Mar. 4, 2022 - Weight Loss Surgery: Importance of Weight Management During COVID-19 This week Kemal Erkan, Chairman of American Surgery Center, is joined by Dr. Isaias Irgau of Christiana Institute of Advanced Surgery (CHRIAS) to engage in a conversation pertaining to weight management during COVID-19. Dr. Irgau, the President of CHRIAS, has practiced weight loss surgery, also known as bariatric surgery, for twenty years. He, along with his associates, are a part of the most experienced group in the area. They start by acknowledging the team of professionals at American Surgery Center, including Dr. Gail Wynn, Dr. Michael Peters, Dr. Rahul Singh, Dr. George Ibrahim, and Dr. Sachin Vaid. Erkan begins the dialogue by bringing to light how the pandemic has affected individuals who are obese. He explains how they are prone to suffer more, and they are more likely to contract the covid-19 virus. He states, “sixty-three percent of our patients who had covid were obese or morbidly obese”. Their patients, along with the rest of the population, have a new sense of normalcy. “Clearly, as everybody knows, with the pandemic there has been a general gain in weight,” Dr. Irgau points out; “within our own practice… we see patients that are coming looking for bariatric surgery… the pandemic has pushed them over the limit, and now they are candidates”.

Even patients who have had bariatric surgery in the past have struggled with keeping weight off during this time. Dr. Irgau proclaims, “the pandemic has clearly been a trigger for weight gain”. The pandemic created a recipe for disaster, stressing more lead to eating more and exercising less. The pair continue to elaborate how the pandemic has disrupted the work-life balance for a large number of people. All of these changes have increased the level of stress for many. “It’s understandable that people lose focus and rely on eating to relieve that stress,” Dr. Irgau states. Another major factor that impacts the lives of many is the confinement to their homes. The decrease in activity level is no thanks to the constant time spent sitting watching the news, especially at the start, and the lack of access to spaces for physical activity. Kemal Erkan defines the simplest form of exercise, walking. He explains how it is a simple activity, and yet, people still do not wish to do so in the pandemic. Dr. Irgau replies with the explanation of fear stemming from the COVID-19 virus. People do not want to be close to anyone that they do not live with. Taking the time to walk, even though it is simple, is a daunting task excused by the fear of the virus. “If you look at the whole lockdown mindset, it was almost a great setback for obesity to flourish, and flourish it did,” Dr. Irgau announces. In terms of their patients, this flourishing of obesity is not something the individuals could undertake. Being at a high-risk weight pre-pandemic, the patients are more apt to gain weight during this time. Dr. Irgau compares a morbidly obese individual to normal weight individual, “if you put them in the same situation as far as eating and activity, you will see far more weight gain in the person who is morbidly obese”. Because obesity is a platform for more weight gain, people who were not eligible for bariatric surgery may now be after the countless hours spent in lockdown.

Even if one did not contract the COVID-19 virus, their health was still affected. Erkan prompts the question, from CHRIAS’s standpoint, what was available to help patients during this difficult time. Dr. Irgau leads his response with elaborating on the availability of telehealth. He explains the ease in which the company adopted the format and the capability to help the patients in a virtual manner. It was very important to him to be able to warn patients about the possibility and likelihood of weight gain in the pandemic without realizing. “You realize you have gained weight when you gain weight,” Dr. Irgau explains, “suddenly you weigh yourself… and you see there have been changes”. It is not easy to keep patients on course in a global pandemic. There is lots of time to do nothing, but Dr. Irgau explains the company’s attempts to combat this by counseling via telehealth. There are biological factors contributing to the weight gain of obese individuals; if the person’s body mass index (BMI) is 28, that person will have a significantly easier journey maintaining their weight than someone with a BMI of 50. “This is not because the person with a lower BMI has more will power or more knowledge; it is because… the hormonal situation within the body of the person… with the higher BMI is conducive to that person gaining more weight,” Dr. Irgau mentions. In contrast, the reverse happens for a person with a much lower BMI; that individual is more conducive to losing weight comparatively.

The pandemic has hit everyone with weight gain; however, it is disproportionately higher in those who are morbidly obese. “One of the things we did very early on,” Kemal Erkan states, ”we made bariatric surgery the priority for our patients… because this needed to be dealt with”. As it is world obesity awareness month, Erkan empathizes with the patients who may feel neglected by other surgery centers who did not remain open during this pandemic; “we are doing what we need to do for our society, so we are serving more people, and that is important… the population does need the intervention of the surgery… we are hoping we can help more people in time,” he further elaborates. The pairing conclude by summarizing the dialogue while emphasizing that obese individuals are not alone, and there is help. Erkan notes that their support group meets on the first Tuesday of every month at 6:00pm and is led by Dr. Gail Wynn, and their full webinars air every second and fourth Tuesday of the month. These resources are available along with these Bariatric Friday discussions.