Surgery: Weight loss alternative

With Americans getting heavier each year, some of the nation’s obese people are taking drastic measures to lose weight. Kevin Krause, clinical assistant professor of surgery and laparoscopy fellow at the Ohio State University Medical Center, said interest in laparoscopic surgery has gone up because Americans are becoming more obese and people are having health problems because of excessive weight. According to the American Obesity Association (AOA), obesity is a disease that affects at least 70 million Americans: More than one-third of all adults and one in five children. Each year, obesity causes at least 300,000 deaths in the U.S. and costs the country more than $100 billion. Krause said there are two basic types of laparoscopic operations that have been proven to be successful in reducing weight in patients over a period of time. One of surgical procedures, called Roux-en-Y gastric bypass, involves creating a small stomach pouch and has long-term effects. He said long-term weight loss is around 70 percent of excess body weight. After the surgery, it takes about one year to lose the weight and become fairly stable. Obesity is caused by the consumption of more calories than are burned through work, exercise and other activities, according to Anorexia Nervosa and Related Eating Disorders Inc. (ANRED). “Most people are not going from 300 to 120 pounds. We are just trying to get them down to a reasonable weight,” Krause said. “Most of the individuals will be mildly overweight, but they will be much better than they were previously.” To qualify for the surgery, the body mass index (BMI) must be greater than 40, Krause said. If people have other medical problems, like high blood pressure or diabetes, the BMI should be 35 or more to qualify for the Roux-en-Y gastric bypass. BMI is a mathematical calculation used to determine if a patient is overweight. It is calculated by dividing body weight in kilograms by height in meters squared. “People who have a BMI of 40 or more really have problems losing weight and keeping it off,” Krause said. “You hear about it all the time in the news that people oftentimes lose weight, but they tend to gain it back.” According to Krause, the operation seems to be effective in helping maintain weight loss, even after several years have passed. The surgery reduces the amount of food that they can eat, Krause said. It dramatically changes people’s lifestyles. For example, “if they try to eat a half of a pizza, they will feel very sick. People get full sooner, and they are not able to eat anywhere near the volume they ate before.” Medical necessity determines if a person is a candidate for the surgery, Krause said. The surgery is not for cosmetic purposes, but for those obese persons who might develop health complications if they do not lose the weight. “It is fairly predictable to say, if someone is 30 years old and they are quite overweight, that they are not going to live nearly as long as someone who is able to lose the weight.” Besides improving the health of obese individuals by diminishing the possibility of developing health problems because of weight, Dr. Bradley J. Needleman, a surgeon at OSU, said in a press release that the “advantages to patients having the laparoscopic approach include shorter hospital stays and less pain.” Needleman also said that “positive results using minimally invasive techniques have caught the attention of insurers, many of whom now cover the operation.” This surgery is covered by OSU insurance plans for faculty and staff. However, the surgery has to be preauthorized by OSU’s Management Health Care System and meet the guidelines of a medical necessity set forth by the National Institute on Health.