Shownotes
Obesity is a chronic, lifelong disease, not a failure of willpower. In this episode of the BariNation Foundation Podcast, April Williams sits down with bariatric surgeon Dr. Monique Hassan and BariNation community member Jasmine Fernandez to challenge the idea that one tool can treat obesity. They discuss the full range of surgical options: surgery, GLP-1s, mindset, movement, community, self-advocacy, and overcoming shame while treating obesity as a chronic, lifelong disease. If you've ever felt shame about needing more than one treatment, this conversation offers permission to stop apologizing and start healing.
What You Will Learn in this Episode:
✅ How bariatric surgery options like sleeve gastrectomy, gastric bypass, and duodenal switch compare, explained through a simple car analogy.
✅ Why GLP-1 medication works for some patients and not others, and how it fits into a full obesity treatment plan.
✅ How to build self-advocacy skills and find a comprehensive care team that treats the whole person.
✅ Why emotional eating, mindset work, and support groups matter just as much as any medical or surgical tool.
This episode of the BariNation Podcast is produced by the BariNation Foundation, a 501 (c) (3) dedicated to advancing metabolic wellness for people living with obesity by providing evidence-based education, stigma-free support, and meaningful connections in the moments that shape daily life. Funding comes from generous donations to the BariNation Foundation from listeners and viewers like you, Johnson & Johnson, and the Texas Center for Bariatrics & Advanced Surgery, led by Dr. Joe Cribbins.
TIMESTAMPS:
00:00 Bariatric surgeon Dr. Hassan shares her magic wand question for setting real weight loss goals
04:07 Why one thing is not enough to treat obesity
05:20 Meet Dr. Monique Hassan, a board-certified bariatric surgeon and Jasmine Fernandez, longtime BariNation member and gastric bypass patient
08:09 Why willpower alone never cures the chronic disease of obesity
10:47 Jasmine's winding path to gastric bypass surgery in 2021
14:54 Naming the inner critic and staying accountable after surgery
18:37 Walking through goals with your doctor and advocating for yourself
31:00 The “fight” and journey of obesity
43:42 Selecting the right tool for you to fight obesity
45:41 The car analogy: sleeve gastrectomy, gastric bypass, and duodenal switch compared
56:48 How to find a comprehensive bariatric surgery provider near you
KEY TAKEAWAYS:
💎 Obesity is a chronic, lifelong disease, so bariatric surgery, GLP-1 medication, and mindset work have to work together, not against each other.
💎 A good bariatric surgeon asks about your real-life goals before ever discussing a treatment plan.
💎 Naming your inner critic takes away its power and makes it easier to catch emotional eating before it starts.
💎 Progress over perfection matters more than any number on the scale, especially in long-term obesity treatment.
ABOUT THE GUEST:
Monique Hassan, MD, is a bariatric and metabolic surgeon who serves as the Division Director of Bariatric and General Surgery and Director of Obesity Medicine at Baylor Scott & White – Temple, and is an Associate Professor of Surgery in the Department of Surgery at The Baylor College of Medicine - Temple Campus.
Dr. Monique Hassan - Instagram
Jasmine Fernandez is a wife, mom of two, operations and logistics leader, and someone who completely transformed her health. Her journey hasn’t been about chasing perfection; it’s been about choosing herself every day. Through gastric bypass surgery, lifestyle changes, therapy, and perseverance, she discovered that lasting change comes from consistency, not quick fixes. “I hope that by sharing my story honestly, I can encourage others to believe that no matter where they start, a healthier and happier life is possible.”
RESOURCES MENTIONED:
BariNation Community - $19 a month
BariNation - Email
BariNation’s How to Find an Obesity Specialist Guide
4 Steps to Find an Obesity Provider
Finding Your Holistic Obesity Care Team
Sign up for BariNation’s Newsletters
BariNation, Bariatric Surgery, NSVS, GLP-1, VSG, Vertical Sleeve Gastrectomy, Lapband, Roux-en-Y, Gastric Bypass, Sadi-S, Obesity Treatment, GLP-1 Medication, Duodenal Switch, Weight Loss Surgery, Obesity Medicine, Chronic Disease, Metabolic Wellness, Emotional Eating, Inner Critic, Self Advocacy, weight loss mindset, obesity treatment options, BariNation Foundation
Transcripts
And then that helps [00:00:35] me to kind of frame or kind of start having a discussion [00:00:40] as to, you know, let's talk about how we're treating this, right? Because if [00:00:45] you have severe Type 2 diabetes and, you know, [00:00:50] hypertension, sleep apnea, and you weigh, you know, your BMI is [00:00:55] 40 versus if you have the same disease processes and your, you know, [00:01:00] BMI is 80, those two treatments are gonna be a little bit different, right?
So [:[00:01:25] Because it's not always about the number on the scale, right? It's about so many other [00:01:30] things, um, in life.
to the BariNation podcast, a [:Jason Smith: Where we fight obesity by living our pillars: movement, [00:01:40] mindset, metabolic wellness, and community.
Natalie Tierney: Four pillars, one mission.
