral exam, Dr Piotrowski eventually will undergo a review of the charts of 50 patients by a diplomate of the bariatric board to become one of the few board-certified bariatric physicians in Connecticut.

“There is a lot of satisfaction in this area of medicine,” Dr Piotrowski said. “You see how you can significantly impact a person’s life in a very short time.”

Despite the fact that obesity is believed to play a major role in the cause of many medical conditions, treatment of obesity is not covered by many insurance plans, Dr Piotrowski said. “My practice is fee for service. I don’t have to spend time dealing with insurance companies. If I want to spend an hour or two with a patient, I can.”

Dr Piotrowski soon will be setting up an office separate from her family practice for the bariatric practice. “You have to create a comfortable office,” she explained. “That means larger chairs, wider doors to accommodate oversize wheel chairs, larger [high blood pressure] cuffs. It needs to be welcoming to overcome the anxiety of getting out and doing it –– going to a doctor or gym is the biggest hurdle for some people.”

Meanwhile, she will see patients in her existing offices in Bridgeport and Sandy Hook. Consultations can be scheduled by calling Spectrum Bariatric at 203-374-5511.