In a weight-loss rut? Surgery or medically supervised programs may get you back on track

For many people, losing even a few extra pounds can be difficult.

But for those whose who are at least 75 pounds over their ideal body weight, the process can become that much harder.

It was for Cape Girardeau resident Evan Ineichen, who tried just about every diet and exercise program out there and still couldn't lose weight. Because of that, Ineichen, 37, opted for surgery and went from weighing 465 pounds to 245.

"I lost the equivalent of two and a half people," he says. "It's a very big life change."

Dr. Carson Cunningham, a bariatric surgeon in Saint Francis Medical Center's Weight Loss Solutions department, performs sleeve gastrectomy and gastric bypass surgeries.

A sleeve gastrectomy, the kind of surgery Ineichen underwent a little over year ago, is a procedure in which a person's stomach is reduced to about 15 percent of its original size.

"With sleeve gastrectomy, we focus solely on the stomach and make it much smaller," Cunningham says. "This will drastically reduce a patient's portion size and makes the stomach empty much faster. It also drastically reduces a patient's hunger."

In a gastric bypass procedure, stomach size is reduced, but the small intestines are rerouted as well, reducing food absorption in the intestinal tract.

"Bariatric surgery is a metabolic surgery. It changes patients' metabolism in many beneficial ways," Cunningham says.

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Candidates for bariatric surgery include people with a body mass index of 35 or more in addition to those with obesity-related conditions such as Type 2 diabetes, high blood pressure and sleep apnea.

Although these surgeries involve stapling, suturing and removing digestive tissue, Cunningham says the risks involved are minimal and the effects can last for years as long as patients adhere to an active lifestyle and are committed to eating healthier foods.

While Cunningham says traditional alternatives to bariatric surgery, such as diet and exercise, can be modestly successful at a rate of 2 to 3 percent, newer medications can help control appetite.

An alternative to bariatric surgery, the intra-gastric balloon, is something Cunningham and his colleagues plan to begin offering this summer. It involves inserting a balloon in a patient's stomach to help reduce portion sizes and control hunger.

Raina Childers, a registered dietitian at HealthPoint Fitness, says the facilities' parent company, SoutheastHEALTH, does not perform bariatric surgery.

However, she is at the helm of a couple of nonsurgical programs that help clients tackle weight issues primarily through diet and exercise.

The first program, Starting Point, lasts for 20 weeks and is a medically supervised weight management regimen. It entails a structured meal plan and regular meetings with a coach, along with attending a weekly class where participants learn about physical activity, stress management and even how to be more assertive. Another component is proper nutrition.

"A lot of people know about nutrition but don't practice it," Childers says. "Most people know the basics, but have a hard time applying them to their stressful and busy lives."

Because of that, many people who struggle with their weight often fall into the traps of consuming lesser-quality food, such as what's available at a drive-thru window, and many lose their willpower when others bring calorie-laden treats to share at work, school or church.

"Once you get out of your home, the food is lower quality and bigger portions," Childers says.

Another program she oversees is called Biometrics, which is available in six-, eight- and 12-week stints.

Unlike Starting Point, Biometrics isn't under a doctor's supervision and is used in combination with personal training. Meal plans are formulated based on a client's food preferences and uses grocery lists and recipes.

But whether a person decides to enroll in the more rigorous Starting Point or the more flexible Biometrics program, Childers says it's ideal to work with clients long after they're finished participating.

For real change to occur, clients are encouraged to seek support for at least a year.

"Data show the length of time a person has support, education and accountability, the longer they can keep off the weight," Childers says. "Most people don't give themselves the time to change."

That goes for people who have turned to surgery for weight loss as well.

Cape Girardeau resident Evan Ineichen lost more than 200 pounds after weight-loss surgery. (submitted photo)

"Even those who have bariatric surgery are encouraged to participate in support groups," Childers says.