What makes AdventHealth's approach to bariatric care different, and how are they setting patients up for long-term success?

In this special episode, BariNation is hitting the road and recording in a professional broadcast studio! Join hosts Jason, Natalie and Sarah as they sit down for this special episode, recorded live at AdventHealth in Central Florida. They’re joined by two expert guests, Dr. Melissa Bagloo and Dr. Shiva Seetahal, to dive deep into the bariatric patient process and the holistic approach AdventHealth takes to support long-term success. This conversation covers everything from qualifications for surgery to the latest advancements in metabolic care. Plus, hear about the exclusive $29/month membership to the BariNation community for patients of the AdventHealth system. Get ready for an insightful and game-changing discussion on the future of obesity treatment and what it means for bariatric patients everywhere!

IN THIS EPISODE:

• (00:00) Opening and introduction
• (02:00) Qualifications for bariatric surgery and how does it work
• (09:25) AdventHealth provides various surgeries and how they support their patients
• (15:52) What co-morbidities does bariatric surgery treat, and when should you consider anti-obesity medication
• (21:51) Discussion of adolescent surgery, treating the whole person, the science behind bariatric surgery and the metabolic effects
• (29:13) Knowing what surgery is right for you, the AdventHealth difference, medications and patient support
• (39:46) What predictions are there for the future of obesity treatment 

KEY TAKEAWAYS:

• The qualifications for bariatric surgery have broadened, allowing more patients to access life-changing treatment. Previously, candidates needed a BMI of 40 or a BMI of 35 with medical conditions. Now, individuals with a BMI of 35 (without medical issues) or a BMI of 30 (with medical conditions) may qualify. This expansion reflects growing recognition of bariatric surgery’s benefits, including diabetes resolution, improved fertility, and reduced cancer risks.
• AdventHealth in Central Florida emphasizes a holistic, team-based approach to bariatric care. Bariatric providers communicate closely with primary care doctors, endocrinologists, and cardiologists to ensure continuity of care before and after surgery. This integrated model helps patients receive comprehensive support for long-term success.
• Bariatric surgery is not just about reducing stomach size and is not a one-time fix, but fundamentally alters hormone regulation and metabolism. This shift is why many in the field now refer to it as “metabolic surgery” rather than simply "weight loss surgery," helping to combat the stigma and highlight its role in treating obesity-related diseases..

RESOURCES:

• Check out this exclusive AdventHealth BariNation Monthly Membership for only $29/mo! 
• BariNation Website 
• Join the BariNation Membership community meetups to support you on your journey with obesity treatment. https://barination.com/pages/join-our-community
• Want to see bonus content? Head over to https://www.patreon.com/BariNationPodcast to get more and support the podcast for as low as $5 per month!    

GUEST RESOURCES:

Melissa Bagloo, MD - AdventHealth Website

Shiva Seetahal, MD - AdventHealth Website

BIOGRAPHIES: 

Dr. Melissa Bagloo is a board-certified bariatric and general surgeon and a Fellow of the American College of Surgeons and the American Society of Metabolic and Bariatric Surgery. A Florida native, she trained in the Northeast before joining AdventHealth. She earned her medical degree from the University of Florida. She completed her general surgery residency at NYU, followed by a minimally invasive and bariatric surgery fellowship at Weill Cornell and Columbia. Specializing in advanced laparoscopic and robotic surgery, Dr. Bagloo has performed over 500 robotic and thousands of minimally invasive procedures. She is dedicated to whole-patient care, helping patients achieve lasting weight loss with minimal recovery time.

Dr. Shiva Seetahal is a board-certified surgeon specializing in minimally invasive and laparoscopic procedures, strongly focusing on patient care and satisfaction. He earned his medical degree with honors from the University of the West Indies, completed his surgical residency at Howard University Hospital, and pursued a Minimally Invasive and Bariatric Surgery fellowship at Atlanta Medical Center. He has been actively involved in research, has published numerous works, and has served on editorial boards for surgical journals. Dr. Seetahal is also a member of the American Society for Metabolic and Bariatric Surgery (ASMBS).

ABOUT:

If the BariNation podcast helps power your bariatric journey, become a monthly podcast supporter and help us produce the show! Visit www.barinationpodcast.com and help us support people treating the disease of obesity with humor, humility, and honesty.

