Weight loss surgery is a big part of a patient’s life, and chances of success from their surgery are enhanced when they are educated and supported. By writing articles, you are providing that important education and support that will make a long-lasting difference to them in their weight loss surgery journey.

Since ObesityHelp.com was founded in 1998, over 700,000 people have become registered members of our site. Each week, the site has over 3,000,000 page-views from people looking for education and support along their weight loss surgery journey.

If this is something you, or a member of your staff, would be interested in, we would feature an original article by you front and center on the ObesityHelp home page, as well as publish it in our weekly community newsletter! On top of that, you will also benefit from extra time in the spotlight as each of our articles are shared on ObesityHelp.com’s Facebook (over 13,000 fans) and Twitter (4,500 followers) accounts. Some articles may also be shared with social discovery sites such as Stumbleupon, Pinterest, Digg, etc. We also periodically re-share articles so potential patients, and new pre-op and post-op community members can benefit from your articles. We have an experienced staff that conducts focused key words searches and other search engine optimization on your article.

We have compiled a list of topics based on member questions and concerns, searches from Google Analytics and member requests to us. If you are interested in ObesityHelp featuring you and your article, please email us at articles@obesityhelp.com for more information!

First, make sure you are logged into your Facebook and/or Twitter account.  Next, log into your ObesityHelp for Professionals account.  Now you’re ready to share your patients’ great surgical experience!

Share Patient Reviews on Facebook and Twitter

1.  Under the “Manage” tab drop down bar, click on REVIEWS

2.  On the review(s) you want to share on your social media, all you need to do is click on the Facebook and Twitter share icons.

That’s all you need to do!

Optional – If you’d like to add a comment, you can.  Make your comment in the “Say something more about this” area and close.  Your comment along with a link to the review will be posted on your Facebook and/or Twitter accounts.

For any questions or assistance you’d like: Call us at 1-866-957-4636, option 1

Photo credit:  Jason Howle cc

Be Visible, Utilize Your OH Profile

For 17 years, prospective patients have visited ObesityHelp for peer-to-peer forums, inspirational before and after photos, surgeon reviews and real success stories! By establishing your presence on ObesityHelp, your practice will be a valuable resource during this crucial research phase of the journey. Bariatric surgery candidates need to know what they can expect when they choose you as part of their bariatric care team. Prospective WLS pre-ops genuinely wanting to make good decisions about their lives and bodies will search out and prioritize information from reputable sources.

You can utilize ObesityHelp for Professionals to add all of the information patients need right onto your professional profile. You can add comprehensive background information, website and social links, updates about your practice, support group and seminar information and a visual testimonial through inspiring Before & After photos. In addition, word-of-mouth reviews are potentially the most valuable resource for obtaining new patients. Your patients can leave their personal reviews right on your profile. People connect with stories, spoken or written, that convey a truly personal experience. For those who are morbidly obese, reading about success stories from their peers can be empowering and provides hope that they can one day achieve the same level of success.

They are turning to their peers, trusted websites and professionals to:

• Seek education and support about treatments and what to expect with surgery.
• Consult online reviews, stories, and posts about outcomes and experiences.
• Read informational articles for tips to help with obstacles and/or long term success.

Your patients want to be able to connect with you. They want to read your tips, office updates and read the articles that you’re sharing. We’re here to help you make sure you can connect with your patients on and off ObesityHelp.com.

If you have social media accounts set-up that you would like your patients to follow, you can highlight them on your ObesityHelp Sponsored profile so that your patients can easily connect with you.

To add your Social Media Accounts:

1. Sign in to your ObesityHelp Professional account.
2. Under the General tab of your account, enter in the full URL to your preferred social media accounts.
   
3. Click the “Save” button.
4. Your social icons will appear at the top of your profile, inline with the “Write Review” button.

As part of our commitment to serve you and the weight loss surgery community, we have just completed some major updates to ObesityHelp for Professionals (OH Pro).

Starting today, you’ll be able to enjoy a more intuitive, faster, and attractive OH Pro at no additional cost.

Same Great Tools Are Now Easier to Use
Our powerful set of tools–including stylish profiles, inquiries, reach tracking, events, and review tracking–are now easier to access and are more intuitive, helping you to get the most out of your OH Pro experience.

Better Patient Information
You can now see information on all of your patients who are registered with ObesityHelp by accessing the “Patients” area on the left panel. We will also be expanding this section in the future to offer you even better connectivity with your patients.

