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Five years ago the fourth floor in the East Wing of Toronto Western Hospital (TWH) underwent a complete renovation for the Multidisciplinary Bariatric Surgery Clinic. Today, it is a hub of patient success stories – due to both personal courage and a program designed to ensure support for every step of the weight loss journey. Each patient is followed for five years after their surgery to lay the ground work for the lifelong changes necessary to maintain weight loss.
"One of the biggest myths around bariatric surgery is that patients don't go through the hard work of eating a healthy diet and exercising to achieve weight loss," said Dr. David Urbach, Surgical Director for the Bariatric Program. "But in fact, surgery is not easy and patients have to be very committed and make significant lifestyle changes to achieve long-term results."
When diets fail
Bariatric surgery changes the gastrointestinal system to help obese patients achieve weight loss. The TWH Bariatric Program has a highly specialized team of surgeons, nurse practitioners, dieticians, social workers, psychologists, psychiatrists, administrative and research support to ensure patients complete the program successfully.
Ontario has a comprehensive province-wide program called the Ontario Bariatric Network (OBN). This streamlined approach aims to reduce wait times and to connect patients with centres that have the expertise in this field. The Ontario model is helping to tackle a growing public health crisis and has many other provinces looking at how to replicate its success.
In 2012, TWH was accredited by the American College of Surgeons (ACS) as a Level 1 Bariatric Centre of Excellence. As a designated centre of excellence the TWH Bariatric Clinic will be continually evaluated and measured against more than 700 other hospitals for their quality of patient care and health outcomes. The clinic was also recognized as having the most robust educational component to help patients prepare for the surgery and plan for a successful long-term outcome.
Healing mind and body
In addition to the medical and surgical care patients receive, there are support groups, cognitive behaviour therapy, mindfulness-based therapy groups, as well as a bariatric surgery aftercare app with psychosocial resources.
"Our program focuses on getting patients physically as well as emotionally prepared for the changes that come with surgery," said Dr. Sanjeev Sockalingam, Psychosocial Director for the Bariatric Surgery Program. "Many of our patients have been dealing with their weight for most of their life, so there are also issues around self-image and self-concept that need to be addressed in order for surgery to be effective over the long-term."
The benefits to the patient are clear and the savings to the health-care system are tremendous. Surgery demonstrates a remarkable improvement in weight related diseases including a reduction and resolution in diabetes, reduced hypertension, lowering of cholesterol levels, elimination of sleep apnea and gastroesophageal reflux disease.
"The changes we see in our patients are truly remarkable and every member of our team feels honoured to contribute to a positive patient experience," said Sandra Robinson, Manager of the Bariatric Clinic. "We are very committed to meeting the needs of our patients and are continually looking for ways to provide education and support to them."