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April Williams: You've just tuned into a podcast that welcomes you into a community, a resource center, and a safe place that powers your [00:00:15] journey towards personal wellness.

Natalie Tierney: Our goal is you leave us today feeling hopeful, inspired, and ready to live your best bariatric life.

Jason and Sarah sat down with Dr. Baglue and Dr. Sedahal to better understand the bariatric patient process, who qualifies for surgery, and why is it the most effective treatment for [00:01:00] the disease of obesity. They were also able to tour the Celebration and Orlando campuses to see how Advent Health Central Florida helps the human spirit thrive.

Click the link in the description of this episode to learn more about this amazing opportunity. Let's dive in to this very special episode.

Natalie Tierney: Thank you so much for joining us. Thank you for having me. This is great. Yeah, this is wonderful. So I'm gonna dive right in. Sure. Who qualifies for [00:02:00] bariatric surgery? Well, so

That our societies have endorsed. Now a BMI of 35 without [00:02:30] medical problems and a BMI of 30 with medical problems. Um, so this is kind of the new, uh, criteria that, that we have adopted and we're able to help more people and reach more patients. So this is, this is very exciting news for [00:02:45] us.

Natalie Tierney: So we're learning a lot about the AdventHealth whole person approach to overall wellness.

Dr. Melissa Bagloo: that's a very important part of how we take care of patients. Um, you know, when you first meet your bariatric surgeon, we're just getting a tiny glimpse into your history. Whereas your primary care provider or your [00:03:15] endocrinologist or your cardiologist knows Much more about you than we do.

Um, they all have my cell phone so that they can reach out at any point, right? So it doesn't matter if I'm [00:03:45] on vacation or. If I'm in the OR, you're always going to be able to get a hold of me. And, and I think that interaction is, is really key to being able to take care of patients.

Sarah Smith: Absolutely.

Natalie Tierney: I love it.

Dr. Melissa Bagloo: So the beauty of bariatric surgery is that we're still learning about it, right? And so the concept that you're just eating less and that's why you're losing the [00:04:15] weight. Well, I think we've proven that to be inaccurate, right?

Um, and so it has a lot more to do with just, you know, eating less that that's just a small portion of this. The gut hormone [00:04:45] change, that chemical milieu that changes in the body, I think that is the key component of, of what the operations can offer.

Right. And, and I think we're in 2025, we're learning all of this about bariatric health and medicine. Why do you think that diet and exercise [00:05:15] are still kind of pushed on on folks with obesity?

Dr. Melissa Bagloo: Yeah. So, you know, that's kind of the stigma that's always been out there, right? And, and as you know, in every part of life, change is hard, right?

information that's out there, right? And so if you're not someone that is heavily involved, even as a provider, right, um, you may not know the benefits of, of what we do from [00:06:00] a surgical perspective. And that's one of the things that I think it's important. As physicians to try to tell our colleagues, but even as patients, right?

Jason Smith: Yeah. It's, it's been one of the things that's [00:06:45] been near and dear to our hearts since we, you know, since we've been post op and for Natalie, that's a long time. Yes. And it, it just is something that we, we, it's so heartbreaking to hear the stories of people that, you know, I, I myself waited five years before I even had the surgery, knowing that I [00:07:00] needed to, but pushed it off, pushed it off.

And, you know, then you start the whole spiral and all those things. It's great to finally have. a voice to talk about that and speak out and get people, more people to understand and on board with that. [00:07:30]

Dr. Melissa Bagloo: I mean, I, I love that about Berry Nation because I think, you know, it has to be kind of like, look, look what we can do.

Um, and, and it's [00:08:00] been around long enough now that people can't really argue that, right? That, oh, this doesn't work. And, and I don't know how many times I've heard that from just general people talking about it when they find out that I'm a bariatric surgeon. And it's hard for me to hold myself [00:08:15] back and be like, no, it does.

It really does work, right?

Like, and, and now you don't, I don't know. Anyone that doesn't know at least someone that's had the surgery, been successful, things are working. So, all of that narrative shift is [00:08:45] making a huge difference and that's why I think it's, it's really starting to, the axis is starting to shift and I love that.

And so now they're saying, yeah, I did it and look at me now, right? And that's something that should be [00:09:15] celebrated and people should be proud that they've done this.

