Return to Transcripts main page
CNN Saturday Morning News
Summer Shape-Up: Interview With J.K. Champion, Noemi Hogan
Aired August 24, 2002 - 08:43 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
CAROL LIN, CNN ANCHOR: Well, some of us hit the gym or hold back on the sweets when we try to lose a few pounds. But for some, that is not an option. More than four million people in the United States are severely obese and for some of them surgery may be the only choice.
Joining us this morning is Dr. J.K. Champion from the Videoscopic Institute of Atlanta and Noemi Hogan, who lost more than 100 pounds after she had gastric bypass surgery last year.
Good to see both of you.
DR. J.K. CHAMPION, VIDEOSCOPIC INSTITUTE OF ATLANTA: Thank you.
NOEMI HOGAN, GASTRIC BYPASS PATIENT: Good morning.
LIN: Noemi, you look terrific.
HOGAN: Thank you.
LIN: We're going to hear your story in just a second. But first, let's understand what are the surgical options? You mentioned two primarily options.
CHAMPION: That's correct.
LIN: Can you explain how they work?
CHAMPION: The surgery for morbid obesity works by either one of two methods, either by restricting the size of the stomach, called gastric restriction, or by creating malabsorption, by bypassing a part of the intestine to decrease the absorption of calories.
LIN: OK. And in your case, Noemi, which one did you have?
HOGAN: I had the gastric bypass.
CHAMPION: Bypass, which was the malabsorptive.
LIN: How does that work?
CHAMPION: OK, what we do is reduce the size of the upper stomach to about one ounce so that people fill up very quickly, so that they can eat a meal that would be about the size of what you would eat on a salad plate or about 1,000 calories a day.
LIN: About like that, right? CHAMPION: Yes. Then we bypass about 20 percent of the intestines. So that reduces calorie intake about 20 percent and also does not allow them to eat deserts or sweets. If they eat sweets, it goes straight into the intestine then you get what's called dumping syndrome and become very nauseated. It's kind of negative reinforcement to change their eating habits.
LIN: And who are the best candidates for this? I mean this is not a method of dieting.
CHAMPION: No.
LIN: We kind of make jokes about, you know, if you want to lose some weight. But this is not what you consider dieting?
CHAMPION: No. This is reserved only for people who have exhausted all their other methods of weight loss, such as dieting and exercise, and failed. And then they have to be at least 100 pounds over their ideal body weight, or have what we call a body index of 40. And that's where you divide your weight by your height.
LIN: All right, and how much of an evaluation does a patient go through? It's not just simply weight itself, is it? I mean is there a more complex evaluation when somebody comes to you and says I want an extreme form to lose weight?
CHAMPION: Well, first we have to evaluate to make sure that they have exhausted all the conservative methods of weight loss.
LIN: Drugs, right.
CHAMPION: Medications, counseling...
LIN: Conventional dieting.
CHAMPION: .... exercise, behavior modification. On average, our patients have been through eight different programs, usually over a period of 10 to 15 years. Once they've done that, then we evaluate whether they're an adequate surgical candidate, do they meet the weight requirements, do they have any medical problems that would counter-indicate surgery or are they too high a risk. Because it is a major operation and they have to be in good enough condition in order to tolerate the operation.
LIN: Now, Amy, looking at you now, I can't even imagine you double your size. It's like you were a completely different person then.
HOGAN: Yes.
LIN: I mean we have some before and after pictures here. There you are in the red shirt?
HOGAN: Yes.
LIN: I can't even recognize you, although you look to me healthy.
HOGAN: Right.
LIN: You look large, but you look healthy.
HOGAN: And that's what I thought I was.
LIN: So what indicated to you that you had to take this extreme form to lose weight?
HOGAN: Well, I started, I've always been a little heavier than everyone else. And I started to have problems with digestion. I started having problems with my knees and --
LIN: Painful?
HOGAN: Yes. Yes. I started to develop a little bit of sleep apnea where I was having problems with that. And I just, I just was looking for something and...
LIN: And what had you tried before?
HOGAN: I had tried Phen-Fen. I had tried, oh, I don't know if I can say these actual people...
