Shownotes
Weight recurrence after bariatric surgery or GLP-1 treatment isn't a personal failure, it's often a natural part of treating the chronic disease of obesity. In this episode of the BariNation Foundation Podcast, April welcomes bariatric surgeon and obesity medicine specialist Dr. Saniea Majid to discuss her groundbreaking research on weight recurrence, why the medical community is moving away from the term "weight regain," and how ongoing, individualized care can improve long-term outcomes. Together, they explore the importance of eliminating shame, redefining success beyond the number on the scale, staying connected with your clinical care team, and empowering patients with practical strategies to navigate obesity treatment for life.
What You Will Learn in this Episode:
✅ Why weight recurrence after bariatric surgery is expected and why the word "failure" needs to be stricken from the conversation
✅ The three categories of response (partial, non, and clinically significant) and why each needs its own plan
✅ How consistent follow-up care and multidisciplinary care help prevent or reverse recurrence
✅ Practical ways to shift from shame to action while protecting metabolic wellness
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 is provided by the 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 Dr. Saniea Majid discusses weight recurrence after treatment and her research regarding standardizing terminology and data sets
04:42 Why patients avoid follow-up care after bariatric surgery
10:01 The wide range of reported weight recurrence after bariatric surgery rates
15:18 Health benefits that remain even with weight recurrence
24:19 The importance of follow-up care
29:15 Why the word failure is banned in modern obesity care
34:44 Recommended definitions for partial response and non-response
45:08 Advice for a listener stuck at limited weight loss two years later
50:32 Dr. Majid answers rapid fire questions related to obesity
01:00:57 Final thoughts on seeking the right team for lifelong care
KEY TAKEAWAYS:
💎 Weight recurrence signals the chronic nature of obesity and calls for more treatment, not self-blame
💎 Regular follow-up care with the right multidisciplinary team is the strongest tool against progression
💎 Revisional surgery and GLP-1 medications are part of continuum care, not last resorts
💎 Patients retain meaningful health gains even when some weight returns
ABOUT THE GUEST:
Dr. Saniea Majid is a board-certified bariatric surgeon and obesity medicine specialist, founder and Medical Director of the Weight Loss and Wellness Center in northern New Jersey. She has built multiple accredited metabolic and bariatric programs and was the first surgeon in the state to perform the SPATZ adjustable gastric balloon and endoscopic sleeve gastroplasty.
A national leader in the field, she just completed a 2 year term of the ASMBS Foundation TREO (Treatment, Research and Education to End Obesity), sits on the ASMBS Board of Directors, and is committed to comprehensive, compassionate care for patients of all ages, including adolescents.
Meet Dr. Majid – Award-Winning Weight Loss Doctor NJ | WLWC
RESOURCES MENTIONED:
BariNation Community - $19 a month
BariNation - Email
BariNation’s How to Find an Obesity Specialist Guide
Sign up for BariNation’s Newsletters
BariNation, Bariatric Surgery, NSVS, GLP-1, VSG, Vertical Sleeve Gastrectomy, Lapband, Roux-en-Y, Gastric Bypass, Sadi-S, Weight Regain After Bariatric Surgery, Weight Recurrence, Bariatric Surgery, Obesity Treatment, Metabolic Wellness, Follow Up Care, Chronic Disease, Multidisciplinary Care, Bariatric support, Bariatric patient education, Clinically Significant Weight Recurrence, Revisional Surgery, GLP 1 Medications, ASMBS, Shame And Blame, Weight Fluctuations, Surgical Success, Long-term weight loss maintenance
Transcripts
Jason Smith: Where we fight obesity by living our pillars: movement, mindset, metabolic wellness, [00:00:10] and community.
Speaker 13: Four pillars, one mission. We're so glad you're here
to you in part by Johnson & [:Thank you, J&J, for your support.
Hi, friends.
, [:Majid, a bariatric surgeon [00:00:50] who just published groundbreaking research on weight regain. And here's the kicker, she reviewed 119 medical studies and almost half of them never even defined what regain means. [00:01:00] The reported rates range from 9 to 91%. 91%. No wonder we're all feeling confused and alone. By the end of this conversation, you'll stop calling it [00:01:10] regain, you'll know why it happens naturally for all humans, not just you, you'll know exactly when a few pounds actually matter, and you'll have a plan you can start with today.