Jason Smith: Absolutely. Absolutely. So with that being said, what types of bariatric surgery are performed at AdventHealth?

Um, I think that's an important kind of point of what we do is that we can match what you need with you rather than just saying, I do sleeves, right? Or I do [00:09:45] bypasses. Um, and, and having, you know, the, the ancillary support and the colleagues that are vested in this, it just really creates that connection.

Jason Smith: Well that's one of the glaring, like the glaring things to me about Advent Health and how amazing the program overall is.

You guys have all this intermingling, you know, conversations. And so. It's impossible for somebody to not feel like they're the, you know, the most taken [00:10:45] care of in the Advent Health System, because it's important for us to know, like, that, that, because the worst thing for someone is having to deal with this anyway, is to get the courage up to do this, to have somebody tell, Oh, well, now you got to do something else.

Like now we're like, [00:11:15] well, how much care can you possibly give me if you're not even listening to what I take the first time? Yeah. That is not the impression that we got when we were in the campus or any of the Advent health professionals that we've spoken to. You all take extreme care and caution to make sure that everyone feels supported and listened to.

Dr. Melissa Bagloo: Yeah, I mean, that's a, that's a big part of this, right? And, and I tell all the patients, you know, it's a privilege to be able to be your surgeon, right? You, you get to choose your surgeon, right? And, and for a patient to choose me, then that [00:11:45] means that I have to do right by you, right?

If you're trying to get pregnant and you can't, right? So what can I do to make sure that I help you achieve the life goals [00:12:15] that you're trying to do, right? Which is different than any other kind of surgical practice, um, because it, it, it kind of brings in the overall health of the patient. Whereas, for example, if you're fixing a hernia, well, there's a lot of important parts to that that you have to consider, [00:12:30] but your life goals aren't really going to be a conversation that you have with that surgeon, right?

Right.

Dr. Melissa Bagloo: We're really dedicated to our patients. Um, you know, I, I am the newest member of our group and I have been very impressed. with seeing how my colleagues have taken care of patients and continue to do so.

this from a whole you perspective, um, I don't think you find that easily. So it's not just that you have one surgeon who's rallying for you. You have an [00:13:30] institution, you know, that's behind you. Um, and that speaks volumes.

Jason Smith: I think one of the things we found that makes AdventHealth different from other programs, uh, in touring the facility, we found that it wasn't.

Like, I would rather [00:14:00] be asleep before the clinical stuff happens. Like, I don't want to see this terrible stuff. You can keep that for behind the scenes. And that's exactly what we found when we were there. And I thought that was amazing. Um, so would you, how would you sum up the Advent Health difference?

So if we can make it more personal to you. If we can [00:14:45] make it so that you feel that we're invested, that, that there is warmth and compassion genuinely right behind all of this, right? Then I can help alleviate a little bit of that anxiety that's there. You know, I always joke with my patients and I say, when you see me looking [00:15:00] nervous.

And that's our goal. That's our goal, to make it so that it's not you're coming in for a procedure, but you're coming in to change your life. [00:15:30] And this is just one small step in that process.

Jason Smith: Yeah, I always tell people that, uh, I don't know anybody that wasn't nervous going into it, but I don't know one person that regrets it after.

Dr. Melissa Bagloo: So the one that I always go to is my first is diabetes, right because it's such a big health concern, and it's so [00:16:00] difficult to treat, right?

And then also a coronary artery disease, high blood pressure, high cholesterol, infertility, um, as a woman, [00:16:30] right? Infertility, it's kind of high on my list of things to try to want to help other people with that want to have families, right? So that that's something I think is great because you have healthier pregnancies for both mom and baby, right?

Natalie Tierney: about. I think that's so what. Great that you emphasized that bariatric surgery can almost instantly help reverse these things. Um, I [00:17:00] struggle with insulin resistance. I had the black markings on my neck and I had read that this.

to know that that's, that's a real, that's a real effect of the surgery is very comforting.

And it's not just one step, right? And so, it's a continuous treatment

Natalie Tierney: algorithm.

Dr. Melissa Bagloo: You can introduce medications at any point, right? And you have to think about what's right for you.

Right? Um, I also have patients that have had surgery, and in their journey, they've lost weight, but maybe they're struggling. Right. Maybe the disease of obesity, which, you know, is still present, right, is, is still [00:19:00] progressing, despite the fact that you had surgery. So let's add an adjunct. Let's put medication in there too.

