Bariatric surgery offers hope to morbidly obese

With the help of bariatric surgeons like Alex Gandsas, M.D., men, women and children for whom dieting just doesn’t work now have another option. Bariatric surgery, such as the gastric bypass that pop singer Carnie Wilson had, should be considered only as a last resort, said Gandsas, who heads the Bariatric Surgery Program at Sinai Hospital.

“This surgery is only for people who find that their excessive weight is adversely affecting their quality of life,” Gandsas said. “They can no longer play with their children, their joints ache, their backs ache, and they are at risk for heart disease, diabetes and cancer.” Eighty-five percent of the bariatric surgeries done in the United States are gastric bypass. Not to be confused with the nearly obsolete “stomach-stapling” procedure, gastric bypass permanently sections off part of the stomach and then re-routes this smaller stomach to the small intestine. The result is reduced food intake and less caloric absorption. Another possible surgery, called the laparo-scopic band (or lap band, for short) cinches off part of the stomach with a surgical belt. The belt is adjustable and primarily acts to limit food intake. Before becoming a candidate for surgery, Gandsas carefully screens his patients medically, psychologically and physically. In general, a person must be at least 100 pounds heavier than their doctor recommended weight. Also he or she must have a body mass index (BMI) of 40 or higher, or a BMI of 35 or higher combined with another condition, such as diabetes. Patients must consider possible complications after surgery, though these can be minimized through prescreening for pre-existing conditions that can interfere with bariatric surgery. In addition, Gandsas evaluates how committed a patient will be to the drastic lifestyle changes required following surgery—changes that are necessary for a successful outcome. Vitamins and nutritional supplements must be taken for life. Altered portion sizes and exercise as well as counseling also improve results. If all goes well, a patient can lose up to 80 percent of their excess weight by the anniversary date of the original surgery. Gandsas suggests anyone considering bariatric surgery should do as much research on the topic as possible, and discuss the matter with their primary care physician. While not for everyone, bariatric surgery is an alternative worth considering. For more information about Sinai’s Bariatric Surgery Program, call 410-601-WELL (9355) or visit http://www.lifebridgehealth.org/bariatricsurgery. Related Links Sinai Hospital of Baltimore  Sinai’s Bariatric Surgery Program