June 08, 2022
Anyone who has ever tried to lose excess weight and keep it off knows how difficult and frustrating it can be. For people battling obesity, however, it can be more than frustrating; it can be harmful.
Obese people are more likely to suffer from numerous diseases, including heart disease, stroke, type 2 diabetes, and certain types of cancers, all of which are among the leading causes of preventable, premature death, according to the Centers for Disease Control and Prevention.
Fortunately, for obese people who have been unable to lose weight through dieting and exercise, bariatric surgery can be a good option. The procedure, which involves reducing the size of the patient’s stomach, or the part of it through which food travels, is minimally invasive, usually covered by insurance, and often starts improving a patient’s health within a few days.
It’s not a magic bullet; patients need to follow instructions for it to work effectively. If they don’t, they may wind up regaining much of the weight they lose.
Still, Abhiman Cheeyandira, MD, a surgeon at Nazareth Hospital, called bariatric surgery “one of the most wonderful procedures” he performs.
“The patients that I operate on are so grateful,” he said. “They are much healthier, both mentally and physically.”
Candidates for bariatric surgery are adults who have BMIs of 35 or higher and/or are 100 or more pounds overweight; have significant weight-related health problems; and have unsuccessfully tried other means of losing weight.
There are two main types of bariatric surgery: The vertical sleeve gastrectomy, which is the most popular both in the U.S. and worldwide; and the Roux-En-Y gastric bypass, which has been around longer.
In a vertical sleeve gastrectomy, 75-80% of the patient’s stomach is removed, creating a smaller, “banana-shaped stomach.” Reducing the size of stomach reduces the amount of food the patient can eat, helping them lose weight.
The sleeve gastrectomy is “probably most suited for people who are otherwise healthy” and have a BMI from 35 to 50, Dr. Cheeyandira said. “If they are not that heavy and they do not have major medical problems like diabetes, the sleeve works very well.”
For diabetics, the Roux-En-Y gastric bypass is more helpful. In it, the surgeon creates a small pouch, then places it so food bypasses the rest of the stomach and is delivered to the small intestine faster. The size of the pouch means the patient won’t be able to eat much food before feeling full. Having food bypass the stomach and part of the small intestine means the patient’s body will absorb less fat and fewer calories, although it also means the patient’s body will absorb fewer nutrients.
“It creates a change in the environment within the body which changes the way the body metabolizes glucose and other nutrients,” Dr. Cheeyandira said.
Bariatric surgery isn’t without risk. Like other surgeries, it can cause pain, nausea, vomiting, bleeding, blood clots and infections. Risks more specific to it include leaks, ulcers, and hernias, especially on larger patients.
Laparoscopic surgeries, such as the type of bariatric surgeries performed at Nazareth Hospital only require small incisions up to half an inch, which reduces the risk of complications from them. Vertical sleeve gastrectomy patients typically can go home the day after surgery, while Roux-En-Y gastric bypass patients usually stay in the hospital two days.
Although the surgery procedures are standard — laparoscopic surgery has been widespread for about 30 years — Nazareth Hospital works to develop individual pre- and post-operation programs for each bariatric surgery patient.
“People have different medical problems, different weights and different expectations, so we try to tailor our approach to each patient differently,” Dr. Cheeyandira said.
If your weight is affecting your overall health and quality of life, and you have tried everything you can to lose weight and are still unable, you may want to consider bariatric surgery. You can learn more about weight-loss surgery at Trinity Health Mid-Atlantic and request an appointment here.