SOUTHERN INDIANA — For years, Memphis couple Stacey and Shawn Carver had unsuccessfully tried a variety of diets in an effort to lose weight, and both have struggled with health issues related to obesity, including diabetes and high blood pressure.

But when they both turned to bariatric surgery at Baptist Health Floyd, it was a "lifesaver," Shawn said. As they've carefully kept up their diet following their gastric sleeve surgeries, they have seen significant changes to their health as they have been able to get off medications.

Indiana has the 12th highest obesity rate in the nation, and these rates have steadily climbed over the past 20 years, according to a 2019 report from the Richard M. Fairbanks Foundation. The Robert Wood Johnson County Health Rankings' 2019 report shows that Clark County's adult obesity rate is about 37 percent, while Floyd County's is about 31 percent.

Baptist Health Floyd's bariatric and weight loss program is among the resources available for Southern Indiana residents to address health issues related to obesity. The hospital offers both surgical and non-surgical options, including counseling and seminars on the Health Management Resources (HMR) diet, which is a medically supervised diet focused on long-term weight loss.

Dr. Lanny Gore, bariatric surgeon at Baptist Health Floyd, said obesity is a severe problem in Southern Indiana. He sees many patients struggling with health problems related to obesity, including Type 2 diabetes, high blood pressure, sleep apnea, disability and osteoarthritis. In addition, stigmas and stereotypes can contribute to psychological issues such as depression, and weight issues can increase risks of cancer.

The issue is only getting worse, according to Alyse Wagner, dietician and health educator at Baptist Health Floyd. Foods with low nutritional value, including those with high calories and high fats, are cheap and convenient, and they are often more accessible than healthy options, she said. Plus, gym memberships can be expensive. Sedentary lifestyles combined with unhealthy food are a "prescription for weight gain," she said.

Wagner said the HMR plan is a highly structured diet, and the medical staff teaches people about portion sizes, how to cook healthy food and what to look for at the grocery and at restaurants.

"It’s very simple, so people can follow it no matter what kind of lifestyle they have," she said. "Accountability is huge. They come to classes every week with a health educator, and they are taught the actual skills to keep the weight off once they lose it."

Gore said the most common kind of bariatric operation performed at the hospital is gastric sleeve surgery, which involves making the stomach smaller. This helps patients control their portion size, and it adjusts hormones connected with hunger. It's a tool for behavior modification, he said.

He notes that for many people, the cost of surgery or seeing a dietician can be an obstacle — Medicaid and most insurance covers these services at Baptist Health Floyd, but not all of them do. He said many insurance companies recognize that the programs are linked to a significant improvement in health.

"Insurance companies realize that when patients go through this procedure, they have a very high chance of getting off their blood pressure medicine, cholesterol medicine, getting less pain medicine for back pain and things like that," he said. "Overall, it improves their health so much that insurance companies are willing to pay for it."

Wagner said people often mistakenly assume that bariatric surgery is a "magic fix-all," but she said it is important to understand the need to continue their structured diet and behavioral modifications after the surgery.

"We teach them all the behaviors that need to be changed, so they still have to put in the work to have the best results," she said. "It’s not just the easy fix that people sometimes think it is. There’s a lot of hard work involved."

WEIGHT LOSS JOURNEYS

For the Carvers, their weight loss journey has been challenging, but they both found that bariatric surgery was the right option for them.

Shawn was facing diabetes and high blood pressures, and he was on insulin and other medications. Stacey encouraged her husband to turn to bariatric surgery, but unlike Stacey, his insurance at the time would not pay for the operation, and he was "dragging his feet," he said.

So Stacey, who was also diabetic and taking insulin, went first. She had her gastric sleeve operation in December 2017, and throughout the process at Baptist Health Floyd, she went from 234 pounds to about 158 or 159 pounds.

Before long, Shawn had changed to an insurance that covered the surgery, and his gastric sleeve operation took place this February. Since then, he has lost about 88 to 89 pounds, he said.

He now is down to 305 pounds, and he hopes to lose about 55 more. About 10 years ago he was at 435 pounds, and when he first came to Baptist Health Floyd for the bariatric surgery, he was at 393 pounds. He is off all of his medications except for one pill for diabetes.

"There’s no way, without the surgery, I couldn’t have done this on my own," he said. "I couldn’t have just said, I going to starting eating the right things, I’m going to start exercising. We’ve done it time and again. We did so many different diets. I hate to say [bariatric surgery] was a last ditch effort, but it kind of was for us."

Since the surgery, adjusting food portions has been essential. It doesn't take much to become full now, Stacey said. They have to be careful about what kinds of foods they eat to maintain their diets, and they typically try to avoid foods like breads and pastas that fill them up "offsets the good stuff," according to Shawn.

"Your basic thing is to eat slow, and listen to your body," she said. "When it’s full, it’s full. It doesn’t take a whole lot."

Lanesville resident Lisa Curry went a different route to lose weight. She had diabetes and high blood pressure and a multitude of medical issues, and she had been through "every diet plan there is," including paleo, keto, vegan, Weight Watchers diets and diet pills. Although her doctors recommended bariatric surgery, she decided against it.

Instead, she went through Baptist Health Floyd's HMR diet program along with her husband, James, who was also overweight at the time. In January 2018, they completely emptied out their refrigerator, freezer and pantry as they started the first phase of the program.

"Actually, we both did pretty well," Curry said. "You never realize how many food commercials are on TV until you can't have any of it...but we did really well, and between January and August of 2018, we had both lost 90-plus pounds."

They moved into the second phase of the HMR program in August 2018, and she has continued to lose weight. She is down by 139 pounds now, and James reached his weight goal in January and moved on to the third phase of the HMR program. She still has a little more weight that she wants to lose, and she is currently continuing the second phase of the program.

Curry has been diabetic since 2002 or 2003, and it just got worse and worse, she said. But since starting the HMR program, her health has dramatically improved, and she is now off of two-thirds of her medications, including all insulin. She also has more energy for physical activity.

"I never thought I'd be off of insulin, but I am," she said." I never thought I'd be off of blood pressure, but I am. I could not walk even a quarter mile before I started the plan without getting winded. Physically, I just couldn't do it. This spring, I checked off three of my bucket list items, including the Triple Crown of Running. Even though I cannot run, I did walk all of them. I love to do physical activity now, between walking, stair-climbing and water aerobics."

Curry is confident that she will not regain weight now that the program has taught her "how to live life without it being food-centered," and she has been relieved to see the health benefits of the diet.

"James and I have six grandkids so far, and it means that I, Lord willing, will get to see them grow up now, whereas it was a question before," she said. "I mean, none of us know when that rubber stamp day is on our bodies, but hopefully, I will get to see it."