She also tells us [:or listening, come right back here and tell us what your biggest takeaway was, uh, 'cause we read each and every one.
All right, friends, [:Hi, friends. Welcome back to the BariNation podcast. Today's episode will hopefully change your life. If you are treating the disease of obesity, [00:01:50] either surgical or medications or a combination of them, weight recurrence, or what you're probably calling regain, is not only common, but to [00:02:00] be expected.
highlighted like I'm back in [:Majid, before we dive in, will you please introduce yourself to the people watching and listening?
again, very grateful for the [:to address. So I'm really grateful that you've, you know, given this priority. My name is Sanaya Majid. I'm a bariatric surgeon, obesity medicine specialist. [00:02:50] Um, I've had the, uh, privilege to start three separate bariatric and medi- metabolic programs. The latest one is Weight Loss and Wellness Center, New Jersey.[00:03:00]
of New Jersey State Chapter [:So [00:03:30] really, really excited to be here.
ing that you were doing this [:And the research that you conducted is really groundbreaking and also a little bit alarming that there are so many [00:04:00] holes when it comes to kind of like definitively diagnosing weight recurrence, right, or, or regain. So our goal for this conversation, friends, is that by the end [00:04:10] of this, you will not call regain regain.
ou can implement immediately [:Dr. Majid, you and I both know that a lot of times patients will not go back for follow-up care. What is [00:04:40] the thing that is driving that? Yeah.
s of me exclusively focusing [:April Williams: Mm-hmm.
is extremely important, but [:really truly believe or understand that obesity is [00:05:30] a lifelong disease. Number two.
April Williams: Mm-hmm.
phase, and everything looks [:So they don't [00:05:50] do that, and when they start-
April Williams: Mm-hmm,
Oh, is it the switch in the [:So there's a [00:06:10] phase of denial. And then when you realize that, wait, the wedding has come and gone, but the weight recurrence is still with you, [00:06:20] then there is a huge element of shame. Mm-hmm. "I can't believe I let this happen to myself."
April Williams: Mm-hmm. "
F Majid: I did surgery. How [:Patients judge themselves, and therefore, [00:06:40] that feeling of, of shame holds them back. So over the years, these are the three major things that I have learned, uh, from my [00:06:50] patients that are stopping them from not coming back.
in the BariNation community, [:Besides people who are really in that pre-op stage. Yeah, life tends to be really great right after surgery, and then all of a sudden it stops behaving the same way, right? [00:07:10] We hit that stall, we hit that plateau, or we start to experience a little bit of regain. And that shame drives people into silence and isolation, and that is the exact opposite of what we [00:07:20] need to do to continue to treat this disease.
oes not cure the disease. It [:Saniea F Majid: control.
[:You get the treatment. Life happens. We just went through all of that, and now you are five years later, 10 years later, back to that [00:08:10] weight. It's not just about the weight and the- Mm-hmm ... medical comorbidities. It's like, I can't believe I failed that treatment. I got the surgery, I got the help, [00:08:20] and I'm back where I started.
April Williams: Yes.
Saniea F Majid: That weighs so heavily-
April Williams: Yes ...
just torture themselves and [:April Williams: Mm-hmm ...
they're experiencing weight [:and isolation only makes it worse.
Yep. It only makes... And I [:But if you're isolated, you're just thinking, "This is 100% me. I'm a failure. I mess things up," which is [00:09:20] not true at all, right? This is your bio- your biology and your body fighting a, a disease that has no cure. It's just a sign that more treatment is
%. And in April, [:You could see it in their eyes, right? Because they're still like- Mm-hmm ... trying to package all- Mm-hmm ... of [00:09:40] that when they show up, and it's brave for them to- Mm-hmm ... ask for help again. Mm-hmm. And I could see it, and I'm like, "We need-
April Williams: Mm-hmm ...
