Steve T. Weiland MD Bariatric Surgeon
Bariatric surgery has long been identified to be one of the only interventions that maintains significant weight loss.
Surgical Associates offers two bariatric surgery options: The Roux-en-Y Procedure and Sleeve Gastrectomy.
The Roux-en-Y procedure reduces the size of the stomach to a small, egg-sized pouch. This decreases the amount of food a patient can take in at meals. Additionally, a portion of the small intestine is shaped into a “Y” and attached directly to the pouch. As a result, food that is being digested travels directly to the lower part of the small intestine, restricting the amount of fat and calories absorbed after eating. The Roux-en-Y procedure is the most common type of weight-loss surgery performed.
During a Sleeve Gastrectomy, approximately 85 percent of the stomach is removed, with the remainder being sewn into a cylindrical, sleeve-like shape. The stomach is drastically reduced in size, but its function is preserved. Weight loss occurs because the reduced stomach volume restricts the amount of food a patient can eat before feeling full. The production of Ghrelin, an appetite-stimulating hormone, is also drastically reduced, helping prevent harmful overeating.
Both the Roux-en-y gastric bypass and sleeve gastrectomy have demonstrated approximately 70% excess weight loss at 18 months and 50 to 60% excess weight loss at five years. Recent published studies have emphasized the positive impact on important medical conditions.
Researchers at the Geisenger Obesity Institute in Pennsylvania published a study presenting the positive impact of weight-loss surgery on heart disease in the June 2017 issue of the AHA journal. The group studied 3400 tightly matched patients relative to BMI, sex, Framingham risk score, smoking history, use of antihypertensives and diabetes status. Half of the patients underwent gastric bypass surgery and the others did not. The group that underwent bariatric surgery saw a BMI drop from an average of 46.5 to 32.5 after five years while the BMI remained the same at 46 in the group that did not receive surgery. At eight year follow-up, 24 patients who had had surgery and 55 patients who had not were diagnosed with heart failure. The surgery group also experienced fewer myocardial infarction’s and strokes compared to the non surgical group.
The STAMPEDE Study published in February 2017 in the New England Journal of Medicine reported five year outcomes comparing randomized patients undergoing bariatric surgery versus intensive medical therapy for type 2 diabetes. At five years, changes from baseline observed in the gastric bypass and sleeve gastrectomy groups were superior to the changes seen in the medical therapy group with respect to bodyweight, triglyceride level, high density lipoprotein cholesterol level, use of insulin, and quality life measures. These findings and others have motivated the American Diabetes Association to recommend bariatric surgery for type two diabetes patients with body mass index of 30 or higher.
These results support the growing body of evidence that metabolic surgery can improve overall health and quality of life. For more information or to refer a patient to Aspirus Bariatrics, call 715-847-0024.
