As the amount of weight loss surgeries in the U.S. continue to rise, doctors are finding different and better ways to surgically treat obesity. One of the newest players in the game is called an intragastric balloon, and as it’s not approved for use in the United States, many patients have chosen to cross the border to Canada to do the procedure.
The intragastric balloon is less invasive than traditional bariatric surgery. It involves inserting a tube down the esophagus into the stomach, so there’s no surgical incision. A deflated balloon is then threaded down the tube, and once placed, blown up to the size of an orange and filled with sterile blue water. It can stay there for up to six months, at which point it is removed to prevent ruptures. This can be done multiple times if the patient continues to need the support the balloon provides. The balloon decreases the patient’s feelings of hunger, making them eat less and lose weight.
Although the average weight of Americans continues to bound upward, there are still very few bariatric surgeries performed annually. Less than one percent of individuals who meet the criteria for bariatric surgery actually have surgery, according to the American Society for Metabolic & Bariatric Surgery. Each year, about 250,000 Americans choose to have some form of weight loss surgery, the most popular being gastric bypass, a gastric band, sleeve gastrectomy, or duodenal switch. These involve removing a portion of the stomach, restricting how much food can go into the stomach, rerouting the intestinal system, or a combination of these methods. The gastric sleeve is cheapest, costing around $10,000, while the others range from $17,000 to $35,000, according to the Consumer Guide to Bariatric Surgery. (more…)
The first-ever endoluminal incision-free bariatric surgery was performed on January 22, 2012, at the 3rd Annual Apollo Bariatric Surgery Conference (ABSCON 2012) in Chennai, India. This operation was actually the first ever known endoluminal revision of a prior sleeve gastrectomy performed in the world.
The operation, which was shown via video link to 80 surgeons attending the ABSCON 2012 conference at the Hyatt Regency Hotel in Chennai, was performed by New York bariatric surgeon, Dr. Elliot Goodman and assisted by Dr. Rajkumar Palaniappan of the bariatric surgery service of Apollo Hospital in Chennai.
The 27 year old, male patient had previously undergone a sleeve gastrectomy in 2011 and has since lost 33 pounds. However, his weight stabilized and he had actually regained 4 pounds within the past month.
Tennessee’s TennCare may not want to pay for nutritional counseling, but the National Institute of Health requires some psychological counseling prior to any bariatric surgery. This counseling includes a psychological evaluation, often with a standardized objective test, as well as interviews to determine a patient’s preparedness for the life change required by weight loss surgery and information about those changes. One reason behind this requirement is that gastric bypass surgery cannot be reversed. It also requires major behavioral change to be successful; if a patient is not compliant with all behavior changes he or she can become very ill – I have even been told about the possibility of death. These are severe consequences for not following doctors orders implicitly.
Yet, the behavior change required is also severe. As a therapist, I see asking that kind of change from someone as setting them up for failure or disappointment because so much change is extremely stressful and mentally and emotionally taxing. I would caution any of my clients attempting such overnight life change, and counsel them on forgiving themselves when they do not stick to their plan. Eating more than planned one day may be a disappointment for someone committed to weight loss, but it can have devastating effects for someone who has had gastric bypass surgery.
We sure do have a confusing relationship with weight and food in our country. On one hand, we herald those who are thin and fit; but then look at the enormous availability of pre-packed, processed food that is ripe and ready for the picking 24 hours a day, seven days a week for anyone living in this country.
When it comes to those who are overweight or obese, our compassion flies out the window as quickly as we can toss that burger wrapper in a nearby garbage can. As obesity reaches epidemic proportions and weight-related conditions like diabetes and heart disease are starting to be diagnosed in younger and younger people, science has started to redefine and rethink its long-held hypotheses on obesity. Namely, that obesity, just like other inherited diseases, is hereditary. Even though, we still don’t have the grasp on the precise mechanism for how obesity becomes expressed, we do know that a variety of biological, environmental, social and psychological factors come into play that make it easier for one person to become obese and another to stay trim his or her whole life.
From diet pills, to body wraps to hypnosis, we have invented, created and crafted a multitude of measures to shed unwanted pounds. And after psychological and behavioral interventions have been enacted to help someone lose weight, in steps the medical community to take a scientific stab to drop those extra pounds that too many of us carry around.
According to the National Institute of Diabetes and Digestive and Kidney Diseases, in cases of severe obesity, treatment through diet and exercise alone fall short of assisting in significant weight loss. One of the ways that medicine has tried to help obese individuals is through surgery.
Gastric bypass surgery is one such popular procedure made famous by Al Roker, Star Jones and about 150,000 additional individuals each year. Recently, other forms of weight loss surgeries, often referred to as bariatric surgery, have also been created. Despite the differences between the styles of procedures, according to the Mayo Clinic, in general, all bariatric procedures alter the anatomy of the digestive system thereby controlling or limited the amount of food that can be eaten and digested.
Even though gastric bypass surgery is the most popular form of weight loss surgery, a new procedure called the Duodenal Switch, or Biliopancreatic Diversion, has been an increasingly popular choice among patients and doctors.
Just like other bariatric procedures, the surgery is not just for anyone who needs to lose a few pounds. In order to qualify for the having the operation performed, you must be at least 100 pounds over their normal weight and have a Body Mass Index (BMI) of 40 or more. If you have a BMI between 35 and 40, you must also have weight-related health problems such as diabetes, high blood pressure, heart disease, breathing problems, sleep apnea, high cholesterol or a few other degenerative conditions.
Duodenal Switch surgery is an effective weight-loss surgery that differs from gastric bypass in several ways. Rather than bypassing part of the stomach, about 75 percent of the stomach is removed. This drastic reduction in stomach size greatly limits the amount of food a person can eat in one setting. The small intestine is also shrunk so that the amount of fat and calories that are absorbed from food is greatly reduced.
Like any bariatric surgery, the surgery itself is just one element. It is by no means a cake-walk to a svelte self. Following surgery, blood clotting, hair loss, and loose stools are all common side effects. Individuals with Duodenal Switch surgery must follow a high-protein diet and lifelong vitamin and mineral supplementation to prevent nutrient deficiency.
For many who have had success with this surgery, they have learned to appropriately manage these potential consequences. And the benefits of losing weight, even if it means a drastic change in how and what a person eats, make it worth it.
Even though insurance companies are beginning to cover more and more weight-loss surgeries, many insurance companies still consider the Duodenal Switch procedure to be experimental and may therefore offer no monetary assistance toward it. If you are curious about it, talk to your primary care physician first and then inquire with your health insurance company.