“The key to successful outcomes
with bariatric surgery is the shortand
long-term follow-up,” said
board-certified general surgeon
Dr. Ramzi Alami, who directs the
Metabolic and Bariatric Surgery
Program at CalvertHealth Medical
Center (CHMC). “That’s why a local
program is so important because
these patients need a lot of support.”
The multidisciplinary program, which launched last
May, takes direct aim at the county’s growing obesity
epidemic and the toll it has taken in driving up the
rates of heart disease, stroke and diabetes locally. A
2020 survey showed the percent of Calvert County
adults who are obese is higher than state and
national averages and is rising.
In a recent interview, Dr. Alami stressed how the
expertise, education and follow-up at CHMC combine
to produce a highly effective program for those
needing weight-loss management. Dr. Alami, who is
fellowship trained in advanced minimally invasive
and bariatric surgery, has performed more than 2,000
procedures and has taught other surgeons in the field.
Surgical Expertise Emphasized
“I’ve been doing this for 16 years now,” said
Dr. Alami, “I’ve basically dedicated about 80 percent
of my practice to bariatric surgery (including sleeve
gastrectomy, laparoscopic and open gastric bypass
and adjustable gastric banding). The vast majority
of these procedures are done minimally invasively,
resulting in less pain and a faster recovery.
“When you’ve done a lot of these operations, you
can foresee where the issues are going to be and what
you need to do before they arise,” said Dr. Alami.
“Safety is what dictates everything. We’ve learned
over time, if you improve these issues before surgery
– for example, bringing the patient’s diabetes more
under control – then you have much better outcomes.
“This surgery has to be very individualized,” he
added. “It is not a one-size-fits-all approach. A lot of
tests and consultations are done prior to bariatric
surgery to choose the most appropriate procedure for
each patient’s needs and aspirations.”
Dr. Alami said a lot of thoughtful planning and
consideration went into elevating the many different
areas needed to support the more advanced surgical care at CHMC. “We’re very well
equipped and ready to face this
challenge.”
Patient Education
Highlighted
He also stressed the impact education
has in ensuring patients are prepared.
“Patients really need to know what
they’re getting themselves into and
they need to understand it to be able
to commit to it.”
Dr. Alami went on to add, “We
know that all patients are going to
lose weight after bariatric surgery …
but how much they lose and whether
they are able to maintain that weight
loss will depend on their eating habits
and level of physical activity.”
This is where the short- and
long-term follow up comes into
play. There are regularly scheduled
visits in the weeks and months after
bariatric surgery to monitor how
well the patient is adapting to their
personalized diet and exercise
plan and to make adjustments.
Additionally, support groups are
available to provide practical
guidance and advice.
“This is why I say a local program
is so important,” he said. “If a
patient has to drive an hour and a
half to appointments, we know their
participation is going to dwindle over
time and this will likely affect their
overall success.”
Lifestyle Change Key to
Long-Term Success
Dr. Alami emphasizes that bariatric
surgery is not a “quick fix” but
instead a tool for lifelong weight
management. “Surgery is just the
beginning of the journey. For longterm
success, patients need to
understand surgery is only one-third
of the equation. Nutrition, lifestyle and
exercise make up two-thirds.”
He explained, “The patient’s
commitment to change is essential.
Most of my patients (some 80
percent) tell me this is the best thing
they’ve done for themselves. Change
is not easy but it’s also not difficult.
The key is making sure they are
really prepped and ready for the
changes they need to make.”
From his very first encounter
with patients, Dr. Alami encourages
them to focus on their relationship
with food and what they want to
achieve. “A healthier lifestyle is pretty
much what everyone wants and that
usually means moving around a lot
more, thinking about what we eat and
enjoying life to the max.”