Saniea F Majid: we [:April Williams: Yes.
e in your, in front of your, [:April Williams: Oh, yeah. Yep. And friends, this, this research study is gonna be linked in our show notes down below. So either if you're watching or you're listening, go click this link, [00:10:10] download this document, and highlight it like I do because it, it's actually a very hopeful document because you very clearly lay out the recommendations and the researchers' recommendations [00:10:20] for how we can, as patients and practitioners, treat weight recurrence in a much more kind and timely fashion.
thing that could potentially [:Why is [00:10:50] there such a huge gap?
me... like fired me up. I'm [:April Williams: Mm-hmm ...
ls ... I'm gonna take a step [:Uh, what we publish in our [00:11:30] medical literature is not like an article in, in a magazine. That needs to be vetted and studied- Mm-hmm ... and researched, and that can take [00:11:40] months if not years. Every single sentence- Mm-hmm ... needs to be accurate. We can't make anything up, and we have to [00:11:50] back every statement-
April Williams: Mm-hmm
right? It has to be, it- my [:Wait a minute, she said 90, 91%. Where did she get- Mm-hmm ... that number from, right? So every- Mm-hmm ... there could be a fact- Mm-hmm ... [00:12:20] check for every sentence, and that is why medical literature has so much of value, right? You can't just produce it by [00:12:30] spending an afternoon. Now, having said that, when I started this journey, and it was basically because of patients, right, as I shared with you, [00:12:40] I had no idea about the state of affairs with this particular problem.
People were publishing [:April Williams: Mm-hmm ...
they were quoting that, oh, [:The criteria they used was all over the place. So they just decided a criteria. I'm [00:13:20] gonna decide if anybody gains five BMI points up, that's weight recurrence for me. I'm gonna decide if somebody gains 20 kilograms, that's [00:13:30] weight recurrence for me. I'm gonna decide if somebody gains, you know, ex- it goes on and on.
like, if we are not able to [:April Williams: Yeah. Yeah, [00:14:00] because you're, you're not talking about the same thing.
it's individualized to that [:Saniea F Majid: Exactly. And there's no standardization, which means [00:14:20] that we can't even talk about treatment of weight recurrence, which a lot of people experience with- Yes
the whole purpose of drawing [:April Williams: Yes. Yes. A- and I remember when you and I first spoke about this a, a year and a half ago, w- w- the, the discussion [00:14:40] was around, like, does this information make a difference to patients? And my immediate answer to you was absolutely 100%, because in my [00:14:50] lived experience, and in the, right, the, the lives of so many people that I have been a part of now, almost every single one of them experiences it, right?
But if you look at this [:They say, "So [00:15:20] nevertheless, if weight recurrence happens, most patients retain significant health benefits compared to their preoperative status, underscoring that weight [00:15:30] recurrence reflects the chronic nature of obesity rather than a surgical failure," right? Importantly, weight recurrence is awfully conflated with partial response and non-response.[00:15:40]
ll existent, those metabolic [:Saniea F Majid: treatment. Absolutely. I'm really glad [00:16:00] that you have picked up on this There's so many elements to this, April, and I, I hope that somebody listening to [00:16:10] this can gain some benefit, because that's ultimately it's for patients, right?
That's what, this is what, this is what this research- Yes ... is for. Number one, when patients-
April Williams: Yes ...
Saniea F Majid: [:If you did not have the [00:16:40] intervention, in this case, this is specifically focused on bariatric and metabolic surgery. If you did not have the intervention, and if you just continued with [00:16:50] life, your weight five years later would be much higher than where you are at that time in spite of weight [00:17:00] recurrence.
p numbers simple. Five years [:April Williams: Mm-hmm ...
gs I also reference, too, is [:If you look at populations as they age, men, women, anywhere- Mm-hmm ... in the world, the weight goes up. That's the [00:17:30] natural-
April Williams: Mm-hmm ...
Mm-hmm ... uh, we should not [:Number two-
April Williams: [:Saniea F Majid: the medical comorbidities, the disease of obesity doesn't start and end with a number on the scale. That's just what's visible. [00:18:00] That's easy to pick up. But it's so much deeper, right? Diabetes, sleep apnea, arthritis, migraines, cancer, heart disease, fat- liver [00:18:10] ca-... I mean, the list is so long.
much less five years later, [:Like, I just [00:18:40] hope everybody understands this, because what happens is people deprive themselves of treatment. And I, I want to reach out [00:18:50] to every single per- and say do not hold yourself back. Because you are doing a disservice to your future you by not taking the step right [00:19:00] now Mm-hmm.
