As the first patient in Michigan to receive an endoscopic sleeve gastroplasty, Christine Holmgren made history.
She also transformed her life.
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The new and minimally invasive procedure uses an endoscopic suturing device to reduce the size of the stomach by up to 80 percent without surgery. And it helped Holmgren jump-start her weight loss journey and regain an active lifestyle.
"Standing, walking, riding an exercise bike — all feel better," the 45-year-old says.
Endoscopic sleeve gastroplasty targets those who have been unsuccessful at maintaining weight loss with other methods and who have a body mass index between 30 and 40 or who qualify but do not wish to undergo bariatric surgery.
Michigan Medicine gastroenterologist Allison Schulman, M.D., MPH, guided a flexible tube with a tiny camera though Holmgren's mouth to sew a series of overlapping stitches in her stomach, creating a narrow curved tube.
By shrinking a recipient's stomach size, the procedure is designed to limit how much a person can eat. That's the same thinking behind invasive bariatric surgery such as sleeve gastrectomy.
"It's a step toward losing weight, but patients have to engage in diet and lifestyle changes as well," Schulman says.
Still, with more than 30 percent of Michigan's adult population considered obese, Schulman expects interest in endoscopic sleeve gastroplasty to spread quickly.
A safe, simple procedure
The outpatient procedure, which took about 90 minutes, allowed Holmgren to go home the same day.
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"It was easy," says Holmgren, a resident of Sparta, Michigan. "There was no real prep, just liquids the day before … I woke up from it ready to go. The next day, I did my usual 'mom' tasks and the only pain I felt was my throat hurt for about three days."
She was able to take her mom to a doctor's appointment 24 hours later. And after that, she was cheering for her son at a track meet. Three days later, Holmgren went back to work without restrictions as a certified surgical technologist.
Although common side effects after endoscopic sleeve gastroplasty are abdominal pain and nausea, Holmgren experienced neither.
Her doctor's only physical directive: Avoid intense workouts for four weeks.
To allow her stomach to heal, Holmgren was told to follow an all-liquid diet for 30 days and remain on Prilosec for six weeks to minimize the risk of bleeding. Holmgren transitioned to semisolid foods for two weeks after that and saw a nutritionist to put together a healthy eating plan as she resumed a regular diet.
Losing to win
In the first month after the procedure, Holmgren lost 25 pounds (and dropped two pant sizes). She ate 800 to 1,000 calories a day without feeling hungry.
More important, the mother of three children and two stepchildren felt better.
"The brain fog disappeared almost immediately," Holmgren says, adding that her sleep and skin improved as a result. Her knee pain and sour stomach disappeared, too.
Holmgren knew the procedure had truly worked when she went from only being able to use her exercise bike for 5 minutes to pedaling in 40-minute sessions at three times the intensity.
"The only reason I stop at 40 minutes is because I have so many things to do," she says, happily.
Holmgren has always been active, coaching volleyball and playing softball, up until last year when she had to drop softball because of knee pain. She also kayaked, swam and hiked.
Several prior surgeries — plus the associated inactivity and hormonal changes — all led to weight gain and her biggest regret: "I wish I wouldn't have gotten heavy."
Teaming up for success
With her Michigan Medicine care team tracking her progress for a year, Holmgren sees her target weight of 165 pounds as achievable. That partnership includes five visits with Schulman, up to three sessions with a behavioral psychologist and monthly nutritionist appointments.
SEE ALSO: How Losing Weight Can Relieve a Host of Painful Problems
"I think Dr. Schulman was brought into my life for a reason," says Holmgren, who has already purchased a swimsuit and is eyeing a resort vacation. "She's helping me turn things around and I'm focused on myself rather than everyone else."
Schulman says Holmgren was an ideal candidate not only because she fit the parameters but because she was motivated to succeed.
Because she was below the threshold for receiving traditional bariatric surgery — typically a BMI of 40 or being 100 pounds over one's ideal weight — Holmgren represents one of many who might benefit from the procedure.
"This nonsurgical option provides a higher number of obese individuals with access to weight loss," says Schulman, who notes that the procedure isn't currently covered by insurance.
For Holmgren, the investment was personal.
"This was for me," she says. "I want to be healthier. I want to be here for my kids."
Now, she's ready to make more history.
To schedule a consultation for endoscopic bariatric surgery at Michigan Medicine, call 734-647-5944.