More Powerful Tools Coming Soon
With our new framework in place, we’ll be adding new functionality into the future.  We invite you to explore all of what is already available to you in the new OH Pro and would greatly appreciate any feedback you may have. We value your partnership with us in serving the weight loss surgery community and look forward to our continued relationship.

Please email your account manager with any questions or to schedule a tour. You can also call us any time at 1-866-957-4636.

Over 600 bariatric patients were asked, “In thinking about how doctors treat their weight loss surgery patients, what do you wish your doctor would have done differently?” Their responses reveal that we have many opportunities for improvement, and little details make all the difference.

Physician Sensitivity is Critical to Patient Satisfaction

The bariatric population is a special one; after years of being exposed to stigma and discrimination, many patients are emotionally raw and sensitive. As a physician, if your goal is to achieve the best outcome for your patients and your practice, try implementing these small steps to make sure your patients feel comfortable.

Choose your words carefully.

Bariatric clients are especially sensitive to language. After enduring years of jokes and jabs, they critically analyze conversations for hints of negativity or judgment. Therefore, how you word a statement may make the difference between bonding with a patient or pushing them away. Choose descriptors and adjectives that have a more positive connotation; avoid anything that has a negative thrust. For example, describe something as “oversized” or “extended” as opposed to “giant” or “huge.”

Select credible and approachable staff.

A young, attractive, super-slim nutritionist who has never had a weight problem will be viewed as less credible than an experienced staff member who can share real life experience and advice for dealing with the challenges of weight loss. Most bariatric patients report feeling comfortable when there is at least one person who works in the office who is also overweight.

Communicate clearly.

Meet new patients in your office first, then take them to the exam room. Look your patients in the eye. Talk carefully about their health history and ask questions empathetically. Offer to answer any questions and ask if there is anything they do not understand. Often, a little encouragement will give your patients the confidence they need to ask questions they have. One WLS patient explained, “My surgeon sketched a picture for me of what exactly he was going to do. I know I had previously seen diagrams of the pouch, etc. … but it really helped me to understand visually as he was explaining things.”

Have appropriate and comfortable equipment.

Furniture for bariatric patients should be solid, sturdy, comfortably-sized, and safe. Select equipment and office tools that are appropriate for this population for every area of your office your patients will go. One bariatric patient wrote: “Did you know that I purchased my own weight extender for the standard bar slide scale that most doctors use. The cost? Around $60. Even if I’m your only ‘oversized’ patient, isn’t my health and well-being worth $60 to you?”

Develop scale sensitivity.

Invest in a bariatric scale or equipment that allows your scale to accommodate overweight patients, weigh the patients in a private area, and never, ever yell out a patient’s weight to other office staff members. A recent WLS post-op wrote: “Scale sensitivity would be a plus not just for bariatric offices but for all offices. Last week I got on the scale and the nurse yelled out, ‘225 pounds.’ I teach in a small town and one of my students was in the waiting room, so now all my students know how much I weigh. Just weigh me and write it down in the chart, thank you.”

Don’t send mixed messages.

You can’t get away with saying “I really care about your difficulties with weight and I know how hard it is for you” when you have posters of nearly-perfect models all over the place. Make sure your staff, office décor, and imagery reflect caring and consideration. Case in point: a bariatric client went to a physician’s office and reported the following: “When I went to my doctor’s office I already felt like a cow. I looked around and saw all California beach blonde types. This made me know they had no clue; they had no idea what I had experienced, and I felt fatter and more uncomfortable.”

Train your staff to do the same.

As you are not likely to be the first person your patients encounter, your entire office needs to be trained to be sensitive in the ways described. Most patients report that their first impression of a physician came from his or her receptionist. Therefore, we must make sure everyone in our offices understands that every patient is our concern, that no patient should be ridiculed or treated as unimportant.

One of the most important aspects of marketing yourself is understanding who you are trying to reach with your message. If you have specific information on your target demographic–age, gender, income, race, home ownership, education, employment status and type–then use that to develop a “typical patient profile.” If you do not know who your target demographic is, your staff can compile this information by reviewing the patient charts of your last 100 to 200 bariatric procedures.

Chances are, the individuals in your target demographic will have particular likes and dislikes, behavioral patterns and values in common that you can refer to when making decisions about how to present your practice. For example, the images and language you would use to sell your message to 20- to 30-year-old professionals will be very different than those you would use to reach 30- to 40-year-old stay-at-home moms. Each demographic has its own characteristics, and getting to really know your target demographic is one of the most important things you can do to promote yourself effectively.