April Williams: Yeah. Yeah
Saniea F Majid: The other point I wanna make su- comment is weight fluctuations.
ery pound you gain is weight [:Mm-hmm So when [00:19:30] should you freak out, right? W- what is that number for you? Yeah. That should really be- Mm-hmm ... determined at your [00:19:40] clinical follow-up, right? Between you and your clinical care team. I don't think it's fair as a clinician for me to expect that my [00:19:50] patients do what I'm asking them to do, live their life in this crazy world, and know is it five pounds?
? No. Even the s- [:April Williams: [00:20:20] Mm-hmm.
why you can confidently say [:But you have an opportunity to say, "Okay, well, my weight might be [00:20:50] creeping up," right? And w- once there's a definitive definition of weight, uh, recurrence, that's a tool. But it's also an opportunity for you to look at the metabolic health markers that are going [00:21:00] on behind the scenes, right? Because your A1C could be lowered.
ing on that you as a patient [:But as your research found, you, you reviewed 119 studies about weight recurrence, and only [00:21:30] 45% of them defined what weight recurrence meant to them. There is no standardized national or international definition.
Saniea F Majid: Exactly.
April Williams: Right?
ea F Majid: And that is what [:Like, it's been crazy
It makes no sense. You know, [:But from my lived patient experience, [00:22:20] to know that there are so many benefits beyond weight loss, right, that are here, and exactly what you said, starting treatment now means that you're gaining less weight over time, and [00:22:30] all of the health issues that could befall you if you continue to live life without treatment are going to really bite you in the butt in the end.
s isn't a conversation about [:Saniea F Majid: Absolutely. And another thing was that the 91% is not factual [00:23:00] because they have not listed their criteria.
cia- some clinicians to help [:April Williams: Mm-hmm ...
sometimes- Yes ... a lot of [:[00:23:30] I really don't think that, um-
April Williams: Mm-hmm ...
own ability to help patients [:and the problem goes away, which I think is the way weight recurrence has been dealt with- Yes ... within [00:24:00] the bariatric and metabolic surgical commun- community, as well as the non-surgeons. And the purpose of this paper was to shed light [00:24:10] for them as well, that, you know, this needs to be really looked at- Oh, yeah
by everyone.
Williams: E- yes. And, and I [:But if you have ghosted your care team, if you haven't had a follow-up appointment in, in years, your data is not included in this, and it's desperately needed. That's what's [00:24:50] going to give us a much more accurate picture about the true impacts and effects of metabolic and bariatric surgery and medication, and all of the other treatments that we're doing, right?
[:Saniea F Majid: care.
icine specialist, thank you. [:April Williams: Yep. Yep. And, and this patient responsibility piece is something that we talk about [00:25:40] often. And you have to take that responsibility.
can we have these difficult [:Because there are people out there that will be the, the match for you, and that's, I think, where obesity treatment [00:26:10] can really go in a different direction. If you trust your team and if they are truly looking at you as an individual and they're treating your biology, your disease, you're going to experience [00:26:20] results that you've never had before because you haven't had that, that level of care before.
Oh
%. I find patients [:At the end of the day, I tell my patients, "Put your health first." Don't [00:27:00] let an uncomfortable experience with the front- Yeah ... desk staff, with the physician, with the surgeon, the be- the not so great bedside manners, [00:27:10] the insurance creating, you know, 10 other, you know, roadblocks, define your health- Mm-hmm ... and your outcome.
April Williams: Mm-hmm.
niea F Majid: You are better [:April Williams: [00:27:30] Mm-hmm.
Saniea F Majid: Um, you keep persevering to find the right fit because once you find the right fit, then it's cruise control.
: Yes. I, I, I... We've been [:But what I realized is that when I don't know what to do or how to punch back, it's my care [00:28:10] team and it's my PCP that's standing behind me going, "Okay, try, try this." And recently, it, uh, it feels like my, my PCP is actually, right, holding my [00:28:20] hand and helping me punch back, and that is a very powerful way to treat this disease.
gas and I can't punch but I [:Saniea F Majid: love that example. I'm gonna steal that boxing ring example, April.
I love it.
. It, it's yours. Thank you. [:April Williams: The BariNation Foundation is a 501[c][3], and we could not do this work without the help of our donors. Thank you, Johnson & Johnson, for not only being our first [00:29:00] big corporate donor, but for believing in the mission enough to help us live it.
