Ingham Expands Weight Management Program
Ingham Regional Medical Center (IRMC) started a comprehensive weight management program in 2004 in response to growing concerns about mid-Michigan’s growing waistlines.
“Weight has become an increasing problem in this country,” said Sherlyn Hogenson, coordinator of Ingham’s Weight Management Program and a registered dietician. “It’s viewed nationally as an epidemic. According to the [Centers for Disease Control], Michigan was in the first four states to have a greater incidence of obesity.”
“Our programs are not designed to create Barbie and Ken,” added Mary Wolf, coordinator of Ingham Bariatrics. “The are really to help take care of a lot of the medical issues [associated with the weight].”
IRMC added bariatric surgery in 2006, and, Wolf, a registered nurse, was perfect for the program since she had successfully gone through the procedure in 1999.
“I’ve lost over 135 pounds now and have kept it off and have had a baby since,” she stated. “But I had to go out of the area for it. We didn’t have it here in Lansing then.”
Plus, the surgery, which restricts the amount of calories the body absorbs by reducing the length of the small intestine, has changed dramatically in the last two years. “It’s much better,” said Wolf. “It’s laparoscopic, so it’s less invasive. When I had it done, it was an open procedure.”
Hogenson oversees the nonsurgical options. Using programs developed by the Robard Corp., Ingham’s weight management includes New Direction for those who need to lose 40 pounds or more and Outlook for those who want to lose 10 or more pounds. New Direction is initially a fasting program, but Hogenson works with the participants to adapt and sustain better eating habits once they go from an all-liquid diet to eating regular foods again.
“The Outlook program is a regular food plan, with optional use of the shakes, that helps people who don’t choose to do the surgery or the fasting program,” Hogenson explained. “It takes a longer time. They lose about one or two pounds a week, if they’re committed to doing it. We’ve had people who have lost 40 to 50 pounds on Outlook and they have really worked hard to do that.”
For those considering the bariatric surgery, Wolf works closely with patients both before and after the procedure. It is only an option though for those who need to lose 100 pounds or more or with two or more serious health issues related to their weight.
“Once people decide they want to do the program, they come in and meet with me individually, we work together with their primary care physician, and we get all the preparatory paperwork out of the way,” Wolf explained. “We ask them what their expectations are of the program, tell them what our expectations are, and determine if they meet the criteria. It can take as long as a year. Then they go see the surgeon, have a psychological evaluation, and lab work. We put them through a minimum six-week group here with a dietician, an exercise physiologist, and a behaviorist. We want to get them used to the recommended changes that they’re going to be undergoing in the future and a different way to look at food and the stressors that cause them to eat.”
“Then we follow up with the patient for a year after the surgery for continued group sessions, weekly for the first 12 weeks, and then monthly for another nine months,” added Hogenson. “So we are giving them support. We also want them stay in touch with us yearly for five years. We want them to stay connected. They do much better if they can stay in the group setting and get the support of their peers.”
“We’re pretty proud that we have a year-long program, and our surgeons are the only two women that I know of who are performing the surgery. Eighty to 90 percent of our clients are women, and they relate better with women,” Wolf said.
IRMC will be adding a program called Renew for those bariatric patients who have either not seen the expected weight loss or are starting to gain weight again.
“It’s 90 percent behavioral,” Wolf stated. “After you get a couple years out after surgery or any other diet, you fall back into old habits and that can spiral out of control. We don’t want that to happen and encourage them to get back with us. We don’t want them to be embarrassed. We just want them to call us. We’ll help them stop that pattern.”
Whether losing weight through surgery or through other programs, the reduction greatly helps overall health issues.
“The medical conditions get better after the surgery,” said Hogenson. “This is the only surgery where diabetes is no longer a big part of their life or hypertension. A lot of people go off their medications after a few months. After losing 80 to 100 pounds, they’re retested. Bone and joint problems can be minimized or prevented.”
“Plus there is a lot of bias in the community,” added Wolf. “The discrimination of weight is in the workplace and at the grocery store. … It really hinders their everyday life, and people want to be healthier. This gives them a way to do it. But this is not a short-term program.”
A few men do participate in Ingham’s weight programs, but they are usually more overweight than the women before they come in, Wolf noted. “They tend to be close to the 400 pound range before they say, ‘I’m uncomfortable and I don’t like how I feel, and I’m tired all the time.’ Then they start getting medical issues. That’s what I’m noticing in the people that have [chosen to have] the surgery.”
Wolf and Hogenson both stressed that their programs provide complete medical oversight, and they work closely with primary care physicians.
“It truly provides a service for people who have tried everything, and they don’t know what to do,” Hogenson stated.
Ingham Regional Medical Center
Sherlyn Hogenson, MS, RD
Coordinator, Weight Management Services
Mary Wolf, RN, BHA, Coordinator Ingham Bariatrics
2727 S. Pennsylvania Avenue Lansing