Johns Hopkins Aramco Healthcare employs distinctive integrated approach to obesity

The patient was a grandmother. She had diabetes, obstructive sleep apnea and a body mass index of 84 — more than four times what experts consider healthy. 

In October 2018, Dr. Hien Nguyen, a bariatric surgeon visiting Johns Hopkins Aramco Healthcare (JHAH) from Johns Hopkins Medicine (JHM) in Baltimore, accepted her as a patient. He and Dr. Michael Schweitzer, director of the Johns Hopkins Center for Bariatric Surgery, were on a clinical rotation to share knowledge with their colleagues at JHAH and to perform surgical procedures, including this patient’s operation and 10 other complex cases.

Five months later, the patient was doing well and meeting her weight loss benchmarks. She says she can now walk in her garden for the first time in a very long time, and she even brought in her extended family to thank Dr. Abdullah Madaani, JHAH's Bariatric Surgery Program director, and his expert care team. 

Fighting a growing health crisis

While this case of obesity may seem extreme, it is far from an isolated occurrence. In Saudi Arabia, one in three adults suffer from obesity, and at least one in 10 have morbid obesity.

JHAH had established the first bariatric weight management program in the Eastern Province of the Kingdom in 2009. However, obesity rates among JHAH’s patient population continue to increase — underscoring a global health crisis. 

In 2016, JHAH, Saudi Aramco, and JHM felt an urgency to expand the weight management program by developing a dedicated, multidisciplinary center for obesity care and enhancing bariatric surgical services, including introducing new procedures and techniques. 

Comprehensiveness was key. The partners strived to engage all departments that are involved in obesity care. In addition, they wanted to serve JHAH patients’ needs across the continuum of care — from pre-surgery assessment to post-surgery support services. 

Partnering on pathways 

The JHM team has been sharing best practices to help JHAH continue to develop the interconnections among services involved in a successful obesity management program, including nutrition, psychology, nursing, care coordination, and health education. 

This kind of information sharing is strengthening the obesity management program JHAH has been cultivating for nearly a decade. A significant amount of collaborative work has gone into defining clear-cut pathways to get patients through the preoperative, perioperative and post-operative processes in the most efficient way.

JHAH obesity management patients participate in an educational program taught by a clinical dietitian, social worker, and registered nurse. During that time, patients also receive individual counseling by a clinical dietitian, which includes goal setting and post-operative bariatric nutrition education. The goal is for patients to achieve at least a 10% change in their body composition or weight.

JHAH’s program emphasizes that weight loss isn’t a quick process, nor is it a quick fix. Making positive changes for long-term wellness is a journey that requires conscious effort.