2. Create a Patient-Friendly Website

Once you know who your patients are, put yourself in their shoes. When looking online for a surgeon, what will entice them to contact you? Your credentials, experience with
bariatric procedures and specialties are all important and should be easily accessible in your promotional materials, but these facts should not be the only thing the patients see. Just as you must get to know your demographic, you must help them get to know you as more than just a skilled surgeon. Energy spent creating additional patient resources is well spent, as long as the content is informative, yet not too technical. Your website is for patients, not other clinicians. Use the same language you would use to describe procedures if the patient were sitting with you in your office.

Once your website is developed, ask yourself these questions as if you were the patient:

• Am I motivated to take the leap into bariatric surgery?
• Does this doctor seem knowledgeable and experienced?
• Does this doctor make me feel comfortable?
• Is this doctor someone I can be honest with?
• Do I have a good understanding of surgical alternatives?
• Does the doctor have a supportive staff that can help me with my insurance and other issues?
• Are there testimonials from other patients who have good experiences with this doctor?

Once you feel you have solid website content developed, survey your target demographic. Contact a few previous patients and ask them to check out your website and let you know of any comments they may have. These are the perfect people to offer honest suggestions that can help you create a sensitive, patient-focused website. Use their opinions to make the proper adjustments to convey a safe, optimistic and accurate message to your patients.

3. Maximize your Ability to Empathize

Most bariatric patients have been plagued by unresolved weight issues for most of their lives. They may be very unhappy with the trials they have faced as a result of these issues, and many have felt disconnected from people and may have difficulty trusting others. Your challenge, as their doctor, is to gain their trust. You can do this by empathizing with their situation. Let them know that you understand how hard it must be to overweight and commend them for making the choice to change. Building empathy into your patient conversations is one of the most productive ways to build patient rapport. Think of every interaction with a patient as a personal testimonial for you and an opportunity to gain a personal advocate. Many highly-qualified surgeons who find themselves with relatively few cases tend to be focused on themselves rather than on their patients. These are the physicians who treat their patients like they should feel privileged to be getting surgery from such a great doctor. While they may indeed be fantastic clinicians, this type of mentality does not lend itself to good first impressions.

The most successful bariatric professionals are those who take the time to get to know their patients and remain involved in their lives throughout their weight loss journeys. Most bariatric patients on ObesityHelp.com are either very happy or very unhappy with their surgeons–there is seldom a middle ground. Ninety percent of the time, patient satisfaction comes down to how they were treated as a pre-operative patient. Take the time to evaluate how you are dealing with each patient and adjust accordingly. Remember, the successful bariatric practices get the majority of their leads through the glowing testimonials of previous patients.

4. Develop Friendly, Supportive Office Staff

Your office staff members are your front line for patient care. They have the ability to set the tone and adjust the office atmosphere. It’s a good policy to make sure your staff treats your patients as well as you do, even when it comes to difficult tasks like insurance issues and enforcing proper aftercare.

Let your office staff be responsible for encouraging happy patients to write testimonials about their experience on your website or on ObesityHelp.com. We know that positive testimonials are a great way to increase referrals. We have also seen patients on ObesityHelp.com say that they have been turned off from a particular bariatric program because they felt that the staff members lacked compassion or were unfriendly. Happy patients tell their friends and family about the life-changing experience they had with you and your office, so encourage your staff to help make every visit an excellent visit.

5. Fish Where the Fish Are Biting

Potential bariatric patients lead particular lifestyles, and you should adjust your marketing plans accordingly. Think about or learn what your patients do in their spare time and their preferred methods of gleaning information, and then choose the most effective places to reach them.

With the advent of the Internet and online shopping, many morbidly obese people have found it more convenient and comfortable to do most of their shopping and socializing from their own homes. Knowing that, explore ways to talk to potential patients through online platforms. Formal advertising is an important component of your marketing plan, but there are also other opportunities that you may not be utilizing. For example, on ObesityHelp.com, you will notice that there are many people asking surgery-related questions on the message boards. Take some time  and answer a few questions. You will be surprised how answering a few questions can really get your name out there! Many members who are “shopping” for a surgeon will make their first contact with a surgeon on the message boards. It’s free, it can be done at your convenience, and it is a good opportunity to make a great first impression.