We're [:April Williams: Hello, friends. Welcome back to [00:01:50] the BariNation podcast. Uh, if you have ever typed into Google, "Why isn't this [00:01:55] diet or this exercise working for me?" Or, "GLP-1 versus bariatric surgery, which one should I choose?" [00:02:00] This episode is for you. Uh, today I'm sitting down with two people we've wanted at this [00:02:05] table for a very long time.
ariatric surgeon and obesity [:Obesity is a chronic, lifelong, relapsing disease, and no single tool treats it. Not surgery, [00:02:35] not GLP-1, not willpower. Dr. Hassan will tell you straight up, she served in the [00:02:40] military. If willpower cured obesity, she'd have never struggled with her own weight during [00:02:45] residency, and that's the whole point. We're also talking about the thing nobody wants to admit [00:02:50] out loud, that inner critic that shows up after surgery or after starting medication and tries [00:02:55] to talk you out of doing the work.
and you're gonna wanna hear [:They're what gets the car on the road and what keeps it running. [00:03:20] So if you've been carrying shame about needing more than one thing to treat this disease, or you've been [00:03:25] told you just need more willpower,
permission slip that you've [:Let's get into it.
ams: Hello, friends. Welcome [:Jasmine Fernandez: Hi. [00:03:45] Hello.
to speak with you both. Dr. [:And Jasmine, you've been a long-term member of BariNation, and you [00:04:00] have onboarded so many things to help you treat the disease of obesity, and [00:04:05] that is really what our conversation is today. So before I get to introductions, I just wanna set the [00:04:10] stage or set the scene for you, my friends. Uh, today, what we're hoping you [00:04:15] leave really knowing and understanding is that no single tool can treat the [00:04:20] disease of obesity.
rs, we thought one thing was [:So what we hope you leave with today is no matter what tool got you here, whether [00:04:50] that's surgery, GLP-1, maybe it's just sheer grit. Maybe you haven't onboarded any medical [00:04:55] treatment for the disease yet today. We hope that you understand le- today leaving [00:05:00] really understanding you're gonna need a lot of different things to treat this disease, and the people on this [00:05:05] screen today are gonna help us understand why and show us what that actually [00:05:10] looks like in, in our lived patient experience.
So there, there's the scene. [:Jasmine Fernandez: [00:05:20] Uh, sure.
on this podcast. I have been [:I am a [00:05:35] board-certified bariatric surgeon and obesity medicine specialist. Um, I [00:05:40] am currently in Temple, Texas, practicing at Baylor Scott & White, um, where we [00:05:45] have a comprehensive center for the disease treatment of obesity, so. [00:05:50]
your alley, and your talk at [:[00:06:00] So it, it's gonna be amazing.
Dr. Monique Hassan: Yay.
would you like to introduce [:Jasmine Fernandez: Hello, everyone. My name is Jasmine Fernandez, and I currently [00:06:10] reside in the Pacific Northwest, the Southside. And [00:06:15] I, uh, I had gastric bypass in January 2021. I, [00:06:20] uh, welcomed somebody I lovingly call Boss Baby in [00:06:25] 2023, and after Boss Baby was born, uh, my [00:06:30] body just went a little off, and I tried [00:06:35] everything to get healthy and continue to be healthy, but it just was not [00:06:40] responding.
s. I did a lot of mindset. [:April Williams: I so appreciate you saying that.
ou, you called out, I think, [:And Jasmine, I'm so [00:07:30] thankful that you're here today because, you know, I've been doing this podcast for a while. I think a lot of people know my story. [00:07:35] But the more stories that we can share about people who have fought back against that shame, made the [00:07:40] decision to onboard care and treatment, and find a provider or a team like Dr.
Hassan [:So if you guys are ready, uh, I think, I think we start.
Jasmine Fernandez: Yeah, [:April Williams: it. Let- let's do, let's do it. All right, Dr. [00:08:10] Hassan, fir- fir- first question to you. Uh, so you, you call your philosophy [00:08:15] Surgery with Soul, and at ASMBS you led a session on integrating, right, medical, surgical, [00:08:20] and innovative therapies to treat obesity.
e in your patients or in the [:Dr. Monique Hassan: Yeah. I mean, I think it's, it's just like what Jasmine had said. Um, you [00:08:40] know, for a long time, people have been fighting this disease and then, you know, they're going to their primary [00:08:45] care, um, and really just being told the same thing, right?
The, the thing [:Um- Mm-hmm ... and I think that [00:09:15] one of the biggest things is that we know that it's not about willpower, right? It's not [00:09:20] about eating less and exercising more. Um, I like to tell everybody, [00:09:25] like, if that was the case, like, I mean, I was in the military, um, so we definitely [00:09:30] know that I have willpower and I definitely have strength, but I was overweight, you know, [00:09:35] years ago during my residency.
e case, then, you know, this [:And so I think that we have to break down the walls and really just say, [00:10:10] "Listen, this is not a failure." Like, this is a disease just like high blood [00:10:15] pressure, just like type 2 diabetes, and we gotta use different tools in our toolbox in order to treat [00:10:20] it. Um, and so we have to take a more holistic approach, right?
Because what we were [:April Williams: No, it, it did not work. [00:10:30] And, uh, Jasmine, you, you hinted to this. So you did all the things and then you made the [00:10:35] decision. What... I mean, do you wanna run us through what all the things were? And then [00:10:40] do you feel comfortable telling us, like, what was the point where you were like, "I am not gonna continue to bang my head against the [00:10:45] wall a- and do this on my own"?
Fernandez: So I tried to the [:Dr. Monique Hassan: Oh.
medical folks, and they were [:They gave me nine days. [00:11:35]
April Williams: Mm.
e like, "We're ready to go." [:'Cause life got to [00:12:00] life and still we're in a pandemic.
