BOOMER Body Tune-Up: Weight-Loss Surgery

THE DIAGNOSTICS

1. Do you have a body mass index of 35 or more? [See below to calculate BMI.]

2. Do you have health issues related to your weight, such as high blood pressure, Type 2 diabetes or sleep apnea?

3. Have you unsuccessfully tried diet and medical weight-loss programs?

4. Have you been unable to keep the weight you’ve lost off for a sustained period of time?

THE Rx

IF YOU’VE ANSWERED YES …

You may have problems ahead. While obesity itself wasn’t classified as a disease by the American Medical Association until last year, it has long been recognized as a risk factor for a host of other conditions. Among them are Type 2 diabetes, high blood pressure, sleep apnea, urinary incontinence and even cancer.

THE BENEFITS OF SURGERY

This spring, an important study revealed that weight-loss surgery (specifically gastric bypass and a much newer procedure, sleeve gastrectomy) can be an effective and long-lasting treatment for some of these health problems, chief among them Type 2 diabetes.

(For those wanting details: The STAMPEDE Study is a five-year study conducted by the Cleveland Clinic to determine the effects of advanced medical therapy – diet, exercise and medication – versus bariatric surgery with medical therapy on glycemic control in patients with a BMI of 27 to 43. The three-year update was reported March 31. Although a third procedure, the adjustable gastric band (the best known of which is the Lap-Band), was not part of this study, it has also proven to be effective in controlling blood sugar levels in patients with Type 2 diabetes. In the study, gastric bypass, which has been used since the early 1990s, had the best results with 37.5 percent of the patients experiencing a reversal of diabetes.

SLEEVE GASTRECTOMY IN PARTICULAR

Sleeve gastrectomy was almost as effective with 24.5 percent of patients achieving blood sugar control without the use of diabetes medications.

However, this new procedure is far less invasive. Sleeve gastrectomy (also known as gastric sleeve) requires no complex rerouting of the digestive system, as is done with gastric bypass.

“We make a tube out of the stomach so it’s no longer a storage organ but is a conduit or passageway like the esophagus and the small intestine,” explains Dr. Joseph M. Karch Jr., general/bariatric surgeon with Bon Secours General Surgery at St. Francis. “You can’t eat as much and [you] feel full quickly.”

Sometimes done as a first step prior to gastric bypass for patients with very high BMIs, the sleeve is increasingly being used as a stand-alone procedure.

Resulting in similar weight loss with patients in the study, these surgeries also reduced patients’ need for blood pressure- and cholesterol-lowering medications.

THE RISKS

All weight-loss surgeries have potential risk. For example, gastric bypass and sleeve gastrectomy can result in intestinal or stomach leakage and the adjustable gastric band can block the outlet from the stomach or erode into the stomach lining.

Yet after two decades of diligently working to minimize complications, Karch maintains that weight-loss surgery “is one of the safest abdominal surgeries we do today.”

INSURANCE

To qualify for insurance coverage, your policy must have a bariatric surgery rider. You must also have a BMI of at least 40, or 35 with one related disease. (Medicare covers bariatric surgery but does not currently cover the sleeve in patients 65 and over in most instances, Karch says.)

Thanks to studies such as this year’s, proving weight-loss surgery can save countless healthcare dollars, there’s hope that insurance companies will cover more of these surgeries in the future. Bon Secours was not willing to publish prices (call 804-893-8683 for pricing).

CALCULATING BMI

To calculate body mass index, divide your weight by your height squared (in inches), then multiply the result by 703. A BMI between 18.5 and 24.9 is considered “normal.” A BMI of 30 or above is considered “obese.”

GETTING STARTED

Consult with a physician about whether you’re a candidate for weight-loss surgery. Some organizations hold free informational seminars on surgeries, insurance and other concerns. For Bon Secours’ schedule, visit richmond.bonsecours.com/news-and-events-calendar-of-events.html.

CASE STUDY: AMY SCHMIDT

At 286 pounds, Amy Schmidt had tried all kinds of diets, including the diet pill fenphen. Although she had had some degree of success with all of them, as soon as she would stop the regimen, the weight would come back.

Schmidt initially was interested in the gastric band, but after talking to some people who had tried it, found the results to be mixed. “If I was going to do something that drastic, I wanted it to be successful,” says the 40-year-old mom.

Believing gastric bypass to be too radical at Schmidt’s weight, Dr. Joseph Karch Jr. suggested the gastric sleeve instead. After a three-day hospital stay for the laparoscopic procedure (typically two days if Schmidt hadn’t had a fever), Schmidt started losing about a pound a day, and at three months, her weight loss has reached a total of 63 pounds. And the weight is still dropping off.

“I felt like I was healthy … until I lost the weight,” notes Schmidt. “Now I have so much more energy. I feel like a different person!”

Terri L. Jones is a Richmond freelance editorial writer and advertising/marketing copywriter and frequent BOOMER contributor. Visit her at WordPlayCreative.com.