6. Blaze New Trails

Do you have a random or wacky idea for your practice, website or marketing literature? Is it something you’ve noticed is missing from your current offerings, and hasn’t been done before? Just because your colleagues have not done something doesn’t mean it isn’t a good idea. Unconventional ideas can be some of the best ideas because they are unique and can set your practice apart from others.

Find ways to participate in community events that will help your name and face to become familiar to people in your area. Organize short seminars in your office and serve specialty food products that you may recommend be incorporated in their post-operative diet. Invite a special speaker–a past patient, a local chef, a nutritionist or a yoga teacher–to present at support group meetings. Host social events that foster relationships between your staff and your patients. Remember, happy patients are your best marketing vehicle!

7. Reach Out Through Video

Patients are consumers. Consumers, on the whole, tend to be buying more goods and service online, and it is relatively simple now to provide online information in a wide array of formats. One easy way to introduce yourself to potential patients is through video on your website. Video is more personal than text and allows potential patients to see and hear you without making an appointment or leaving home, which makes them feel comfortable learning more about your practice, and you–a professional they will come to trust. Aim to have some sort of introductory video on your website and on your ObesityHelp profile, and update it periodically to keep it fresh and accurate.

As with the other marketing tools, review and get feedback on the video from a typical patient perspective: would prospective patient “Mary Smith” want to make an appointment with me after watching my video? Have I given her enough information that would make her choose me as her surgeon? What other visual elements will appeal to 25- to 45-year-old women who are struggling with their weight? Ideally, your video should be warm and inviting without over-promising or sugar-coating the truth. Consumers today are cautious, and bariatric patients in general have trust issues. Be up-front, genuine and realistic while maintaining a friendly demeanor to attract consumers.

8. Connect With Local PCPs

Most primary care physicians (PCPs) encounter a fair amount of obese patients, and are usually the first point of reference when patients begin investigating bariatric surgery. Unfortunately, many PCPs shy away from bariatric surgery as treatment from morbid obesity. As an industry, we need to begin communicating with PCPs and viewing them as allies in the treatment of obesity. Teaching PCPs about the benefits of bariatric surgery can be a tough task. Fortunately, ObesityHelp works with PCPs from all over the country to educate them on the benefits of bariatric surgery, so you will not be alone in your efforts. You can do your part by reaching out to the PCPs in your local area and explaining the merits of a surgical approach, especially as research reveals new benefits. Most PCPs are not as well-versed in the reduction of obesity comorbidities after bariatric surgery as you are. You can bet that this sort of sharing of information can help you form an enriching partnership and a new referral stream.

I remember clearly the day that one of my office staff members told me about Warren Kushnick. He had already obtained his insurance authorization for gastric bypass surgery at another facility. He was continuing to research where to have his surgery since he was told that he was high-risk and he felt the other facility was “taking their time” with scheduling his surgery.

After talking with my staff and attending a lecture, Warren had decided to have his surgery with us.  While reviewing his health questionnaire, I learned that Warren was 63-years-old, weighed 365 pounds, had severe sleep apnea, hypertension, and chronic heart rhythm problems secondary to coronary artery disease for which he had open heart surgery and bypass grafting. Wow! I had to admit, to undertake a laparoscopic gastric bypass on a patient who brings all this to the table (literally), was more than a little concerning to me.

After meeting Warren and his wife in consult, there was nothing, within my best medical judgement, that was going to prevent me from performing his surgery. Why? Simple – Warren reminded me so much of my own father who had struggled with obesity for years.

Growing Up With Obesity

My Father, Jack Nease

My father was a Judo Instructor in the military and in relatively good physical condition. I remember him lifting weights routinely. Five years after he was discharged from the Army, he began to gain weight quite rapidly. This is where genetics, lack of exercise and good home cooking come into play. At the age of 36, he developed Rheumatoid Arthritis, and was placed on steroids, another weight gain factor, along with many other types of medications for two years. All this weight gain made the joint pain even worse. My dad missed many of my ballgames, which was such a big part of my life growing up. I was involved with several organized sports, but my father rarely was able to toss a football or throw a baseball to help me practice. It was even difficult for him to be a spectator at my games, because he gained so much weight he avoided being in crowds.

Me, in my younger times.

