Bariatric Surgery, shedding pounds and fighting Type 2 Diabetes

Bariatric Surgery, shedding pounds and fighting Type 2 Diabetes

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Ever since she was a teenager, Candice battled to maintain her weight with running. But when she was diagnosed with osteoarthritis — an incurable and often painful degenerative joint condition — her doctor told her she should avoid high-impact exercises.

Her running days seemed over. And soon her weight began to climb.

Candice, like many others before her, decided to have bariatric surgery. More than 180,000 Americans receive bariatric surgery each year to answer a growing list of adverse health conditions that can be significantly improved through surgical stomach reduction.

While often called "weight-loss surgery," research shows bariatric procedures can also be effective in helping control a wide range of other conditions, improving cardiovascular health and even curing Type 2 diabetes in some patients.

The curative impact on diabetes patients — research shows that surgery and post-surgery lifestyle changes have kept about a third of all patients in remission for up to 15 years — is one of many reasons why a growing number of insurers are covering the surgery.

Although Utah is not yet on the list of states in which large group health insurance plans must cover bariatric surgery, a growing number of plans held by Utah employers do — and patient demand at University of Utah Hospital has been so great that the hospital's bariatric surgery team had to grow in response.

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Since joining the team in September, Anna Ibele, M.D., has been delighted by the amount of patient and physician interest in bariatric surgery she has encountered. She enjoys interacting with her patients and teaching others about the benefits of weight loss surgery.

"Bariatric surgeons really get to have a relationship with their patients," Ibele said. "Our group strongly believes that the key to weight loss success is not only the surgery but lifelong follow-up and support for our patients. When you stay with them for a long time the way we do, you get to see this incredible lifestyle benefit."

The University of Utah Health Care team has expertise in several types of bariatric surgery, including:

  • Roux-en-Y gastric bypass surgery, where food passes through a surgically reduced stomach pouch and directly into the middle portion of the small intestine
  • Sleeve gastrectomy, in which three-quarters of the stomach is removed
  • Adjustable gastric banding, in which an inflatable device is inserted around the upper section of the stomach

All of these procedures can now be performed laparoscopically through a series of small holes, and don't leave much if any scarring.

In more than a decade of practice, Ibele has watched these operations — and the significant lifestyle changes they assist in facilitating — help patients fulfill lifelong dreams to take vacations, go sky-diving and participate in triathlons.

"That's the thing that attracted me the most," she said. "There are just all these incredibly positive, happy, really cool personal stories."

Ibele cautions her patients, though, to think of bariatric surgery as a tool to use for success and not a miracle cure. And she staunchly rejects a lingering stigma that the surgery is a "short cut" for weight loss.

"That's so unfair," she said. "This is not the easy way out. When people can lose weight through diet and exercise, I think that's great, but there are a lot of reasons why not everyone has that option."

Photo credit: University of Utah Health Care

In fact, Ibele noted, she seldom has a patient ask about how many pounds will be shed as a result of the surgery. "Patients are concerned with weight loss," she said, "but they're equally concerned with what it will mean for their ability to change their overall health and improve their quality time with friends and family."

Patients who choose bariatric surgery at University Hospital participate in multiple consultations, undergo hours of testing and meet with a dietician and psychiatrist to begin working toward necessary diet and lifestyle changes that will be required post-surgery. Smokers must quit using tobacco at least three months prior to their initial consultation.

Post-surgery, Ibele noted, patients must maintain a lifelong commitment to a healthy lifestyle and make regular and long-term follow-up visits to monitor their weight loss and watch for potential complications, which is why University of Utah Health Care hosts monthly support group meetings for post-operative bariatric surgery patients.

And long-term success, Ibele said, requires commitment from not just a patient but their family and friends as well.

"Anyone who looks at this realistically would absolutely realize that successful bariatric surgical patients have a lot of dedication," Ibele said.

Candice knows that. A year and a half after her surgery, she said she still struggles every day to make the right dietary choices.

"It's a tool, but it doesn't do the work for you," she said.

Day by day, she's winning the fight. Her surgery didn't just remove fat — it has helped her keep it off. And that means she's even been able to return to running.

"The surgery has really helped me maintain and control [my weight] fluctuation," Candice said. "I finally feel like my outside reflects who I am on the inside — strong, confident and ready to take on anything."

Curious if Bariatric Surgery is right for you? Get your questions answered by attending a free weight loss seminar.

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