Spotlight on Dr. Michael Nusbaum, MD, FACS, FASMBS Noted Bariatric Surgeon, Yearly Patron of the HealthCorps Gala
Dr. Michael J Nusbaum has been a HealthCorps supporter and patron for a number of years. He was born in Livingston, NJ. He attended Washington and Jefferson College and Oxford University for his undergraduate studies. He then attended Rutgers Medical School and entered into the field of surgery training at Saint Barnabas and Memorial Sloan Kettering Cancer Center. He is an accomplished academic author with numerous academic publications and recently released a textbook entitled, “Metabolic Medicine and Surgery” through CRC Press. He is currently the Chief of Bariatric Surgery at Morristown Medical Center, Director of Bariatric Services for Atlantic Health and the Surgical Director of the Metabolic Medicine and Weight Control Center for Atlantic Health. He has served as an adviser to HHS and is part of the President’s Patient Access Summit held at the White House. He holds numerous patents and has both started and sold several tech companies. He resides in Far Hills, NJ with his wife and three children. The following are some thoughts from this gifted and world-renowned bariatric surgeon.
How did bariatric surgery and treating obesity become your focus of interest?
In 1998, the obesity epidemic was just being recognized. At that time, the majority of bariatric surgery was being performed with open operations. Since there were only a handful of surgeons performing laparoscopic bariatric surgery, it was considered the forefront of innovation at that time. After receiving training from Michel Gagner, I performed the first successful laparoscopic gastric bypass at Saint Barnabas Medical Center later that year. I then became enthralled with the happy patients and the ability to have a meaningful positive impact upon their lives.
Share a bit more about your training background and where you currently practice?
I attended medical school at Rutgers Medical School and then did my surgical training at Saint Barnabas Medical Center, UMDNJ and Memorial Sloan Kettering Cancer Center. I currently practice out of Morristown Medical Center where I serve as: Chief of Bariatric Surgery, Director of Bariatric Surgery, Surgical Director of the Metabolic Medicine and Weight Control Center.
How has the field of bariatric surgery evolved since the first surgical interventions?
Since 1998, much has changed in the field of Bariatric Surgery. I was the first surgeon to perform a Robotic-Assisted Gastric Bypass in the New York tri-state area, and I invented the technique of intra-operative upper GI fluoroscopy to detect leaks (post-surgery) back in 2000. Today, we have added Sleeve Gastrectomy to the procedures that we can offer our patients. We also perform non-invasive body contouring using lasers instead of incisions, and liposuction.
How do you decide if bariatric surgery is the appropriate treatment for a specific patient?
Bariatric surgery is a selection of last resort. It should only be considered when all other non-surgical options have been exhausted and have not been successful. The choice of surgery is very patient- specific and is based upon many factors.
How do lifestyle change efforts come to bear in the patient who seeks bariatric surgery?
We often say that there is your life before bariatric surgery and after bariatric surgery. A patient’s life and lifestyle choices change completely after surgery. This includes an increase in exercise and healthy eating, as well as ongoing nutritional counseling. These lifestyle commitments help to support a long term successful outcome of the surgical intervention.
Is there a lower and upper age cut off for bariatric surgery?
Consideration of the age of the patient who is being assessed for possible bariatric surgery is based on the type of surgery selected and the health condition of the patient. While pediatric bariatric surgery remains controversial in some circles, there is clearly a role for the surgery in certain children. As for the upper age limits, it is based on physiologic age and not biologic age.
Do you feel we are making progress slowing or halting the obesity epidemic in the U.S.?
We are clearly making a dent, however, less than 1% of patients who qualify for bariatric surgery, actually undergo the surgery each year. This means that we are not helping enough people. In addition, efforts to stop the burgeoning pediatric obesity epidemic have resulted in a leveling off of the rate, but has yet to show a reduction in pediatric obesity rates in the US.
What are your thoughts specifically about teen weight issues and obesity? Are habits more entrenched at that point?
It is never too late to develop good habits. The key to teen weight issues are regular daily activity and healthy eating habits. Clearly that is easier said than done, but the key to both is to make them part of your everyday life. Everyone should schedule time to exercise. Don’t say that you’ll do it when you have time, because you’ll never have the time. Don’t say next time I go out to eat I’ll eat healthier. Just do it.
What is your perspective on the HealthCorps model for intervention? Can we make inroads in the teen age group with regards to obesity and lifestyle change?
Absolutely. I firmly believe in the HealthCorps model, and I believe that healthy kids showing other kids how to become healthy is a strong motivator. Teens can not only influence younger kids to develop good habits but also their peers. The coordinators as close-in-age mentors can definitely help to impact and change teen behaviors. And HCU will now offer the curriculum in schools that may not have access to in-house coordinators.
What is your personal feeling about the “team” approach to managing obesity? Do patients require support from a variety of different health practitioners in order to successfully maintain their hard-earned weight loss?
I feel that the team approach is essential to managing obesity and that a multidisciplinary approach is paramount to success. That team should include: Dietitians, Nutritionists, Metabolic Specialists, Exercise Physiologists, Psychiatrists and Psychologists, support groups, counselors, family members and Bariatric Surgeons.
What can parents do to intercept generational obesity challenges in the family?
Genetic obesity is clearly a problem that is not easily dealt with by many. The analogy would be trying to teach a first-time swimmer to swim upstream, against a current. They just can’t do it and when they do they only get so far, and then they get pushed back when they give up. This is where the Metabolic Specialist and Bariatric Surgeon come into play. Parents need information and guidance when they are dealing with obesity in the family, especially when it is generational. The need to know all the treatment options and they need to have access to specialists like myself, even if just to begin a conversation.
What is at the root of the burgeoning obesity statistics – Is it genetics? The environment? The abundance of processed food? Too little physical fitness? Emotional eating? The age of computers?
It is really all of the above. Genetics definitely plays a strong role in many patients who struggle with serious weight issues. Environment also plays a role when it comes to behaviors and eating habits. Processed foods are a problem, especially when it comes to HFCS (high fructose corn syrup) and other sweeteners. We are certainly eating too many processed foods on a regular basis, with little consideration of portion control and quality (nutrient value) of foods. Lack of physical activity is definitely an issue for almost all of those who have a weight issue; however, with genetic obesity, individuals can exercise and still not see results. Emotional eating is always a problem and it needs to be treated through counseling.
You’ve been a big supporter of HealthCorps, attending the Gala, our yearly (and largest) fundraiser every year. Why have you made this pledge to HealthCorps?
Efforts like HealthCorps have measurable impact. I have supported HealthCorps and will continue to support HealthCorps. I would like to see HealthCorps have a role in the Affordable Care Act (ACA). I believe that the HealthCorps model could and should be supported through federal funding and pushed out across the country. I, personally, will do everything I can to see that happen.
As busy a physician as you are, you found time to author a book, correct?
My novel, “Ere Aworan” is available from Amazon and Barnes and Noble. There is a version for Kindle and Nook as well. It’s a moving story of The Underground Railroad, slavery, love, hope and redemption. Click here for more information.
You can also read more about Dr. Nusbaum.
-Amy Hendel, PA/HealthCoach