“What is so outstanding to me about weight loss surgery is how dramatically it can change a person’s life,” says bariatric surgeon Francesca Dimou, MD, MS. “Even before they leave the hospital, they are on less medication. When you see them three months later, they may have lost about 50 pounds and they are able to walk around and live their life. The transformation that weight loss surgery can provide is very rewarding to me as a surgeon.”
Obesity is a common, serious disease that affects more than one third of adults and one in five children in the United States. Being overweight or obese increases a person’s risk of type 2 diabetes, heart disease, stroke, fatty liver disease, kidney disease and other health issues.
Dimou, who joined the Section of Minimally Invasive Surgery in 2019, helps people lose weight and keep it off.
People who have weight loss surgery, also called bariatric surgery, are often motivated by a desire to improve their overall health. Typically, people who have bariatric surgery have tried to lose weight with diet and exercise, but have gained most or all of that weight back. Dimou says that people come to her for a variety of reasons.
“Fathers have come to me, saying their daughter wants to run around in the back yard with them, but they can’t do that because of their body weight. Their joints hurt,” Dimou says.
Obesity can limit a person’s mobility and impact their ability to live their life. The disease also has a serious mental health impact.
“I see a lot of young women in my clinic,” Dimou says. “They are in their 20s or 30s, and they have a lot of pressures on them. They are already struggling with their weight and health, and they have the added stress of what we see in the media.”
While people come to the Weight Loss Surgery Program at Washington University School of Medicine in St. Louis with different motivations, Dimou hopes to give each person an important tool to help transform their life.
Overcoming Obstacles
Dimou completed an Advanced Gastrointestinal and Minimally Invasive Surgery Fellowship at New York Presbyterian/Weill Cornell Medicine. She earned her medical degree and completed a general surgery residency at University of South Florida in Tampa. During residency, Dimou also earned an MS in statistics and clinical sciences from University of Texas Medical Branch in Galveston, where she conducted outcomes research in general surgery.
Becoming a doctor was always Dimou’s plan. She made the decision when she was a child and her younger sister was diagnosed with autism.
“I thought I would be the doctor who would cure autism,” Dimou recalls. “Throughout high school I never veered away from being a physician. When I got into medical school, I thought I would become a neurologist, but I realized that wasn’t the right fit for me.”
Instead, Dimou chose surgery. She enjoyed working with her hands and loved to see the changes she could help patients achieve.
“As a woman, there were certain obstacles to becoming a surgeon,” Dimou states. “Surgery is a traditionally male-dominated field. More and more women are going into medical school, but it seems like women are sometimes discouraged from surgery. This is despite the fact that many female medical students are very good in the operating room and very willing to learn.”
Dimou was not discouraged from pursuing surgery. She says she was influenced by one of her mentors in medical school.
“She was so smart, so great in the OR, such a great teacher and mentor for me,” Dimou remembers. “She told me that, if I wanted to be a surgeon, I couldn’t let anything stop me.”
Dimou did not let anything stop her. She went on to become an expert in robotic surgery and a physician in the Weight Loss Surgery Program at the School of Medicine.
Her interest in robotic surgery began during her fellowship at Cornell. She gained experience with both laparoscopic and robotic surgery, and found that she preferred the robotic approach. In robotic surgery, the surgeon sits at a console in the same room as the patient and controls the arms of a robot using instruments to perform the operation.
“The robot is a great innovative tool,” Dimou says. “It improves ergonomics and provides 3D visualization that allows me to do bariatric surgery while mitigating certain technical aspects that might be encountered during a bariatric operation.”
Robotic bariatric surgery is a new approach currently offered at very few weight loss surgery programs. Dimou is eager to grow the practice, noting that the enhanced visualization and ergonomic benefits for the surgeon make robotic surgery a safe and effective approach to bariatric surgery for many patients.
Your Journey is Unique
The Washington University Weight Loss Surgery Program offers bariatric surgery as an option for people with severe obesity who are unable to maintain weight loss through lifestyle changes. Patients in the Weight Loss Surgery Program receive expert care from Washington University physicians in a program accredited by the MBSAQIP (Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program). The program was recently recognized as a Blue Distinction Center for their expertise in delivering specialty care.
The bariatric surgery process involves a team of experts, including behavior counselors, dietitians, physical therapists and surgeons. Every member of the team helps ensure that people receive the best weight loss results.
Dimou notes that many people worry about regaining weight. She says that weight loss surgery is one part of the equation when it comes to overcoming obesity. The other components—diet, exercise and lifestyle modifications—are equally important to long-term weight loss.
She also emphasizes the importance of having realistic goals and not comparing yourself to others.
“Your journey is unique,” she says. “We live in an age where there is so much information at our fingertips. It’s easy to compare ourselves to other people. But everyone is unique. Your weight loss depends on your starting weight, diet and the type of surgery you had, among other factors. You have to take that journey and make it your own.”