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weight loss

A Team Approach to Weight Loss Management at Northern Westchester Hospital

November 13, 2020 by Beth Besen

Members of the team at Northern Westchester Hospital’s Center for Weight Management, which is housed in the Center for Healthy Living. (L-R): Rachel Goldman, Angelique Nicholson, Carla Larca, Julissa Pena, Laura Spallina

The Inside Press recognizes that weight management is a multi-dimensional issue, one which encompasses a myriad of physical and mental health issues. The following article seeks to provide some key information, and is neither judgment by nor opinion of the writer, editor or publisher.

These days, “home for the holidays” isn’t exactly the exciting work-break or reunion most of us associated with the phrase in years past. No, sadly, many of us have been home for quite awhile now, carefully working from that same home (if we’re lucky enough to be able to do so), helping our school-age children to learn from that same home and even supporting grown-and-flown adult children and/or parents who’ve returned to the nest as well. Likely, even Hallmark would agree that coziness has its limits, and holidays might take more than the usual toll on some.

For example, weight gain. Most years, as we approach the holiday season, we are both invited to indulge and cautioned to simultaneously take care; mouth-watering special holiday recipes on one morning talk show, “how to handle the office party and make healthy food and drink choices” on another. Let’s face it, celebrating and enjoying ourselves while remaining on the alert for hidden calories and sneaky sugars isn’t easy. Now, it’s not only that time of year again, but it comes on the heels of a nearly nine-month lockdown during which some of us became more sedentary, ate and drank more, and, much to our dismay, have had to recognize we’ve put on few pandemic pounds.

Sound familiar? Many readers will likely shake their heads in agreement, but also shrug it off as something they can deal with. However, for seriously overweight and obese people, additional weight-gain is actually quite critical. According to a CDC COVID-19 alert: “Obesity May Increase Risk for Severe Illness”. When President Trump was diagnosed as positive for the coronavirus, he was considered at higher risk for complications due to his age (74) but also due to his weight (undisclosed, but notably overweight).

Understanding Obesity

But what exactly is obesity? How do we define it? And, more to the issue, once defined, what can we do to better understand and remediate how it affects our health? For answers to these and related questions, The Inside Press turned to three members of the team of experts at Northern Westchester Hospital’s Center for Weight Management at Chappaqua Crossing; specifically Ms. Rachel L. Goldman, FNP-BC, CDCES. (Family Nurse Practitioner- Board Certified, Certified Diabetes Care Education Specialist); Ms. Pat Talio, RD, CDCE; and Dr. Mitchell S. Roslin, MD, FACS, Director of Bariatric Surgery.

In broadest terms, the condition of being overweight or obese is defined as having too much body fat, and the most widely used determining measure for this is the Body Mass Index, commonly referred to as the BMI. A simple equation originally proposed by a Belgian mathematician in the nineteenth century, the BMI is the body mass or weight (kg) divided by the square of the body height (m) or kg/m2.

Category BMI range – kg/m2

Severe Thinness < 16
Moderate Thinness 16 – 17
Mild Thinness 17 – 18.5
Normal 18.5 – 25
Overweight 25 – 30
Obese Class I 30 – 35
Obese Class II 35 – 40
Obese Class III > 40

Of course, like most tools, the BMI is not perfect; it doesn’t distinguish between body fat and denser tissue like muscle and bone. An athlete may have a high BMI and be perfectly healthy. But, for most people and healthcare professionals, the BMI is the gold-standard for determining people at risk for health problems due to excess weight. All interviewed for this article concur with this and with the World Health Organization’s (WHO) recommended body weight based on BMI values for adults. It is used for both men and women, age 18 or older.

While the BMI is but a simple measurement tool, the Center for Weight Management is a full-on toolbox of state-of-the-art health help. According to Goldman, when a potential patient calls the Center, the first order of business is a comprehensive medical screening including “a really long conversation with the patient to discuss their weight struggle over time; our relationship with food is complicated with many possible factors at play including emotional issues, lack of time to cook, lack of time to exercise. We take blood, and screen for weight-related underlying conditions–hormonal or metabolic conditions that make weight loss hard and unsustainable–and look for side effects of medications taken for other things. I’ve seen people who’ve been struggling to lose weight for years without knowing they have an underlying thyroid condition.”

