Interview With Dr. Joseph Naim of Soma Weight Loss, Part 1

Soma Weight Loss Dr. Joseph Naim discusses his bariatric surgery training and career and how experience contributes to an effective bariatric procedure. In this video, you’ll also learn about what drives Dr. Naim’s passion and the payment types and financing options available to patients.

Dr H Joseph Naim Part 1  

Hello, I’m Dr. Joseph Naim. I’m a bariatric surgeon. I’m a board-certified, fellowship trained surgeon. My specialty is weight loss surgery. Actually, all of my practice is dedicated to weight loss surgery. The reason is that there is an epidemic of obesity in America. And fortunately, we have multiple options that we can provide the patients with, in term of surgical weight loss.  
Basically, they are two different bands, two different companies, but they do the same thing. I would tell to most of my patient that the risk and complication are the same, but they’re welcome to go online and do research, but it is basically the same kind of system for weight loss.  
As you can see, the adjustable gastric system, which comes in two different packages, one is the Lap Band and one is the Realize Band. It’s basically a silastic ring that gets placed on upper part of the stomach. This band helps the patient control his appetite or her appetite, and also reduce the amount of food that they can eat in every sitting. The system has a tube which is connected to the reservoir, which gets placed under the skin. So nothing is visible. The difference here versus stomach stapling procedure is that, we can adjust the size of this band by injecting some fluid in that chamber. Basically, there’s saline that gets injected and you can see the size of the band gets smaller gradually. And by this adjustment, we can control the weight loss. Just like we can make the band tighter, if the patient is losing too much weight, not happy, we can make the band looser.  
There is a new procedure that we’ve been providing into my program within the last couple of years, and that’s called a sleeve gastrectomy. One of the reasons that I’m a fan of this procedure is that, the weight loss is superior to the Lap Band procedure. But I like to emphasize that this is more invasive procedure in the term that, as you can see in this picture, it involves stapling of the stomach. Not only we have to staple the stomach, about 80% of the stomach gets removed from the body. So, this operation obviously is irreversible, but has the great results, there’s no need for adjustment. And also unlike the gastric bypass procedures, there is no dumping syndrome, there is no malabsorption, and very uncommon for anybody to get into vitamin deficiency from this operation. So, I like to recommend this operation to any of my patient who come to my office. And after talking about the risks and benefits, usually they decide if they want to proceed with the sleeve gastrectomy, or the band, or the bypass. So in my program, I offer all of these, and we can tailor the patient to any of these procedures that we think they can have the best results.  
Sleeve gastrectomy and the band procedure, just like Lap Band or the Realize Band, these are considered restrictive operations. Meaning that, basically, the procedure creates a smaller stomach and just reduces the amount of calorie the patient can get. Malabsorptive operation like the biliopancreatic diversion that some people may be familiar with, or gastric bypass, involves bypassing a segment of the small intestine. Therefore, less of what the patient eats gets absorbed. Therefore, you have a possibility of vitamin deficiency, iron deficiency is common on people who take gastric bypass procedure. And in this operation, it’s important for the patient to be on multivitamins, not as much on the restrictive operation, not as much on the band operation, not as important for the sleeve gastrectomy. And it’s important in the sleeve gastrectomy to mention that, not only the patient has less space to eat, also because the stomach is removed, we know that the ghrelin hormone, which is also known as the hunger hormone, is remarkably reduced. So, there’s a second effect from this operation that my patients are just not hungry. And that’s why I think we have superior results compared to other banding procedures.  
I like to emphasize that also I have a lot of experience with this. Not every program offers the sleeve gastrectomy. Because I work closely with hospitals like Tri-City Hospital and Cedars-Sinai, we’ve been able to do close to 100 of these operations and we had great results.  
The banding operations these days are done as an outpatient. So, we have surgical centers or the hospitals that we can do the operation in, and most patients go home the same day. Obviously, the hospital has more equipment, more facilities, and if there is a need for overnight stay, it’s already there. In term of the stapling operation like the sleeve gastrectomy or gastric bypass, they’re always done in the hospital facility because they require one to two nights hospital stay. I only work with the hospitals that are known as the Center of Excellence. We have Tri-City Hospital, which is known as a Center of Excellence. What that means is that, the hospital has shown to have a high volume with very good results. Therefore, not only I have a lot of experience, the anesthesiologist has experience, the nurses have experience, the radiologists have experience. We have a whole system or alleys of different specialists like psychologists, dietician, cardiologists, pulmonologists, endocrinologists, available in a hospital every day, they can come and visit the patient as needed.  
That’s important because most patients that have morbid obesity, not only do they have a struggle with the weight, they also have multiple medical problems like diabetes, like high blood pressure, like sleep apnea. So they’re a little bit higher risk compared to healthy people. So we like to cover all the aspects to make sure that everybody goes through the procedure safely, and everybody goes back to the family the same night or after one to two nights, and they enjoy the rest of the life with the family, with the kids.  
Patient who go under a sleeve gastrectomy require a one-night hospital stay, at least. So after the one night, they will go home and the recovery is about three to five days. All the operation that I perform are done laparoscopically through the keyhole incisions, therefore the pain is very minimal. Most of these procedures have about three to five days recovery. The band operation, because there is no stapling, patients go home the same day and they can be back to work, let’s say, in a matter of three to four days, they can be back to work. In term of the diet, all these procedures, because there’s some change in anatomy of the stomach, I would recommend all my patients to be on a liquid diet for two weeks. So two weeks of liquid, followed by two weeks of puree. After about four weeks, they’re used to the new stomach and they can start eating solids. They always have to chew the food well. They have to understand that not to drink and eat at the same time because that may cause some irritation, and will not help them to lose weight.  
So we have instructions, written instructions, we have programmer coordinators, office managers, PAs and nurses, that are there to answer all the questions. I am always available in term of any medical questions. And this way, we will not only do the procedure, we will help them to…through the process, after surgery, so they can get the best results. 

