Dr. Christine Ren-Fielding Discusses Bariatric Surgery in Mishpacha Magazine
UncategorizedDr. Christine Ren-Fielding was recently featured in Mishpacha Magazine. In the article, Not A Piece of Cake, Dr. Christine Ren-Fielding discusses bariatric surgery and the psychological effects of the commitment to loose weight. The exert below highlights Dr. Christine Ren-Fielding and Dr. George Fielding’s thoughts on the topic.
In New York University’s surgical weight-loss program, Orthodox Jews make up the largest ethnic clientele base — so much so that the NYU’s program has clinics in both Brooklyn and Monsey. Does that mean observant Jews are more prone to obesity?
“It’s hard for me to say whether the Orthodox have a higher rate of obesity,” Dr. Christine Ren-Fielding, a top-tier bariatric surgeon who launched NYU’s surgical weight management program in 2001, told Mishpacha. “What I can say is that it’s a food-oriented and baby-oriented society, two factors that contribute to the process. Sports isn’t a popular pastime or a priority, and from my experience with this community, neither is vanity, especially with men. So it’s not really a looks thing — they come to us when their weight has gotten out of control and it’s affecting their health and their quality of life.”
Dr. Christine Ren-Fielding shares a practice with her husband of ten years, Dr. George Fielding, who matches her passion for making the world a thinner place by beating back the obesity epidemic. “I do this surgery for two reasons,” Dr. George Fielding said in a magazine interview around the time they joined forces. “It’s to give fat people a normal life and to give them a shot at a normal lifespan as well.”
Dr. George Fielding, a jovial Australian, is considered a pioneer in Lap- Band surgery. In fact, he could be a poster boy for Lap-Band. In 1999, weighing 320 pounds himself, he had a fellow surgeon perform the same Lap- Band surgery on him that he’d begun performing on patients several years prior in his Brisbane clinic. And 17 years later, his band is still in place and he’s kept his weight down to about 210 pounds.
With a wife like Dr. Christine Ren-Fielding, that’s not surprising. She herself is a petite, high-energy woman who admits she has no fat genes and was never an overeater. In fact, she only eats one meal a day, ingesting about as many calories as her patients do after weight management surgery.
But Dr. Christine Ren-Fielding has much more at stake than just making her patients fashionably thin like herself. She wants them to have health. She wants them to have quality of life. And she, too, is often stymied by the troubling long-term statistics.
“This is the big question we’re trying to answer,” she admits. “We’re doing a lot of research in this area, and we know that surgery isn’t foolproof. It’s a tool to make you feel less hungry, but if your issues go beyond physical hunger, you have to work those issues out with a therapist or counselor.”
The NYU group provides mandatory psychological support before surgery, including education about the changes patients will have to make in a way that will improve their chances of successful long-term weight loss. And they offer free post-surgery support groups.
“If you’re not losing, we have to address why,” says Dr. Christine Ren-Fielding. “Is it what or how you’re eating, or is there something about the operation that doesn’t give you appetite control? This is like any other disease. We want to monitor you to keep this disease in remission.”
Dr. Christine Ren-Fielding is extremely invested in her patients’ follow-up health, and is heartbroken when after all their hard work of pre-op, undergoing physically altering surgery and all the post-op challenges, they gain their weight back.
“I don’t view it as ‘Oh, no, they’ve ruined my operation,’ but I’ve done this invasive procedure on them, tried to help them, to give them quality of life, and so I feel very sad. Then we try to figure out why — and the most common culprit is sugar. They’ve gone back to cake, candy, and sugary drinks.”
The operation, she says, is a tool, and if people bring sugar back into their lives, the tool won’t help.
“I tell them, ‘You’ve been given a gift, a chance to lose all that weight and be healthy, and now you’re sabotaging yourself by going back to your bad habits of eating junk.’ ” Patients feel secure when there is a longterm follow-up commitment from the doctor, but they don’t always realize the huge commitment they themselves must make regarding behavioral changes.
“If I see that the patient is noshing all day, I’ll discourage him from doing the band even if that’s the procedure he thinks he wants, because I don’t believe he’ll be able to maintain the lifestyle change,” Dr. Christine Ren-Fielding says. “I tell him, ‘There’s no magic here. Your life is going to change. You can never cheat. You must always be vigilant, because otherwise the band is going to cause you pain and you’ll throw up, your teeth will be affected, and you’ll split your band.’”
Dr. Christine Ren-Fielding even provides her post-ops with a 30-second hourglass timer to teach them about chewing and swallowing from now on. One must wait 30 seconds after swallowing to take the next bite — a huge time interval for those used to downing a full plate in a minute.
Ten years ago, gastric bypass surgery carried a 1-in-200 risk of death within 30 days of surgery. Some physicians claim that number is now as low as one in a thousand, but it’s still a frightening statistic.
Dr. Christine Ren-Fielding says it’s important to place those fears within the proper context. “For example,” she explains, “if a patient has been diabetic for more than seven years, he should have the gastric bypass, because hormonally and endocrine-wise, it’s the best operation to treat diabetes.” And while a bypass may seem drastic, “the fallout of diabetes — the circulatory problems, the risk of losing a leg, or going blind — to me is more horrifying than having your stomach rerouted.”
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