Goldman notes that patients have continued to work with the Center remotely during the pandemic lockdown, and that the Center’s online content has grown and greatly improved. She also shares that the team has seen new patients as well, “people who recognize they’re extra vulnerable and are searching for new ways to be successful. We’re here for them, and eventually we come up with a plan which may include any or all of the following: nutrition counseling, medical-nutrition therapy, FDA- approved medication, surgery.”

Nutrition Counseling is Key

Explains registered dietitian Pat Talio: the foods we use to fuel our body aren’t all created equal. Talio discovered this herself as a freshman away at college for the first time. Having come from a “family who always ate well, used fresh and healthy ingredients and got outside to play sports a lot”, Talio wasn’t prepared for the relatively nutrient-poor but abundant food choices at college, and soon found she was on her way to gaining the proverbial “freshman 15”. Fortunately, she also found her way to health services who recommended she meet with a dietitian. The dietitian not only opened up her eyes to healthy food choices, but also to a regular exercise program (she’d been unaware that her home-based backyard sports games were about more than fun and were actually a means toward an ongoing healthy lifestyle).

What’s more, this all led to an abiding interest in nutrition, and her ultimate choice of career; Talio has been a practicing Registered Dietitian since 1985, and is further certified as a diabetes specialist. She sees a variety of clients including cardiac and pulmonary rehab patients for whom she points out that “nutrition is an important part of recovery.”

When asked about the differences, if any, between her work pre- and post-COVID-19, Talio says, “I never thought I’d be working from home but the hospital has been very supportive with technology and thinking outside the box! There’s greater scheduling flexibility for their appointments–and all without traffic and waiting rooms.” Her patient roster has remained fairly steady, but she does allow that the virus has led to new inquiries and perhaps provided an extra push to people who have been on the fence about seeking help; “they’re re-evaluating their health and their choices”. And, she adds, “I’m so thankful I’m able to offer support.”

Bariatric Surgery Option

Patients whose Center personal plan includes surgery often see Dr. Roslin, considered one of the best bariatric surgeons in New York, and an innovator in the search for new and better treatments of obesity. Roslin is full of compassion for his patients and their struggle as he describes the importance of surgical intervention.

He begins with what he calls Point #1: obesity is a chronic relapsing condition. He then provides a useful visual to what that means by saying “it’s like a rubber band that always wants to bounce back.” “And,” he adds, “this makes treating obesity extremely challenging.” Explains Roslin, “There’s an assumption that obese people overeat. That’s wrong. It has to do with insulin resistance which encourages fat formation as well as other metabolic activity. It’s impossible to tease out which comes first and they can also be synchronous. It’s not lack of will power.

Surgery is the only reproducible mechanism we have; it breaks insulin resistance and blunts recidivism–and it’s underused. The number of people who are in their 30s and 40s with obese BMIs will likely not be able to lose weight without surgery.” Roslin shares that his patients rarely come in due to some seminal event–e.g., a death in the family–but because they’ve reached a point in their lives “when functional impairment overcomes the fear of surgery threshold.” And, further, he notes “a majority have gained a significant amount of weight during the pandemic, as much as 25-30 lbs in the last few months.” Unfortunately, that doesn’t mean that they’ll be able to shed the weight as quickly as they put it on.

To be sure, surgery is not a substitute for a healthy lifestyle, and even though Roslin sees it as the linchpin to starting that healthy lifestyle, he, like Goldman and Talio all agree that the only way to truly treat the complex issue of obesity is to help the patient learn to make a sustainable lifestyle change. Sums up Roslin, “the reason centers like ours are so important is because we teach you!”

For more information or to speak to a member of the Center for Weight Management team, call (914) 223-1780.

Filed Under: Cover Stories Tagged With: Bariatric Surgery, Northern Westchester Hospital, Nutritional Counseling, team, weight loss, Weight Management

Spring into a Healthier You at Dr. Briones Medical Weight Loss Center

March 22, 2020 by Deborah Raider Notis

When Dr. Maria Briones started working with orthopedic patients at Burke Rehabilitation Center in 1999, she noticed that many of her patients’ problems, from arthritis of the knees and hips to broken bones, resulted from carrying extra weight. Much of the natural wear and tear on people’s joints and the need for joint replacement surgery was, according to Briones, exacerbated by excessive weight.

