Weighing All OptionsWeight-loss surgery can be a lifesaver, but takes a lifelong commitment.
By the time most people turn to the University of Virginia Health System for help, they've struggled unsuccessfully for years to lose the weight that is harming their health.
Weight-loss (or bariatric) surgery can be the turning point in a person's struggle with obesity. Within a year of the surgery, many patients lose well over 100 pounds and return to a normal, healthy weight. But it's not as simple as that.
Clear Expectations
To a casual observer, surgery may seem like a quick fix. But the truth is, surgery only brings off weight for the short term. The pounds are likely to steadily return after the first year unless the patient takes long-term steps. To do it right, patients must strictly limit their calorie intake, take in the right nutrition and exercise regularly (see "A Commitment for Life").
UVa surgeon Bruce Schirmer, M.D., notes that gastric bypass surgery is designed for people who are prepared to make serious lifestyle changes. The surgery is generally limited to adults who are twice their ideal weight, have related health problems, and have already tried diet and exercise. "Nearly everyone who comes to see me has lived with and fought obesity for years," Schirmer shares. "Finally they realize, ‘I can't do this by myself, I need help.'"
In a minimally invasive gastric-bypass operation, UVa surgeons staple off the lower portion of the stomach. This reduces the functional stomach to a walnut-sized pouch and allows food to enter directly into a lower section of the small intestine.
To ensure weight-loss success, patients work closely not only with Schirmer but a psychologist, nutritionist, nurse coordinator and their primary care doctor. Psychologist Andrea Bauchowitz, Ph.D., notes, "We want patients to be as well informed as possible. To optimize success, we help them identify the thoughts and beliefs that impact their habits and set realistic and achievable goals."
Benefits and Risks
Surgery can reduce or eliminate serious health problems: "If the person has been on insulin for type 2 diabetes for less than five years, there's an 85 percent chance of getting them off their medications," Schirmer says. "For high blood pressure, we get about half the people completely off their medication." Sleep apnea and musculoskeletal/joint problems may also be improved. But as with any major surgery there are risks; blood clots in the legs, pneumonia and gastrointestinal maladies.
"Weight-loss surgery is a very powerful tool. If you use it correctly, you are likely to have good results," Schirmer says. "To see the dramatic transformation in these patient's lives is incredibly rewarding," he adds.
The first step is talking to your primary care provider. Some insurance programs will pay for weight-loss surgery but only after the patient has gone through a medically-supervised diet program. Learn more about the University of Virginia Health System's Bariatric Surgery program.
Learn more about Bruce Schirmer, M.D., and Joe Northup, M.D., who specialize in weight-loss surgery at UVa.
What are your usual food choices? Here's an estimate of the calories you can save by cutting out the small things-and keep off the extra weight that can result from too many calories adding up.
This article appeared in the Fall 2007 issue of Vim & Vigor, a family health magazine sponsored by the University of Virginia Health System. To receive Vim & Vigor at home four times a year, subscribe today. It's FREE.
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