Banner Fort Collins Medical Center

WIN 2017

Spirit of Women magazine is a national publication presented to women by hospitals and their physicians. The magazine provides up-to-date, evidence-based healthcare information and promotes our hospitals as leaders in women's health excellence.

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23 Body mass index (BMI) is a measure of body fat in proportion to your weight and height. To calculate your BMI, first multiply your weight in pounds by 703, and then multiply your height in inches by itself. Divide the first number by the second number to get your BMI. Or, for an online BMI calculator, visit www.nhlbi.nih. gov/health/educational/lose_wt/BMI/bmicalc.htm. BMI? WHAT'S YOUR Formula: 703 x weight (lb) height (in) 2 Roux-en-Y gastric bypass One of the most common "gold standard" bariatric procedures is the Roux- en-Y gastric bypass (RYGB), chosen by roughly 30 percent of patients. Although it is done laparoscopically, using small, keyhole, minimally invasive incisions, it is still considered major surgery. For the relatively extensive RYGB, surgeons divide the stomach into upper and lower sections to create a small pouch. They then reroute the small intestine to allow food to bypass the lower stomach as well as the first and second sections of the small intestine, which will restrict your food intake. RYGB, which is reversible, can help you lose up to an average of 70 percent of excess body weight (your current weight minus your ideal healthy body weight) within two years. "The majority of patients with a Roux- en-Y gastric bypass will have moderate to very good weight loss," says Dr. DeSimone. Continued on page 24 W hen you're substantially overweight, dropping pounds can make a big impact on your health in addition to altering your appearance. If you have a body mass index (BMI) of greater than 40, as nearly 38 percent of American adults do, shedding excess weight can decrease your risk of heart disease, stroke, diabetes, gastroesophageal reflux disease (GERD), joint problems and some forms of cancer. It may even help you live longer. Trouble is, diet and exercise alone aren't likely to be effective when you're obese. "The literature shows that 98 percent of obese patients are not going to be able to lose significant amounts of weight with diet and exercise to make a positive impact on their health," says Dr. Jeffrey DeSimone, a bariatric surgeon at Crouse Hospital in Syracuse, N.Y. In fact, a landmark study in The New England Journal of Medicine known as the STAMPEDE trial, which involved 150 obese patients with Type 2 diabetes, found that after five years, those who underwent weight-loss (bariatric) surgery lost more weight and kept it off compared with those who worked with a nutritionist and a personal trainer to lose weight. The surgical weight-loss patients had better diabetes control too, and some were even cured of the condition. Game changer Because bariatric surgery is proving to be so helpful and safe, it's being offered to patients earlier now. "Ten years ago, patients wouldn't be referred to a bariatric surgeon until they had tried dozens of diets, their weight was still going up, and they were starting to experience related conditions such as diabetes, high blood pressure and high cholesterol," says Dr. DeSimone. "[Today] the ideal candidate for bariatric surgery is someone with a BMI over 40 who has made a good attempt to lose weight with diet and exercise one or two times but who hasn't yet developed serious obesity-related conditions." People with a BMI of 35 who have one or more related health issues, such as diabetes, high blood pressure or heart disease, are also contenders for the surgery. "Bariatric surgery shouldn't be a last resort," says Dr. DeSimone. Choosing the best bariatric surgery can depend on several factors, including the amount of weight you need to lose and your overall health. Keep in mind that bariatric surgery is also considered elective and may not be covered by your health plan, so be sure to check your policy.

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