Unless you live under a rock, you’ve probably heard some miraculous-sounding weight-loss stories recently. They’re everywhere, thanks, in part, to the runaway popularity of Ozempic and Wegovy, prescription drugs that suppress appetite as long as you take them. But can they deliver life-long weight loss? The jury is out on that, but there’s another tool in the weight-loss toolbox that is a proven life changer, according to surgeon Arif Ahmad, MD. It’s bariatric surgery, and Dan Krischer, who was once 508 pounds, is a testament to how it can work long-term.
On August 12, 2019, Krischer had a sleeve gastrectomy, or “gastric sleeve” a type of bariatric surgery that reduces your stomach to about 15% of its original size. Dr. Ahmad, head of Mather Hospital’s metabolic and bariatric surgery program, performed the minimally invasive surgery, which has the same very low level of risk as laparoscopic gallbladder surgery. Krischer was home from the hospital the next day, and the day after that, he went to work. His diabetes was gone. His sleep apnea soon resolved. Within 18 months, he had lost 300 pounds.
Krischer, now 62, has maintained his current weight, about 200 pounds, ever since, packing on muscle. “I’m living now,” he says. That’s the best way he can put it. He’s living.
The long journey to wellness
It was nearly 20 years ago that Krischer first went to one of Dr. Ahmad’s seminars on bariatric surgery. At the time, Krischer was in his mid-thirties and the father of young kids. He weighed north of 300 pounds, but that didn’t seem like such a big deal. “I looked around and it seemed like everyone was bigger than me,” says Krischer, who lives in Port Jefferson Station. “I was young and I thought, ‘I can lose the weight on my own.’”
But by 2019, he had type 2 diabetes and sleep apnea, took 13 medications and tipped the scales at 500 pounds. He was getting sick multiple times a year and was in and out of the hospital. In early 2019, he had cellulitis, a potentially serious infection of the skin, which required a lengthy hospital stay and rehab. Then on Easter Sunday that year, he woke up and was having trouble breathing. “It really alarmed me,” he said. His wife, Rosemarie, and grown son and daughter were scared, too. Krischer had pneumonia. Back into the hospital he went. When he got home, he signed up for another of Dr. Ahmad’s free seminars. “This time, after the seminar, I made an appointment to see him,” Krischer says.
“He was trapped in his own weight,” says Dr. Ahmad, whose program treats the most patients of all Northwell Health hospitals. “He had a very high body mass index [BMI], which severely affected his quality of life.” Staying at that weight, the physician adds, would likely have cut his life short by 15 years or more.
The invisible effects of weight-loss surgery
As a person becomes obese, their body starts working against them. For example, your joints hurt too much to move, so you don’t exercise. That makes you put on more weight, which makes your joints hurt worse. Same with metabolic disorders like diabetes: The weight makes diabetes worse, which makes the weight gain worse, which signals to your brain that you’re hungry. “It means that people are satisfied by eating a lot less,” he says. Levels of ghrelin will stay low for years after the surgery, but about 15% of patients do regain significant amounts of weight. The most successful patients are like Krischer dedicated to maintaining healthy lifestyle and eating habits. For those who are struggling a year or more after surgery, Mather has a program called “Back on Track,” which helps people with their health goals.
Kickstarting healthy habits
Dr. Ahmad got Krischer involved in his own treatment from the start. Before even scheduling the operation, the surgeon asked him to lose 40 pounds. This would get Krischer healthier for surgery, as well as help kickstart a healthier approach to eating. Krischer, who was highly motivated by that point, went further: He lost 56 pounds before surgery. He got help in that early effort from a nutritionist who works just across the hall from Dr. Ahmad’s office. Nutrition has always been a key part of the program. In fact, Dr. Ahmad himself did an 18-month fellowship in nutrition something unheard of for most bariatric surgeons. But he felt it was important to fully understand that aspect of bariatric and metabolic surgery. Mather’s program also includes social workers, who are licensed counselors and offer support to patients before and after surgery. There is a cardiology and sleep center on site, as well as post-op support groups that meet regularly. “We have it all under one roof,” says Dr. Ahmad. It’s one of the reasons the program has been recognized by the nonprofit Surgical Review Corporation (SRC) as a Center of Excellence in Metabolic and Bariatric Surgery. It also earned Healthgrades’ Bariatric Surgery Excellence Award for six years in a row. The program also benefits from the fact that Mather Hospital is the first Robotic Surgery Center of Excellence in New York State, according to the SRC. (See “A leader in robotic surgery,”p. 15.) Why that expertise matters: Using robotic surgery offers even more precision, allowing him to operate safely on people with very high BMIs.
A revamped lifestyle and a drive to help others
Krischer considers his gastric sleeve surgery one of the best choices he ever made. It’s why he speaks at Dr. Ahmad’s seminars once a month. “I always tell people that the doctors will get you to where you need to be, but if your head isn’t right, you will put the weight back on,” he says. For Krischer, reaching and maintaining his health goals meant completely changing his lifestyle. As vice president of Long Island’s Own Home Food Service, a food delivery service, he has some flexibility. Every day at 11 a.m., he heads to the gym, where he does cardio (the bike or the treadmill) or weight training. He’s transformed both his body and his habits. “I used to wear a 7X. Now I wear a large,” he says. He appreciates the small things, like being able to tie his shoes, and the big things, like being able to fly again. One of his most embarrassing moments happened at a Long Island airport a few decades ago. He and some colleagues were set to fly on a business trip when an airline representative told Krischer he needed to buy a second seat in order to fly. He told his colleagues he wasn’t going with them after all and went home. “And then I didn’t fly for more than 20 years.” Things are different now, and freedom from self-consciousness at the airport is the least of it. Both his son and daughter are now married, and each recently had their first child. “Back on that awful Easter Sunday, my son and daughter both said to me, ‘Dad, you’ve been there all along. We want you to be there when we get married and have kids. But you’re not going to be if you don’t do something about it,’ ” Krischer says. It was the motivation, the reset he needed. And it’s why he tells his story, month after month: Others can get their lives back, too.