January 2011

Weight Reduction Surgery

The most popular New Year's resolution is dieting. So I asked one of my friends and colleagues Dr. Carlos Juarez to fill me in on the newest information on surgical management of obesity. Bariatric surgery is one of the most common surgical procedures performed by general surgeons in the US. Dr. Juarez is one of the leading Bariatric Surgeons in Fresno whose practice is essentially dedicated to surgical weight management.

Dr. Juarez explained that obesity surgeries are very good at restriction of calorie intake, decreasing the release of the hunger hormone Gherlin and lastly severely discouraging cheating on your diet. Obesity surgery has been around since 1960's, but because of the increased safety, laparoscopic techniques and reduction in complications, has gained significant popularity since the mid 90's.

Dr. Juarez has performed over 300 Lap-Band procedures. The procedure involves placing a prosthetic device around the stomach and creating a small pouch. This procedure has the lowest risk and is performed on an outpatient basis. It requires the most amount of will power, but patients generally reduce 50 to 60% of their excess weight within the first 2 years. Lap-Band procedure is covered by some insurance companies or alternatively costs $9500.

Dr. Juarez comments that the newest procedure is the Sleeve Gastrectomy. This procedure involves cutting and removing 80% of the stomach, which not only restricts food intake but also decreases the production of the hunger hormone Gherlin. This hormone is responsible for sabotaging most people on a diet! Surgical complication risk is only about 0.3% and the patient rapidly sheds 2-3 pounds per week. The average patient will reach 70% of their goal in one year. This is a relatively new procedure and often not covered by insurance. The cost of this procedure is $11,000.

Finally Dr. Juarez has performed over 600 Gastric Bypass procedures. This is the procedure that has been around the longest with a proven track record in the most obese patients. It involves restricting the stomach and bypassing a small amount of small intestine to decrease absorption. This procedure has a high success rate with 80% weight reduction in the first year, since the calorie intake is limited and some of the food does not get absorbed. Furthermore, overeating causes "dumping syndrome" which makes the patient feel unwell for at least 2 hours and discourages cheating!

This procedure is associated with 0.2% risk of malnutrition, vitamin deficiencies, and leaks requiring second surgeries.  Gastric Bypass surgery is often covered by most insurance carriers or otherwise costs about $15,000.

Obesity surgery is not for everyone but if being overweight has taken a central role in your life and is impacting your health, you should at least find out more about this option.

Learn more about  Dr. Juarez and Obesity Surgery by visiting: www.californiabariatrics.net.