Cincinnati—'Tis the season for New Year’s resolutions—and for many Americans, weight loss tops the list of desired changes.
UC Health surgeon Lisa Martin Hawver, MD, says weight loss surgery is a good option for patients who have tried diligently to lose weight by other methods and failed.
“Weight loss surgery is the most extreme form of weight reduction and should be reserved for those who would benefit most from shedding extra weight, such as patients with diabetes or orthopedic problems,” explains Martin Hawver, a fellowship-trained laparoscopic general surgeon with UC Health and assistant professor of surgery at the University of Cincinnati (UC) College of Medicine.
“Patients must have a strong commitment to lifestyle changes that include a healthful diet and exercise to achieve long-term success with bariatric surgery,” she adds.
There are two basic types of surgical weight loss procedures: restrictive procedures such as adjustable gastric banding, which limit the amount of food the stomach can hold and are most appropriate for patients with a target of 50 percent excess body weight loss; and combined restrictive and malabsorptive procedures such as traditional Roux-en Y gastric bypass surgery, which is most appropriate for patients who need to lose 70 percent of excess body weight.
For those who are good candidates for weight loss surgery, there is a newer procedure—known as laparoscopic sleeve gastrectomy or “gastric sleeving”—now being covered by some insurance companies, including United Health Care.
“Sleeve gastrectomy is a good alternative to traditional gastric banding or bypass techniques that does not require a synthetic object to be implanted in the body, such as in banding, and maintains the body’s ability to absorb nutrients normally,” says Martin Hawver.
Operating through several small incisions, in a sleeve gastrectomy, Martin Hawver creates a smaller channel for food to travel through by surgically removing a portion of the stomach. This restricts how much food the organ can hold and does not require the type of surgical “rewiring” of the intestines, bowel and stomach necessary for Roux-en Y gastric bypass surgery.
“Bariatric surgery is the only known cure for type 2 diabetes, so for people who have compromised lifestyles because of the disease, it can result in a greatly increased quality of life,” explains Martin Hawver. “Most people go home on fewer medications after gastric bypass and their diabetes will be cured in a few months.”
UC Health offers a team approach to bariatric surgery that includes dedicated nurses and dieticians available to support patients through the entire process. Prior to surgery, patients undergo a psychological evaluation to determine if they are able to make the lifestyle changes necessary to be successful as well as gauge whether the patient has fair expectations regarding outcomes.
Martin Hawver stresses that diet and regular exercise are key regardless of which type of bariatric surgery the patient chooses to have.
“The importance of a patient dedication cannot be underestimated. The patient must be committed to the life-long changes in diet and exercise that will allow them to keep the weight off,” says Martin Hawver. “That includes exercise—starting slowly and working up to five times a week—and a low carbohydrate, high-protein diet made up of healthful foods.
Only people who are considered severely obese—typically those with a body mass index of 35 or more—are appropriate candidates for surgical weight loss.
“It can take up to five years with gastric banding to lose the weight; with gastric bypass, it takes up to two years, but with patient commitment and a supportive medical team, the surgical weight loss can result in great outcomes,” adds Martin Hawver.
According to the National Heart, Lung and Blood Institute, attaining and maintaining a healthy weight can help reduce a person’s risk for heart disease, high blood cholesterol, high blood pressure, diabetes, gallbladder disease, gynecologic disorders, arthritis, some types of cancer and even some lung problems.
For appointments with UC Health’s surgical weight loss team, call (513) 475-8787 or visit ucphysicians.com for more information. Martin Hawver and her colleagues see outpatients in West Chester (UC Health Medical Office Building) and Clifton (Christ Hospital Medical Office Building) and perform surgery at UC Health University Hospital as well as Christ Hospital, which is designated as a Center of Excellence for Bariatric Surgery by an external review board.