April Williams: Right. Yes.
: All of those things, like, [:I carry a backpack everywhere I go on my back to keep [00:12:30] exercising because with my busy schedule, I don't have time to exercise, so [00:12:35] I rock, as, um, somebody has called it. And none of it worked. [00:12:40] Diets, exercise, um- There's one other thing that I [00:12:45] tried phen- phentermine about 20 years ago. Zero to 10, do not recommend for me, [00:12:50] for my body-
'cause my, my heart was like, "Hey, what are you doing to us?"
April Williams: Mm-hmm.
Jasmine Fernandez: [:April Williams: Yeah.
Jasmine Fernandez: And that stuck
April Williams: [:Mm-hmm. It all starts up here, right? [00:13:55] We think that surgery, we think that medication is going to be the one thing. Right. And then just [00:14:00] like what you said, Jasmine, right, life likes and all of a sudden, oh, it's not the only [00:14:05] thing that, that I need. And if we don't continue to go back to a toolbox to [00:14:10] pick up the tools that we need for this moment in life, that disease is gonna ramp up in our life [00:14:15] again and it's going to feel like it's out of control.
Dr. Monique Hassan: Right.
Jasmine Fernandez: Yes.
Dr. Monique Hassan: [:Um, you know, that helps you to stay accountable. But [00:14:45] really staying in ther- therapy. I mean, because not only are you [00:14:50] gonna get negative n- noise from other haters, right? But [00:14:55] you have that inner critic that's really going to potentially sabotage [00:15:00] you. And so, um, you gotta, you gotta do a lot of that work as well in order [00:15:05] to stay on this path.
to know you a little bit in [:Jasmine Fernandez: [00:15:20] Oh, that inner critic, sh- um, I call them Bertram [00:15:25] sometime, and Bertram is not nice.
Mm. And Bertram is [:I started, uh, doing my current favorite hobby, [00:15:55] which is customizing Hot Wheels and Matchbox cars. Uh, it's, it's a lot of [00:16:00] fun. Uh- I recommend customizing over purchasing 'cause it, [00:16:05] it's, it's something that keeps you busy that's satisfying. I don't [00:16:10] like, uh, tracking my food 'cause personally it's just difficult for me.
It feels like s- it's [:Right. No matter what, you [00:16:35] eat. You're always... Or I was personally always just eating just because, [00:16:40] and actually sitting with emotions and realize that it's going to pass just like a [00:16:45] tide in the ocean a- and maybe just 30 seconds or six [00:16:50] seconds. Sometimes an emotion lasts and sits all day, and realizing that it's, the emotion is just an [00:16:55] emotion and it's not just like your whole personality has made a really big difference.[00:17:00]
Uh, I think, I, I think when [:Hassan, you onboard that treatment, and all of a sudden you [00:17:25] get breathing space between you and the disease.
Jasmine Fernandez: Mm-hmm.
and you can go, "Oh my gosh, [:So you [00:17:40] can call it out because- Yeah ... you realize, oh, I am not the disease, but the disease is, it's [00:17:45] like a roommate inside of me.
Dr. Monique Hassan: Right.
learn that we can have this [:And what we call in BariNation, right, the work of weight loss surgery, the work [00:18:05] o- o- of, of treating the disease of obesity are these conversations that you're having with [00:18:10] yourself. It is realizing, oh, I can't track my food because that's triggering, but I can do this. [00:18:15] That becomes the work. And people think that it's something very prescribed and that you're gonna [00:18:20] follow this exact same thing.
all. And Dr. Hassan, what I [:Dr. Monique Hassan: Yeah, absolutely. I think that the first step [00:18:40] is, um, for most patients, at least in my practice, I [00:18:45] really wanna know what your ultimate goal is, right?
body has the goal of being a [:And then that helps [00:19:25] me to kind of frame or kind of start having a discussion [00:19:30] as to, you know, let's talk about how we're treating this, right? Because if [00:19:35] you have severe type 2 diabetes and, you know, [00:19:40] hypertension, sleep apnea, and you weigh, you know, your BMI is [00:19:45] 40, versus if you have the same disease processes and your, you know, [00:19:50] BMI is 80, those two treatments are gonna be a little bit different, right?
So [:[00:20:15] Because it's not always about the number on the scale, right? It's about so many other [00:20:20] things, um, in life. Um, and, and we're also... I [00:20:25] personally find that I s- I say to a lot of patients, you know, "My goal [00:20:30] is always to get you off of medications," right? And they're like, "Oh, what?" And I'm like, "Yeah, I just [00:20:35] want you to be taking vitamins.
can take a lot of them. But [:Because, I [00:21:00] mean, you know, n- there's not no absolute, and, and no patient [00:21:05] can, can be successful if they're not an active participant in their treatment plan, right? [00:21:10] Yes. So.
ne, w- yeah. Mm-hmm. Mm-hmm. [:Jasmine Fernandez: Just advocating for [00:21:25] myself. Mm. I really have to advocate and not think that I'm too much or I'm just [00:21:30] being annoy- annoying to my medical team, but advocating and continuing [00:21:35] to advocate for myself and learning that it's okay to ask for help. Mm. That's [00:21:40] something that I was not ... I continuously this whole week have been [00:21:45] asking my grandma, how, why is it so hard for us to ask for help?
