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Obesity is the second leading cause of preventable death in the United States and the rates are increasing. But physicians at Mount Auburn Hospital are working with patients to combat the disease head on. Bariatric surgeon, Julie Kim, M.D., and her team have performed more than 4,000 bariatric procedures and have seen firsthand how weight-loss surgery can change the lives of people battling their weight.

“Obesity is a disease that can be treated,” says Dr. Kim. “Achieving a healthy weight is especially difficult for people who are more than 75 pounds overweight, but weight-loss surgery has incredible success rates.”

The most advanced bariatric surgery techniques
Within the last 10 years, bariatric surgery has advanced significantly and is one of the safest surgical procedures a person can undergo.

“The field has dedicated itself to becoming evidence based, which has resulted in stricter standards and guidelines,” says Dr. Kim. “We are more selective about bariatric surgery candidates and have a more rigorous pre- and post-operative process.”

The actual procedures have also evolved. With minimally-invasive techniques, surgeons can perform bariatric surgery through smaller incisions, which speeds recovery. In addition, patients have more surgical options than ever before, which include:

• Laparoscopic Gastric Bypass (Roux-en-Y). In the mid 1960s, bariatric surgery was first introduced to the public with the gastric bypass procedure. Instead of performing the procedure with large, open abdominal incisions, today, surgeons are taking a laparoscopic approach.
  
  During this procedure, surgeons reconstruct the stomach to make a small pouch at the top, which limits the amount of food a person can eat. Then, surgeons resection the small intestine to the pouch, bypassing the rest of the stomach. This changes the way the patient’s food is processed, which helps aid in suppressing hunger. On average, patients lose about 60 to 80 percent of excess weight within 12 to 18 months.

• Laparoscopic Adjustable Gastric Banding. This procedure works by placing a silicone band around the top of the stomach—creating a pouch, roughly the size of a golf ball. The pouch restricts the amount of food a person can consume. Patients also feel fuller, longer because food remains in the pouch for an extended period of time before passing to the rest of the stomach. On average, patients will lose about 40 percent of their excess weight in about three years.
  
  After surgery, physicians can adjust the band using saline and a special needle that is inserted through a port that is under the skin, but above the muscle. Like a belt, the band can be cinched or expanded by adding or removing saline.

• Laparoscopic Sleeve Gastrectomy. During this procedure, surgeons remove the lateral part of the stomach to create a long, narrow, banana-shaped stomach. This restricts the amount of food a person is able to consume at one time. In addition, patients have suppressed appetites because the portion of stomach that releases a hunger hormone is removed. On average, patients lose about 50 to 70 percent of excess weight within 12 to 18 months.

When is surgery an option?
Patients must be at least 18 years old and have a Body Mass Index (BMI) of 40 (about 100 pounds overweight) or greater to be considered for bariatric surgery. They can also be considered for weight-loss surgery if they have a BMI of at least 35 (about 75 pounds overweight) and have one or more comorbidities, such as diabetes.

Dr. Kim and the bariatric surgery team at the Mount Auburn Hospital’s Weight Management Center believe their work with patients can help improve obesity rates. “Obesity is growing the fastest in the adolescent population,” says Dr. Kim. “Subsequently, when we are helping parents get on a path to healthy living, we are also helping the following generations develop healthy habits.”

Register for a free surgical weight management information session at the Mount Auburn Hospital Weight Management Center. Call (617) 499-6767.

*Dr. Kim is also a member of the Tufts Medical Center Physician Organization.