Doctors and patients are increasingly choosing
less-invasive surgeries to help people lose weight, but the core message
remains: Eat healthy and get moving.
The latest data from the Centers for Disease Control and Prevention attest to alarming rates of obesity in America.
It's a serious health problem, and there is no fix,
according to doctors and dietitians across the Tristate. But there are
techniques, both new and old, surgical and non-surgical, to shedding
pounds and living healthier.
At the Jewish Hospital Weight Management Center, the
message is "more than a diet." The comprehensive treatment includes a
balance of smart eating, attitude and activity to manage weight.
As the number of overweight and obese Americans
continues to rise, so does the prevalence of weight-loss surgery. For
people considered extremely obese who have been unable to lose weight
through lifestyle changes, it's a viable option.
How it Works
Patients at UC Health and its hospitals are eligible
for weight-loss surgery if their BMI is higher than 40, or above 35
with at least two serious health problems related to obesity, like
diabetes and heart disease.
The most common form of weight-loss surgery to date
has been the gastric bypass, according to Dr. Tayyab Diwan, bariatric
and transplant surgery specialist at UC Health. Gastric bypass surgery
reduces the size of the stomach and re-routes food to bypass part of the
small intestine. Within six months, patients experience significant
weight loss, often in the hundreds of pounds."The bypass has been
considered the gold standard of weight-loss surgery," Diwan says. "It
reduces the amount of food the person can eat at one time, leading to
significant weight loss."
But more patients at UC Health are skipping the
bypass in favor of the sleeve gastrectomy, according to Diwan. Data has
shown the newer bariatric procedure to be nearly as effective when it
comes to long-term weight loss, with less risk of complications.
Like the bypass, the sleeve gastrectomy involves
permanently removing a large portion of the stomach. Unlike the bypass,
however, the portion left behind is a slim "sleeve" naturally connecting
to the intestine, making it less complex. The sleeve gastrectomy is
performed laparoscopically, meaning the incisions made in the patient
This less-invasive approach has led to growing
popularity among both surgeons and patients across the U.S., and the
Tristate is no different. In fact, the sleeve gastrectomy has become the
primary weight-loss procedure recommended to patients at UC Health.
"When results indicate that long-term weight loss is
the same, people will gravitate toward the simpler procedure with less
risk," Diwan says.
The only major risk, he says, is a three percent
chance of the new, sleeve-like stomach developing a leak, adding that
the chances of complications following the gastric bypass are
The only disadvantage, he adds, is that the gastric
sleeve has less long-term data, compared to the bypass, to determine its
In June, the gastric sleeve was further validated
when the Centers for Medicare and Medicaid Services (CMS) approved the
procedure for insurance coverage. When the CMS endorses a procedure,
most primary insurance providers will follow, says Diwan.
Improves Transplant Options
At UC Health, the sleeve gastrectomy is helping
patients overcome medical battles beyond just obesity. Late last year,
the sleeve was first implemented as a means of spurring dramatic weight
loss in patients who otherwise would be considered to be too overweight
for kidney transplants.
Obesity in transplant patients has been associated
with substantially greater risk for complications, according to Dr.
Steve Woodle, chief of transplant surgery at UC Health.
In the past, extremely obese patients in need of a
new kidney would be placed on the transplant list and told to lose
weight, but only one percent of patients would actually achieve weight
loss significant enough for transplant surgery.
As a result, a decade ago, UC Health became an early
pioneer in utilizing weight-loss surgery to prep patients for
transplant surgery. Until recently, the gastric bypass was primarily
used. The sleeve is now replacing that procedure.
"It doesn't make sense to give a patient a
transplant and not address the death risk associated with obesity,"
Woodle says. "And in a small percentage of patients, they see their
kidney function improve so much post-weight loss surgery that they no
longer need the transplant."
The weight-loss procedure itself is only one aspect of curbing a patient's obesity, according to Diwan.
"Many patients are 40 or 50 years old, and they've
been eating a certain way their whole lives," he says. "The procedure is
meant to jump-start a healthier lifestyle. It's up to the patient to
maintain that lifestyle and live a healthier life."
Easier said than done for many. But the key to
maintaining a healthy lifestyle isn't a trendy diet or fitness regime.
It's old-fashioned calorie management, according to Lauren Niemes,
executive director of the Nutrition Council in downtown Cincinnati.
"As a society, we're taking in more calories than we're burning," Niemes says. "That has to change."
Although Niemes admits hormones, genetics, and even
certain bacteria can play a role in a person's weight, she says calorie
balance is the primary driver. Nutrient-dense foods. including fruits,
vegetables and whole grains are the core components of a healthy diet,
One of the simplest ways for a person to lose excess
weight, according to Niemes, is by eliminating sugary drinks and going
for brisk-paced daily walks.
Fad approaches to weight loss like the South Beach
Diet and Atkins are not the answer, she maintains. While they may seem
effective in the early going, Niemes sees them as a quick and
unsustainable fix to a lifelong issue.
Instead, she recommends that a person define a diet and exercise regimen that can be sustained for life.
"Maintaining a healthy weight is a complex issue,
and each person's management style is going to be different," she says.
"Weight-loss surgery is an option. But as a dietitian, I would like to
see more of a focus on prevention."