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Battling the Bulge

  • November 20, 2009
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Barnes-Jewish Expert Says Surgery Can Help Morbidly Obese

Matching audio soundbites also available by calling the Barnes-Jewish Hospital Medical News Service at (866) 747-4075

October 10, 2006, ST. LOUIS – It's no secret Americans are getting heavier, but now more people than ever are battling morbid obesity, meaning they are more than 100 pounds overweight. This has lead more people to turn to surgery to drop the weight.

In fact last year over 140,000 Americans had bariatric surgery. It's one of the most effective treatments for morbidly obese people who haven't been able to lose weight in any other way. Dr. Christopher Eagon is a bariatric surgeon at Barnes-Jewish Hospital in St. Louis. He says the most common of these surgical procedures is the gastric bypass:

"That operation involves separating the stomach into two compartments: a very small upper pouch which is about the size of an egg or a golf ball, and the lower 98 percent of the volume of the stomach, which is about football-size. The main reason people lose weight with that surgery is that the pouch fills up very quickly when they start to eat so they feel full very soon and their calorie intake drops way down."

Dr. Eagon says patients notice the effects of surgery immediately. Typically, for the first three to six months after surgery, they don't feel hungry. When they do begin to feel hunger again, that hunger is satisfied by a small amount of food.

But more importantly, bariatric surgery can dramatically improve a patient's overall health. Dr. Eagon says blood pressure and cholesterol levels go down, sleep improves and blood sugars plummet:

"In the case of these surgeries, about a third of the patients are diabetic and taking medications to control their blood sugar. And oftentimes their blood sugar control, already by two or three days after the surgery is much better than it was before. They often go home on about half the dose of insulin they were on before the surgery if they were taking insulin beforehand. And within a matter of three weeks to three months after the operation about two thirds of the patients who were diabetic are off of all their diabetes medicines and have blood sugars in the normal range."

Dr. Eagon says these effects are long-lasting. Although patients typically regain five to 15 pounds after their first year post-surgery, on average patients keep off 55 percent of the excess weight for at least 15 years.

There is some risk to bariatric surgery. Complications can include infection, blood clots and breathing difficulties and in rare cases, death. But Dr. Eagon says the risk is smaller than the risk of remaining obese:

"And it turns out that people who have the surgery have about one fifth the likelihood of dying compared to those people who don't have the surgery. So in the long run, that's five to 10 years out from surgery, the chance of the patient being alive is better if they have the operation than if they don't. And that's what's on these people's minds before the surgery. They want to be there for their children when they graduate from high school or when they graduate from college."

Many insurance carriers cover bariatric surgery. Medicare will pay for bariatric surgeries performed at hospitals certified as Centers of Excellence by the American Society for Bariatric Surgery. Barnes-Jewish Hospital was certified earlier this year.

For more information about bariatric surgery, call 866-TOP-DOCS.

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For assistance or help with technical problems, call Jason Merrill at 314-286-0302.

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