I’ve been practicing in the field of bariatric surgery for about five years. I like to emphasize that even if patients don’t come to us, they have to make sure that the surgeon’s experienced and is well trained. I spent about a year, prior to starting my practice, through a fellowship to get trained in this specialty. I’m board certified in general surgery. So I have a lot of experience with this procedure. That’s why we can provide the safest environment for the patients. I enjoy what I do because all the patients are happy, and we like to work with every patient individually, treat them as a human being and try to give them what they’re asking for.  
I have a patient coordinator – her name is Laila – and she’s able to answer all the questions. Usually, she does not get involved in some of the medical advice, but in terms of lifestyle modification, in terms of what to eat, in terms of how long is the procedure, what’s the next step. We have multiple staff which will help the patients to go through the insurance. Interestingly, most of these procedures are covered by insurance companies. And we will provide that free of charge for the patient, to do an insurance authorization. And unfortunately, if for some reason the insurance will not cover the procedure, we have special cash packages that will help the patient to go through financing, because I believe that these are life-saving operations and the patients come to us because this is what they need. Otherwise, nobody really wants to have surgery unless they need it.  
Feel free to pick up the phone, make the call. My staff is available to answer any questions you have, and I’m available to provide you with a complimentary consultation so we can get you on track to a healthy, active lifestyle.  
Definitely. It’s been shown that people who are overweight don’t live as long as people who have lost weight and are healthier. So it has been documented, and I think that this is a life-saving procedure. And if you ask any of my patients, they will tell you that their life has changed.  
I’ve done about 1,000 weight loss surgeries. So, every patient is unique in each case. There’s always things that stay in your mind. I have to say that my youngest patient is 12 years old. So she’s lost about 40, 50 pounds. She’s very happy. My heaviest patient is about 640 pounds. He’s lost about 300 to 350 pounds, and he’s very happy. So they’re all unique. Very interesting that sometimes people, when they go under the stomach banding operations, I have a few patients that their husband even does not know about it. I don’t usually recommend this. I think that having a family support is important. But because these procedures are done so safely, it’s about a half-hour procedure, they go home the same day. It’s interesting that the significant other would not even know that they had a stomach banding.  
No, I like to emphasize that the most important step is for you to come and see the surgeons, see the doctor. In my program, when you make an appointment, we don’t require you to go through hoops before you see me. The first thing that you do, you come and see me. I want to make sure that we are comfortable to each other, I want to make sure that you trust me, and I want to make sure that you’re gonna be a good patient. And after that step, we will help you to go to every steps in terms of having a psychological evaluation, having a dietary evaluation, getting your insurance to cover the procedure. So, after you come and see the whole staff, you will feel comfortable. But I want you to make the call and come and see me.  
In case you’re worried about meeting me, you’re maybe a little bit shy, we have a very good website that you can go on,, and that website has a lot of information that you can get. Or you can just pick up the phone and talk to my program coordinator and they will give you all the information. At the same time, we have seminars that you can come, with no questions asked, just listen to me talking. At the same time, in the seminars, there are patients who had the lap-band surgery, the patient who had the sleeve gastrectomy, the patient who had gastric bypass, and you can talk to them. So that would be the first step for you to get familiar with the options. And I want you to feel comfortable, and they all do. We make them feel at ease.  
Once a month we have seminars which are usually combined with a support group. Usually, one of my old patients runs the support group so they can [inaudible 00:05:01] the patients. Support groups are an important part of the patient experience because all these procedures are gonna give you the best results, in combination with lifestyle modification. That’s what we call it. So as the patient comes to the support group once a month, they get reminded to stay on track, to continue eating healthy, to continue being active, and basically that’s what support group does. If they have any questions, they can ask some other patients. And again, my program coordinator can answer a lot of questions because they have talked to thousands of patients. So, we recommend it highly. Unfortunately, not everybody can attend it, but we recommend it as much as they can to attend the support groups.  
Again, they will also see me on a regular basis. I see all my patients every three months for the first year and we’ll emphasize that diet modification, that behavior modification, to make sure they have good results following the surgery.  
Does the patient play a part in the surgery? One hundred percent. These procedures, especially when it comes to the stomach banding, are basically tools that we provide the patient with. So they can take this tool and use it the way it’s supposed to be used and get the benefit from it because they’re basically losing their weight and controlling the medical problems, or they can just have the surgery done and forget about the other part and they unfortunately will not have as good a result that I expect. What’s a good result? I want my patient to lose at least half of the excess body weight. And if they do not change any habits, unfortunately, sometimes they may not get there. That’s why I want them to come to the support group, that’s why I want them to come and see me, that’s why the adjustments are important, so we can give them the tool they need to lose the weight and keep it off.  
I want to emphasize that these are not diet programs. These are surgeries, and basically the only diet they have to be on is to eat healthy and be active. So we will have booklets that we’ll provide you, I have dieticians that will contact you and will tell you what to do today to make the right choices. Basically, low-calorie diet is what you’re recommended. And if you make healthy choices, that’s all you need to do to have good results.

Have Questions? Contact Soma Weight Loss

If you’d like to learn more about the bariatric procedures performed at Soma Weight Loss, we’re here to help. Set up a free consultation at one of our three Los Angeles locations or call us at 855-SOMA-411 (766-2411) for more information. We are here to help!