1. The Truth is, Weight Loss Surgery Can Change Your Life Ranjan Sudan, M.D. – Medical Director Alene Wright, M.D. R. Armour Forse, M.D.

2. Multidisciplinary Team Surgeons Medical Physicians Nurses Registered Dietitian Program Manager Insurance Specialist Physical Therapists Psychologists

3. Program Highlights Offer three different options Offer laparoscopic and open approaches Individualize options Multi-disciplinary approach Life-long follow up Support groups Leaders in robotic surgery Intense level of care

4. What is Morbid Obesity? More than 100 pounds over ideal weight Severely affects health and increases risk of dying prematurely Body mass index (BMI) of 40Kg/M2 or more

5. Indications for Surgery A BMI of 40 or more A BMI of 35 or more if serious medical issues are present Benefits of surgery outweigh risks At least one well documented attempt to lose weight by medical means

6. Types of Obesity Surgery Gastric Restrictive Lap band Combined mode of action Roux en Y Bypass BPD/DS

7. Lap Band (Continued)

8. Surgical difference BPD/DS

12. Results Lap Band Average of 30-40% of excess body weight lost Gastric Bypass Average of 55% - 65% of the excess weight lost and maintained B.P.D. with Duodenal Switch Average of 75% of excess weight lost and maintained

13. Results (Continued) Diabetes Type 2 Virtually 100% cured Hypertension Most cured or improved Many medical conditions resolved Sense of well being improved Depression improved in most cases

14. Creighton Weight Management Program Birgit Khandalavala, M.D. Medical Director Shelly Oestmann, R.D., L.M.N.T. Nutritionist

15. Our Mission To improve the quality of life through lifestyle changes lifelong

16. Our Focus To maintain weight loss with the use of lifestyle tools Behavior Modification Nutrition Activity/Exercise

17. 5 Step Program Outreach Group Sessions Medical/Medication Very Low Calorie Diet Surgery

18. Use the Lifestyle TOOLS and BUILD a HEALTHIER LIFESTYLE