Mm. And she couldn't answer [:Dr. Monique Hassan: Mm-hmm.
ouldn't answer the question. [:April Williams: Mm. I, I,
nna- Can I just make a point [:So even if you say to me, for example, your, you talked about phentermine and how [00:22:50] you felt about phentermine. It, for me, in my practice, I could have put it on, [00:22:55] put several patients on phentermine and it worked. But you were like, "Listen, I didn't like how it f- [00:23:00] made me feel." It's okay to say that, and I think that it's super important.
And the [:I get so many patients who show up and they're like, "Well, whatever you wanna do, [00:23:35] Doc, is, is what I wanna do." No, no, that's not how it's gonna work, right? Uh, this [00:23:40] is your body. You have to make these decisions. And you know, I've had some negative [00:23:45] criticism from patients about that. "Well, she just, she didn't wanna tell me what I wanted to hear, [00:23:50] you know, or what I should do."
ell, because you should have [:And if [00:24:15] I come out and I say, "Hey, okay, let's just do a GLP-1," and you're uncomfortable and [00:24:20] you just don't wanna say anything, and you walk out of the office, that doesn't benefit you, right? [00:24:25] And you know, even if you try it and that's not your path or that's not what you wanna do, you're [00:24:30] not gonna stick to it, and I think that that's really important.
So I think that- [:And also, I know, [00:25:00] I mean, the studies have shown it, patients who show up the day of, you [00:25:05] know, their consult ... First of all, that's the hardest thing you can possibly do is walk through the door [00:25:10] to come in, you know, because you're, you're greeted with so many [00:25:15] looks or you, you know, you feel uncomfortable. The seats aren't the right seats, and the bathroom's [00:25:20] not the
n uncomfortable environment, [:[00:25:40] Sorry, I, I ... You know, that was a whole rant, but yeah.
ams: Oh, we, we, we are here [:Right. And what both of you have experienced in your life, being Black [00:26:10] women, is unfair. It, it's not right. Yeah. And yet it [00:26:15] is your lived experience.
Dr. Monique Hassan: Right.
ut both of you have made the [:Dr. Monique Hassan: [00:26:25] Mm-hmm.
eople watching and listening [:Every doctor I've ever told to told me I [00:26:35] was crazy." There, there is a real hesitation to put yourself, your soul, on [00:26:40] the line to try this- Mm ... one more time.
Dr. Monique Hassan: Mm-hmm.
illiams: What can you say to [:Jasmine Fernandez: Research your research [00:26:55] Don't just go to one person. Don't just go to one doctor. [00:27:00] Don't just hear from, "Oh, somebody's cousin 20 years ago had this," or, "This happened to [00:27:05] me." Research your research and actually ask yourself how do you feel about it and not about other [00:27:10] people's opinions. Because if you feel like you're not heard [00:27:15] or that even people in your life are dismissing your thoughts...
my own father still doesn't [:April Williams: Mm-hmm.
And he lives with me, or he [:April Williams: Mm-hmm.
andez: Hearing that and then [:[00:27:40] Because I did rebound gain weight after having my baby, and [00:27:45] I'm telling you, research your research. Don't give up just because you heard one negative thing. [00:27:50] I actually went to get my annual labs today, and there was somebody that was, [00:27:55] uh, in my... The person taking my labs was like, "Oh, did you have [00:28:00] gastric bypass?"
good." "Thank you." And she [:Don't just, you know, think that one person is the say-all [00:28:20] be-all. There's other opportunities for learning and growth even with yourself. You know? [00:28:25] You have to be your own expert of your body [00:28:30] and how you feel.
%. I think it's like, on, [:Like, GLP-1s, I'm happy to follow you, but we all know that [00:28:50] sometimes patients don't want to come in on GLP-1s. Like, they, that's just [00:28:55] sometimes in their courses. Um, but with surgery, I tell them, [00:29:00] right, and, you know, 7- 70-plus percent of our patient population is female, [00:29:05] right? You go to the gynecologist whether there's any problem or not, right?
You check in every year. [:I need..." Or, "I need help with X, Y, Z thing," right? 'Cause I don't live [00:29:35] your life, and so you have to come in, so we have to have a good [00:29:40] relationship, and I can trust that when I tell you to do something, that is the thing that you're going to [00:29:45] do. You're not gonna walk out and be like, "Oh, she's crazy." No. Like, I mean, you may still say [00:29:50] that.
ou, you know, do the things, [:'Cause, you know, you'll just cancel, [00:30:10] right? Mm-hmm. And that's not doing you any favors, right? You're not gonna get any healthier. You're not gonna get [00:30:15] to the goal that you wanna get to if you don't have the person that you [00:30:20] want as your advocate, right? And so that's what I'm here to do as your surgeon [00:30:25] or as your obesity specialist, right?
to be your champion. I wanna [:Yes. But I just want you to get treatment, right? That's [00:30:50] all I want for you. Yes. So yeah.
want. And I wanna highlight [:And, and [00:31:05] I know why you're doing that, because that's what's required of you if you have the disease of [00:31:10] obesity. And I know you don't wanna hear that, and, and I'm sorry, but I and we as an [00:31:15] organization, we're gonna continue to say that. If you have the disease of obesity, you have been [00:31:20] called to fight.
stening to this now and, and [:You [00:31:40] can do the uncomfortable things even though you don't want to do them, because [00:31:45] the reward for doing that is you learn how to put your fists up and you learn wh- when you punch [00:31:50] back. Mm-hmm. And you learn how to get your training team behind you for, for [00:31:55] all of those seasons. Mm-hmm. And Dr. Hassan, right, what you're saying is [00:32:00] it, it...
