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Gastric
Bypass Surgery, or stomach stapling, is the only hope
for many obese people who wish to lose weight. Severely
overweight, they have tried diet, exercise, everything
they can, and now are turning to bariatric surgery for
obesity.
Iris
Santiago struggled with a severe weight problem since
she was a teenager. There was the "yo-yo"
cycle of dieting. Go on a diet. Lose 10 to 20 pounds.
Slip up on the diet. Regain the lost weight, and a few
extra pounds with it.
By
her early 30s, Iris had been on at least 10 diets, owned
expensive exercise equipment, paid thousands of dollars
to a weight loss center–and still wore a size
28 dress. With 300 pounds on a 5' 1" body, she
also had high blood sugar levels, was at risk for a
multitude of major health problems, and most sadly,
Iris was unable to play with her young son.
"One
day when I was in the shower, I realized that I had
hit rock bottom," she says. "My sister told
me several years earlier about an operation for obesity
and at the time I really didn't think of it as an option.
But right there in the shower, at that moment, I decided
to find out all I could about it, and have the operation
if I was considered to be a good candidate for the surgery."
A nursing assistant at University Hospital,
Iris didn't have far to look for help. After researching
the surgical options for obesity, she became a patient
at the hospital's Obesity Treatment Center. She had
gastric bypass surgery in February 1999, and today,
at age 35, has lost nearly 170 pounds.
"I've not only lost weight,"
she says. "I've had a rebirth. I walk differently
and breathe differently, I've been given a new life."
While Iris was recuperating from her
surgery, she received a get-well card from a niece,
who praised her for having the courage to undergo the
procedure. Iris's response was, "Having the surgery
didn't take courage. Courage was walking around with
the weight of another person for all those years."
Many Seek a Surgical
Solution for Obesity
Iris
Santiago is one of the growing numbers of severely obese
patients turning to surgeons for help in losing weight.
According to a recent New York Times
article, the number of bariatric operations–surgeries
that facilitate weight loss– in the United States
has doubled over the past five years to 40,000 surgeries
annually.
"Many
people can lose weight by changing their diet and exercising,
but so many others struggle with the constant ups and
downs of losing and then regaining weight," says
Dr.
Asha Bale, director of The Obesity Treatment Center
and assistant professor of surgery at New Jersey Medical
School.
"Bariatric surgery is the last
hope for obese people when all other attempts at weight
loss have failed."
Morbid
Obesity is defined as being overweight by more than
100 pounds or having a Body Mass Index (BMI) of 40 or
more. BMI is a formula that compares a person's height
and weight. (Check your BMI at The Obesity Treatment
Center Web site:www.TheUniversityHospital.com/otc)
There
are several types of bariatric operations, but the "gold
standard" procedure is the Roux-en-Y gastric bypass.
During this operation, the stomach is divided to create
a small pouch, enabling food to bypass the first part
of the small intestine and the first part of the second
segment of the small intestine. The surgeon then connects
the two pieces of small intestine "side-by-side"
in a Y fashion to complete the bypass.
Gastric bypass works by reducing the
stomach's capacity to hold food by about 90 percent.
The patient, who is taught to eat small amounts of food
very slowly, feels "full" sooner than before.
Says Dr. Bale, "This diminishes the body's ability
to digest foods and absorb calories, especially those
high in sugar and fat, so the patient learns to make
healthier food choices." Gastric bypass, she adds,
is not the same as "intestinal bypass," a
bariatric surgery that was popular many years ago, but
had some serious complications.
At University Hospital's Obesity Treatment
Center, gastric bypass surgery is performed as an "open"
procedure. The patient is asleep under general anesthesia.
An 8- to 12-inch incision is made from the patient's
breast bone down to the belly button.
The average patient will lose about
80 percent of their excess body weight over a one-year
period, although results vary with the individual. Ten
years after the surgery, many patients have maintained
a weight loss of 60 percent or more.
Like any operation, gastric bypass surgery
has possible complications, such as leakage where the
stomach pouch is joined to the small intestine and the
development of gallstones. To help prevent the stones,
a bile thinning medication is prescribed for three months
following surgery.
Not a Quick Fix,
But a Lifestyle Change
To help patients maximize the benefits
of surgery, The Obesity Treatment Center offers a full
array of pre- and post-operative services, including
endocrine medicine, psychiatry, and nutritional sciences.
Candidates are screened by highly qualified psychiatrists
to ensure they can handle the stress the operation can
bring. Prior to surgery, a physical therapist develops
an individualized post-operative exercise plan for each
patient. Patients are seen regularly by certified nutritionists
who teach them what to eat, how to chew and how to prepare
balanced meals.
The surgery is not a one shot, quick
fix for obesity, cautions Dr. Bale. A post-operative
liquid, given for about a week, and then a pureed foods
diet very gradually builds to a well-balanced meal plan.
When patients eat high-fat, high-sugar foods, there
is often an unpleasant consequence: a "dumping
syndrome" characterized by nausea, sweating, and
faintness. Regular exercise is also key to losing the
weight and keeping it off.
Many patients who have had gastric bypass
say that the results have been well worth it. Sixty-three-year-old
Sam Tuma, another Obesity Treatment Center patient who
has lost more than 100 pounds, says he is "doing
things I haven't done since I was a kid." More
significantly, he no longer needs the diabetes medicine
he had been taking three times a day, and his medicine
to control high blood pressure has been cut in half.
"That's
exactly the result we are looking for," says Dr.
Bale. "Not only do we want to help patients lose
weight to look better, but we want them to improve their
overall health.” She adds, "It's not a cosmetic
procedure, but one designed to lower the risk of conditions
associated with obesity such as high blood pressure,
Type II diabetes, back pain, and sleep apnea."
Annette Romano, who lost more than 150
pounds following surgery at the Obesity Treatment Center,
admits that the decision to have the operation was difficult
for her. "I was at my wits end and felt I had no
other choice," she says. "I couldn't even
get up the stairs. But I have young kids...and wanted
to be around to take care of them."
"I have to say that having the
surgery was scary. I didn't know what to expect, and
I did have some complications. But I am so happy with
the results. It's a new me."
For
more information about gastric bypass, or to determine
your own BMI, visit the Web site of The Obesity Treatment
Center at http://www.theuniversityhospital.com/otc.
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