“Losing all the weight can be a lifesaver for these patients with knee and hip problems who use canes to walk,” says Briones, who opened her Medical Weight Loss Center, a Mt. Kisco-based medical weight loss facility in 2007. Briones partners with her patients, motivating them, and investing in their weight loss success.

Individualized Plan for Patients

Briones focuses on whole body health. She works with her patients to set up goals and plans. She identifies any medical causes of weight gain and designs a manageable weight loss reduction program for her patients. She creates individualized nutrition plans, vitamin and supplement regimens, and professionally designed, customized exercise plans. If necessary, she provides FDA-approved appetite suppressants and hormone replacement therapy. 

Most importantly, Briones helps her patients develop a long-term wellness plan, teaching her patients how to maintain their weight loss and offering ongoing support whenever they need it. Her plans are adaptable to the changing needs of her patients. “My patients feel like I am a friend,” says Briones, who credits her warm relationships with her patients for much of her success.

Former Pound Ridge resident Nancy Farkas, who spent three years as Dr. Farkas’s patient, whole-heartedly agrees that Briones’s close relationships with her patients is key to their success. “Dr. B is wonderful to speak with, she’s inspirational. We had a wonderful relationship.” Farkas, who saw Briones approximately once a week, was impressed with the detailed yet flexible program that Briones built for her. “I followed her specific schedule and her careful instructions, and that was a huge thing for me.”

Briones has lived in Westchester for over 25 years, spending the past 15 years in Chappaqua. “This is a great place to raise a family.” She started her career as an internist. Born in Spain and raised in Nicaragua, Briones attended medical school in Costa Rica before coming to the United States.

Long-Term Relationships with Patients

“People tend to stay with me,” says Briones, who has significant client retention and a high percentage of success. She believes that feeling good about yourself is key to staying healthy. That is why Briones encourages her patients to take steps to ensure that they do not look older than they feel.

In addition to weight loss therapy, Briones offers non-surgical weight loss solutions, including cellulite treatments, Cool Sculpting, and Lipo Light Therapy. She started adding cosmetic procedures, like Botox and Ultherapy as well as other anti-aging, skin tightening, and skin rejuvenation therapies. These cosmetic procedures are designed to help patients maintain their youthful radiance.

Briones works with two certified medical assistants, both of whom help with everything from interacting with patients to taking vital signs. “Her staff is so helpful,” says Farkas, who believes that everyone at the Medical Weight Loss Center goes out of their way to “act in your best interest and to motivate you to stick with the program.”

Briones encourages everyone to try to be their best self. “Don’t be afraid to make a change in your life. It’s always better to try. Anything is possible.”

Filed Under: Words & Wisdoms From Our Sponsors Tagged With: Dr. Maria Briones, hip problems, Knee problems, weight gain, weight loss, weight loss reduction, Weight Managment

My Get Fit Journey

October 21, 2016 by The Inside Press

grace-bennettIn time for our ‘Gratitude’ edition, I’d like to mention a journey I’m on at the Saw Mill Club in Mount Kisco. I announced on Facebook recently that I’d gained a lot of weight over the last year. I’m grateful that I have the opportunity to work out twice a week with a wonderfully engaging and pro personal trainer, Sarah Eichorn. She’s making a huge difference in how I feel both physically and mentally in my still kind of new empty nest years.

The changes in how I look and feel are coming in little increments, and I’m embracing Sarah’s belief that a positive journey is as important to my well-being and long term success as any weight loss I experience. I’ll be writing more about this special journey in the next edition, too!

So, tell me. What are you grateful for? Maybe your experience could also be a story in a future edition of Inside Armonk! Please drop me a note any time: editor@insidearmonk.com

Filed Under: Armonk Just Between Us Tagged With: Get Fit, Gratitude, journey, Just Between Us, Sarah Eichorn, Saw Mill Club, weight loss

Dr. Maria Briones: Transforming Lives One Pound at a Time

April 21, 2016 by The Inside Press

By Miriam Longobardi

Anyone who has ever struggled to lose weight knows how difficult and frustrating it can be, both losing the weight and keeping it off. Those who have significant weight to lose –beyond a few extra pounds after a vacation–face a greater challenge. Enter Dr. Maria Briones, owner of Dr. Briones Medical Weight Loss Center located in Mt. Kisco.