Which means others like you [:Dr. Monique Hassan: Right. And that you can't search for it.
s: And that you can't search [:That's okay. This is not a you thing. This is a, a, a [00:32:45] disease thing. The disease requires you to find that, that person and that team. And if [00:32:50] you need help finding 'em, we, we have that resource for you. Because again, [00:32:55] this is what the disease requires.
Dr. Monique Hassan: Mm-hmm.
illiams: Hate to say it, but [:Mm-hmm. And you know that the disease is now progressing because you have these words, right? It's [00:33:10] lifelong. There's no cure. It's progressive. Right. It's gonna keep doing what it d- what it does in, in, in your life. [00:33:15] And you're gonna need to, to find care. And now that you know what treatment [00:33:20] feels like and the life that it provides you, you do not want to go back.
And we are here to [:I'm out." [00:33:45] No. "I don't want to bariatric anymore. I don't wanna do all the things. I don't wanna think about all the things, and I'm just gonna [00:33:50] stop doing it." Mm-hmm. And I did. I gave myself permission to do that, and you know what I discovered? [00:33:55]
Dr. Monique Hassan: No.
ot treating the disease as I [:Dr. Monique Hassan: Hmm.
have surgery and to onboard [:Jason Smith: Yeah.
nk yous, because without the [:A big [00:34:40] thank you to Johnson & Johnson and Dr. Joe for your donation to the BariNation [00:34:45] Foundation.
ight? Like, you have to... I [:We just think about it. [00:35:00] If you do, that's so overwhelming, right? Yeah. Like, you, there's no way [00:35:05] that you could ever see the end of it, right? If you look at the end of the t- like, [00:35:10] when does this journey end? Like, cancer patients don't say that, right?
April Williams: No, [:Dr. Monique Hassan: So we have to treat this one day at a time. So every day you [00:35:20] wake up, and every decision that you make in that day [00:35:25] defines how you're gonna do and how your path is gonna be.
Jasmine Fernandez: Mm-hmm.
ue Hassan: And we don't have [:Jasmine Fernandez: Right?
que Hassan: It doesn't stop. [:And, and stop worrying about what's happened in the [00:36:00] past. We can't, you know, we can't change that. And you k- you know how I feel, [00:36:05] April, about Bad Bunny, and you know- I do ... that's what he says, right? We can't [00:36:10] change the things in the past, so all we have to do is worry about what we can do right now in the [00:36:15] present.
ake up and don't worry about [:April Williams: let it go. J- Jasmine, how, how have you embraced this? What, what are you, [00:36:35] what are you doing and thinking on the good days, and what are you doing and thinking on the bad days?
Jasmine Fernandez: Oh. [:Mm-hmm. It, it's just food. Yeah. And the [00:37:05] 80/20 is good. Just asking myself why and what was going on with [00:37:10] myself and trying to, like, do essentially a debrief, but not in shame. Like, okay, [00:37:15] maybe this time or next time, if this happens, slow down. Mm-hmm. Don't [00:37:20] just stomp over to the store 'cause- Mm-hmm ... and get you a snack, 'cause my job is very close [00:37:25] to a snack store.
store and get you a big ice [:That's, that's the only rule. Everything else, it doesn't matter [00:37:50] the title.
in our community and they're [:Go to anything." Yeah. Because the topics are always grounded in [00:38:05] those pillars, right? Yeah. So what we call our pillars, other peoples might call toolbox, but it's gonna [00:38:10] always come back to movement, mindset, metabolic wellness, and community. No matter where you [00:38:15] are, no matter what treatment you've onboarded, no matter if it's a good or a bad day, you are gonna leave [00:38:20] there with something that you needed to continue to have a good day or to turn that [00:38:25] bad day into not such a bad day, right?
The goal is not [:Dr. Monique Hassan: Correct. Right. There's no... Right. It's, it's, it's progress [00:38:35] over perfection, right? Mm-hmm. So we have to, we have to think about it that way. And I [00:38:40] think one of the biggest things that we hear constantly in the [00:38:45] community is the shame around the things that you eat, right? And for other [00:38:50] disease processes, we don't do that, right?
So somebody who is an [:Um, it's just, it's, it's so frustrating [00:39:30] because we don't continue to chastise people who smoked and had lung [00:39:35] cancer and got treatment and then say, "Oh, well, you did that to yourself." You know, we d- you know, [00:39:40] we don't do that. Um, and so we don't do the same thing with, you know, [00:39:45] alcoholics. "Oh, well, you know, you got cirrhosis because you drank s- you know, for so many years."
So why do [:April Williams: N- no. A- and I, and I'm sure Jasmine, you agree with [00:40:05] this, too, right, obesity definitely is a disease that it's still okay to shame people [00:40:10] over.
Dr. Monique Hassan: Mm-hmm. Mm-hmm.
t to ourselves. There's that [:We, we gotta research the research- Mm-hmm ... [00:40:30] because there is something that we can do to kinda stop that shame [00:40:35] spiral or that shame in our lives, and you know what it is? It's us [00:40:40] saying, "I'm not gonna listen to this anymore."
Dr. Monique Hassan: Mm-hmm. "
not going to agree with this [:I'm just not going to believe [00:40:55] that anymore." And the power of that, which I've come to learn, is I don't have to [00:41:00] actually believe that 100%. I just need to say it, and then I need to do [00:41:05] it.
