Northwestern Medicine and Delnor Health & Fitness Center transform bariatric support

THE CHALLENGE

OBESITY IS A PUBLIC HEALTH CRISIS: Almost 40% of American adults are obese and getting heavier—a trend that shows no signs of slowing down.1 More significantly, almost 8% of this group is severely obese, with a body mass index of 40 or more.2 Since obesity heightens an individual’s risk of developing heart, kidney and liver disease, a wide range of cancers and more, it’s clear we’re in the midst of a public health crisis3 —and an expensive one at that. Obesity costs the U.S. economy an estimated $270 billion a year4 in medical care and lost wages and has also spurred a rise in bariatric surgeries to treat severe obesity. By 2020, it’s estimated over one million Americans will have turned to bariatric surgery as a solution for morbid obesity.5

The ASMBS total bariatric procedure numbers are based on the best estimation from available data (BOLD, ACS/MBSAQIP, National Inpatient Sample Data and outpatient estimations).

*New methodology for estimating outpatient procedures done at non-accredited centers

DIETS, WEIGHT LOSS PROGRAMS AND SURGERIES AREN’T ENOUGH

Research shows that Americans must add physical activity to the equation if they hope to achieve and maintain weight loss and physical fitness goals. Less than 25% of Americans heed current best-practice recommendations for an hour of moderate to vigorous exercise a day.6 To improve outcomes, bariatric physicians/surgeons often pair other treatments, from eating plans to fitness programs, with weight loss surgery. However, many bariatric patients are turned off by the lack of personalization and/or expense of personal training found at most commercial fitness centers. They also may have existing chronic co-morbidities, such as diabetes or arthritis, requiring guidance from experienced, credentialed fitness professionals: BARIATRIC PATIENTS NEED A HOLISTIC APPROACH WITH PROFESSIONAL SUPPORT “Lifestyle changes, including exercise, are essential for long term success following bariatric surgery. The Metabolic Health and Surgical Weight Loss Center is incredibly lucky to partner with the Delnor Health & Fitness Center to provide exercise screenings, education, and fitness programs in a welcoming atmosphere. It is these lifestyle changes that will ensure lifelong success for our patients.” - Matthew Pittman, MD Director of Bariatric Surgery, Northwestern Medicine Delnor Hospital

BARIATRIC PATIENTS NEED HOLISTIC FITNESS PROGRAMS WITH CLINICAL SUPPORT

Bariatric physicians have found that many patients do best with an integrated treatment approach, where body, mind and spirit work together with the support of trained, credentialed professionals such as physical therapists (PTs) and registered dietitians (RDs). This holistic approach requires partnering with state-of-the-art wellness facilities, which offer these (and other) aforementioned resources. Wellness Centers provide help with motivating, engaging programming, professional support staff and a general sense of “fitting in” that many of today’s commercial gyms and fitness centers often lack.

THE SOLUTION

NEXT STEPS FITNESS PROGRAMS™ AT DELNOR HEALTH & FITNESS CENTER

Delnor Health & Fitness Center, managed by Power Wellness (Power), and affiliated with Northwestern Medicine Delnor Hospital, offers medically integrated programming via the Next Steps Fitness Programs™: Ten 8-week, medically based fitness programs designed for individuals transitioning from or managing a medical condition, or simply needing additional support.

TABLE 1 – NEXT STEPS FITNESS PROGRAMS™ PATHWAYS
CANCER FITNESS

Improve your muscle function, range of motion, and reduce fatigue.

COGNITIVE HEALTH

Slow age-related decline and reduce disease related cognitive impairment through structured exercise.

FIT FOR SURGERY

Prepare for surgery by increasing strength and endurance for a quicker, easier recovery.

ORTHOPEDIC FITNESS

While managing a recurring injury or after completing therapy, this program can help you become active again

TRANSITIONAL CARE

If you have health issues due to an inactive lifestyle, this exercise program can help you improve your health and stamina.

CARDIAC FITNESS

Reduce your risk of cardiovascular disease through this heart-healthy program.

DIABETES FITNESS

Manage your type 1 or type 2 diabetes or pre-diabetic symptoms through physical activity.

FUNCTIONAL FITNESS

Increase your daily function and reduce pain with this gentle movement exercise.

PULMONARY FITNESS

This individualized, supervised program will increase your level of physical activity if you have pulmonary or respiratory conditions.

WEIGHT MANAGEMENT

Learn how to set realistic goals and develop new physical activity habits while pursuing a healthy weight

Next Steps Fitness Programs™ Weight Management Program at the Delnor Health & Fitness Center has been offering bariatric patients the resources and strategies they need to become more active, fit and healthy through good nutrition, education and exercise since its inception in 2014. Delnor Hospital’s Bariatric physicians have come to depend on this program to support both surgical and non-surgical weight loss patients

