Weight loss through surgery

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Plan of action: Dr. James Siatras, surgeon and medical director of the Northwest Indiana Center for Bariatric Surgery at Methodist Hospitals, consults with patients about their health issues and which type of laparoscopic surgery would work best for them. | Supplied photo

At Northwest Indiana Center for Bariatric Surgery at Methodist Hospitals there is much more involved in helping patients lose weight than just surgery.

“In the whole process, surgery is just a tool. To help patients achieve their goal, they need to form a close relationship with the center and they need to continue to follow-up for years afterward,” said Dr. James Siatras, surgeon and medical director of the center.

“This is a lifelong process,” he said.

Included in the process are an entire team that includes the surgeon, dietitian, nurse coordinator and other support staff who monitor patients’ vitamin levels, stay on top of their diets, teach them how to read food labels and more.

The process starts when a prospective patient comes to one of the regularly scheduled seminars offered free at Methodist. The seminar covers an overview of the process and an explanation of how it would help resolve such health issues as diabetes and high blood pressure, Siatras said.

“Weight loss is secondary for most patients. Their weight is a threat for health problems,” he said.

Gold standard of surgeries

The next step is a surgical consultation, in which they talk more specifically about the individual’s specific health issues and which of the three surgical procedures offered they would prefer — laparoscopic sleeve gastrectomy, laparoscopic adjustable gastric band (or lap band surgery), and laparoscopic gastric bypass, the latter of which Siatras refers to as the “gold standard” of bariatric surgeries and most commonly performed bariatric surgical procedure, with excellent excess weight loss results and comorbidity resolution.

In the gastric bypass, a portion of the stomach is stapled to create a smaller stomach and the small intestine is divided, restricting the amount of food that can be taken in and decreasing the amount of calories absorbed. With lap band, a band is placed around the top of the stomach and fluid is injected to make it tighter or looser. This restricts the amount of food taken in. With sleeve gastrectomy, two-thirds of the stomach is removed with the edges stapled together to form a sleeve, restricting the amount of food that can be taken in.

A patient is allowed to have the surgery if their body mass index is 35 or greater with one other medical code related to obesity or a BMI of 40 or greater, Siatras said.

Beyond will power

Patients also must be tobacco-free and go through a three- to six-month weight loss process in which they are put on a special diet and work hand-in-hand with the team to undergo a lifestyle change before surgery.

“We absolutely won’t do surgery if a patient isn’t ready. This is a big surgery. We want everything in place to give the patient the best possible outcome,” Siatras said.

That said, Siatras said any overweight person is a good candidate.

“This is not an issue of will power. If it was, they wouldn’t be surgically treated,” he said. “It goes way beyond their not wanting to exercise.”

Siatras said many patients have something going on that prevents them from losing weight, whether it is genetics or medications they’re taking.

More information is at www.methodisthospitals.org/northwest-indiana-center-for-bariatric-surgery.aspx.