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Surgery eases weight loss for obese patients


by Chris West
Public Relations
 MUSC surgeons can facilitate weight loss in the extremely overweight by performing a procedure that limits the capacity of the stomach itself, rapidly resulting in the loss of large amounts of weight.

Morbidly obese patients, those who are 100 pounds or more above their ideal body weight, are at risk of serious health problems. With certain other qualifications, patients may be eligible for gastric bypass, thereby insuring sustained weight loss, prevention and reversal of further health problems.

“Gastric bypass surgery is a procedure that involves stapling the stomach into a small pouch and bypassing the body of the stomach by bringing a branched piece of the small intestine up to the pouch. This has the effect of causing early satiety,” according to Karl Byrne, M.D. “For the first six weeks after surgery, their diet is pureed and has the consistency of baby food.”

Patients are free to eat anything they want, so long as it is in that consistency. “After six weeks the patients graduate up to eating regular food, just in small quantities,” Byrne said. “The surgery also helps patients refrain from eating certain types of foods, like candy and sweets.”

“High amounts of sugars may cause a patient to feel weak, sweaty and their heart races, much like a hypoglycemic attack,” Byrne said. “This is called the ‘dumping syndrome.’”

The main risks associated with gastric bypass are predominantly the surgery itself and the nutritional risk, although the latter is not usually severe, according to Byrne. Other complications consist of a leak or ulcer formation at the hookup of the small intestine and the pouch, and due to such rapid weight loss gallstones can form and may lead to the removal of the gall bladder.

“Our policy is that if patients have a gall bladder with stones before the surgery, it is removed,” Byrne said. “If not, they are put on a drug called Actigal that cuts the instances of gall stones down from 25 percent to about 3 percent and they stay on this for a six-month period.”

The surgery is conducted only after a psychological assessment of the patient, which is conducted  by Patrick O’Neil, Ph.D., and his team from the Weight Management Center. “The initial assessments determine whether any psychiatric disorders are present, which would get in the way of post-op procedures,” O’Neil said.  “A disorder could be worsened by the weight loss or the procedure itself.

“Most have a good psychological outcome from the surgery. They are more energetic, have more self-esteem, their appearance has improved, and they don’t experience as much discrimination associated with being overweight,” O’Neil said.

“We do the surgery to improve the patient’s overall lifestyle,” Byrne said. “But it is  also done to prevent the associated health problems such as: diabetes, hypertension, sleep apnea syndrome, degenerative joint disease and pseudo tumors associated with rapidly sustained weight loss, thereby improving the patient's overall health and reducing the cost of their treatments.”