Weight Loss Surgery:
Treatment for Obesity has Proven Itself
HealthWorks spoke with Michael Jiser, MD, a surgeon at Emerson Hospital, about the Surgical Weight Loss Program. He is one of three surgeons who specialize in laparoscopic gastric bypass surgery and gastric banding, or lap-band surgery, at Emerson.
Has weight loss surgery proven itself?
Absolutely. Weight loss surgery has been performed for about 40 years, but today we perform it laparoscopically—through small incisions—so it’s a safer, less invasive procedure. Surgery has proved to be the best treatment for obesity, which is associated with several health conditions, including high blood pressure and heart disease, diabetes and sleep apnea.
What are the surgical options available at Emerson?
We offer gastric bypass, which creates a permanent, small stomach pouch that restricts food intake and limits the absorption of calories and nutrients. The other option is gastric banding, known as lap-band surgery, in which we place a small, adjustable band to create a small pouch that does not interfere with the normal digestive process. We explain both procedures to patients, but ultimately they decide which option is right for them.
What is the main criteria for someone to be eligible for weight loss surgery?
The most important criteria is the individual’s body mass index (BMI). Generally, patients should have a BMI of 40 or higher, which translates into approximately 100 pounds overweight for someone of average height. However, if someone has a BMI between 35 and 40 but has serious health problems, they may qualify for surgery.
How much weight can an individual expect to lose?
On average, patients who have gastric bypass surgery can expect to lose about 70 percent of their excess weight during that first year. So someone who is 100 pounds overweight will lose about 70 pounds. Gastric banding patients lose weight a little more slowly—about 40 percent of their excess weight in the first year. But by year two or three, they catch up to those who had gastric bypass surgery.
What is the current safety record for weight loss surgery?
Weight loss surgery is quite safe as long as the surgeon is well-trained and experienced. Our group has performed more than 400 weight loss surgeries, and our rate of complications is significantly below the national average. All surgery carries a certain degree of risk; we discuss this with patients, who must consider the risks associated with surgery versus those associated with remaining obese.
Is there any advantage to having weight loss surgery at Emerson?
Yes. Weight loss surgery requires a good deal of follow-up, especially during the first two years after surgery—not only appointments with the surgeon, but stopping in for lab tests and attending a support group, which is an essential part of treatment. There is no question that patients are better able to receive the follow-up care and support they need after
surgery, as well as the visits that are required during the evaluation period prior to surgery, at a program like ours, which is right in the community.
What is the most important thing an individual needs to know before having weight loss surgery?
As we tell our patients, despite the fact that they might be concerned about having surgery, the operation itself is the easy part. The challenge comes with making the lifestyle changes, including maintaining their diet and committing to an exercise program, that are necessary for successful weight loss. Our program at Emerson includes a nurse
practitioner, dietitian, psychologist and program coordinator—each of whom is committed to helping patients achieve their goal.
For more information on the Surgical Weight Loss Program, including the schedule for upcoming information sessions, please call 978-287-3532.