Saniea F Majid: Thank you.
ean into these visuals if we [:failure- [00:29:30]
Saniea F Majid: My favorite
t that language ourself, and [:But you very clearly called that out [00:29:50] in, in your research study, and you're, you're pushing back on this language. So why is it so important to remove the word failure from, right, from the care continuum, and [00:30:00] what words are you advocating that we adopt?
g, April and I have not gone [:Um- Yep. When people use... You know, words matter. Words matter. You've got to pay attention to [00:30:20] how you describe, um, whatever you're going through or whatever somebody, what you think somebody else is going through. So words matter- Mm-hmm ... number one. Number two- [00:30:30]
April Williams: Mm-hmm. Mm-hmm.
Saniea F Majid: Mm-hmm ... it's the reflection of knowledge.
the problem is, it tells me [:So if somebody [00:31:00] really understands the chronic, relapsing, progressive nature, right? Every word matters. Chronic, relapsing, progressive [00:31:10] nature of the disease of obesity, they're not gonna use the word failure. It cannot fit in the vocabulary. Um, if a patient is [00:31:20] being blamed- I don't-- by, by a clinician or by my front desk or a nurse, that person is no longer part of my team.
Because [:Oh. [00:31:50] And none of those explanations fit. And like in my-- like the way I feel a clinic- a clinical care team should be [00:32:00] structured to address this- Mm-hmm ... disease or this patient population. So failure is absolutely out, and I'll-- I'm really [00:32:10] grateful and proud of the, of the achievement of this group. The paper that you're seeing is actually our second paper.
t paper was published back in:So we said, "If you're not gonna stop with just our paper, we don't want like this o- this major [00:32:50] journal to even accept any publication- Yeah ... that has that word, word." We told all our national conferences. ASMBS, for example, [00:33:00] adopted it, and we said, "No longer are the word failure and recidivism be- going to be part of any of our talks or our sessions."
years ago- [:April Williams: Wow. I think I read that in, in here, but to hear you say it is really powerful, because what that means is, right, that [00:33:40] language change or that language demand can shift to the patient population.
ing about, right, failure or [:So we're just using these words arbitrarily because, again, there, there [00:34:20] is no, th- there is no definition, th- there's no matrix that we can help people find it in. And what you are advocating for is that we, we shift our [00:34:30] definitions, and I'm just gonna read them, uh, uh, e- exactly so we're saying them right.
ght recurrence. Can you tell [:Saniea F Majid: So the definition that we supported is a [00:34:50] calculation, um, which is, it's been published for many years out of Wendy King's work.
have to give her the credit [:Then we can [00:35:30] really say, okay, if I, if everybody uses this definition, this calculation, we can then say the weight recurrence- Mm-hmm ... in your patient [00:35:40] population versus my patient population now means something. Let's dig deeper and say- Yes ... why is yours 10% and my [00:35:50] 5%? What is it that I'm doing different? Yes.
nuously improve patient care [:make up data. Mm-hmm. [00:36:20] We have to go by what the patient's information looks like when they show up. Um, the other part, um, is it's not just you [00:36:30] lose all the weight and then you gain some weight back, right? Some patients respond partially.
April Williams: Mm-hmm.
d: So the- Yes ... the whole [:when patients get treatment for cancer, some respond, some fully respond, like, and some respond partly, and [00:37:00] some do not respond at all. So non-responders, partial response, and full response. These are the three categories. Mm-hmm. Now, I know nobody [00:37:10] likes to-
April Williams: Yes ...
Saniea F Majid: hear the word cancer. This is just as an analogy, as an example.
April Williams: Mm-hmm.
Saniea F Majid: When you respond fully-
April Williams: Mm-hmm ...
aniea F Majid: right, you're [:That is then the focus with that [00:37:40] patient. So even if somebody responded 100%, right, they'd still need to come back for regular follow-up because the focus of that follow-up should be, [00:37:50] how do I maintain it, right? The partial response-
Speaker 13: Yes ...
We've got to figure out what [:Is it the right operation for that patient? Is it-
April Williams: Mm-hmm ...