When I was 12 years old, my mom and dad brought lawn chairs to one of my games because it had become too difficult for him to climb the bleachers. He weighed 300 pounds at that time. As luck would have it, he exceeded the weight limit of the lawn chair and it collapsed beneath him. My mother tried to help him up from this terrible and embarrassing position, but she could not do it on her own and enlisted the help of two men in the crowd. Despite the laughs of some of the people, my dad pretended that it did not bother him but I knew differently. I was very protective of him and couldn’t do much about the adults who were laughing, but I could do something about the one kid on the opposing team whose laughter seemed to never end. Let’s just say it ended quite abruptly after being introduced to his first black-eye. (Here’s one for you Dad!)

I Can Do It On My Own

As I grew up, I found myself drawn to medicine for many reasons. As a third year medical student at Ohio State University, I had heard about the disease of obesity during my surgery rotation. I talked to my dad about considering gastric bypass surgery. He was now 350 pounds and had developed sleep apnea, hypertension, diabetes and severe problems with degenerative joint disease of his knees. His response to me was, “Once I get my knees replaced, I’ll get around much better and lose this weight.” Well, he had both knees replaced shortly thereafter and you probably can guess – he did not lose any weight. In fact, he gained more weight and four years later he needed one of his knees replaced again. By this time, I was at the University of South Florida for my surgical residency, where bariatric surgery was an integral part of my training. My dad was now 400 pounds. I tried to convince him that the operation he really needed was a gastric bypass and not another knee replacement. But dad said this time he could do it on his own. If only his knees would hang in there long enough for him to lose the weight.

Dad, in his heavier times.

Over the next few years, he continued to battle the weight and related health problems, and I began to see a dramatic decrease in the quality of his life. His highest weight was just under 500 pounds. He had become oxygen dependent, and required assistance of a ventilator at night. He never complained and rarely asked for anything. My dad was truly one of those rare people who gave more than he received or expected back in life.

Bitter Sweet

Early in 2000, my wife, Sheila, and I were expecting our second child, but since it was early in the pregnancy, we did not announce it to anyone and told our 2-year-old son Garrett, to keep it a special secret. Well, as you can imagine, it was not a secret for very long and on Easter Sunday, Garrett informed my parents of our own bit of Easter “Good News.”  My dad, who was a “kid magnet,” was so thrilled to be a “Paw-Paw” again and couldn’t wait for the day to arrive.

Sadly, the day never arrived for my dad. Two days after Easter on April 25, 2000 he was defeated by the devastating diseases process called morbid obesity. I no longer could call or go visit him. He would never know my children who are now forever deprived of his unconditional love as I had growing up. I was angry and hurt to be robbed of such a wonderful friend and father, but much as I knew he silently suffered, I also knew he was now at peace.

To Be or Not To Be

Even though I saw what bariatric surgery could do to help achieve long-term weight loss surgery in my training, I had no plans of making it part of my medical practice. There was no immediate gratification knowing that the surgery went well. In general, most surgeons are of the mentality of, “Have surgery and fix the problem.”  If someone has a bad appendix, you remove it and it takes care of the problem. If it’s a tumor, remove it and your job is done. Albeit, there may be further treatment necessary, but the surgeon’s job is generally complete and there is satisfaction knowing you are aiding in the recovery.

However, bariatric surgery is just not that way. There is nothing immediate that tells you whether the risk was worth it because results are not instant (this is where a surgeon has trouble dealing with delayed gratification).

And since you get to know the patient on a more personal level than with other types of surgery, you worry even more so and really feel it when there is a complication. This factor, along with an overall higher risk groups of patients, continued insurance coverage and reimbursement problems, high malpractice costs for this specialty and a new baby on the way — I just wasn’t sure. Not to mention, my anger at such a disease that took my fathers’ life. I didn’t think I could deal with it on a daily basis.

The road leading to bariatric surgery as my specialty was not as simple or a clear path from the beginning. I’m not sure I actually chose this field or whether it chose me. Dealing with obesity was certainly not new in my life, but to dedicate my whole practice to it was not an immediate or easy decision. Over time, however, the pain and anger of my father’s death seemed to have lessened and after a few years of advanced laparoscopic general surgery, I decided to consider adding bariatric surgery to my practice. I first implemented a program that would provide proper support, and after the first few cases I was hooked. I got such a unique satisfaction that I could help those who undoubtedly faced similar health problems and social situations as my father. And it wasn’t hard to get used to that delayed gratification after the first few “success stories.”

Back to Warren

Dr. Nease talks with Warren about his progress.