Um, I don't think there's any one time [00:19:30] point that you can say, this is the time that you do this or this it's like anything else in life, it's, it's every individual has to think about things on a personal level and see where they're at on their journey and what is most likely to help them [00:19:45] at that time point.

Dr. Melissa Bagloo: Yeah, absolutely. And you may not want to implement it on day one because the surgery is doing that. But then, now I know as [00:20:15] your surgeon, okay, so your, your, your goal is to get as much weight loss as possible. I can kind of assume that if we're talking about that medication at that time. And obviously I would verify that, right?

And so just keep that there and then reevaluate because we change how we feel, you know.

Sarah Smith: Absolutely. So how do you support your patients

Um, so It's not always easy for me to be the first point of contact because I am in the operating room, I am running between various [00:21:15] hospitals, seeing patients, um, but all you have to do is tell my team that I need to talk to Dr. Bagloo and within 24 48 hours I will get back to you, right? Um, whether it's a question that you forgot to ask me during the consult, something that has changed that you [00:21:30] want to talk to me about, or maybe you just want a follow up appointment with me because you haven't seen me in a while, right?

Natalie Tierney: So, Dr. Sita Hall, uh, who qualifies for bariatric surgery?

Dr. Shiva Seehatal: So, traditionally, bariatric surgery has been offered to adults, but that paradigm has changed as the obesity epidemic has started to expand and affect our kids.

Natalie Tierney: That's wonderful. I, I was a pediatric patient and that's so near and dear to my heart.

Dr. Shiva Seehatal: Absolutely. That's a great question. The the paradigm has shifted. It's no longer just weight loss [00:22:45] surgery like it was 20 years ago.

All right. And we've come into the new era where we were treating the whole person. So you do have, um, cooperation [00:23:15] between internists, endocrinologists, surgeons, mental health specialists, physical therapists, you name it, whatever is required to treat the whole person. That's what we aim for. Well, and that's a good

Patients just want to get from one to the other, and it's very hard for them to do those things when they have extra appointments, or one appointment doesn't line up with another appointment, then that sets them back some, because I, you know, there are different [00:23:45] times in my, you know, my process where I was, it's the same way, so.

So you guys streamlining the process just makes it that much better.

Natalie Tierney: Absolutely. So how and why does bariatric surgery work?

What's the, can you give us a little insight on the, the, the science and mechanics behind it?

If 70 percent of the population is overweight, there's no way 70 percent of Americans are, are, Indisciplined.

Natalie Tierney: Yeah.

In a more effective way. [00:25:15] Now where the surgery comes in is it affects the hormone producing cells in the gut, um, which a lot of them come from the stomach and the small intestine, which are affected when we do sleeves and bypasses and Saudis and so [00:25:30] on. The hormones that are produced affect our metabolism.

Sarah Smith: That's [00:26:00] amazing.

Dr. Shiva Seehatal: Yeah, it's, it's, it's interesting when you take a deep dive, you can get really deep into it.

Veering towards that path of calling it metabolic surgery as a patient to realize, Oh, this is just a wonderful side effect [00:26:30] and not the main reason. I think that has been really meaningful for me.

Dr. Shiva Seehatal: That's a great point because there's so much stigma as well involved in calling it weight loss surgery, and it's not accurate.

Natalie Tierney: We're learning, right, the importance of metabolic health. Why is diet and exercise still? It feels like [00:27:15] it's being pushed on us still to this day. It's 2025. But, uh, why do you think that that is? Is that the stigma? What's your take on it?

Dr. Shiva Seehatal: Well, I, there's two, two analogies I like to use when we talk about diet and exercise.

You're not, you're not going to have. That, uh, the other is a sports analogy, which appeals to some folks. You, you know, if you want to play basketball, you want to play golf. You have to get the fundamentals down your [00:28:00] swing, um, ball handling. If you don't have that, you can't do the fancy stuff. So diet and exercise are, we're moving away from, uh, this misconception that that's the only thing that's required.

So we're trying to put it in that context.

Natalie Tierney: Makes total sense. It's kind of like the training wheels, right?

Dr. Shiva Seehatal: Yeah. You're giving me a third analogy. Yeah.

