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Bariatric surgery may be the answer in life-and-death situations

Procedure has risks and patients must comply with post-operation lifestyle

POSTED: July 22, 2013 12:20 a.m.

The battle against obesity can’t always be won by traditional means alone.

Sometimes people need surgical help to overcome the health hurdles brought on by the disease.

Dr. Alex Nguyen, bariatric surgeon with Northeast Georgia Physicians Group Surgical Associates and medical director of the Bariatric Weight Loss Center at Northeast Georgia Medical Center, said by the time most of his patients come to see him about weight loss surgery, they’ve already tried every other weight loss method out there.

“They always list all these frustrations of trying to exercise, trying to diet and trying pills and seeing doctors for forever,” Nguyen said.

Not every patient who has had trouble losing weight is a candidate for surgery. Patients must meet certain qualifications like having a body mass index of 35 to 40 and a co-morbidity, like diabetes or heart disease, or have a body-mass index greater than 40.

Nguyen said he believes everyone who comes into his office deserves a shot at conservative therapy, diet and exercise under the direction of a dietitian, but he knows it’s not always going work for every patient. He said each case is unique and some people have a metabolic disorder or genetic predisposition that prevents them from losing significant weight. Some medications used to treat obesity-related diseases can cause weight gain.

The surgery is not without risk and patients are required to demonstrate they will be compliant with their new post-operation lifestyle for a period of time prior to the surgery.

While weight loss alone can be reason enough, it isn’t always the deciding factor for having the surgery.

Some patients, like Mark Watson of Clarkesville, need surgical weight loss to help with diabetes.

Watson was diagnosed with diabetes in 1997 and his condition worsened to the point of needing to wear an insulin pump, take three insulin shots daily and use oral medications. He also took medications for blood pressure and cholesterol.

Watson said he felt “hopeless” because of his diabetes and said he “knew how he was going to die.”

His doctor told him he likely wouldn’t live another 10 years because of his condition and suggested gastric bypass.

According to a 2004 article in the Journal of the American Medical Association, there is “strong evidence” bariatric surgeries improve diabetes. Up to 80 percent of patients are able to discontinue their diabetes medications.

Nguyen said weight loss surgery has been shown to “cure” patients of diabetes even before any weight loss has occurred.

“When you see diabetes in an obese patient, you’re going to give them a much bigger favor to cure them of their diabetes or by intervening earlier,” Nguyen said.

The last time Watson had to take insulin for his diabetes was Aug. 7, the day of his surgery. Since then, he’s lost 100 pounds.

Watson said his quality of life has greatly improved.

“It is amazing how good I feel,” Watson said. “Absolutely amazing how good I feel.”

Watson often meets with other patients who are considering the surgery and tells them about his experience.

He said most people he speaks with are concerned about the permanent diet changes that go along with the surgery.

He admits he sometimes feels “heartbroken” because some people don’t want to make a lifestyle change that could save their lives.

“You’re going to die from diabetes definitely,” Watson said. “... You weigh that against having the surgery because your eating habits are going to have to change. Really, do you even have to think about this?”

Watson said he feels hopeful for the first time in a long time and wants to help others recognize that there are options for people like himself.

Other health conditions have been shown to improve after the surgery as well.

Dr. Heather Westmoreland, cardiologist at the Northeast Georgia Heart Center, said many of her patients have weight issues. The ones who are able to lose weight, through diet and exercise or surgery, often experience an improvement in their heart health as well.

“A lot of those patients who have bariatric surgery and drop 100, 150 pounds, they no longer have diabetes. They no longer have hypertension,” Westmoreland said. “Their diseases drop dramatically.”

Nguyen said the sooner physicians intervene, the better it is on patients.

He said he’s hopeful patients and the health care community will take obesity more seriously now that The American Medical Association has recently classified obesity as a disease. The designation is also shared by several other health organizations.

Nguyen said he believes the designation will create new opportunities and improvements in patient care.

“With more recognition of this as a disease there will be more funds dedicated to research and more resources dedicated to developing treatments besides just surgery and pills,” Nguyen said.

Watson said he tells everyone who asks about his weight loss about the surgery and what it’s done for him. He said he feels people who might be curious about the weight loss and improving obesity-related diseases will seek medical help.

“I’ve made it a mission of mine to let people know there is hope,” Watson said.


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