LIN: That's all right. Go ahead.
HOGAN: But I tried the different weight loss places, the Jenny Craigs and Nutri-Systems, the Weight Watchers and just exhausted. And back and forth for most of my life, from probably adolescence going back and forth.
LIN: Why didn't it work?
HOGAN: I think what happens is with me was I would lose, you know, a significant amount and -- or if I didn't lose fast enough or, you know, then I would double or triple it back up on. And then that became more frustrating. And then I just became depressed from it and then it just built on more and more and more. And it got to a point where I didn't even realize I was heavy, as heavy as I was. And then when I looked at that picture, I just couldn't believe that that was me. Because when you look in the mirror, you don't see how much you've gained. You just, you know, your clothes are a little tighter and things like that. And I just ballooned way beyond where I needed to be for my height.
LIN: Right. Right. We want to take some e-mail questions and some callers coming up next. I also want to find out more about the recovery period and what the risks are in surgery like this.
Coming up, you're going to have your chance to ask our doctor and our successful patient here. Call us now at 404-221-1855. That's 404-221-1855. We're going to answer your calls and your e-mails after the break.
(COMMERCIAL BREAK) LIN: All right, it's time for another installment of our Summer Shape Up series. Today, as you know, we're talking about surgery for weight loss. We're taking your questions, so please call us at 404- 221-1855.
And joining us again, Dr. J.K. Champion from the Videoscopic Institute of Atlanta and gastric bypass patient Noemi Hogan.
Good to see you both again.
CHAMPION: Thank you.
LIN: We actually have a caller now. Cheryl (ph) in Georgia has a question. Cheryl, go ahead.
CHERYL: Hi, yes, I am calling just to ask about long-term studies with this surgery. I have a dear friend who had this surgery done some years ago and she has developed symptoms similar to Crone's Diseases. So what I'm curious about is what are the long-term I guess outlook for people who have this surgery?
LIN: OK, Doctor?
CHAMPION: Well, the surgery has been done since 1981 and the longest study that's been done, it came out of East Carolina University, with Dr. Fories (ph) out of Greeneville, North Carolina. And that followed a group of diabetics over a period of 15 years, one group who had the surgery, one group who got denied surgery because of insurance considerations. The actual survival was four times higher in the group that had surgery that had diabetes versus the group that doesn't.
The main complication that we see long-term can be vitamin deficiencies because people do need to take supplements and they do absorb iron and calcium and B12...
LIN: Because you're eating so much less.
CHAMPION: Yes. So they do absorb iron and B12 and calcium less. We have to monitor that. But many of the people that had an old operation actually had an intestinal bypass, which is a totally different operation. We can't tell that the gastric bypass really affects the G.I. tract at all. It doesn't cause diarrhea, it doesn't cause constipation.
LIN: Right.
CHAMPION: So probably this patient you're referring to had an old intestinal bypass and we've recommended every one of those patients have that revised or undone.
LIN: Really?
CHAMPION: Yes.
LIN: OK. Noemi, did your insurance pay for the operation? HOGAN: Yes, it did.
LIN: It did.
HOGAN: Yes.
LIN: But in some cases do patients have to pay cash? Because, as you're saying, insurance doesn't always cover the procedure.
CHAMPION: That's correct. Only about 52 percent of insurance companies in our experience provide coverage for the procedure.
LIN: So how much does it cost?
CHAMPION: In our experience about $23,000 at our facility. But it can range up to $60,000 depending on the hospital.
LIN: Wow. Now, Noemi, you're surviving on about 1,000 calories a day, is that right?
HOGAN: Probably.
LIN: With the supplements.
HOGAN: Right.
LIN: What was the recovery period like? How long did that take?
HOGAN: I would say it probably took about three months before I wasn't aware of -- what happens is as you grow older you're not aware of your body and of your stomach and how your food digests. And once you have the surgery, because it is a surgery that affects your insides, you feel things. So you're more aware of your body and you're more aware, when you swallow something, you can actually feel it going down.
So I would say it probably took about two to three months before I wasn't conscious of how my food passed through my body.