I was determined to not allow my father’s fate with obesity to be that of Warren and his family. Despite the high risk involved, Warren went on to have a laparoscopic gastric bypass in October of 2003. To date, he is proud to tell anyone who will listen that he has lost over 100 pounds and his health has dramatically improved.

For all the Warrens out there and in memory of my dad, Jack Nease, this is how and why I have chosen to fight the battle against obesity. I am truly blessed to be a part of this specialty and am thankful to all those who have had the courage to make a difference for themselves, their family and friends.

For the Love of My Father originally appeared in ObesityHelp Magazine Summer 2004. To see the full pdf version, please check out Dr. Nease’s website.

Dr. Blaine NeaseBariatric Surgeonhttp://www.yourwls.com/ – Center for Surgical Weight Control

Patients are able to track their weight beginning with their pre-operative visit and at every visit thereafter through ObesityHelp’s weight loss tracker. When patients return to our clinic for a post-operative visit, they are given a copy of their current weight analysis. We then encourage them to load this information into the tracker. The easy-to-use graphic visualization allows patients to view their overall weight loss progression.

The weight loss tracker not only motivates the new WLS patient, but is also beneficial to the WLS patient who has hit a plateau and has come to you for support. Our staff suggests this tool, along with the use of food and exercise journals, as a way to help get the patient back on track. Following surgery, it is vital for exercise to become part of the patient’s everyday lifestyle. We all know that exercise is an important part of the patient’s overall success, and that the surgery will help limit food intake.

The patient should also be encouraged to become accountable for making good choices. Tracking weight loss is one of the simplest ways for patients to reflect on and reinforce their new behaviors. ObesityHelp’s weight loss tracker shows patients the success those behaviors have brought them.

Using OH’s weight loss tracker, in combination with exercise and making the right nutritional choices, can improve patient outcomes, encourage patient compliance and make plateaus shorter and less stressful.

Jeremy Korman, MD, FACS, is a practicing bariatric surgeon in Marina Del Rey, CA. This article originally appeared in ObesityHelp’s magazine Bariatrics Today Issue 2.

Dr. Jeremy KormanBariatric Surgeonhttp://labariatriccenter.com – LA Bariatric Center

QHow old were you during your WWII military service, and what was your rank?

I was about 26 years old, and a Navy medical officer and photographer on two ships: the LST-6 (landing ship tank) during the Normandy invasion and the AKA-103 (attack cargo ship) at Okinawa. I was initially an Ensign, on LST-52 on the Atlantic crossing from Boston to England, and later I was promoted to Lieutenant [Junior Grade], and then full Lieutenant. I made five trips across the English Channel from Portsmouth to the Normandy coast of France.

QWhat was your set-up for emergency triage on the tank deck off of Normandy?

On the LST-6, our tank deck was converted into an emergency and hospital room after all the heavy military equipment (tanks, trucks, etc.) had been discharged to the beach. The stretchers holding the wounded served as hospital beds. There were three doctors on our ship including myself. We had adequate quantities of IV solutions, ten or twelve bottles of type-O blood, ample vials of morphine sulfate for pain, and sulfa drugs for infection. The surgical equipment was quite good—we kept what was needed for major surgery on one of the mess hall tables. In addition to the tank deck set-up, we had first-aid stations scattered about the ship, where emergency equipment such as bandages, antiseptic and so forth could be used by the personnel top-side in case our ship was hit.

QDid you perform surgery as the medical officer on the ship?

During the Normandy invasion there were three doctors, one a qualified surgeon from Kentucky. We did one abdominal exploration for a shrapnel perforation and completed an arm amputation on a severely torn upper arm. We used the mess hall dining table for the surgery.

QWhat was the environment that led to your development of weight loss surgery?

I had always been interested in research, and during the last year of my residency in 1953 I devoted my time and effort, along with Drs. Arnold Kremen and Charles Nelson, to a small bowel absorption study in dogs to evaluate the absorption characteristics of various segments of the small intestine. After completing my service and going into private practice, one of my patients, R.D., of Savage, Minnesota, who weighed between 275 and 385 pounds at various times, complained that she could not maintain her weight loss and, no matter what she did, she would always regain the weight she had lost. I told her about our experiment in dogs and that although the malabsorption did result in weight loss, it had never been performed on humans. She told me that she wanted the surgery no matter what. In those days, we did not have the [Institutional Review Board] regulations nor the litigation that we have today, so after consultation with Dr. Kremen, we decided to perform the first surgery in April of 1954 at Mount Sinai Hospital in Minnesota.