Photo by Carolyn Simpson/Doublevision Photographers
Photo by Carolyn Simpson/Doublevision Photographers

Dr. Briones began her career as an internist in New York City in 1994 and in addition to her weight loss clinic works at Burke Rehabilitation Center in White Plains. During her career she has always been concerned about obesity and its related diseases such as hypertension, diabetes, heart disease and stroke as well as some cancers. At Burke she also noted that some of her patients who had undergone hip and knee replacements needed the surgery as a result of obesity. “I want to help people before obesity takes a toll on their health and body and possibly avoid surgery and some of the diseases connected to obesity.”

At her weight loss center, Dr. Briones assists patients far beyond helping them develop healthier eating habits to lose weight. Her approach is very personal and addresses the many psychological effects of obesity. “In addition to the effects on the body, being obese changes how people feel about themselves. The most common are loss of self-esteem and depression. As I help them lose weight I didn’t have to use any medication.”

All patients must undergo a health evaluation and obtain medical clearance to participate in the diet plan. After that, patients come for weekly visits to be weighed and spend time being counseled by Dr. Briones. “They need to change the relationship they have with food.” She helps them develop a plan which they must be disciplined enough to follow. Part of her plan involves using Optifast, a meal replacement program that must be medically supervised. “With Optifast patients can see results similar to surgery sometimes in as little as six months,” Briones reports. Depending on the amount of weight to be lost, patients begin with the Optifast meal replacements very strictly for approximately four to six months. “It’s like people that want to quit smoking –they have to really be ready for it and commit to following the program.”

Elysa Belessakos, a patient and one of Dr. Briones’s many success stories, says that working with Dr. Briones changed her life. “The woman is brilliant,” said Belessakos. “She completely devotes herself to her patients and gives us one-on-one personal attention.” While some people relate to group support such as Weight Watchers, Belessakos feels the emotional support she receives from Dr. Briones helped her sort through emotional eating issues that in the past always caused her to gain back weight she had lost. “A lot of people dealing with obesity don’t want to sit in front of a group and talk about their weight loss struggles,” says Belessakos. Through a combination of the Optifast meal replacements, Lipo-Light, which is a machine that burns fat cells in targeted areas of the body, and Dr. Briones teaching her about nutrition and talking her through strategies to avoid emotional eating, Belessakos is down 40 pounds. “I get so many compliments!” she enthusiastically reports.

After sticking closely to the Optifast plan, which also offers nutrition bars and soups in addition to the meal replacement shakes, transitioning back to mainstream food can be challenging. Dr. Briones is considering adding a nutritionist to her staff but Briones helps her patients with meal planning, food shopping and menus to help them keep the weight off and follow up with her for maintenance.

Belessakos says that it is the level of devotion she and the other patients receive from Dr. Briones that gives them the support and encouragement they need to maintain their weight loss. “It’s her personality that sets her apart from other doctors. So much of weight loss is psychological and you get one-hundred percent of her attention. She listens, gives you feedback and is so warm and encouraging that nobody wants to stop seeing her.”

A wife and mother of three children, Dr. Briones continues to learn and explore new medical breakthroughs through professional associations and by attending conferences regularly. She recently added anti-aging and skin care products at her center. Belessakos adds, “She absolutely loves what she does and genuinely cares about each of her patients with compassion.”

Dr. Briones feels that in addition to being healthier physically, one of the greatest accomplishments she sees in her patients is their attitude toward life. “Not only are they active and have more energy but their social and intimate lives improve. It’s amazing the effect weight loss can have on a person’s life.”

For more information, visit http://www.brionesweightloss.com/.

Miriam Longobardi is a freelance writer, fourth grade teacher and single mother of two daughters living in Westchester. A breast cancer survivor, she volunteers for the American Cancer Society, has completed four marathons and travels the world. Follow her on Twitter @writerMimiLong.