Dr. Monique Hassan: Mm-hmm.
nd what becomes available to [:Because just like what you said, Jasmine, right, when, when I stop listening to people saying, "Oh, I need to do [00:41:20] this diet or follow this program or, or do exactly that," when I just said, "You know what? [00:41:25] I'm not gonna believe that anymore. I'm just gonna do what I think is [00:41:30] best for me, and then I'll judge m- what I do next based on the evidence that I [00:41:35] gather."
Dr. Monique Hassan: Mm-hmm.
e is, oh, that was the right [:That's what stops shame. It's us.
Dr. Monique Hassan: [:April Williams: It's hard to do. It takes practice. Yeah. And when you have a community where you can [00:42:00] practice that, it becomes easier, right? Like, I feel like almost every day in BariNation, [00:42:05] somebody's flexing muscle, right? Somebody's putting up the fist. Somebody's like, "Yes, okay. Thank you.
I can do [:Dr. Monique Hassan: Mm-hmm.
April Williams: So [:Mm. And I wanna be really clear, right? We are [00:42:35] not Team Surgery. We are not Team Shot. We are Team Let's Treat Obesity, [00:42:40] right? Yeah. So we know that a lot of people, uh, have onboarded to GLP-1 medication, [00:42:45] right? The research says, like, one in 10 Americans, they, they believe, right, is, is on this [00:42:50] medication. We also know that medication has some, some shortcomings.
People can't stay on [:Mm-hmm. So this is not about, like, oh, this, this versus this. This is a [00:43:15] conversation of obesity requires all of these things. So w- [00:43:20] we've talked about the toolbox, and we know that medication and surgery can be one of those tools. [00:43:25] Will you walk us through, Dr. Hassan, w- what are the tools that you see other [00:43:30] people using that have proven most effective for, like, your general patient [00:43:35] population?
found to be the most helpful [:Dr. Monique Hassan: Yeah. I mean, I think, like I [00:43:45] said, um, one of the biggest things is kind of figuring out what the goal for the patient is, right? [00:43:50] There are so many tools, right? So, and I, again, I think now [00:43:55] is, now is a really unique time in the treatment of the [00:44:00] disease of obesity, where we have so many tools.
mean, it's actually kind of [:Um, so in terms of options, there's oral pills, of course, [00:44:45] right? Um, Jasmine mentioned phentermine. Some of those, though, you know, they have a ton of [00:44:50] different side effects and, you know, when you sit down with your treatment pr- you know, [00:44:55] your provider in order to map out a treatment plan, it's really important to have an [00:45:00] honest conversation about what medications you're already on and what supplements you're on, [00:45:05] right?
medications, I [:[00:45:30] Um, sometimes we have to add an oral and a GLP-1, but, you know, [00:45:35] but somehow we can make that work based on your treatment plan, or based on your [00:45:40] treatment goals.
April Williams: Mm-hmm.
for surgery, I created a, a [:Um, and so o- one is sleeve [00:45:55] gastrectomy, the other one is gastric bypass, and then the third is duodenal switch, or s- [00:46:00] you know, single anastomosis duodenal switch. Um, and I like to kind of base it [00:46:05] based on how much weight as opposed to how all [00:46:10] the complications that can happen with those surgeries, right?
Mm-hmm. So again, [:Um, but I'm just there just to do that, so you gotta tell [00:46:40] me How many times do you wanna bring your car in for service, right? [00:46:45] So if you have a sleeve gastrectomy, right, so that's a pretty... I li- [00:46:50] I like the analogy of, like, a Honda Accord or a Toyota Camry, right? So it's pretty [00:46:55] reliable. Hmm. Gets from point A to point B.
It works. It's great. [:The gastric bypass is really like we're stepping it up [00:47:20] another notch, right? So it's like a Mercedes or a BMW. Gonna have more [00:47:25] service, right? So you're gonna need labs. You're gonna need all those things. You're gonna have to come in for more checkups, [00:47:30] but the ride from point A to point B is gonna be a little bit [00:47:35] faster than your Honda Accord or your Toyota Camry, right?
And it may be a little [:April Williams: Mm-hmm.
Dr. Monique Hassan: So it's the same thing with those types of operations.
, the duodenal switch or the [:You [00:48:20] gotta bring it to a specialist, right? And so- Mm-hmm ... you've gotta bring that [00:48:25] car to a bariatric surgeon. So that is how I kind of frame the [00:48:30] surgeries. And then in terms of medications, again, we gotta look at [00:48:35] your medical history, what you're already taking, and then seeing exactly how those [00:48:40] would fit.
er, the meds, either oral or [:April Williams: I am s- my soul is [00:49:05] so happy right now. I am a car person. And Jasmine, you literally, you ju- you just [00:49:10] customized a Ferrari. Can, can we see the Ferrari? I mean, I think we n- I think we need, [00:49:15] we need to see this.
So this is the Ferrari. And [:You have to take it all apart, um- Yeah ... take everything [00:49:30] out of it, and then you have to, uh, strip the paint-
Dr. Monique Hassan: Yep ...
Jasmine Fernandez: [:Dr. Monique Hassan: Mm-hmm.
