Doctors Applaud Medicare Decision On Weight-Loss Surgery

Medicare’s decision to consider funding gastric bypass surgery gives new hope to thousands of extremely overweight Americans for a better quality of life, according to experts in the Weight Management Center at Bridgeport Hospital.

“Prevention — a healthy diet, regular exercise, and other good lifestyle habits — remains the best cure for weight-related health problems, but for those who need special help, gastric bypass may be a viable option,” said Dr Daniel Tran, medical director of the Weight Management Center at Bridgeport Hospital, an entire service dedicated to patients who undergo the procedure, including presurgical evaluation and follow-up.

In July, Medicare officials reversed their earlier position that obesity is not an illness, opening the way for possible coverage of weight-loss treatments such as gastric bypass surgery.

Dr Tram says that an estimated 70 percent of Americans are overweight, and there may be as many as 25,000 people in the Bridgeport area alone who meet the weight criteria for gastric bypass.

Gastric bypass surgery involves partitioning the stomach so that it is able to hold less food. This can make people feel “full” more quickly when eating and reduce their hunger. The procedure can be done with traditional surgical instruments in about an hour or using minimally invasive (laparoscopic) techniques in about two hours.

“Benefits of the minimally invasive approach include a shorter hospitalization and faster recovery,” said Dr Tran.

The first step for patients in arranging for gastric bypass surgery is to consult a dietitian.

“It’s important to understand the factors that contribute to a person’s obesity, including eating habits and heredity, as well as why traditional weight loss methods have failed,” said Laurie Jordan, the hospital’s chief clinical dietitian.

Another step in determining whether a person is a good candidate for gastric bypass is a psychological evaluation.

“This evaluation is conducted to gauge a person’s motivation,” explains Dr Tran. “The weight loss made possible by gastric bypass is part of an ongoing process of diet and lifestyle changes — the person must be committed to making and sticking with these changes.”

Candidates for gastric bypass generally exceed their ideal body weight by at least 100 pounds, or have a body mass index (BMI) of at least 40. BMI is calculated by dividing weight (in kilograms) by height squared (in meters). For example, a person who is six feet tall and 300 pounds has a BMI of about 41. (A BMI of 18 to 24 is considered healthy. Several websites that calculate BMI are available on the Internet).

People with a BMI of at least 35 may be eligible for gastric bypass if they have a chronic health condition such as diabetes, coronary artery disease, high blood pressure, high cholesterol arthritis, or sleep apnea. Candidates must also be recommended for the procedure by their primary care physician.

After candidates have met the initial criteria for surgery, they undergo preadmission testing, which focuses at their cardiovascular and respiratory health, sleep pattern and other factors that may be affected by their weight.

Traditional gastric bypass surgery requires a hospital stay of about a four to five days as compared with two to three days for the laparoscopic technique. Patients receive calls from the Weight Management Center staff during the first week after discharge, and make follow-up visits to the center one month, three months, six months, and one year after surgery.

For a free booklet about gastric bypass surgery and the Weight Management Center at Bridgeport Hospital, call toll free 888-357-2396.