Filed Under: Cover Stories Tagged With: Dr. Briones Medical Weight Loss Center, Dr. Maria Briones, health, Inside Press, obesity, theinsidepress.com, weight loss, Westchester

Reframing Loss and Gain

October 21, 2015 by The Inside Press

Apple picking with the family in 2014: From left, Timothy Radice, Gabriella Radice, Gavin Radice, Kourtney DeRosa-Radice.
Apple picking with the family in 2014: From left, Timothy Radice, Gabriella Radice, Gavin Radice, Kourtney DeRosa-Radice.

By Kourtney DeRosa-Radice

Not too long ago, I was 85 pounds heavier than I am today. I moved to Westchester, had two children back-to-back and pretty much put my needs and wants on the back burner.  I prepared my children organic baby food, dressed them in the cutest little outfits, brought them to those fancy gym classes for little ones and LOVED them beyond words.  However, my self-care was another story. I started eating frozen processed foods, traveled around in faded black sweatpants, canceled my gym membership, and pretty much stopped caring for myself. My days of being that women I once was were now gone; this was the new me, the new mom me. My priorities were different and that was okay, or so I told myself.

One day, after getting a glimpse of a picture of my kids with a “stranger,” aka mom, I decided to take action and started a journey down a road that would eventually lead me back to the women I once was, the women I loved and knew so well. Ironically this journey pretty much mirrored all that I had been doing for my children. My days started consisting of eating mostly clean, non-processed foods (similar to what my children had been eating), completing daily workouts (though not at fancy gyms like my kids) and dressing like I was leaving the house (even if I wasn’t).

The result of my efforts was a huge weight loss, which I am congratulated about daily. Each day I hear the words, “Wow, congratulations on your loss…” “Awesome job with your loss…” “You must be so proud of your loss…” Hearing the word loss day after day, used in such a positive manner feels odd. I had been programmed from a young age to think of loss as a negative. I’ve always connected loss to sadness. I’ve connected it to stress and aggravation.  I’ve viewed it as loss–not gain.

Then, one day, after being at a Moms Night Out and talking about my loss yet again, I had that “ah hah” moment.  You know, those moments when you realize you need to rethink our thinking! Wait, I thought. my weight loss isn’t the only loss in my life that has been positive. I quickly went through the moments in my life where I experienced sadness as a result of loss.

I thought about my husband losing his job on the trading floor when the markets went electronic. I thought about losing a beautiful home in Pleasantville in a bidding war. I thought about losing out on what I thought was my dream teaching position in Westchester. Then I thought about what I gained from each of these experiences. My husband losing his job led me to become a nutrition coach which has allowed me to support hundreds of people with their weight loss. Losing our dream home in Pleasantville encouraged us to expand our search and this led us to finding a home in Armonk. And that dream job–well, had I been offered it, I would have never decided to stay at home part time with my children. This idea that a loss could actually bring you to a happier place, a healthier place, an all around better place was now clear in my mind.

As we approach the Thanksgiving Holiday and I continue to think about this whole idea of loss I can’t help but wonder if everyone already knows what it took me 36 years to figure out. Do people know that loss, though negative in some aspects, can also be positive as well? Do people know that sometimes a loss is actually just a gain in disguise?

This year things will be different at my Thanksgiving table for sure. For one, the food I typically prepare will be getting a facelift. There will be no marshmallows on my sweet potatoes and no cream in my corn. There will be no green bean casserole with cream of mushroom soup and no gravy on my turkey. There will, however, be a revised list of what I am thankful for. This year I am going to take a step back and reflect on all that I have lost. I plan to give thanks for all the loss in my life that has brought me to the place I am today. Sometimes it is hard to see the positives in loss, but, when you put on those special lenses, they begin to jump out at you.

With this I challenge you to go beyond only giving thanks for what you have gained this year and, instead, think about what YOU have lost. Have you experienced a loss this year, which has inadvertently led to a positive in your life?  As you sit at your Thanksgiving table and you give thanks for all the gains you have attained, remember to include your losses too. After all they deserve to be thanked as well.

Kourtney DeRosa-Radice is an Armonk mom, public school teacher and Team Beachbody Health and Fitness Coach.  When not enjoying her children or teaching her students she devotes her time to assisting clients in reaching their health and fitness goals. Kourtney can be reached at: Kradice@beachbodycoach.com

reframe4

Filed Under: Armonk EtCetera Tagged With: advice, Family, health, Inside Press, reflection, theinsidepress.com, weight loss

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