Saniea F Majid: inability to [:April Williams: Mm-hmm.
know, picking on- Mm-hmm ... [:What is it? Bariatric health, what is [00:38:30] it, right? So that's a separate focus of your clinical- Yeah ... care team. And then the non-response. There are patients- Yeah ... who'll be like, "I only lost a few pounds," [00:38:40] or, "I didn't get the response that I should have gotten." That is a different category- Mm-hmm ... and I believe and [00:38:50] my group believes that the insufficient weight loss or non-response is not equal to weight recurrence.
They're two totally [:And compare it to what I believe should be your trajectory [00:39:30] with your bariatric metabolic health specific- Yes ... to you. When I say you, doesn't mean your neighbor or your coworker because they can be of a [00:39:40] different ethnicity- Mm-hmm ... a different gender, have different metabolic health profile.
April Williams: Mm-hmm.
Saniea F Majid: So what works for you.
So [:April Williams: Mm-hmm.
specific factors matter. So [:And again, cannot happen without follow-up. I can talk about this forever- Yeah ... as you can see, April.
ams: And the- But it's, it's [:Then you have people that have lost a significant amount of weight and notice that there is some recurrence, but it's not [00:40:40] clinically significant. And then we have, right, that partial response. So I'm just- I'm reading from the research, and friends, if, if you download this, it's page four. But they outline w- [00:40:50] what defines partial response, non-response, and clinically significant weight recurrence, and that looks like 20% or more regained from [00:41:00] maximum weight loss.
d what you're saying is that [:Saniea F Majid: Correct ...
April Williams: approach.
Saniea F Majid: And the three are not the same. They're not equal.
April Williams: Okay. No, they're not equal.
And everybody just
Saniea F Majid: clumps [:April Williams: And what I,
Saniea F Majid: what
April Williams: I
Saniea F Majid: apprec- ... into one category, which drives me crazy.
s patients, right, we, w- we [:But your job with your clinician to understand what lever to pull first, at what intensity, because this really is about you and how your body is responding [00:41:50] to treatment. It's not about, right, the, the big aggregate data. It's you and, and your biology.
Saniea F Majid: Well said. Well said.
l Williams: It's fascinating [:And what I really [00:42:10] appreciated is, is I'm just gonna kinda read them, right? You have post-operative clinical care recommendations. Routine post-op follow-up is number one. It's the first thing you talk about. Then you move on to [00:42:20] RD visits, behavioral health resources, physical activity, support group participation, right?
sus complete non-responders. [:Saniea F Majid: Absolutely. Yeah, because they, the, this [00:42:50] needs to be done.
ody on this planet, I think, [:And even if you go through [00:43:20] treatment and it is stabilized, right, or you are in remission, you are going to follow-up care two, three, four times a year even when everything is good. Exactly. [00:43:30] So this model fits obesity be- right? Yeah. Because like what you said, it's chronic. It's always present. Uh, it, it's chron- Yeah
There is no cure. There are [:Saniea F Majid: Abs- w- uh, on point, and that's, that's... [00:43:50] Nobody misses, no cancer patient or the family member will allow them to miss their follow-up appointment. But somehow when it comes to [00:44:00] obesity-
April Williams: Yeah, no
Saniea F Majid: we think of 10 other things we'd rather do than check in.
Yes. Yes. Yes. Well, and I'm [:This is scary. I don't wanna do this. I'm so [00:44:40] frustrated." Okay, you need a safe place to, to say those things out loud, because once you get them out, what you can fill that void with is an actionable [00:44:50] plan to continue to move forward and treat this disease. That's, that's how this works.
ses, April, you have no idea.[:I'm gonna sound like April.
I'd be thrilled. So we, we, [:So this person says, "Three months after surgery, I stopped losing weight. Because of reactive [00:45:30] hypoglycemia, I was put on Ozempic for a year and actually gained seven pounds. Now, I've been on Mounjaro for four months. I've lost a few pounds, and my blood sugar is [00:45:40] better. After two years, do I accept that I'm only going to have lost 35 pounds, and that's it?"
Yeah.
st of all, I'm really sorry, [:and come [00:46:10] up with a individualized treatment plan that works for her. It cannot be a generic thing.