They're all tools that we can acquire to, to carry on and have that [00:29:00] lifelong success.

Jason Smith: Absolutely. So, um, how do people know what surgery is right,

Dr. Shiva Seehatal: is the right fit for them? So that's a great question. And that's honestly, it's, that's not a, uh, uh, easy choice. It takes a lot of things into consideration.

You have to look at your personal health, how, what your weight loss goals are, how you got there. What's your time period is for wanting to lose the weight and other factors on that, you [00:29:45] know, that that keys into what would be the best pathway forward for you.

Jason Smith: Gotcha. So you would say that's what people need to consider when they're deciding what surgery is best for them.

Dr. Shiva Seehatal: Yeah. So I've been a part of AdventHealth for over five years now. Proud, proud member of AdventHealth and um, first and foremost, I would say as a faith based organization, they really [00:30:15] do go beyond, they care about the patient and uh, A lot of places would say that and you, you hear it a lot, but I've, I've lived it and I've, I've been blessed to be a part of it.

We maintain [00:31:00] that, that quality and. Thanks. You know, it's just, it's just a pleasant experience when you walk in through that front door, we try to make it that way because we understand that, you know, it's, it's difficult as a patient, one to make the decision and then through to have to follow [00:31:15] through, through all the steps that are, you know, inevitable.

Uh, so we try to make that process as easy, um, as effective and at the end of the day as fulfilling. Uh, as we possibly can.

Correct. Yeah. So that's one of the biggest things I try to explain to people is just [00:31:45] letting them know like when you're looking, this is something that's extremely important because it speaks not only to the, to the care that you're going to get pre op, but also post op and the follow up and those types of things.

Dr. Shiva Seehatal: Well, all our facilities are accredited or center of excellence. Um, we maintain that and it's very, very stringent. It's, you know, um, not just the hospital, but the providers, uh, all the staff involved are trained and maintain that, that [00:32:15] standard of care.

So, we, we stand by that, and that makes a huge difference. We report our outcomes, we keep up to date on the latest, uh, data and science, uh, as well as technologies.

Dr. Shiva Seehatal: So that's a great question.

So we've seen patients come off of insulin, get down to pills, or have their diabetes [00:33:00] cured completely. Let go of their CPAP machines within the first month after surgery off of their high blood pressure medication, not just a matter of coming off the meds, but those things can cause numerous side effects down the road with kidney disease, eye disease, heart disease.

And there are also several types of cancers that have been associated with, um, obesity that are improved. Things like breast [00:33:45] cancer and colon cancer.

Sarah Smith: Wow. So it's not just improving. Someone's quality of life. I mean, this procedure can really extend somebody's life.

It helps you to regain that that agency

Dr. Shiva Seehatal: Yeah, that's a great question. So we're seeing a lot of that now, uh, with the recent, um, popularity of these [00:34:30] medications and they are absolutely are effective and they play a huge role in the overall path.

[00:35:00] These are all factors we would have to consider in choosing the best the best treatment plan.

Sarah Smith: And the anti obesity medication cannot be used as an adjunct treatment like. Post Bariatric surgery?

Once you have a tool, there's no reason to say, I'm only going to use this one. Use each one when [00:35:30] appropriate to get the desired response or effect. So we, we try to integrate everything that's available and that was shown to be effective and safe into a complete health package. Tailored to each individual who, who we treat.

Jason Smith: Yeah. Well, and it's hard because a lot of people feel like, you know, it should be a one shot done. Right. And it's very hard to get out of that mindset because we think that, you know, as, as you know. Obese patients like we think that it like is, Oh, this is [00:36:00] our only shot.

Like we're going to do this. It's going to be great. And this is just going to fix all the things.

Natalie Tierney: Yeah.

Natalie Tierney: Yeah.

Jason Smith: So it's good to have these conversations come out and be at the forefront because it really makes a difference in people's lives.

Sarah Smith: So how do you support your patients through this process?

Dr. Shiva Seehatal: So we begin by having a face to face.

Then we, we kind of, [00:37:00] uh, discuss a plan forward. Um, you know, have a contingency plan as well. So, okay, let's, let's aim for this. If not, let's do this. And it's always an algorithm, but I think it starts with having that Personal [00:37:15] interaction. So you can get to know each other. So not just me getting to know them.

