drkdhuffman

ready2B: I'm glad to hear that medication helped you on your road to the ultimate solutions to your health issue; bariatric surgery. I've been working with bariatric surgical patients for 25 years. I don't think there is another physician in the world that has done more to spread the world of bariatric surgery than I, but I'm not someone that believes that obesity is 'cured' by bariatric surgery. This health issue is just much too complicated than that. So I advocate nutrition, behavior, exercise, support, medications and surgery. I'm not promoting 'speed' what I do suggest to those who have an open mind is that you consider medications in limited situations for limited periods of time and to keep your ears and mind open as the medical community continues to develop safer and more effective medical therapies. Just as bariatric surgery has gone from 4-5 hour open gastric bypass to single port incisions and endoscopic procedures to gastric pacing, gastric space occupying devices, and some day deep brain stimulation, medications will and are evolving. I'm certain that in time we'll have personalized weight management medications that hone in on a patient's unique needs, but until then I still recommend that those who are struggling post operatively speak to their bariatric surgeon, bariatric physician or primary care physician and don't give up. Get back into support and exercise (the two most important things you can do), make sure your adjustable band is optimally filled, ask your bariatric surgeon if you qualify for a revisional surgery and if a short course of medications can help you get 'back on track' then consider a low dose, short course of a medication FDA approved for weight management. Dr. Kevin Huffman

Hello group, this is Dr. Kevin Huffman. I'm board certified in obesity medicine and have worked with bariatric surgical patients for nearly 25 years now. I thought I'd give you my insight into the use of anorectic medications such as phentermine, Tenuate, Bontril, Qysmia among others. I'm a firm believer in using all available tools to combat this chronic disease. Of course I'm a big fan of bariatric surgery and believe it the most effective tool we currently have in treating those with BMI of 35 and above (maybe even 30 and above when associated with co morbid diseases such as diabetes), but bariatric surgery isn't a cure, its just a very effective tool that when used with alteration in macro and micro nutrients, increase physical activity, behavior modification and even medications in some cases it can help you and your physician manage your disease for life. When I first joined the ASMBS 15 years ago, I took a lot of heat for suggesting that anorectic medications had a role in postoperative bariatric surgical care, but as time has passed many of my bariatric surgeons acknowledge that anorectic medications may in fact play a limited role in some postoperative patient care plans. We know that postoperatively those undergoing gastric sleeve and gastric bypass show reduced levels of ghrelin, a hormone that stimulates appetite. We suspect that is in part why our postoperative patients sense less hunger after surgery. However at about 18-24 months postoperatively many patients complain that their hunger levels return to preoperative levels. This may be a function of 1) a return to hunger stimulating foods e.g. carbs, 2) return to old habits or 3) maybe a compensatory mechanism in the GI tract ramping up ghrelin products. In any case getting patients back into high Protein diets with adequate hydration and exercise along with the most important tool SUPPORT GROUP, may be all that is necessary to help reduce hunger, however in some limited cases I have found anoretic medications in low dosages for limited period of time can be an effective tool to getting 'BACK ON TRACK' Hope this helps some of you and if my comments can be of use, please let me know I'll jump in from time to time to give you my perspective. Thank you Dr. Kevin Huffman