April Williams: Yes.
ght? That's why clumping all [:They say, "I have a dietician, I have a psychologist." I, uh, you really need somebody [00:46:50] who, uh, uh, lives that, that embodies it, that is beyond a checkbox. And, um, in her case, she's post-op. We need to look at her [00:47:00] anatomy. We need to figure out if the right operation was done, uh, for the right patient, and then put all of these pieces together to come up with a- Mm-hmm
the tailored plan [:April Williams: Mm-hmm. I know you offer this level of tailoring for your patients in, in your clinic. You, you have built your [00:47:20] model really on this research and, and you are working extremely hard to do exactly what you say, which is, right, to help people avoid weight recurrence in the first place.
But it's that [:Saniea F Majid: there.
. I have learnt all of this- [:April Williams: Mm-hmm ...
Saniea F Majid: right? And that is how I got to-
April Williams: Mm-hmm ...
Saniea F Majid: [:As a surgeon, surgery was and still is the most powerful treatment, but it didn't end there. We had a- Mm-hmm ... [00:48:20] multidisciplinary individualized treatment plan, um, 15 years ago. My slogan for my very first program all... was, "Let's unite in the fight [00:48:30] against obesity." That was before obesity was even- Wow ... called a disease.
ity as a disease in- Yeah ...:April Williams: Mm-hmm.
and you pay attention, what [:It happens. People just either don't appreciate it or they don't know [00:49:00] what to do with it, and that's why we published this paper, to help both clinicians as well as patients. And, um, currently my practice is called Weight Loss and Wellness Center. As I [00:49:10] told you, I've got, I've had the privilege of starting three programs, um, two for hospitals.
and Wellness Center. Anybody [:April Williams: Yeah. That, that is something that we spend a lot of time educating, right, the people who watch and listen to this podcast and our members.
ou find the clinician or the [:And if you really [00:50:00] want an integrated approach to this, right, so where you're not feeling like things are being kind of farmed out, you want it all in one place, there are questions that you can ask a- as a [00:50:10] patient to really understand what, what system or, or what, what practice you're signing up for. But you do have to do the work.
work or the, the, the reward [:Saniea F Majid: Dang.
April Williams: This [:Majid, she hasn't seen these. She doesn't know what these questions [00:50:40] are. We are just gonna go top of mind for whatever comes up, and this is gonna be fun. That's my
Saniea F Majid: favorite kind
rst one, but- I know, right? [:Does the word actually matter to a patient sitting in your
. It should be re- it should [:So recurrence.
April Williams: Bingo. And [:Saniea F Majid: False. Capital F.
April Williams: Capital [:Saniea F Majid: They blame themselves and they feel ashamed.
curred. Uh, and the only way [:We have to acknowledge that this is a disease, and that weight recurrence signals the disease is progressing. Yeah.
Saniea F Majid: So- [:April Williams: Oh, now there's a mic drop moment. There's a m- how we avoid that altogether is just [00:52:30] regular follow-up that you, that you go to, that you go to.
coming regularly." Shift the [:April Williams: Right. Well, and, and shift the next steps to really focus- Exactly
's in my control? What's not [:Oh
y God, revisional surgery is [:April Williams: Thank you. Thank you- Yeah ... for saying that. We, w- we have a, we, we have a [00:53:30] title that we bestow on our members who have revisional surgery. We call them revisionists, right? Because they are continuing to envision their [00:53:40] life as they fight and treat the disease of obesity. So spot on. Spot on.
ualizing the treatment plan, [:So if 10 years ago- Yes ... you needed surgery X, and then 10 years l- later you need surgery Y, okay. This is what you need today. That's what [00:54:00] you needed at that time. Mm-hmm. Why do we have to sit and justify X and Y?
. Uh, a- again, it goes back [:Saniea F Majid: Exactly.
ing that's at your disposal, [:Saniea F Majid: Correct.
ons after bariatric surgery; [:Saniea F Majid: I think it's exactly right. Multimodal treatment options is the way to [00:54:40] treat this disease.
.. chemo, radiation, surgery [:And I think that the need [00:55:10] to go to a place, your clinical care team needs to be an expert in all the above. They can't just be-
April Williams: Mm-hmm ...
