In this heartfelt episode of the Pound of Cure Weight Loss podcast, Dr. Matthew Weiner and Zoë explore Raquel’s inspiring story of transformation. Raquel shares her experience undergoing gastric sleeve surgery, navigating emotional and spiritual healing, and embracing her cultural roots, including the meaningful gifting of an Ojo de Venado. Her journey exemplifies resilience, recovery, and the powerful connection between medicine and spirituality.

Gastric Sleeve Surgery: A Key to Recovery

Raquel’s path to healing began with her decision to pursue gastric sleeve surgery, a life-changing step to address obesity, chronic pain, and limited mobility. Weighing over 387 pounds and coping with trauma from the tragic loss of her husband and struggles with addiction, she found hope through Dr. Weiner’s guidance. The surgery not only enabled her to lose weight but also paved the way for essential double knee replacement surgeries, significantly improving her quality of life.

Ojo de Venado: A Spiritual Connection

A standout moment in this episode is the gifting of an Ojo de Venado by Raquel to Dr. Weiner. This sacred Yaqui symbol of protection and blessing was offered to Dr. Weiner on the day of her surgery as a gesture of gratitude and trust. For Dr. Weiner, wearing the Ojo de Venado became a source of grounding and strength during challenging times, embodying the interconnectedness of patient and caregiver.

Recovering from Trauma: Finding Strength Through Healing

Raquel’s life is a testament to overcoming adversity. After the loss of her husband, addiction, and the temporary loss of her children, she found recovery through a Native American program. Her determination to heal extended beyond physical transformation, as she regained custody of her children, pursued a meaningful career, and embraced her cultural identity. “Healing from trauma isn’t just about the events—it’s about finding strength and purpose in their aftermath,” she reflects.

Spirituality in Medicine: Honoring Cultural Practices

This episode highlights the profound role of spirituality in healing. Raquel shares how practices like sage cleansing and the Ojo de Venado provided comfort and focus during her journey. Dr. Weiner emphasizes the importance of recognizing and incorporating diverse cultural practices in healthcare, fostering a deeper bond between patient and caregiver.

Life After Gastric Sleeve Surgery: A New Chapter

Now nearly two years post-op, Raquel has lost over 150 pounds, achieved mobility through knee surgeries, and embraced a healthy lifestyle. Beyond her personal success, she dedicates her life to helping others as a domestic violence facilitator, embodying her philosophy: “We go through these things, we fight, we heal, and then we teach.”

Conclusion: Resilience and Renewal

Raquel’s story, shaped by gastric sleeve surgery, cultural traditions like the Ojo de Venado, and recovery from trauma, inspires hope for those on similar paths. This episode serves as a reminder of the strength found in resilience, community, and embracing holistic approaches to healing.

In Episode 55 of the Pound of Cure Weight Loss podcast, Dr. Matthew Weiner explores the complex causes of obesity and shares innovative strategies for achieving lasting weight loss. Drawing from decades of experience as a bariatric surgeon and his deep understanding of physiology, Dr. Weiner delivers actionable insights into weight loss surgery, GLP-1 medications, and the power of healthy food.

Understanding the Root Cause of Obesity

Obesity is not just about overeating or inactivity—it’s deeply tied to our evolutionary biology. While our ancestors thrived with fat-storing mechanisms, modern diets rich in processed foods have disrupted this balance. These diets push our body’s metabolic thermostat to a higher "setpoint," making weight loss increasingly difficult.

The Metabolic Thermostat: A Key to Weight Regulation

Your metabolic thermostat regulates body weight, hunger, and metabolic rate. It aims to maintain a specific "setpoint," making it hard to lose weight with calorie restriction. Efforts to lower calorie intake often backfire as the body slows its metabolism and increases food noise (cravings and hunger).

Why Does the Setpoint Increase?

• Processed Foods: Disrupt hormonal signals and promote fat storage.
• Weight-Gaining Medications: Certain drugs, such as insulin and antidepressants, elevate the setpoint.
• Hormonal Shifts: Pregnancy, menopause, and chronic stress all contribute to weight gain.

Four Proven Ways to Lower Your Setpoint

Dr. Weiner outlines four key strategies for achieving sustainable weight loss:

1. Focus on Healthy Food

Adopting a diet rich in fruits, vegetables, nuts, seeds, beans, and lean protein is more effective than calorie counting. These whole foods support long-term metabolic health and help reset the body’s physiology.

