Anyone drastically overweight and looking to lose excess pounds has myriad places to do it in the state, including the Nutrition Teaching Center at Rhode Island Hospital and the Nutrition and Weight Management Center at Westerly Hospital, as well as weight loss and nutritional programs provided by many doctors and clinics.
For the morbidly obese, largely defined as those weighing 100 percent more than they should and having a body mass index of at least 40 percent, there is also bariatric surgery that reduces the size of the stomach with a gastric band, or resecting and rerouting the small intestine to a small stomach pouch.
And now for the first time in the state, according to the doctors who founded it, The Miriam Hospital’s new Center for Weight & Wellness in East Greenwich offers weight loss and surgical screening in one location.
“Treating obesity can be a challenge,” said the center’s co-director, Dr. Siva Vithiananthan, a surgeon and chief of minimally invasive and bariatric surgery at Miriam’s Center for Bariatric Surgery. “A lot of programs are not successful because they don’t offer patients cohesive treatment.”
He founded the center with Dr. Vincent Pera, director of weight management at Miriam with 27 years of experience in the field. Pera said, “The biggest benefit of patients at the center is the combined expertise available to help them gain a greater understanding of obesity and receive coordinated, comprehensive treatment.”
The doctors first kicked around the idea of a center about eight years ago, with a concerted effort made to make it happen about a year ago, Vithiananthan said, because “we had to have the money and support behind it.”
The surgery, if warranted, takes place at Miriam, with the screening for it done at the center.
“It’s an entire medical and psychological evaluation, patients are seen by a psychologist, social workers, exercise physiologists and nutritionists, and if surgery is the option, by surgeons as well,” Vithiananthan said.
The doctors perceived the need for the center based on a number of factors, Pera said.
In his weight-management program at Miriam, “we’ve seen well over 10,000 patients over the years, some do well, some don’t, and many are in the middle [and] come back for treatment and to reset,” Pera said. “For our patients, we felt they’d benefit from a more cohesive approach in one place.
“We feel it’s important to evaluate the whole patient, do very detailed psychological evaluations, weight and lifestyle evaluations and so forth,” he said. “For the surgical option, there are very strict criteria from a psychological perspective.”
The road to surgery is not quick, Vithiananthan said.
“In evaluation, we ask patients if they’re in a good mind frame for this complicated operation. Are they willing to stick to new rules, make this change? Do they understand how they’ll eat?” he said. “By the time we do this, it can be six months to a year before they have surgery.”
And no matter if it’s surgery or sticking to a weight-loss management plan, once patients reach their goal they can come back for maintenance, free of charge, Pera said.
The center, which opened in January, works with many patients who aren’t morbidly obese but in the midrange, Pera said, patients who need “behavioral intervention, working to overcome the stressors and issues that trigger maladaptive behavior.”
One stigma about obesity is that it’s uncontrollable, Vithiananthan said.
“Surgery doesn’t cure it, medical intervention doesn’t cure it,” he said. “It’s control. Diabetes patients can see vast improvements and come off insulin with diet and exercise but it’s not cured, it’s controlled and dormant. Obesity fits that same model.”
The buzz over the center has been good, the doctors said, adding that it’s the only one like it in the state and one of very few in New England. Vithiananthan added that, “What we’re doing here probably has a stronger behavioral component” than others.
One point in their favor: Obesity was recognized as a disease in 2013, which Vithiananthan said, “was a political nightmare to get there. Until recently, obesity was something doctors didn’t want to treat because there was no way to get paid for it.”
Glocester resident Kathleen Shaw, 62, who runs the operations center for a major New England bank, swears by the treatment she received from Pera and Vithiananthan. At her peak weight, she was 334 pounds. In 2009, Vithiananthan performed bariatric surgery and her weight is now around 135. She’d been under Pera’s care since 2000. She welcomes the new center as a place to come for support.
“These programs collectively saved my life,” Shaw said. “Having a center like this now is a real boon.” •
