The Doctor Is In: Weight-loss surgery sheds pounds, improves health - The Explorer: Northwest Chatter

The Doctor Is In: Weight-loss surgery sheds pounds, improves health

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Patrick Chlasson, M.D.

Posted: Wednesday, August 1, 2012 4:00 am

Many of us have been on some type of diet in our lives. Some of us have spent our entire lives trying the latest fad diet, each time ending up right back where we started. And 90 percent of diets fail in the long run.

More than 72 million Americans are obese or severely overweight. Each year, obesity causes at least 112,000 deaths in the United States, and it’s associated with numerous health problems: Type 2 diabetes, high cholesterol, hypertension, gallstones, liver disease, sleep apnea, gastroesophageal reflux disease (GERD), heart failure, degenerative joint disease, birth defects, miscarriages, asthma, and cancer.

  If you’re more than 50 pounds over your ideal weight, you may benefit from weight-loss surgery. Weight-loss surgery – also known as bariatric surgery – once thought of as primarily a cosmetic procedure, can offer lifesaving health benefits. It’s estimated that in 2008, approximately 220,000 people in the U.S. had weight-loss surgery.

A 2004 study published in the Journal of the American Medical Association found that bariatric surgery patients lost between 62 and 75 percent of their excess body weight. Beyond simple weight loss, there were significant improvements to chronic health conditions: 76.8 percent of bariatric surgery patients experienced remission of Type 2 diabetes; hypertension was eliminated in more than 61 percent of patients and significantly lowered in 78 percent; more than 70 percent experienced a drop in cholesterol levels; and sleep apnea was eliminated in more than 85 percent of patients.

There are various types of bariatric surgeries that are all performed using laparoscopic techniques.

Gastric sleeve

Gastric sleeve is the most recent procedure to be approved by the American Society of Metabolic and Bariatric Surgery for weight loss.  This procedure involves removing the lateral aspect of the stomach creating a long gastric tube thereby limiting the amount of food one can eat.

Roux-en-Y gastric bypass

This procedure was, until recently, the most commonly performed bariatric surgery procedure.  It involves dividing the top part of the stomach creating a small gastric pouch in order to reduce food intake. They then attach a Y-shaped section of the small intestine to the pouch to allow food to bypass the lower stomach and parts of the intestine.

DUODENAL SWITCH

This procedure is gaining in popularity because it offers the most predictable results for weight loss.  It is also the most complex bariatric procedure.  The first part of the procedure involves creating a sleeve stomach restricting food intake.  This is followed by dividing the small bowel (duodenum) just beyond the stomach.  Most of the small bowel is then bypassed.  Then a Y-shaped section of the small intestine downstream is attached to the cut end of the duodenum allowing food to pass into the distal intestine.  Because even more of the small intestine is bypassed, even fewer calories are absorbed. This operation is ideal for our heaviest patients.

Adjustable gastric banding

This still represents about15 percent of all weight-loss surgeries; although the numbers are decreasing as the sleeve procedure becomes more popular among patients. Surgeons place a band around the upper stomach which slows the transit of food from the upper stomach to the lower stomach. The band can be tightened or loosened over time to change the passage’s size. The stomach’s size is not changed with this procedure and it generally results in less weight loss than the other procedures.

As with any surgical procedure, bariatric surgery may present risk. Talk with your doctor about whether you’re a candidate for weight loss surgery and together, discuss the risks and benefits. Remember that you must be committed to maintaining a healthy lifestyle – including adopting very different eating habits and increased exercise – as well as nutritional counseling and lifelong medical follow-up, after surgery.

(Editor’s Note: Patrick Chiasson, M.D., is board-certified general surgeon specializing in Bariatric Surgery.  He practices with Dr. Steven Burpee.  Their practice has been designated as a Bariatric Center of Excellence by the American Society of Metabolic and Bariatric Surgeons.  The office phone is 219-8690 or www.tucsonlaparoscopy.com.)

© 2014 The Explorer. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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