Walking across a parking lot, tying shoes, getting in and out of a car—lugging around an extra 20 or 30 pounds of body weight can make such everyday activities a chore. But being 100 or more pounds overweight can make the tasks many of us take for granted almost impossible.
People who have struggled to lose weight (and keep it off) can seek medical treatment from a physician who specializes in bariatrics, a field of medicine that focuses on the treatment of obesity and diseases associated with obesity. Individuals with a body mass index (BMI) over 35, or approximately 100 pounds or more overweight, may qualify for bariatric surgery.
Traditional Weight-Loss Surgery
Dr. Jayaraj Salimath, D.O., Medical Director of the Methodist Weight Loss & Surgery Center and a specialist in minimally invasive and bariatric surgery, describes the two traditional types of weight-loss procedures: gastric bypass and Lap-Band.
Gastric bypass surgery makes the stomach smaller, making a person feel full more quickly and thus less likely to consume excessive calories. The surgery also causes food to bypass the first section of the small intestine, resulting in fewer calories being HEALTHabsorbed. However, Dr. Salimath points out that fewer nutrients are also absorbed, which can lead to malnutrition.
In Lap-Band surgery, a silicone band is placed around the upper stomach to restrict food intake. Dr. Salimath explains, “You’re putting a foreign body into the human body.”
Leading-Edge Weight-Loss Surgery
In addition to the gastric bypass and Lap-Band procedures, Dr. Salimath offers an alternative surgical approach to weight loss called the sleeve gastrectomy, currently available only at Methodist. In the sleeve gastrectomy, a procedure refined in the past three years, most of the stomach is removed, reducing not only its volume but also the level of appetite-producing hormones secreted by the stomach.
“You lose as much weight with the sleeve gastrectomy as you do with the gastric bypass,” Dr. Salimath says. “But there is no dumping syndrome (vomiting and diarrhea caused by rapid emptying of the stomach) and no malabsorption (poor absorption of nutrients) because we do not alter the anatomy of the small intestine, where most absorption occurs. With the sleeve gastrectomy, there is no rerouting of the small bowel.”
Quality of Life Gains
Weight-related disorders, including diabetes, high blood pressure and elevated cholesterol, often diminish in severity or even disappear after patients drop a significant amount of weight with the help of bariatric surgery, Dr. Salimath explains. And women with infertility related to obesity are often able to conceive after losing weight.
Sleep apnea is also often resolved after surgery. “The first thing patients tell me after losing weight is, ‘Doc, I can sleep now,’ and this means increased energy to do the things they couldn’t do before,” Dr. Salimath says.
People who are not candidates for gastric bypass or Lap-Band may qualify for the sleeve gastrectomy because the newer bariatric procedure leaves the small intestine intact, which has resulted in “very few complications.”
For example, individuals who need knee or hip replacement surgery but do not qualify due to obesity are usually not candidates for a gastric bypass either. Dr. Salimath says these patients may qualify for the sleeve gastrectomy and lose enough weight to undergo joint replacement.
“People with congestive heart failure who are struggling to get around because of obesity (and do not qualify for traditional bariatric surgery) may also benefit from the sleeve gastrectomy,” Dr. Salimath explains. “And the newer procedure is a viable option for teenagers too, because the anatomy of the small intestine is not altered.” TPW