Dieting is frustrating for most of us, but for some, it’s nearly impossible. When diets fail for some obese people, health problems (such as hypertension, sleep apnea and diabetes) can develop or worsen. Bariatric, also known as weight-loss surgery, can be a viable option.
Weight loss surgery works by limiting the amount of food you can eat or digest. There are three types: The laparoscopic gastric banding (lap-band) is an inflatable band placed on the top of the stomach that squeezes the stomach into a smaller size. The gastric sleeve surgery is the newest type of bariatric surgery. It restricts the amount of food you can take in by permanently removing a 60 to 85% of the stomach, leaving a sleeve-shaped piece. No by-pass is required; the stomach remains connected. It also removes the section of stomach that produces Ghrelin, the hormone that causes us to feel hunger. The third choice is the Roux-en-Y gastric bypass, which reduces the size of the stomach and bypasses part of the small intestine, reducing absorption of food and nutrients. There is also a fourth option, called the duodenal switch, but this is an invasive procedure and done by specialists at bigger hospitals.
Bariatric surgery is done through laparoscopy, which is minimally invasive. While all surgical procedures have their risks, studies have shown that obese people who have weight-loss surgery are less likely to die from heart issues, cancer, and diabetes.
Omar Shamsi, MD, internal medicine and medical weight loss specialist from the Healthy 4 Life Center at Community Healthcare System, says the criteria most insurance companies require for surgery is a body mass index (BMI) above 35 and with one of the following major medical issues: hypertension, diabetes, or obstructive sleep apnea. A patient can also have a BMI of 40 with none of the medical issues. “Which of the three surgeries is chosen, depends on which medical issue the patient has,” says Dr. Shamsi. “If the patient is young and exercising and wants to lose less weight, but not too much, we go with the lap-band. If he has one or two medical issues and wants to lose a moderate amount then we opt for the sleeve. The most weight loss requires the gastric bypass. Candidates for surgery are those who have tried many diets in the past and are struggling. They realize that their diabetes and other issues will play a toll on their heart, kidneys and their body.”
Before surgery, most weight-loss doctors, including Dr. Shamsi, requires his patients to go through a six-month period of medically managed weight loss, which includes diet and exercise and sometimes medication. If the patient is still struggling, then Dr. Shamsi will talk to them about surgical options.
Weight-loss surgery can benefit people of all ages, says Dr. Shamsi. “We’ve done surgeries on people over seventy,” he says. “It depends on their lifestyle, quality of life, and if they are stable enough to have surgery. We did surgery on a seventy-two year old woman and she said she felt like a 40-year-old after the surgery. She can get around better now and travel. I always tell my patients that I want them to be able to enjoy life. The benefits are not just weight loss, but they can get off medications, their cholesterol and sleep apnea improves. When someone loses weight they start feeling better, their depression improves and confidence goes up. Problems with fertility can also improve.”
—For further information about weight-loss surgery, contact the Healthy 4 Life Center at 219 947 6122