Jasmine Fernandez: And [:Dr. Monique Hassan: Yeah, see? It's super specialized, right? Those Ferraris. [00:49:50] So if you're a switch or, you know, or any kind of, kind of [00:49:55] malabsorptive operation, then there you go. And I guess we could al- even [00:50:00] put provisions in a whole nother category, but that's when you trade in one car for [00:50:05] another and all that kind of stuff.
So yeah. So yeah.
lliams: I, I cannot tell you [:Mm-hmm. So, so let's say [00:50:30] that y- you have been going through your life and, and you've never had a car. You've gotten around by scooter- Yeah ... you've gotten around by [00:50:35] bus, or maybe you got by a car but it just wasn't reliable, it kept breaking down on you. Mm. That is [00:50:40] you getting through life- Mm-hmm ... without treating the disease of obesity.
Dr. Monique Hassan: [:April Williams: And what I think all three of us are hoping you leave this conversation with is, hey, [00:50:50] you, you, you are looking for a new car.
Dr. Monique Hassan: Yeah.
ms: And you have gone to the [:Dr. Monique Hassan: Mm-hmm.
u, you made a purchase, may- [:to see if, if it's working. Mm-hmm. I feel like [00:51:10] we've all done that with diet and exercise.
Dr. Monique Hassan: Mm-hmm.
be we've done that by really [:I, I just need a car. [00:51:25] I need to get going down the road."
Dr. Monique Hassan: Right.
here to say congratula- good [:[00:51:45] We- Yeah ... we know the shame and the blame and all that stuff that you, that you just said, "You know what? I'm not gonna listen to any of this [00:51:50] noise anymore. I'm just gonna do this." Awesome. Yeah. That, that, that [00:51:55] deserves a moment of its own 'cause you, you did what you needed to do. Maybe now you're like, [00:52:00] "You know what?
m ready for a reliable car." [:But now [00:52:20] you know what it's gonna take to not only own that Ferrari, but maintain that Ferrari.
Dr. Monique Hassan: [:April Williams: And maybe you have that conversation and you're like, "Ooh, I don't have the budget, I don't have the time, I don't have the garage space, I [00:52:30] don't, I don't have the abilities that Jasmine does to, to polish that paint so that it shines."
[:[00:52:55] Yeah. And that car is gonna get filled with people and memories and [00:53:00] things and different maintenance, and that's what I feel like those pillars are, right? Yeah. My [00:53:05] car was a VSG and, and I, and I've gotten a little upgrade because I've onboarded a [00:53:10] GLP-1 medication as well. Yeah. But you know what also makes my car go?
The gas that I put into [:Dr. Monique Hassan: Yeah. Absolutely. Okay. And, and that's the [00:53:40] thing. There's no shame. Remember, this is a prolonged journey, right? So [00:53:45] today you could be in your VSG car, right? And next week, next [00:53:50] month, next year, three years, 10 years from now, right, you need a upgrade, right? [00:53:55] So all of these things... And that's why I love this car analogy when I talk to patients, even if, [00:54:00] even if they know nothing about cars, they seem to still understand, you know?[00:54:05]
"No." I'm like, "Okay. Well, [:you know, we could, we could change the analogy, you [00:54:25] know, from a regular two-cycle bike to a, a, you know, a Harley. [00:54:30] Um, you know, it's all of those things. Um, and so you gotta, you gotta have some mode of [00:54:35] transportation through this, this thing that we call life, and navigating this disease called [00:54:40] obesity, so.
April Williams: I love it.
Jasmine, I can see you [:Jasmine Fernandez: I've had many cars in my life, [00:54:50] let's just leave it at that. Old, new, c- just, just gas, [00:54:55] electric-
April Williams: Mm-hmm.
rum brakes, disc brakes, you [:April Williams: Yeah. You've probably had it. But it, but to see you [00:55:05] driving the car that you're driving now, right?
ust your life and how you're [:Jasmine Fernandez: Thank you. 'Cause it... Yeah. There's so many barriers in my life. [00:55:25] Mom, working a full-time job, managing, uh, a spouse, uh, [00:55:30] managing a house with a grandma.
rks agin me- against me, but [:April Williams: And that, oh, talk about [00:55:45] powerful. A- and your life has not suffered because you have put yourself [00:55:50] at a different priority. Your, your life from what I can see, right, has, has grown [00:55:55] and expanded.
nser, but you've also become [:And, and [00:56:15] I'm just gonna leave it at that. It's gonna be uncomfortable, but I, I'm not going to put myself [00:56:20] in, in a position where my car's gonna break down and then I'm, and then I'm out of, out of transportation." You're, you're not doing [00:56:25] that anymore. You're not doing that anymore. No. No. All right. [00:56:30] S- second to the last question, and this is for both of you.
Uh, can we give our, our [:Dr. Monique Hassan: Yeah. I think [00:56:50] that, one, um, you know, obviously on your site, obviously you [00:56:55] have links to or ways to find f- providers, right? Mm-hmm. And I think [00:57:00] that any of the providers that probably are gonna be associated with BariNation probably will have [00:57:05] most of this kind of holistic approach, right? So I think that that's probably the first place to start.[00:57:10]
of the reasons I'm on social [:And, and I [00:57:35] do think it's like speed dating, right? So you show up and, [00:57:40] you know, number one, what, what do you have in terms of treatment [00:57:45] options in your office? I personally would [00:57:50] want to go to a place that has comprehensive care, right? Yeah. And that means what, [00:57:55] for, for all of you that are listening, what that means is that they have some [00:58:00] aspect of medical treatment, right, and surgical treatment.