Saniea F Majid: excellent [:The obesity care centers need to be a fully [00:55:40] functional, comprehensive place where when you come in as a patient, you can get, uh, all treatment [00:55:50] options under one roof. You don't have to go and start your story again and start again. I mean, who needs that?
you saying that. That, that [:So I've, I spoke on a panel at this year's ASMBS, and it was about what integrated care can look and feel like for a patient, and the number one thing that [00:56:10] really came up for people was having to retell their story- Oh my God ... over and over and over again to, to new people, and they were just like, "It's exhausting, and it's [00:56:20] traumatic, right?
I wanna, I wanna say my story one time, and then I want everybody to have access to that so I'm not going over it again." And that's exactly what you just said. So you
Saniea F Majid: know, when [:April Williams: Oh my God ...
ain?" And then they transfer [:So I'm gonna brag about this because, not because it's about me. It's because I want to, number one, educate the [00:57:10] audience listening, um, so they can go look for those kind of clinical care models and also help inspire, motivate if [00:57:20] any clinicians listening to this is every single time with the, the three practices, programs that I, I started, the criteria [00:57:30] was very clear.
erything, medical, surgical, [:Speaker 13: Mm-hmm ...
en I'm talking to a patient, [:If you're not ready for [00:58:00] it today, you want to come back a year later, we already have a relationship. We pull up our notes. A year ago, this is what we talked about.
April Williams: [:Saniea F Majid: What has changed- Yeah ... and where are you today with how you feel about things? I think it is so important. I like it because I value the [00:58:20] long-term relationship with my patients, and, um, it gives patients confidence that, you know what, this person knows [00:58:30] me.
t you quoted of the patient, [:But if everything was done- Yeah, maybe ... under one roof, then they could understand, you know, if the patient... how did the patient respond to [00:59:00] one medication versus the other, not just extend and prolong treatment if that's not working for her.
iams: Yeah. Yep. It, it is a [:And I think as a patient, you just [00:59:20] have a hard time maybe really understanding or knowing that that is the kind of care that serves you best. Because it does take some work to find it, but man, once you find it, [00:59:30] it's a whole different ballgame. I mean, it, it, it is like a, a whole different team that is there in the ring with you, and that is worth- Yeah
the effort to,
d April, it's not just about [:It makes- Yeah ... a difference in outcomes- Yeah. No, it- ... because you don't waste [01:00:00] time. You go from one to the other smoothly, seamlessly as long as you show up.
ams: Oh, I didn't even think [:Saniea F Majid: psychology of Thucydides
April Williams: Oh, look at that.
Biology of [:I- do you think we accomplished those goals?
add is make sure you follow [:April Williams: Yes.
like, "Look, I'm showing up, [:April Williams: Is number two, [01:01:20] yep. Friends, I will link the, the research study that Dr. Majid did, did with her team, links to, to contact Dr. Majid if you would like to explore [01:01:30] on- onboarding care with her. We also had a... We've had several phenomenal conversations with Dr. Majid in the past, and I will absolutely link those in these notes as well, because we [01:01:40] talked about a lot of similar things in this episode, and especially when it, when it just comes to, right, how, how we can step away from this shame and blame that we might feel ourself and [01:01:50] step into care is about what those previous episodes were, were all about.
e final thought or one final [:Saniea F Majid: Absolutely. Obesity is a disease that you can conquer [01:02:10] You don't have to live with it. So make sure you, um, don't deprive yourself for the right treatment.
[:April Williams: Yep. Well, there, there are reasons for that, but this conversation really helps us dispel some of those reasons, right? [01:02:30] Weight recurrence is to be expected. You are not the outlier. It's a sign that the disease is progressing, and you possibly need more treatments.
that treats it holistically [:Saniea F Majid: Absolutely.
April Williams: That's what this is all about.
n, and I'm just very excited [:Saniea F Majid: [01:03:10] Absolutely. Thank you.
All right. It's been a pleasure.
are looking for a safe place [:Saniea F Majid: If this episode helped you, help us make
April Williams: the next [:One final thank you to our [01:03:50] donors, Johnson & Johnson and Dr. Joe Cribbins of the Texas Center for Bariatrics and Advanced Surgery, who make this show possible. We are deeply grateful for you.
: [:Jason Smith: Our mission is to advance metabolic wellness for those [01:04:10] living with the disease of obesity by bringing you evidence-based education, stigma-free support, and meaningful connections in the exact moments that shape your day-to-day.
l Williams: A quick reminder [: