Extreme weight loss

Bariatric surgery is just the beginning, not the cure

Anita Townes was running out of options. The 43-year-old was diagnosed with a mild case of scoliosis and degenerative disk disease caused by her weight. At the time, her 5-foot-9-inch frame carried 322 pounds.

The six medications she took to ease the muscles spasms, the back pain and the numbness in her left leg only masked the problem. So, she switched doctors in search of a cure.

Ultimately, she was referred to a neurologist, the first medical professional to point out that without significant weight loss, the benefit of any treatment would eventually be reversed. Her primary care physician then referred her to Dr. Eric Yancey, a Chesapeake Regional Medical Center bariatric surgeon.

Townes had known that bariatric surgery was often successful for treating obesity. After an informative consultation with Yancey and much soul-searching, it became an option for her.

Since her surgery last May, Townes is 82 pounds lighter, six pant-sizes smaller, free from pain and content with the progress she has made. “If I stopped losing weight right now, I would be happy. Hopefully, I can lose at least 40 more pounds.”

According to Yancey, the average female can shed 100 pounds to 120 pounds one year after the surgery. The average male can lose 125 pounds to 140 pounds. The weight loss begins leveling off at a year and a half after surgery.

Medical benefits go beyond weight loss

“The information explosion is making people aware of the incidence of morbid obesity and that there are surgical options. They don’t have to suffer in silence anymore,” observed Yancey.

Now considered “epidemic,” obesity has become the second-leading cause of preventable death in the United States. Approximately 127 million American are overweight. As many as 60 million are obese and nine million are severely obese, according to the American Obesity Association. Excess body weight is measured using the Body Mass Index. Overweight is defined as a BMI of 25 or more, obesity is 30 or more, and severe obesity is 40 or more.

Because of the extreme weight loss that results, bariatric surgery also cures many life-threatening health problems. According to Yancey, the decreased stress on the heart can increase the average lifespan for patients by about 10 years.

“There is more than a 90 percent cure rate for Type II diabetes, and the end of sleep apnea and joint pain in all patients,” he said. “The cure rate for hypertension so that patients can get off of medication is 75 to 80 percent. All patients have an improvement in their blood pressure profile after surgery and subsequent weight loss.”

Recognizing the medical benefits of bariatric surgery, Medicare and Medicaid started covering the costs only recently, and other insurance companies are following their lead.

Are you ready?

Candidates for bariatric surgery should have a body mass index of 40 or more. But the point at which an individual should consider the procedure varies. “It’s different for everybody, but they really must have exhausted all other measures. It should not be a first option for anyone,” said Yancey. Find your BMI here.

During gastric bypass surgery – the most common bariatric surgery and the one Townes had – the stomach is closed off, leaving only a small pouch for food. The small intestine is rerouted, bypassing the duodenum and making a direct connection between the stomach and the small intestine. As a result, the patient feels full on fewer calories.

According to Yancey, there is a success rate of about 70 percent to 80 percent for bariatric patients. However, he cautioned, “It is not a magic bullet. Only in combination with diet and exercise can you realize significant weight loss, otherwise, patients will lose weight initially but will ultimately gain most, if not all, of it back.”

Range of tools boost the chance of success

Since obesity is a complex chronic disease involving environmental, genetic, physiologic, metabolic, behavioral and psychological components, its treatment must be multidisciplinary.

Until recently, bariatric surgeons, like Yancey, have been coordinating the full range of multidisciplinary services required before and after the surgery to boost the chances of successful weight loss. Chesapeake Health has created a program to meet their needs.

Prior to surgery, bariatric patients meet with an exercise physiologist at the Chesapeake Health Lifestyle Center to develop a fitness plan. According to Erin Kennedy, a certified personal trainer, cardiovascular exercise helps prevent respiratory complications during surgery, improves circulation, reduces fat around the liver and strengthens the immune system. After surgery, strength training is emphasized to counteract the loss in muscle mass and decrease in the body’s metabolism.

A dietician teaches the patients how to limit their food intake to a number of ounces and grams. And they learn how to think about the nutrients they need to consume in a day.

Patients also meet with a psychiatrist and undergo a sleep study. After surgery, they are offered a free month membership at the Lifestyle Center and a more flexible payment system thereafter. They also are encouraged to attend monthly support group meetings.

Patient education is emphasized throughout treatment. “We want an informed patient who knows that surgery is a tool that goes along with changing lifestyle habits,” said Ruth Cody, program coordinator. “With diet exercise and behavior modification weight loss can be sustained indefinitely. Without lifestyle changes the weight can be gained again.”

Anita Townes says the freedom from pain and smaller clothing sizes motivate her to continue her restricted diet and to walk as much as possible during the day.

“I feel good,” she says. “I can sit down and don’t have a problem. I can get up without a problem. I can walk without a problem. I feel wonderful.

For more information about the bariatric program at Chesapeake Health, call the Bariatric Program Coordinator at 757.312.3000 or e-mail ruth.cody@chesapeakeregional.com.