Bari
Chatwith Dr. Sehat
Honest conversations about weight loss surgery, healing, and hope, from a bariatric surgeon who has also been the patient.
Start here
Find the episodes for where you are right now
Weight loss surgery is a process that takes months. Pick your stage and start with these.
Thinking about it
What obesity is, what surgery treats, and whether medication is enough.
Choosing a procedure
Sleeve, bypass, OAGB, duodenal switch, SADI-S, and what the first surgical visit looks like.
Getting ready
Insurance approval, the pre-op class, the liver-shrinking diet, and vitamins.
Life after surgery
The first weeks home, changing cravings, vitamins for life, and skin removal.
Every episode
All episodes
Newest first. Every episode is on Spotify, Apple Podcasts, and Amazon Music.
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New
Guest
Cosmetic Surgery after Bariatric Surgery with Dr. Leah Baldwin
Body contouring after massive weight loss: fleur-de-lis and extended tummy tucks, arm and thigh lifts, back and gluteal lifts, fat transfer, scar care, who is a good candidate, and insurance.
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10
Guest
Bariatric Surgery with Dr. Nicole Fearing
A bariatric program director walks through the first surgical visit: who is a good candidate, how to choose between procedures, real risk numbers, surgery day, and why follow-up lasts for life.
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9
Guest
Medical Weight Loss
Nurse practitioner Andrew on phentermine, Contrave, and GLP-1 medications: who is a candidate, side effects, cost, and how medication can work alongside surgery.
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8
Life Updates & Recap of ASMBS 2026
Finishing fellowship, presenting at the national meeting, and why the future of obesity care looks like a cancer team, with surgery, medication, and nutrition working together.
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7
Guest
How Insurance Approval Works
Dana, who handles prior authorizations and had a gastric bypass herself, explains the path from consult to surgery date: coverage checks, supervised weight loss visits, denials, and appeals.
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6
Guest
Patient's Journey with Drea
Drea started at 533 pounds, had a duodenal switch, and lost 372 pounds. Now a clinic nurse, she talks about the first two weeks, protein and fluids, vitamins, and changing her relationship with food.
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5
Guest
Pre-op Class and Nutrition Guidance
A registered dietitian and a bariatric coordinator cover the pre-op class, the diet stages after surgery, protein goals, bariatric vitamins, and the pre-op liver-shrinking diet.
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4
Myth-Busting Bariatric Surgery: What People Get Wrong (and What's Actually True)
A short episode on the most common misconceptions about weight loss surgery.
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3a
Bariatric Surgeries, Visual
A whiteboard walkthrough of the sleeve, gastric bypass, one-anastomosis bypass, duodenal switch, and SADI-S, for visual learners.
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3
How Bariatric Surgery Works: The Science, the Options, and the Results
How each operation changes the stomach and intestines, what weight loss to expect, and the risks specific to each procedure.
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2
Beyond BMI: What Bariatric Surgery Really Treats and Who Qualifies
Why it is called metabolic surgery, obesity as a chronic disease, the 2022 ASMBS/IFSO guidelines, and a patient case with a surprise ending.
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1
From Patient to Surgeon: Why I Started Bari Chat
Dr. Sehat on his own weight loss surgery and why he started the show.
Your host
Dr. Alvand "AJ" Sehat
"I don't ever remember being a skinny kid."
Dr. Sehat is a bariatric and foregut surgeon. Before that, he was the patient. He struggled with his weight for most of his life, lost it once in high school, and watched it come back through college, medical school, and residency.
His rock bottom came during surgical residency: sleep apnea that had him dozing between cases, and a flight where he had to ask for a seatbelt extender. He had a sleeve gastrectomy with a surgeon he had assisted in the operating room, and it gave him his health back.
Bari Chat exists because good information about weight loss surgery shouldn't be gatekept. Every episode aims to replace stigma with understanding and fear with hope.
His own results
- Fellowship-trained in bariatric and foregut surgery
- Now practicing in Torrance, California
- Raised in East Texas, schooled in San Antonio
Procedures at a glance
The five main operations
A quick reference to go with Episodes 3 and 3a. "Excess weight loss" means the share of your weight above a healthy weight: 50% of 100 extra pounds is 50 pounds.
| Procedure | What changes | Typical excess weight loss | Watch for |
|---|---|---|---|
| Sleeve gastrectomy | About 70–80% of the stomach is removed, leaving a narrow tube. The most common operation in the U.S. | 50–60% | Can worsen acid reflux. Not reversible. |
| Roux-en-Y gastric bypass | A small egg-sized pouch is connected to a loop of small intestine. Nothing is removed. | 60–70% | Marginal ulcers (no smoking, no NSAIDs), internal hernias. |
| One-anastomosis bypass (OAGB) | A longer pouch with a single connection to the intestine. | 65–80% | Bile reflux. |
| Duodenal switch | A sleeve plus a long intestinal bypass with a short common channel. | 80–90% | Vitamin and protein malabsorption, diarrhea. Needs extra A, D, E, K. |
| SADI-S | A sleeve with a single connection past the pylorus. | 80–90% | Lifelong vitamins and labs. Lower bile reflux risk than OAGB. |
Ranges vary between studies and surgeons. Which operation fits you depends on your health, your goals, and conversations with your own surgical team.
Resources
Read it for yourself
Don't just take the show's word for it. These are the sources the episodes lean on.
Who qualifies: the 2022 guidelines
In 2022 the ASMBS and IFSO replaced the 1991 NIH criteria. In short:
- BMI ≥ 35Surgery is recommended, whether or not you have related conditions.
- BMI 30–34.9Surgery should be considered with metabolic disease such as type 2 diabetes, or when other treatments haven't worked.
- Asian patientsLower cutoffs apply. Surgery should be offered from BMI 27.5.
- AgeNo upper age limit. Adolescents can qualify at specialized centers.
Insurance plans often still use older criteria. Episode 7 explains how approval works in practice.
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