LIN: Was it painful? I mean was it painful to have that done?
HOGAN: No, it's not painful, it's just, it's, in the beginning it is painful. I mean, but that's with any surgery. That's with anything you do. I mean I had two children. That was, the recovery was painful for that. So it's a soreness. It's a soreness.
LIN: Just an awareness.
HOGAN: Awareness.
LIN: All right.
Let's take some e-mails. Let's see what we've got coming in to the CNN Center on this segment as we talk about extreme measures to lose weight. Here's an e-mail that reads, "Last June I had weight loss surgery. In the beginning, I could not eat much. Now I can eat just about as much as anyone else. Can a stomach staple be corrected and more of your stomach stapled? I had this surgery because I did not have much willpower or self-control."
So it sounds like this person had the procedure but the stomach has, or the capacity has since expanded and they're eating as much as they did before.
CHAMPION: Well, two things can happen. Number one is depending on how the stomach was constructed, sometimes some surgeons don't completely divide the stomach. So the staples can pop loose and the food go back into the distal stomach again. That's called a staple line disruption and that happens in about 15 percent of the cases if they don't divide the stomach. So the stomach can go back and you can redivide the stomach.
Number two, people can overeat over a period of time with a lot of overeating and a lot of vomiting, and they can actually stretch the stomach out. That happens in less than probably two percent of patients. But you can go back and reduce the size of the stomach again. So that can be corrected.
LIN: Noemi, I mean some people would say why can't you control the urge? You know, this is such an extreme form. I mean can you explain what your mind set was like about food and your eating?
HOGAN: It's like a crutch. It was like a crutch. I could eat all day long constantly for no reason at all. Anything upset me, I would eat. Anything made me happy, I would eat. And that's how I was raised as a child, you know, you're rewarded with a treat. So I was constantly rewarding myself, you know? And that's why for a long time I didn't tell people about the surgery, because you have people that will say well, just go on a diet or just exercise.
LIN: They think it's like plastic surgery?
HOGAN: Exactly.
LIN: You just want to get your nose done.
HOGAN: You just, it's just a vanity thing. But if it was that simple, we wouldn't have so many people in the world today that are overweight or obese, if it was that easy to just go on a diet.
LIN: Dr. Champion, you say that this is a disease, like any other?
CHAMPION: Yes. Yes. I think it helps people to look at this as the same as diabetes. This is a disease of the metabolism or the way the body handles fat and sugar. And the reason these people wind up 100 pounds overweight is their metabolism has slowed down about 20 percent. So they absorb about 20 percent more calories than the average person. So they only need about 1,000 to 1,200 calories to be healthy. If they eat more than that, then they wind up 100 pounds overweight with time.
So the surgery allows them to cut down to 1,200 calories and be satisfied. It controls their hunger. The reason people fail the diets is they go on a 1,200 calorie diet for six weeks then they get hungry and start snacking again.
LIN: Right. And it's that vicious cycle we talk about.
CHAMPION: So that's what we call yo-yo diets. Yes. So the surgery helps give you a tool that you can use the rest of your life in order to control your appetite by filling that small pouch up with food.
LIN: All right, thank you very much.
CHAMPION: Thank you.
LIN: Dr. J.K. Champion.
CHAMPION: Thank you.
LIN: Noemi Hogan, good luck to you.
HOGAN: Thank you.
LIN: You look great.
HOGAN: Thanks.
LIN: But as we described before, this is an extreme measure, only for obese people.
CHAMPION: Correct.
LIN: All right, thank you very much.
CHAMPION: Thank you.
LIN: Well, as the summer winds down, so does CNN's Summer Shape Up. Next week is our last edition in our 15 week series and we're going out with a bang. Join us to hear from Suzanne Somers as she discusses fitness for life. That is next week right here on CNN.
And remember, if you miss anything about Shape Up, log onto our Web site at www.cnn.com.
TO ORDER A VIDEO OF THIS TRANSCRIPT, PLEASE CALL 800-CNN-NEWS OR USE OUR SECURE ONLINE ORDER FORM LOCATED AT www.fdch.com