QWhat was the initial reaction of the medical community to weight loss surgery?

The paper with our results and the R.D. case report, published in the Annals of Surgery, was received enthusiastically at the American Surgical Association meeting in Cleveland in 1954. Shortly thereafter, a number of surgical groups began to do variations of the JIB (jejunoileal bypass), but I decided not to perform any more procedures until I had a chance to see the results of our case and the operations that were being done by others.

As far as the general medical community goes, however, there was a lot of resistance to weight loss surgery, especially amongst internists, as well as some surgeons. They thought it was crazy to treat obesity with surgery. In an interview with Dr. Ancel Keys, an internationally known nutritionist, he said with a slight smile, “what you should do is to sew the patient’s mouth shut!” That shook me a bit, but did not deter me and I decided to perform the surgery anyway.

QWhat type of weight loss surgery did you perform?

I performed JIBs at first, but because of the problems associated with that procedure, I switched to the Gomez horizontal gastroplasty, then Mason’s vertical banded gastroplasty, and finally the Roux-en-Y gastric bypass (GBP). I did a few gastric banding procedures but found the weight losses were not as significant as with the gastric bypass. I used the open method exclusively, but today our group does it primarily laparoscopically, tailoring the choice of operation to each patient. There are certainly going to be other technologies down the road, but the most important thing is that these procedures pass the test of time and prove to be as safe as possible.

QWhat were the disadvantages of gastroplasty?

It was not as effective as gastric bypass, and, in trying to improve the results, the stoma was often made too small, resulting in stomal obstruction. The adjustable band improved that situation considerably, but, in our experience, was not as effective as the GBP. We later found that the GBP was a more effective way of treating Type 2 diabetes as well.

QWhat role did aftercare play in your early experience with weight loss surgery?

Lifetime follow-up is vital to achieving good results and evaluating long-term success. This often requires telephone contact or mail response.

QWas a psychiatric evaluation necessary for having weight loss surgery in the early years?

We did not believe that formal psychiatricevaluation was necessary in every case. If we felt, based on a good history and physical examination, that a particular patient needed to have a psychological evaluation, we recommended it, but certainly not for every patient.

QWhat advice would you give to surgeons new to this field?

Get the best training in current techniques at Centers of Excellence, attend national meetings, and keep abreast of all the new changes in this dynamic field.

QWhy do you think weight loss surgery has gained such prevalence?

Obesity has grown to epidemic proportions in our country, and at this time there is no effective medical treatment for the morbidly obese. We need more effective preventive measures on a national level.

QWhat do you see as the next frontier of bariatric surgery?

There will be growth of robotic-type approaches and transluminal endoscopic procedures.

QTell us about the book you have written on weight loss surgery, and about your inspiration for your most recent book.

I wrote my first book, Surgery for Morbid Obesity, which was published by Springer-Verlag in 1984. It was a standard textbook for a number of years. When the newer approaches appeared, there were some discussions about a second edition, but, unfortunately, I was too busy to get into it.

My most recent book, Normandy to Okinawa, is a combination of my diaries as a Navy medical officer aboard LST-6 during the Normandy invasion and the AKA-103 at Okinawa and an abridged history of WWII. I had kept a daily diary and I was also a photographer on the ship. When I came back from duty and began my practice, I put the diaries and the photographs in the closet where they resided for fifty years. I have five daughters, and a few years ago my wife and my daughters encouraged me to start working on my diaries and ultimately publish them. It took me ten years to put everything together, but it was finally accomplished.

This interview with Dr. Linner appeared in ObesityHelp’s magazine Bariatrics Today, Issue 1 2008. Dr. Linner  was a pioneer in bariatric surgery, his groundbreaking research led to the world’s first published account of a weight-loss operation. For 40 years, he dedicated his life to the study and treatment of obesity. He served as the former ASMBS president, published several articles and a book on bariatric surgery, served as a consultant to the U.S. Department of Health and Human Services, and won awards from the American Society for Metabolic and Bariatric Surgery. Dr. Linner passed away November 8, 2013 at age 95, Family members say Linner was most proud of being remembered as a doctor who was dedicated to his patients and who kept up with them long after they left the hospital. “Patients showered him with thank-you notes”, his wife said.

Dr. John H. LinnerFormer President of the ASMBS