And so... And [:And so you want [00:58:30] somebody who is going to be thinking about what your goals are and [00:58:35] how best to fit what decisions we come up with at one point and how [00:58:40] that's gonna affect you for the rest of your life, right? So, um, so that's, I think, one of the [00:58:45] most important questions is what, what treatment options do you have?
And then secondly, [:And what that means is [00:59:15] that are they a quality metric? Do they look at their metrics, and are they a quality metric [00:59:20] program? So those are some of the things that I would start asking. Tell me about your quality. Are you looking [00:59:25] at ... You know, 'cause people, people ask me all the time, which I, I don't mind that they [00:59:30] ask me this, but they ask me about my complication rate.
t's super important. I mean, [:Jasmine Fernandez: Mm-hmm.
nique Hassan: But it doesn't [:I [00:59:55] think it really has to do with how the surgeon or how the program [01:00:00] deals with the complication, right? Is the surgeon there all the time? Is, you know ... Are [01:00:05] there multiple partners within the program? I think tho- those are important because, you [01:00:10] know, I can't always be at the hospital 24/7, but if I do have a complication, [01:00:15] are there gonna be people that are gonna be around to help you, and then am [01:00:20] I, as the surgeon, committed to you and your process in getting you through this on your journey?[01:00:25]
So, um, so yeah.
hat I'm gonna do, as soon as [:So Jasmine, for her-
I'm sorry. I have no notes, [:Mm-hmm. And that's all I have to [01:01:10] add. Thank you.
April Williams: Oh,
o, I just saw this on social [:And so one of the biggest things is women [01:01:30] empowering, right? Look at this. This is girl power right here, right? And so [01:01:35] if you think about ... I saw this and I thought about it and I'm like, "Oh my gosh, yes." So [01:01:40] if you have that inner critic that's always super negative, right, [01:01:45] and if you labeled your inner critic as a man- [01:01:50] Like, are you gonna let a man tell you what to do with your body?[01:01:55]
say, "Bob, get out of here. [:you've labeled your inner critic as a man, then you're like, "Well, [01:02:25] no. No, Paul, you don't know what's going on in my body," right? "You [01:02:30] don't know what periods are like, and you don't know what it's like to live in this body [01:02:35] post-menopausal or, or at this weight or whatever it is," right? Then it [01:02:40] helps you to just dismiss that inner critic so, so harsh.
Um, [:April Williams: I literally am... I, [01:02:55] I'm shooketh in the best possible way because I can name out the names of [01:03:00] people, both men and women, in my life who have- Yeah ... criticized, who told me I couldn't, who [01:03:05] did all that. And I, I, I have a very, uh, active fighter that, that lives in [01:03:10] me.
she's a fighter. And ooh, I, [:Dr. Monique Hassan: Right. If you name [01:03:25] it- Oof ... then it like, yeah, it's like, "Get out of here." Yeah, so yeah. [01:03:30] All right.
April Williams: Isn't that great?
of a, of a better way to end [:Dr. Monique Hassan: Mm-hmm. "
April Williams: I have made [:I'm gonna pick my car, and I'm gonna learn to drive it, [01:03:55] and I am not gonna stop driving because that's- Mm-hmm ... what is required of me."
Dr. Monique Hassan: Yeah. [:April Williams: Oh my goodness. This episode, this episode has just filled my [01:04:05] soul with so much, like, happiness and hope and joy. Thank you both for, for [01:04:10] coming on and having this conversation.
n judge a book by its cover, [:And we can find [01:04:35] you in, i- in this, this holistic treatment that we need. And we, we can bring you on, [01:04:40] on our team to help fight with us. So thank you, Dr. Hassan.
san: Absolutely. Absolutely. [:April Williams: Jasmine, you have added so much rich, [01:04:50] richness and depth to this conversation. Thank you for being such a wonderful advocate for [01:04:55] not only the community and BariNation, but for yourself.
your story is helping other [:Jasmine Fernandez: Thank you, April. Uh- Thank you, Dr. Hassan.
Yeah. Friends, we, we... I, [:My ask for you today, if this conversation resonated [01:05:20] with you, will you let us know by leaving a comment on whatever platform you are watching and listening? [01:05:25] And if you don't feel comfortable leaving a public comment, we get that. Send us an email to [01:05:30] [email protected]. We are a 501[c]3 nonprofit, and your feedback [01:05:35] helps me go out and ask for the funds to support this show, [01:05:40] and your comment helps us do that.
onated, please donate to the [:We deeply appreciate it. And friends, we will [01:06:00] see you in the nation soon. Bye, guys. Bye. Bye. [01:06:05]
Dr. Monique Hassan: If this episode helped you, help us make the next one. Become a donor
April Williams: at [:Your $5 monthly [01:06:20] gift is all it takes to amplify patient stories and spread hope to people fighting the disease of [01:06:25] obesity. One final thank you to our donors, Johnson & Johnson [01:06:30] and Dr. Joe Cribbins of the Texas Center for Bariatrics and Advanced Surgery, who make this [01:06:35] show possible. We are deeply grateful for you.
rney: Thanks for joining us. [:Jason Smith: Our mission is to advance metabolic wellness for those living with the disease of [01:06:50] obesity by bringing you evidence-based education, stigma-free support, and meaningful [01:06:55] connections in the exact moments that shape your daily life.
eminder that the information [: