Fremont Area Medical Center

SUM 2013

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but it comes back even worse than before. TheyÕll gain it back, and then some. Surgery is meant to break that cycle,Ó he adds. But because surgery carries inherent risks, itÕs primarily recommended as a last or next-to-last resort. ÒItÕs always best if you can lose the weight by yourself and maintain it,Ó says Dr. Bernita Berntsen, a general surgeon at St. Francis Health Center in Topeka, Kansas, and a fellow of the American Society for Metabolic and Bariatric Surgery. ÒThe trouble is, for someone who is morbidly obese, carrying around the extra weight leads to comorbidities and can lead to a decrease in lifespan. It doesnÕt make sense to continue carrying the extra weight.Ó People considered good candidates for bariatric surgery are generally past the point where consistent exercise is a realistic method of weight loss. ÒYouÕre not talking about a young, healthy 18-year-old who can sustain high levels of activity,Ó says Dr. Robert Cooper, a bariatric surgeon at Schneck Medical Center in Seymour, Ind. ÒYouÕre talking about people who are 200 pounds overweight, have bad knees, a bad back, cardiac problems and hypertension. You canÕt expect those people to do an extreme amount of exercise.Ó SURGICAL OPTIONS The most common bariatric surgeries, in order of complexity, are: • Gastric band Ð An adjustable ring is placed around the top portion of the stomach, reducing its effective size to a small pouch. • Sleeve gastrectomy Ð The stomach is surgically reduced to about 15 percent of its original size. • Gastric bypass Ð A large portion of the stomach is stapled off, and the small intestine is attached to the portion that is still open to receiving food via the esophagus. to consider bariatric surgery MAKING A COMMITMENT Bariatric surgery can help lead to significant weight loss Ñthe average patient loses 70 to 80 percent of his or her extra weight in the first year, although results vary considerablyÑbut long-term results depend on the patientÕs adherence to a prescribed diet plan. ÒItÕs not a free ride,Ó Dr. Cooper says. ÒThe people who come to me for this surgery are brave. TheyÕre willing to undergo an operation and put in the effort afterward to get a decrease in weight and improvement in health.Ó • 4 Check it out As with any elective surgery, be sure to investigate your doctor's credentials before proceeding. "Often, you can Google your doctor and fnd out a lot about their credentials," says Dr. Gerald Cahill, who is a bariatric surgeon at Franciscan St. Margaret Health in Dyer, Ind. "But many people go to seminars as they're considering having the surgery, and they'll talk to specifc doctors and ask them how many of these procedures they've done. You want to make sure they have years of experience doing these types of surgeries, and that they have the right certifcation and a good record of taking care of their patients post operation." SHUTTERSTOCK Dr. Cooper offered this analogy about the roles of the different surgeries: ÒEach is a tool we can use for weight loss, but it depends on how we use each tool. We have a shed, and it has several different shovels in it. Each shovel is right for digging a specific type of hole,Ó he explains. Along with the health benefits of weight loss, bariatric surgery does have the potential for both short- and longterm complications. Short-term complications can include infection, pneumonia and blood clots. Longer term, surgery can affect the bodyÕs ability to absorb certain vitamins and minerals, while less common side effects include dehydration and hernias. 4 reasons • Diet, exercise and medication have failed to produce weight loss. • Your BMI is 40 or higher, which is considered morbid obesity. • Your BMI is 35 or higher, and you also have weight-related medical issues such as diabetes or sleep apnea. • You are prepared to make substantial changes in your lifestyle. w w w. s p i r i t o f w o m e n . c o m S U M M E R 2 013 SPI RIT O F WOM EN 31

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