When Ali Tavakkoli, MD, a bariatric surgeon at the Brigham, describes the impact that weight loss treatment can have for a patient, he doesn’t talk about percentages, body mass index (BMI) or numbers on a scale. Instead, he talks about his patients’ day-to-day lives. In a recent interview, Tavakkoli smiled as he fondly recalled a patient who had undergone a weight loss procedure telling him how excited she was to have gone to a movie theater for the first time in her life with her grandchildren — something she had been too afraid to do before losing weight.
“Obesity is a disease that has dramatic impacts on patients’ health and quality of life,” said Tavakkoli, chief of the Division of General and GI Surgery. “Weight loss treatment can transform people’s health and well-being and open doors to new opportunities their weight previously restricted them from pursuing.”
Tavakkoli, his co-directors and their staff at the Center for Weight Management and Wellness (CWMW) aim to transform the way weight-related diseases, like obesity, are treated across the nation. The newly launched center at the Brigham allows patients to access the vast array of weight management services the hospital has to offer in one place. In addition to surgical procedures like the ones Tavakkoli performs, the CWMW offers services such as endoscopic procedures and counseling focused on diet, medicine and lifestyle modifications.
The Brigham has offered a variety of weight management services for many years, but they were scattered across departments and divisions throughout the hospital, making it difficult for patients to understand their weight-loss options. The CWMW brings all of these services under one umbrella, providing patients with easy access to experts across the spectrum of obesity medicine.
“I truly believe the Center for Weight Management and Wellness will be the model for the rest of the academic centers in the country,” said Caroline Apovian, MD, a leading expert in obesity medicine and one of the center’s founding co-directors. “We are the first center in the country that combines all three modalities for obesity care in one place: medical weight management, surgery and gastrointestinal (GI) procedures.”
Focusing on What’s Best for the Patient
The center’s mission is to provide holistic and seamless care for all patients. Clinicians at the center recognize that every patient comes with a different story. Having a diverse array of services available enables clinicians to provide every patient with the unique combination of supports they need.
The center offers a wide range of surgical procedures such as gastric bypass surgery, sleeve gastrectomy, gastric band and revisional surgery. It also offers endoscopic options designed for people who meet the qualifications for bariatric surgery but are not quite ready to undergo operations.
Beyond procedures, patients can also seek medication, lifestyle coaching and counseling services. The center offers group programs for patients to discuss their weight loss journeys together, dieticians to help patients develop healthy eating habits and educational services to teach patients about meal planning and nutrition. Additionally, on-site physical therapists help patients recover post-surgery and develop new exercise routines.
Patients typically sign up for an appointment online after their physician refers them to the center. Once they come in, medical professionals assess their needs and point them to experts who can help them across all three disciplines. The clinicians then collaborate to meet each patient’s unique needs.
“I think this center is really unique when you look regionally or nationally because it focuses on an unbiased assessment of people when they come in and offers multiple ways to help them,” said Tavakkoli, who specializes in noninvasive gastrointestinal procedures. He is an expert in metabolic surgery and studies how to improve surgical outcomes to not only help patients lose weight but also improve diabetes outcomes and increase overall health and well-being.
Reducing Risks, Improving Outcomes
Physicians recommend that patients do not wait to get help with weight loss. Losing weight can help protect against and treat conditions such as diabetes and heart disease. Notably, it can also help protect patients from some of the severe risks associated with COVID-19. According to the Centers for Disease Control, having obesity may triple a person’s risk of hospitalization due to a COVID-19 infection. As BMI increases, so does risk of death from COVID-19.
“Most patients wish that they had not waited so long to get help with obesity,” said Apovian, “A lot of that has to do with stigma surrounding obesity, and stigma can only be removed with education.”
Anyone looking to lose weight can visit the CWMW. While physicians typically do not recommend patients with a body mass index under 25 for surgery or medication, any patient, regardless of their BMI, can come in for lifestyle advice and counseling.
“The center puts the patient first. We do what’s best for them in the most efficient way possible. The people that work here are incredibly accomplished and have deep expertise. Each discipline has several experienced leading physicians and researchers in the field,” said Christopher Thompson, MD, director of Endoscopy, and a co-director of the CWMW. Thompson specializes in gastrointestinal endoscopic techniques and has pioneered many of the endoscopic procedures existing in the field today.
In the future, the co-directors hope to broaden access to the center’s services geographically, expand virtual care and recruit more clinicians to center sites. The team also hopes to grow the research component of the center.
“We have a very robust research program looking at bariatric and medical treatment outcomes. We are finding that there is heterogeneity in weight loss in procedures, medication and surgery. We’re trying to get to the underpinning of those differences. Why do some people lose a lot of weight after bariatric surgery and some people don’t? This is what we’re currently investigating,” said Apovian.
Thompson emphasizes that a primary goal of the CWMW is to make weight loss treatment more accessible to those who want it.
“To us, it’s important for patients to know that obesity is a disease and that their need for treatment is not their fault,” he said. “We just want to help patients in whatever way we can.”