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A team approach to weight management is critical to success

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For many in Hawaii, weight loss is more than improving appearance. It offers a better lifestyle, greater mobility, reducing medication and lowering risk from diabetes, heart disease and other chronic conditions, some of them life-threatening.

Nevertheless, shedding excess weight – especially from a condition of obesity – can be challenging, and even more so without proper education in reaching and maintaining a healthy weight.

Hawaii Pacific Health 360º Weight Management Centers’ Dr. Maria Ver and Lianne Metcalf. Photo by Anthony Consillio

“Gaining weight is easy, losing weight is hard,” says Dr. Maria Ver, a surgeon at Pali Momi Medical Center. “Our bones and muscles are made to accommodate a certain weight. If we gain more weight, our body doesn’t perform optimally, and we are prone to getting diseases, like diabetes, high blood pressure, sleep apnea, and joint pains. There are also a lot of emotional and social health problems related to weight gain.”

Weight management has become a more prevalent challenge over the last several decades throughout the U.S. and in the islands.

“The American Diabetes Association found 13 percent of Hawaii residents are diabetic and 42 percent are pre-diabetic,” says Lianne Metcalf, a registered dietitian at Pali Momi, “That’s really high and it’s a major health concern here.”

Ver, a bariatric surgeon since 2013, further warns, “Obesity is a worldwide disease. One out of four people in Hawaii is obese.”

Ver and Metcalf are both team members at the Hawaii Pacific Health 360° Weight Management Center at Pali Momi, which includes two bariatric surgeons, an obesity medicine physician, two bariatric nurses, two dietitians, and one medical assistant. The highly trained and specialized professionals collaborate to design a wellness program that can address medical diseases and keeps their patients healthy.

“We help them change their lifestyle. Patients reduce or eliminate their medications and we reverse chronic medical conditions that would otherwise have taken a long time to resolve,” Ver says. “This program also provides long-term support for patients. We follow them over time and continue with healthy lifestyle counseling.”

Pali Momi’s program offers both surgical and nonsurgical programs and services. “Our approach is unique because we tailor our specialized care around the needs of our patients. This is not a one-size-fits-all program,”explains Dr. Mark Grief, a surgeon at Pali Momi and medical director of the 360° team.

Photo by Anthony Consillio


The center offers a comprehensive approach to weight management, focusing on the “CHANGE” process, which stands for Comprehensive Health Assessment, Nutrition, Guidance and Exercise.

A new diet program is also becoming available for busy individuals who don’t have time to shop and prepare balanced and nutritional meals. The Ideal Protein Protocol launches in February, offering medical-grade foods such as protein supplements, protein bars, shakes and a variety of mixes. “You won’t have to go to the grocery store as often. It’ll be there ready for you,” Metcalf says.

For some patients, bariatric surgery options are also part of treatment. Ver describes the Roux-en-Y gastric bypass surgery as “having your stomach go from the size of a football to the size of a golf ball and altering the path of your small intestine. Not only do you feel full faster, but more importantly, there are significant changes in digestion and body metabolism, which makes you feel fuller faster. We need to appreciate that bariatric surgery is metabolic surgery.” Another surgical procedure, the sleeve gastrectomy, which reduces stomach size by 80 percent, gives patients a 55-75 percent reduction of excess weight loss, like the bypass surgery.

The programs and services at Pali Momi have been life-changing for patients and staff members alike.

“Aside from lifestyle improvement, like being able to sit at a restaurant booth, some women no longer have reproductive issues and have started families,” Metcalf says. “We have patients who have become marathon runners, world travelers and even offered better job opportunities as a result of their weight loss.”

“It’s very rewarding to see patients get better, be happier and remain healthier,” Ver adds. “I’m getting them out into the world, and that makes me feel awesome.”

Metcalf encourages people to make health a priority.

“Learning what to do long-term is half the battle. Become educated on being a healthier you. It’s not always the easiest thing to do, but it’s a necessity. We are here to help.”


A height-to-weight formula, also known as the body mass index (BMI), is the most common measure used to determine if people are overweight or obese. The Centers for Disease Control and Prevention states a BMI over 25 is considered overweight. For someone 5 feet, 4 inches tall, that’s 146 pounds. For someone 6 feet tall, that’s 185 pounds. Anything above a 30 BMI puts people in danger of a medical-related disease, and health risks increase exponentially at a BMI of 40 or more.

To calculate your BMI, click here.

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