So they're getting to know me so they can trust that I have their best interest at heart.

Dr. Shiva Seehatal: I appreciate that. We've come to realize that too. And as you said, we're, we're bonded for life. Once we, once we establish. Um, not that scares some people off sometimes, maybe, but I tell them even after surgery, [00:38:00] I like to tell my patients surgery is not the point of this whole thing. Surgery is the point is to get you healthy and keep you healthy and keep you happy and where you want to be.

If you get into that mindset, then it's easier and you get away from thinking it's just a one stop. And if it doesn't work, then I failed or, you know, something went wrong and I have no other recourse. It's very, very rare that it's a one shot for anybody. That's usually [00:38:45] the crazy exception, more than the rule.

I don't need any further communication unless I do another follow up. At my. Two year mark or whatever, and really getting people comfortable with understanding that this is a constant [00:39:15] communication situation. Anytime you have questions, anytime you need anything, you know, people should be able to reach out to their teams.

So I really appreciate what you guys are doing with that.

Dr. Melissa Bagloo: that criteria expansion, right? So I think that is very exciting that it's already started. And thankfully we're starting to see some insurance [00:40:00] companies kind of expand what they're willing to include in their coverages.

So same thing, expansion of criteria. Um, because I think that You know, obesity [00:40:30] is, is seen now as the epidemic that it has been, um, but that the conversation is evolving. And, and that's going to allow us to be able to do that multi modal kind of approach to it. I know with our whole U [00:40:45] experience, we are trying to create a center where you could go to and have all of the various parts of obesity management.

Natalie Tierney: Yeah,

Right. I love that AdventHealth is, is really considering what it's like for us as patients and really trying to create an environment that is convenient as well as, you know, comforting and supportive. Yes, yes.

Like we have the surgery and that's all we can do. There's nothing else left. You know, like even as to the point of revisional, like revisional even has, you know, is, is finally now the stigma is starting [00:41:45] to lift a little bit on that. Right. And it's, it's good to see that it's being supported by Advent Health in that way.

So,

Dr. Shiva Seehatal: It's exciting to think about where we're going to be because, um, Uh, for me, this journey towards being a bariatric surgeon has, has been almost 20 years. It's something I was, since medical school, I always thought. So to see the landscape change over [00:42:30] that time has been incredible. Uh, I never thought we would be here in my lifetime where we have all these facilities available, all these things.

What about that aspect of it? What about. The, the pharmaceuticals, the access to the healthy food, telling people to eat healthy is great, but that's like telling them to lose weight and come back. It's [00:43:15] ineffective. How can we facilitate that partner in the community with providers that can get you access to, to, to, uh, Proper foods, get away from the food deserts, partner with, um, providers [00:43:30] who can, uh, offer exercise options for people of all, you know, the whole spectrum from, uh, the very athletic to those with possibly disabilities and everything in between.

Natalie Tierney: Absolutely. I know for myself, I I've been thinking a lot about the patient experience with with very nation. How can we support the patients? And I'm [00:44:15] seeing as we're we're speaking more with providers such as yourself, we're seeing it start to shift to be it. patient centric. I think that is where I would love to see more.

Sarah Smith: I think for me, um, what I [00:44:45] would love to see, well, I, I liked. That you're, you know, you've talked about whole person care throughout, uh, this whole conversation.

Dr. Shiva Seehatal: I

And you come to find out like they had, there was a host of things that could have been, you know, that could have been. Diagnosed and fixed without the way, [00:45:45] like the way less, of course, you know, exacerbates those things, but we are more than just a diagnosis of obesity. And the fact that, you know, everything is becoming more patient centric is just amazing to me.

Natalie Tierney: Yeah,

Jason Smith: that would be wonderful. Yeah.

Natalie Tierney: We would love that. Well, thank you so much, Dr. C. DeHaul for your time, your expertise. We really appreciated it.

And I know our listeners will too.

April Williams: That wraps up another empowering episode of the Berry Nation podcast. If you enjoyed today's episode, keep the conversation going by joining the Berry Nation membership community, [00:46:30] where you can attend live support events, access on demand resources, and find a caring community.

Natalie Tierney: Join us at berrynation. com.

Jason Smith: And just remember at the end of the day, you've got this, we've got you, and we'll see you next time. Bye [00:47:00] everybody.