2. Build Muscle

Strength training helps alter fat storage mechanisms and improves overall metabolic health. While not as powerful as other methods, maintaining muscle mass can complement other weight-loss efforts.

3. Leverage GLP-1 Medications

Medications like Wegovy and Zepbound mimic hunger-regulating hormones to reduce food noise and lower the setpoint. These drugs are highly effective when used long-term, achieving up to 25% total body weight loss in some cases.

4. Weight Loss Surgery

Bariatric procedures such as gastric bypass or sleeve gastrectomy lead to hormonal changes that lower the setpoint. When paired with GLP-1 medications, surgery can result in transformative weight loss of up to 50% of total body weight.

The Importance of Combining Treatments

Dr. Weiner emphasizes the power of integrating healthy eating, GLP-1 medications, and weight loss surgery. This approach customizes weight-loss strategies to individual needs, enhances results, and provides durable, long-term weight control.

Support and Community: Keys to Success

Dr. Weiner highlights the value of support networks and peer-led groups. These resources, paired with professional nutritional guidance, help patients stay motivated and achieve their weight loss goals.

Takeaways:
Obesity is a complex condition that requires a multifaceted treatment plan. Combining weight loss surgery, GLP-1 medications, and healthy food provides the best path to success.

For more resources, visit Pound of Cure Weight Loss to join support groups and access expert insights.

In Episode 54 of the Pound of Cure Weight Loss Podcast, Dr. Matthew Weiner and Zoë Schroeder sit down with Dr. Ethan Larson, a plastic surgeon specializing in lipedema care. Together, they delve into the complexities of lipedema, available treatment options, and the transformative role of plastic surgery for lipedema.

What is Lipedema?

Dr. Larson explains that lipedema is a chronic condition that primarily affects women. It manifests as an abnormal accumulation of fat in the legs, arms, and sometimes the abdomen, often triggered by hormonal shifts like puberty or menopause. Unlike normal fat, lipedema fat does not respond to diet or exercise, leaving patients frustrated.

Key Facts About Lipedema:

• Resistant to metabolic breakdown.
• Often accompanied by pain and swelling.
• Can coexist with obesity, which is treatable.

Lipedema Treatment Options

While diet and exercise support overall health, they do little to address lipedema fat. Dr. Larson highlights lymphatic-sparing liposuction as the most effective treatment, designed to:

• Remove abnormal fat while preserving the lymphatic system.
• Improve functionality and reduce pain.
• Enhance cosmetic appearance as a secondary benefit.

The Role of Plastic Surgery for Lipedema

Plastic surgery for lipedema is more than cosmetic; it’s a functional solution that addresses discomfort and mobility challenges. Dr. Larson answers common questions about the procedure:

• Does the fat return? Not in treated areas, but untreated regions may develop new fat pads.
• How much fat can be removed? Up to 8–10 liters per session, depending on individual needs.
• What about risks? Safety measures ensure optimal outcomes while minimizing complications.

Comprehensive Lipedema Care

Effective lipedema treatment often requires a multidisciplinary approach:

• Dietary Adjustments: Anti-inflammatory diets can help manage secondary symptoms.
• Surgical Interventions: Lymphatic-sparing liposuction is the cornerstone of treatment.
• Patient Advocacy: Self-education and persistence are key to navigating insurance challenges.

Addressing Barriers in Lipedema Treatment

Dr. Larson discusses systemic challenges, including:

• Limited awareness among healthcare providers.
• Lack of insurance coverage due to insufficient diagnostic and procedural codes.
• High out-of-pocket costs, with surgeries starting at $12,000 per session.

He stresses the importance of awareness and advocacy to improve access to care.

When to Consider Plastic Surgery for Lipedema

Dr. Larson advises patients to stabilize their weight for at least three months before surgery. For those using GLP-1 medications like Wegovy or Mounjaro, he recommends completing weight loss before planning surgery to ensure long-term success.

Lipedema Support and Resources

Organizations like the Lipedema Foundation are vital for raising awareness and advocating for systemic change. Dr. Larson encourages patients to utilize resources like Lipedema.org to connect with knowledgeable specialists and support networks.

Final Advice for Lipedema Patients

Dr. Larson’s key recommendations:

1. Get Diagnosed: Work with a specialist to confirm your condition.

2. Set Priorities: Identify treatment goals to guide your care plan.

3. Plan Ahead: Ensure long-term weight stability and realistic expectations.

Connect with the Experts

Visit www.larsonplasticsurgery.com or www.poundofcureweightloss.com to learn more