What if you planned a once-in-a-lifetime vacation, but when you got to your destination, being overweight kept you from living your dream?

In 2016, this happened to Erin Fletcher. When the Crossville, Tennessee, resident and her daughter, Maegan, vacationed at the Grand Canyon they hoped to complete one of the park’s premier hikes, Bright Angel Trail.

But when they arrived at the trailhead, Erin realized that the day's sightseeing had caused edema in her legs. Edema, or swelling, is often the result of being seriously overweight, and it can cause discomfort and make movement difficult. As a result, Erin was unable to continue and watched from the observation area as her daughter completed the hike without her.

“I thought, ‘Okay, I’ve failed,’” said Erin. “I’m watching my daughter hike with someone else.”

“I thought, ‘Okay, I’ve failed,’” said Erin. “I’m watching my daughter hike with someone else.” Missing out on this journey inspired Erin to change her life by losing weight. When she returned home, she contacted the University Bariatric Center at The University of Tennessee Medical Center.

Tennesseans Struggle With Obesity

Erin wasn’t alone in being too overweight to enjoy life. Obesity continues to be a serious medical issue for many Tennesseans.

According to the Robert Wood Johnson Foundation, since 2000, the obesity rate in Tennessee has steadily increased from 20.9 percent to 34.8 percent, and the state now ranks sixth in the nation for obesity.

Health issues like diabetes, hypertension (high blood pressure), heart disease and obesity-related cancers can stem from carrying too much weight.

People can experience other issues, too. For example, Erin had to use a CPAP machine to sleep and she experienced daily migraines as a result of her extra weight.

A Scientific Approach to Weight Loss

The University Bariatric Center at The University of Tennessee Medical Center provides a comprehensive approach to weight loss through diet, exercise and surgical options.

Accredited by the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program, the center maintains the highest standards of patient care. It provides a wide range of services, including:

• Medical weight loss - Medications, meal replacements and behavior modification, under medical supervision
• Clinical research - Weight-loss clinical trials, giving patients access to new medications and regimens
• Weight-loss surgery - Minimally invasive procedures including gastric sleeve and gastric bypass

The multidisciplinary team of surgeons, educators and counselors partners with patients to provide a weight-loss program that addresses individual needs and helps patients achieve and maintain weight loss.

Gregory Mancini, MD, the center’s medical director, said, “Before surgery, our patients undergo an intensive education and preparation process.”

This process starts with screenings. That’s because the center has found that many of its patients have gotten behind on their medical care. This can happen for a variety of reasons, but often the component is emotional. For example, a patient may be embarrassed that they can’t fit in a waiting-room chair. Or they may fear their primary care doctor will embarrass them about their weight.

We start with routine screenings such as mammograms, blood work, Pap smears and endoscopy,” said Mancini. “This helps us detect any diseases and conditions that might have been missed. Our patients can then get any needed treatment as they progress through the weight-loss process."

After the screenings, the center’s patients learn about diet, exercise and lifestyle, and begin a medically monitored diet, which is overseen by the center staff. Some patients must reduce their weight in order to be healthy enough for the weight-loss surgery. Others are able to lose enough weight successfully on the diet and don’t need surgery.

Success isn’t just measured in pounds lost, but in overall health. Over the last 20 years, the goal of weight loss surgery shifted from measuring how many pounds a person loses to measuring how healthy a person becomes as the weight is lost.

For example, said Mancini, “We can measure this by the reduction in diabetes medication a patient takes, or in noting that they no longer need a CPAP machine because their sleep apnea symptoms have improved.”

In addition to the support of the center’s staff, Erin’s family rallied around her. “They asked what my goal for the surgery was, and I said to walk Bright Angel with Maegan.”

Erin’s dad, who turned 87 this year, said he would show his support by hiking the trail with her. Then the rest of the family surprised Erin by committing, too.

How Bariatric Surgery Caught Early-Stage Cancer

After an initial consultation with Mancini to learn about all of her options, Erin decided to have gastric sleeve surgery. During a gastrectomy, a section of the stomach is removed, leaving behind a smaller stomach pouch. Patients live a normal life after surgery, eating 6-8 small, healthy meals a day.

Erin had successful surgery in April 2017. Although most bariatric centers don't do post-surgery pathology (lab tests), University Bariatric Center routinely does. When a section of Erin’s stomach was sent for pathology, the results showed she had early-stage chronic lymphocytic leukemia.

Although most bariatric centers don't do post-surgery pathology (lab tests), University Bariatric Center routinely does.

The University Bariatric Center then coordinated Erin's care with David Aljadir, MD, at the Cancer Institute, one of the medical center’s six Centers of Excellence. Because the cancer was caught early, and chronic lymphocytic leukemia doesn't always require immediate treatment, Aljadir put Erin on a regular monitoring schedule. Should treatment become necessary, her chances of survival are greatly improved.

Bariatric surgery as a whole has been shown to have a positive impact on cancer. Mancini said, “Through reduction of total body fat, bariatric surgery appears to promote hormone balance and provide a protective effect."

Bariatric surgery reduces both the first incident and possible recurrence of many forms of cancer. This is most dramatically observed in estrogen- and progesterone-sensitive tumors such a breast, uterine and cervical cancer.

Watch the video below to hear Gregory Mancini, MD, dispel common myths about bariatric surgery.

Back Where it All Began

In the year after her weight loss surgery, Erin dropped 100 pounds, going from a size 22 to a size 10. She no longer uses a CPAP machine to sleep and her migraines are gone – along with the daily medication she took to control them.

“The whole staff, especially Dr. Mancini and Lynn Castle, the center's physician assistant, has been so supportive and encouraging on this journey,” said Erin.

In May 2018, she returned to the Grand Canyon where her weight-loss journey began. There, accompanied by her family, Erin accomplished her dream by hiking Bright Angel Trail.

This September, she followed up her Grand Canyon hike by participating the Cumberland County Hiking Marathon, completing 30.75 miles in one month (more than 4.5 miles over the 26.2-mile requirement). Erin, who walks at least 10,000 steps a day, said her lifestyle change has been phenomenal.

“I wasn’t able to enjoy life before. Now, thanks to University Bariatric Center and my commitment to a healthy lifestyle, I can.”

If you’re interested in learning more about University Bariatric Center’s weight-loss program, call 865-305-9355 or click the link below.