calories vs. macros for weight loss after Bariatric Surgery
Weight Loss
Video Blog: What is Restrictive Weight Loss?


The Talking it Up Show with Arlean Edwards is a local production that interviews keynote speakers within the CSRA. I, Dr. Jacome, was invited to join Arlean on set in a series of videos where I talk about what it takes to live healthy. This is the fifth video we are sharing from this series. You can find the first four videos on Calories, Dieting, Family Dynamics, and Preparing for Change on our blog. Be sure to stay tuned to see what other exciting topics I cover in the coming months!

Below you will find the transcription of the entire video.

Arlean: We’re back and it is time for Live Healthy MD. And this is a rockstar right here—Dr. Francisco Jacome. How are you today?

Dr. Jacome: Good, good!

Arlean: I’m excited about the segment, as always. You know, I interject me so that people get a chance to see me and this is what I’ve done. You know, I could never say, I don’t have to ever say that I was over 200 pounds because no one would ever know that. That we 26, 27 years ago. But I think it’s important for me to do that and you all are doing a great job—transforming and saving lives.

Dr. Jacome: It is, it is saving lives. I think, you know, we were talking about, right before we started, about your weight and how your weight has changed.

Alrean: Yeah when I said I was a chunky monkey? *laughing*

Dr. Jacome: I think it’s important for everybody to understand that a lot of people feel alone in the problem, a lot of people feel like there is no body else in the world—even the people you see who are walking around the street and they are thin. I can tell you that everybody in the world struggles with food. I don’t believe there is a single person that doesnt. Making the right choice is difficult to do it all the time.

Arlean: Because there are so many choices!

Dr. Jacome: Exactly right. Our food taste so much better than what it did before. Many, many years ago, there was not as much food nor the same type of food that we have right now. So food is certainly a difference. So I wanted to talk today about the procedures; things that we can do as physicians to help you lose weight when diet and exercise don’t work.

So I want to mention there are two types of procedures. There are procedures in which we can give you the ability to eat very little—and we call those procedures restrictive, meaning we can restrict the amount of food that you can eat. And we also have procedures that do not only restriction, meaning not only giving you the ability to eat very little, but also changing things in your body that will promote weight loss.

Arlean: Really?!

Dr. Jacome: One of them is energy expenditure. So the procedures that we consider them weight loss are procedures that you haven't done and the weight loss is guaranteed. You will start losing weight immediately after the procedure. And again those are procedures that carry complex changes inside your body that will promote this. But on top of that they also promote, like we said the last segment, diabetes cured, hypertension cured, meaning blood pressure problems cured, cholesterol cured, sleep apnea and so on. Today, I want to talk more about the procedures that only give you restriction.

Arlean: Okay!

Dr. Jacome: Okay, so within these procedures we have three that are the main ones, are the most common ones. People are already hearing a lot more about the gastric balloon, which it seems to be brand new here in the United States when in reality its been out, its been being done for over 20 years outside of the United States.

Arlean: wow, wow!

Dr. Jacome: Actually in the late 1980’s there was a gastric balloon that was used here in the United States that ended up going away. But now it has come back. So there are two types of gastric balloon. Number one, I want to mention that to place a gastric balloon, it does not require surgery.

Arlean: No?

Dr. Jacome: No! We can do it through endoscopy. A lot of times, I like to say, people don't  know what an endoscopy is; but everybody knows what a colonoscopy is.

Arlean: Yes we do! *laughing*

Dr. Jacome: But forget about colonoscopy. So I want to say that an endoscopy is the same thing but not from behind but it from this side...above. So pretty much a patient gets medication, goes to sleep, and we can place the balloon endoscopically.  Two types of balloons: one is a single balloon, it's just one balloon that goes inside the body; and the other type of balloon is a double balloon. So instead of being one, there are two balloons, smaller, that go inside the body.

It is very important to understand that this procedure is a procedure that is meant to change behavior. So by getting this, the patient gets the sensation of fullness, which allows the patient to eat and love less. And that alone, the behavior change with exercise, it will create successful weight loss.

Arlean: And when you get full, your brain gets the signal that we’ve eaten, and we’ve eaten enough.

Dr. Jacome: Yes. So you have the sensation of fullness, you don't want to eat a lot. At that point, hunger is usually the thing that makes us choose the wrong things to eat. I know it's very redundant. But if you’re hungry, you can't control what you are going to eat. You're just like, impulse, get something that will give you immediate gratification. 

Arlean: ...a twinkie, a donut, whatever.

Dr. Jacome: So the other procedure that I want to mention also that creates this is something that was very popular before called the lapband. The lapband is a plastic ring that goes on top of the stomach that creates pressure. It kind of divides the stomach like an hourglass if you want to think about it. And the pressure that is created with the lapband on the stomach is signaling to the brain saying “I am full”. Instead of the balloon being inside occupying space.

So there are two procedures that do not require surgery, but again does not give you weight loss—it helps you modify behavior.

Arlean: Its helps you modify behavior, and that’s key. But my question for Live Healthy MD, are all the procedures are available?

Dr. Jacome: We offer all of them. We have all of them available for our patients and when you come to see us we will go over a ton of details and what exactly what they mean and how they work.

Arlean: Wow—awesome, awesome! I learned a lot today! I really, you know at the end of each segment, I always let you know how much I appreciate you.

Dr. Jacome: I appreciate the opportunity to be able to transmit this to people that don’t know, because it is very important.

Arlean: It is! Because I’ve been in their shoes, I know how important it is. I was fortunate that I wasn’t diagnosed with diabetes, I was fortunate that I wasn't diagnosed with high blood pressure or cholesterol, or any of those other diagnosis that is related to being overweight, in my case obese. It was a miracle, but I know how you feel. And I know that you all, you are making a difference.

Dr. Jacome: We want to!

Arlean: You do! We are going to go to a break. We will be right after the break. We want to thank Dr. Francisco Jacome at Live Healthy MD, Augusta, GA, Dublin, soon to be in Macon, and in a neighborhood near you. We will be right back after the break.

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