Surgery option to keep weight loss vows
Squeamish overeaters pay heed: This a story about weight loss surgical procedures that could get a little graphic.
Roughly 60 days since thousands pledged to get fit and drop the extra weight, several pledge-takers see little progress from their efforts and a few may even be considering weight-loss surgery.
The American Society for Metabolic and Bariatric Surgery estimates 18 million Americans currently qualify for the surgery, but only 1 percent — about 160,000 — actually underwent one of the procedures in 2013.
One reason is cost. Local health plans do not cover weight loss surgery, said Dr. Eric Hanly, medical director of St. Mary’s Hospital Bariatric and Metabolic Surgery Program.
Depending on the procedure, surgery may cost $15,000 to $25,000.
Insurance does provide some benefits in some areas of the country, but where it does, it requires patients to jump through many hoops to qualify, including several mental health and diet programs, according to America’s Health Insurance Plans, a national trade group.
Another reason only 1 percent take the weight-loss surgery plunge is risk. Different complications from various procedures can be serious, Hanly said.
Despite the cost and potential complications of bariatric surgery, more than 300 Mesa County residents elected to go through the procedure at St. Mary’s since the bariatric program launched about two years ago.
The reason is greatly improved health.
OBESITY RISKS 30 AILMENTS
“Obesity is not a lifestyle choice,” Hanly said. “Nobody chooses to be obese.”
The chronic, life-threatening disease prompted by excessive weight can cause as many as 30 serious health conditions, including diabetes, heart disease and even cancer, he said.
Research shows obese patients are at an increased risk for developing insulin resistance and type 2 diabetes, hypertension, cardiovascular disease, stroke, sleep apnea, gallbladder disease, gout, and osteoarthritis, a 1999 research study published at PubMed.gov said.
Certain cancers also are associated with obesity, including colorectal and prostate cancer in men and endometrial, breast, and gallbladder cancer in women, according to the study.
“Obese individuals may suffer from social stigmatization and discrimination, and severely obese people may experience greater risk of impaired psychosocial and physical functioning, causing a negative impact on their quality of life,” the study reported.
Obesity causes an estimated 300,000 premature deaths each year, Hanly said.
“Gastric bypass for morbid obesity is a treatment like no other in medicine, as a single surgical procedure can cure four or five of the patient’s health problems,” Hanly said, quoting Dr. Harvey Sugerman, past president of the American Society for Bariatric and Metabolic Surgery.
SEVERAL OPTIONS FOR SURGERY
In general, there are three categories of weight-loss surgery: Restrictive procedures that reduce how much the stomach can hold, malabsorptive procedures that shorten the digestive tract and combined procedures that do both, Hanly said.
At St. Mary’s, Hanly and his fellow surgeons perform adjustable gastric band, sleeve gastrectomy and gastric bypass, among other procedures.
Community Hospital also offers a bariatric surgery program that provides similar services.
Gastric band employs laparoscopic tools to place an adjustable silicone band around the upper part of the stomach, according to WebMD.com.
“Squeezed by the silicone band, the stomach becomes a pouch with an inch-wide outlet. After banding, the stomach can only hold about an ounce of food,” WebMD.com said.
The band may be tightened or loosened using a hydraulic system involving saline.
In the sleeve procedure, the stomach is “restricted by stapling, dividing it vertically and removing more than 85 percent of it. This part of the procedure is not reversible. The stomach that remains is shaped like a very slim banana and measures less than 5 ounces,” according to the website ObesityHelp.com.
The surgery is often recommended because the nerves to the stomach and the outlet valve remain intact. This preserves the functions of the stomach while drastically reducing the volume of food it can hold, ObesityHelp.com said.
Patients experience fewer complications and higher rates of success using this procedure, Hanly said.
With a gastric bypass, staples are used to divide the stomach into a small upper section and a larger bottom section. The top section of the stomach is where the food you eat will go. The pouch is about the size of a walnut. It holds only about 1 ounce of food.
Next, a small part of the small intestine is connected to a small hole in the pouch. Masticated food travels from the pouch into this new opening into your small intestine. Because of this, the body absorbs fewer calories, according to the National Institutes for Health.
Patients are selected based on National Institute of Health criteria for the performance of weight loss surgery:
■ A body mass index of 40 or higher; 35 with serious related health problems. Men who are 100 pounds overweight and women who are 80 pounds overweight would probably qualify.
■ The ability to commit and participate in treatment and long-term follow-up.
■ An unsatisfactory result from a medically managed weight-loss program.