IN FOCUS: Bariatric Surgery
Bariatric (weight loss) surgery has long been recognized as an effective tool to help extremely overweight patients get their weight under better control. And recent news about the positive effects of weight loss surgery on diabetes has generated even more interest in the work of NuHealth's department of Bariatric Surgery at Nassau University Medical Center. As a nationally-recognized Center for Excellence in Bariatric Surgery, the department is well positioned to help patients reach their weight loss goals and improve their overall health.
"Obesity is a major factor in many debilitating diseases," noted Dr. Venkatesh Sasthakonar, director of NuHealth's Bariatric Surgery department. "The recent studies showing that bariatric surgery can eliminate diabetes altogether confirm what we have found for years. It can also help effect a positive reduction in hypertension and cardiovascular disease."
Two randomized clinical trials recently published in The New England Journal of Medicine demonstrate bariatric surgery is the most effective treatment for type 2 diabetes in obese and morbidly obese patients. In a study conducted by the Cleveland Clinic, within one year, diabetes remission rates for patients who underwent bariatric surgery were about 40 percent compared to about 12 percent for patients treated with the best pharmacotherapy available. Results of a Catholic University of Rome Italy and New York-Presbyterian/Weill Cornell Medical Center study showed even greater remission rates - about 85 percent for bariatric surgery versus zero for medical therapies. Both studies suggest surgery should be considered sooner and more often for patients battling the twin epidemics of diabetes and obesity.
The U.S. National Institutes of Health recommends bariatric surgery for obese people with a body mass index (BMI) of at least 40, and for people with BMI 35 and serious coexisting medical conditions such as diabetes. Long-term studies show that patients who undergo bariatric surgery can achieve percentage losses ranging from 25% to 80% of excess body weight and cut their mortality nearly in half.
Bariatric surgery can be performed as a minimally invasive (laparoscopic) procedure, requiring only six small incisions in the abdomen. All weight loss surgeries work by physically altering the size of the stomach to restrict the amount of food that you eat and/or altering your body's ability to absorb food. Overeating is curbed because exceeding the capacity of the stomach, or eating foods that are high in fat causes nausea and vomiting. It is important to note, however, that successful weight loss is dependent on the individual's willingness to exercise and follow a healthy nutritional plan.
The Adjustable Gastric Band, also known as the Lap-Band®, is a popular option with many patients. Gastric banding entails placing a band that compartmentalizes the stomach into a small upper pouch and a larger lower part. You feel full earlier as the upper pouch is small. Thus it works by only restricting the amount of food you eat. As the name suggests, your surgeon can adjust the band via a port placed under the skin to ensure proper weight loss.
The recent studies in the news regarding bariatric surgery and its effectiveness in combating diabetes have focused on the Roux en Y Gastric Bypass. Gastric bypass can be performed as an open or minimally invasive procedure. The surgeon creates a small stomach pouch and bypasses a part of the intestine, restricting both the amount of food you eat and the opportunity for food to be absorbed. Gastric bypass usually enables a faster loss of weight, but it is irreversible. Also, the patient will need daily supplements of essential proteins, vitamins and minerals after surgery because there is less opportunity for these to be absorbed naturally.
"Bariatric surgery is an effective option for those who have had little or no success in losing excess weight through other methods," said Dr. Sasthakonar. "But it is not a magic solution - the patient must be committed to follow a restricted diet and maintain an active lifestyle to achieve long lasting results. That is why our team of physicians, nurses, nutritionists, psychotherapists, exercise consultants and others work closely with our patients to help them adjust to the lifestyle changes."
To learn more about bariatric surgery options at NuHealth, call (516) 486-6862.