HOW THE WEIGHT MANAGEMENT PATHWAY HELPS BARIATRIC PATIENTS

By offering seamless integration between Delnor’s medical providers and the Delnor Health & Fitness Center this program optimizes physicians’ time and patients’ results. Here’s how: Weight management patients receive an initial assessment by a board-certified bariatric physician and a registered dietitian (RD) at Northwestern Medicine Delnor Hospital, to determine the factors that may have contributed to the participant’s weight issues. The RD designs and shares effective diet-related options for weight loss, in some cases prescribing a “quick-start” program that uses nutritional products. The RD ensures that over time, the patient integrates accessible food into his/her diet. a. Patients also participate in weekly classes with the RD covering nutrition, exercise and healthy habits. At Delnor Health & Fitness Center each patient starts with an intake assessment completed by a degreed and nationally-certified fitness specialist. a.As a condition of employment at the Delnor Health & Fitness Center, these specialists must be accredited by a nationally-recognized certification body such as the American Council on Exercise (ACE), the National Academy of Sports Medicine (NASM), the American College of Sports Medicine and/or the National Strength and Conditioning Association (ACSM, NSCA). The patient starts the Next Steps Fitness Programs™ Weight Management Pathway with a customized, 8-week fitness program. This program includes two supervised group exercise sessions weekly, including a variety of cardiovascular, variable resistance and strength equipment along with land and aquatic classes

While Delnor’s staff provides individual and personalized service to the Weight Management Program’s bariatrics patients, Power Wellness ensures that support, resources and continuing education on this populations’ special needs are available to the Delnor fitness staff. Another key service the Delnor staff provides, fueled by the structure Power developed for this program, is real-time communication with the participants’ physicians, including detailed assessments that track their patients’ progress, outcomes and experiences

“The Next Steps Fitness Programs™ have proven to be a highly beneficial option for bariatric patients, whether they’re transitioning out of rehab or need guidance to develop a healthy lifestyle. Working with this population has shown me how exercise can make a momentous and transformational difference in patients’ lives. It improves their abilities, boosts their confidence and empowers them to strive for still greater results. Seeing their remarkable progress first-hand is eye-opening and makes me realize that exercise is truly medicine.” - Monica Green, B.S., ACE CPT, ACSM EIM-L1 Field Medical Integration Manager

FITTER, SLIMMER AND MORE ACTIVE BARIATRIC PATIENTS

Between 2017 and July 2019, 133 bariatric patients ranging in age from 20s to 70s participated in the Next Steps Fitness Programs™ Weight Management Program at Northwestern Medicine Delnor Hospital. During this time frame 67 (50%) completed the program. These participants experienced statistically significant changes in their weight and BMI.

THE RESULTS

Hudson Institute’s Food Policy Center 2018 research shows that obese people hold starkly different views on diet and exercise than their normal weight peers. Obese and overweight people are simply less likely to exercise; however, of the bariatric patients who participated in the Next Steps Fitness Programs™ Weight Management pathway, nearly a third (29%) joined the Delnor Health & Fitness Center, and another 46% became members upon program completion. These transitions represent a positive behavior shift, moving from inactive to self-directed exercise participants.

COMPLETION RATES SPELL SUCCESS FOR PATIENTS AND PROVIDERS

With an overall (since 2014) 54% completion rate—a higher than industry average result for bariatric patients— Next Steps Fitness Programs™ Weight Management pathway shows that a medically supervised approach to incorporating fitness into the bariatric experience improves physical health and increases the odds for weight loss success. With nine participants still enrolled, the Weight Management program is also an effective tool for Northwestern Medicine Delnor Hospital and Delnor Health & Fitness Center and has the potential to increase Center membership, thus driving revenue. Two years and 110 pounds less “The Next Steps Fitness Programs™ set me up for ongoing success for the long term by meeting me where I was, not where anyone thought I should be. Because of that, I took away the team’s shared belief that EVERYONE deserves to be in a gym and it keeps me coming back, two years later and 110 pounds lighter.” - Cheryl Curry Next Steps Fitness Program™ Participant

ABOUT POWER WELLNESS

Power Wellness is the nation’s largest management company in the medical fitness industry. Founded in 1996, Power Wellness has managed over 50 fitness centers for healthcare systems, academic institutions and community foundations and municipalities. Today, Power Wellness serves over 120,000 customers, managing 5 million visits by our 3,200 team members nationwide. With three strategic service lines, Power Wellness has the valueadded resources to help you succeed.

Power Wellness makes a difference in their client partners’ communities

“With an estimated cost over $250 billion annually, obesity continues to be one of our nation’s most pressing health epidemics. Our Next Steps Fitness Programs™ are cost effectively helping all populations–youth to seniors– improve quality of life and ‘bend the cost curve’.”

- Ken Gorman Founder & CEO, Power Wellness

REFERENCES

  1. Tanya Albert Henry, The State of Obesity: Better Policies for a Healthier America 2018, (the Trust of America’s Health and Robert Wood Johnson Foundation) as reported by the AMA-assn., November 2018
  2. Craig M. Hales, MD,, Cheryl D. Fryar, MSPH,, Margaret D. Carroll, MSPH, et al, Trends in Obesity and Severe Obesity Prevalence in US Youth and Adults by Sex and Age, 2007-2008 to 2015-2016, JAMA, April 2018
  3. Weight Loss Surgery Centers Industry in the US – Market Research Report, IBISWorld, December 2018
  4. Estimate of Bariatric Surgery Numbers, 2011-2017, American Society of Metabolic and Bariatric Surgery (ASMBS), June 2018
  5. Afshar S, Seymour K, Kelly SB, et al. Changes in physical activity after bariatric surgery: using objective and self-reported measures. Surg Obes Relat Dis. 2017;13:474–83. [PubMed] [Google Scholar]
  6. Campaign resources, including interactive tools, fact sheets, videos, and graphics, are available at https://www.health.gov/PAGuidelines/
  7. Why Obese People Find it So Tough to Slim Down, June 20, 2018 https://www.webmd.com/diet/obesity/news/20180620/why-obesepeople-find-it-so-tough-to-slim-down#1