Southwest Washington Medical Center



 
 

When the pounds really must come off

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An interview with
Dr. Leslie Cagle, Bariatric Surgeon, PeaceHealth Medical Group Surgical Specialists
  

It's no secret that a lot of people struggle to maintain a healthy weight.

But while some strain to lose 10, 20 or even 30 pounds, others stare at a seemingly insurmountable weight-loss goal — perhaps 100 pounds or more. "Carrying 100 extra pounds is called morbid obesity and according to obesity surgeon Dr. Leslie Cagle, there is a reason it's called "Morbid," it shortens people's life.”

Increasingly, extremely obese people are turning to a more promising option: surgery.

“According to multiple reports, diets, exercise, and medicine therapies have proven to not produce significant weight loss in the majority of the obese population. Surgical procedures such as the Lap-band and bypass produce far more successful results and sustained weight loss over time,” says Dr. Cagle.

And, the American Obesity Association and others say the benefits of the surgery appear to outweigh its risks, particularly when the health risks of being severely obese are taken into account.

Those risks include high blood pressure; high cholesterol; type 2 diabetes; gallbladder, liver and acid reflux diseases; incontinence; cancer; degenerative joint disease; obstructive sleep apnea; and many others.

Is it right for you?

Ideal candidates for weight-loss surgery have:

  • A body mass index (BMI) of 40 or more.
  • A BMI between 35 and 39.9 plus a serious, obesity-related health problem.
  • Tried non-surgical weight-loss methods and are still severely obese.
  • The commitment to make needed lifestyle changes following surgery.

Consider the options:

“Various operations can help people lose weight, but all involve making the stomach smaller. That limits the amount of food it can hold and allows a person to feel full sooner,” explains obesity surgeon Paul Dally, MD. Types of surgery include:

Adjustable Lap-Band. The Lab-Band Adjustable Gastric Banding System is minimally invasive surgery. A silicon band (lap band) is placed around the stomach. This hollow band creates a small pouch that holds about 2 ounces of food at a time. The opening can be adjusted to let in more or less food.

Advantages of Lab-Band surgery include:

  • The outlet from the stomach is quite small
  • Patients tend not to be hungry for a period of time
  • Lap band technique involves smaller incisions than open surgery, resulting in a shorter hospital stay, less pain, faster healing and, ultimately, a quicker return to an active, healthy lifestyle.
  • The lap-band is also adjustable and is a reversible procedure.

Roux-en-Y gastric bypass. This surgery involved first creating a small vertical stomach pouch of less than one-ounce capacity. Then a bypass of most of the stomach and some of the small intestine is created. 

The bypass helps you lose weight because:

  • The stomach pouch is quite small
  • The outlet from the pouch is small so you must eat slowly
  • After a bypass, patients tend to stay away from sweets
  • Interrupting the satiety center causes you not to be hungry for eight to 10 months.

KNOW THE PROS AND CONS

In general, risks from any type of weight-loss surgery include complications such as infection, leaking, bleeding, blood clots and intestinal blockage. Gallstones and nutritional deficiencies also are possible, but they can be prevented with medication and nutritional supplements.

“Benefits include rapid weight loss, and the weight is likely to stay off. Also, people often see improvements in their obesity-related medical conditions, which could have been life-threatening,” Dr. Cagle says.

Is it your time to lose? Let us help.