With more than one third of Nova Scotians classified as obese, the demand for surgery is on the rise.

There is a considerable wait for the laparoscopic procedure, known as a sleeve gastrectomy, but there is much more to the procedure than the actual surgery. The program involves education, mentoring, lifestyle behavior change, and chronic disease management with patients pre-surgery. This time and effort is necessary to support long term success.

But this life-changing surgery is something people like Katie MacEachern are willing to wait for.

Despite the long, difficult wait, Katie stayed optimistic. The 34-year-old Truro resident had tried everything from well-known weight loss programs to pills, but was getting heavier and was unable to climb stairs without taking a break.

“When I started the process, I had a lot of issues like a fatty liver and Type 2 diabetes,” Katie says. “I had a long road, but I worked hard beforehand with my brain and my diet and changed my relationship to food.”

Once Katie met the bariatric team at the QEII Health Sciences Centre, her habits changed. The team’s holistic approach to mental health, diet and behaviour change has been the key success for patients like Katie, says program co-founder and endocrinologist, Dr. Tom Ransom.

“For some people there’s a big psychological component,” Dr. Ransom says. “Everyone’s obesity is different … so the strategies are individualized.”

Before surgery, patients work with the bariatric surgery team to prepare for surgery and to create behaviour changes, helping to ensure long-term weight loss success post-surgery. The team helps patients focus on enhancing chronic disease management, along with lifestyle and behaviour changes. Patients work to determine sources of their obesity, such as easy access to quick, high calorie foods, fast foods and convenience foods. They also focus on their eating and lifestyle routines, such as when and where they eat and whether or not they are engaging in physical activity. Food addictions, family challenges and emotional eating routines are examples of other areas of focus.

Patients write in food journals, commit to specific meal plans, and exercise. Surgery is not guaranteed until patients demonstrate their commitment and understanding to this new, healthy way of life.

“Surgery is permanent and it will affect how they eat for the rest of their lives,” Dr. Ransom says. “They have to decide if it’s something they can live with long term and there are people who realize that it isn’t for them.”

For Katie, her unhealthy relationship with food began in Grade 4. She’d been diagnosed with bone disease in her knees and had to avoid physical activity. Also allergic to food dyes and dairy, Katie soon started to sneak food.

“I ate everything I wasn’t supposed to and I did it in secret. I set up bad habits early,” she says.

Today Katie avidly writes in her food journal and is physically active. She knows how to properly fuel her body and feels well-equipped to navigate her weight loss journey.

“Sometimes my brain falls back into old habits, but I’m not dwelling on the past. Instead, I’m making sure I’m eating right, journaling, being active and focusing on how far I’ve come so far,” she says.

Stories like Katie’s invigorate surgeon and program director, Dr. James Ellsmere. Although he knew medicine was a rewarding career, he never expected to see such dramatic results.

“We’ve learned that by far and away if you’re morbidly obese and have diabetes, your outcomes are radically better with weight loss surgery when combined with optimal medical care and behaviour modification,” Dr. Ellsmere says. “The multidisciplinary approach is so important. Surgery is a small part of the overall treatment, but it’s a key cog.”

Between 60 and 70 surgeries are performed each year, but Dr. Ellsmere and Dr. Ramsom along with colleagues Diana Lawlor, nurse practitioner; Michael Vallis, psychologist; Jenna Crown, dietician; Andree Roy, physiotherapist; and Peggy Ryan and Dianne Russell, administrative assistants are determined to expand the program, raise awareness of the disease and help more Nova Scotians get their quality of life back.

Ideally, Dr. Ellsmere says up to 300 surgeries per year would be performed at the QEII.

“The community of resources the clinic needs is substantial,” Dr. Ellsmere says. “With events like Strides for Obesity we’re looking to raise awareness because there are a lot of misconceptions out there still, but we’re also raising money for those resources so we can expand the clinic and help more people.”

The QEII's bariatric team hosted its first three-kilometre walk called Strides for Obesity this past fall, in partnership with the Canadian Obesity Network and Leslee Ellsmere, community pharmacist and Strides for Obesity project manager. More than 100 participants and their families came together on a summer-like day in October to raise funds to eventually expand the QEII's bariatric surgery clinic, to help reduce wait times and improve access and care. More than 20 volunteers including past and current patients, university students, and healthcare professionals came out to set up and cheer the group on to a total of $6,300 net.

Katie couldn’t remember the last time she’d walked three kilometres, but when it came time to lace up her sneakers she was nervous, but determined to support the clinic that helped give her a new lease on life.

“The wait times are really long and as we wait more we weigh more, and that creates more health problems,” Katie says. “Any money raised for the QEII's bariatric surgery program is a good thing.”