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Aug 24

Ask the IU Health Expert: Battle against the bulge – Indianapolis Recorder

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While nutrition and exercise are the keys to our fittest selves, it can be a real struggle to lose weight and keep it off when you are significantly overweight. Very few people can accomplish that kind of substantial weight loss on their own. The IU Health Bariatric Program offers many options that can help reverse obesity and restore health. Read on for answers to some common questions about medical weight loss treatment options.

When should someone seek medical help for weight loss?

Obesity is a chronic life-threatening disease that causes many serious health conditions, including coronary artery disease, high blood pressure, stroke, Type 2 diabetes, high cholesterol, metabolic syndrome and sleep apnea.

When you realize that your weight starts interfering with your quality of life and negatively impacting your health, you may want to seek medical help.

How do I know if I am a candidate for bariatric surgery?

First, it boils down to insurance. Each insurance company sets specific criteria needed to approve a patient for bariatric surgery. Generally, if you have a body mass index (BMI) of 40 or more, or of 35 with a serious health condition, you may be a candidate for the IU Health Bariatric Surgery Program.

If an individual qualifies, there are other aspects that doctors consider, including that persons willingness to:

1

Agree to program expectations you need to comply with taking vitamins, showing up for doctor visits, be willing to engage in exercise and more.

2

Cut back on food consumption after the surgery, your diet will be substantially modified, and you will feel full more quickly; in anticipation of these changes, decreased food intake is also practiced prior to surgery.

3

Stay focused on your goals you need to be willing to continue working after surgery to lose and maintain your weight.

4

Be fit for surgery you should take care of yourself and be healthy enough for surgery.

5

Have support seek support from family, friends and professionals to keep you on track and help you achieve your goals.

What are the surgical treatment options?

There are different surgeries to accomplish different goals, which are tailored to each patient. All procedures are very safe and performed using minimally invasive techniques, which leads to less pain, faster recovery and fewer complications. Here are the most commonly performed surgeries:

1

Roux-en-y Gastric Bypass: This operation reduces the amount of food consumed by decreasing the size of your stomach to that of an egg. It also makes you lose your hunger and decreases the absorption of some vitamins and minerals. The Roux-en-Y gastric bypass effectively helps patients lose about 70 percent of their excess weight in the long term and reverses several of the health problems associated with severe obesity.

2

Sleeve Gastrectomy: This operation reduces the stomach size by surgically removing about 80 percent of the stomach. It also decreases hunger sensation and does not require manipulation of the intestines. It leads to roughly 60 percent excess weight loss in the long term and leads to improvements of health problems associated with severe obesity.

3

Gastric Band: This operation uses an Adjustable Gastric Band to restrict food intake by making it harder for food to transverse the band. It does not require cutting of the stomach or the intestines and does not lead to malabsorption. Patients lose about 40 percent of their excess weight.

4

Revisional Surgery: This is corrective surgery to alter or repair previous weight loss surgeries that may have failed. Patients whose previous bariatric surgery produced undesirable or inherent limited outcomes are possible candidates for revisional surgery.

What are the non-surgical treatment options?

Surgery is not for everyone. Not all insurance plans cover it, and not all overweight patients qualify for it.

IU Health offers comprehensive non-surgical weight loss treatment plans, supervised by health care professionals. We begin by conducting a complete physical exam, including blood tests and an electrocardiogram to gauge your current health and the best tactics to help you accomplish your weight loss goals. In addition to ongoing medical monitoring, treatment may consist of fitness, nutritional and behavioral counseling; medication; support groups and cooking classes.

If you have had limited success in losing weight and keeping it off, there are a bevy of options available to help get you back on the road to better health, and a program can be created just for you.

What resources would you recommend to someone exploring medical weight loss treatments?

The IU Health Bariatric Program provides numerous resources to people regarding weight loss treatments. Besides the procedures our surgical team offers, a visit with our medical bariatrician Dr. Ashley Gilmore can help you determine which non-surgical weight loss option might be best for you.

You can always visit the programs website (iuhealth.org/bariatrics), which includes several links to additional online resources, or other online resources are available on the Obesity Society website (obesity.org/home) and the American Society for Metabolic and Bariatric Surgery (asmbs.org).

Dr. Dimitrios Stefanidis is director, MIS/Bariatric Surgery, at IU Health.

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Ask the IU Health Expert: Battle against the bulge - Indianapolis Recorder

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