Stanley J. Rogers, M.D.
UCSF Bariatric Surgery Center
Until recently, bariatric surgery was considered merely cosmetic. However, new studies have demonstrated that the surgery is by far the most effective and permanent weight reduction treatment. Most traditional weight-loss programs focus on dietary restrictions that have a limited efficacy with a recidivism rate approaching 100 percent at one year. Medical treatments, including orlistat (Xenical) and sibutramine (Meridia), lead to a one-year weight reduction of only about 5 kg. achieved with a 1,500-calorie-per-day diet alone.
Studies recently published in the New England Journal of Medicine (N Engl J Med 2007;357:741-52 and N Engl J Med 2007;357:753-61) definitively demonstrate improved long-term survival in patients undergoing weight-loss surgery, including both gastric bypass and gastric banding. For patients who undergo these elective surgical procedures, dramatic improvements in morbid conditions are achieved, including hypertension, diabetes, hypercholesteremia, sleep apnea and arthritis. Bariatric surgery is not always possible for obese patients who have advanced fixed cardiopulmonary disease.
For patients who satisfy the rigorous weight-loss surgery preoperative evaluation and ultimately adhere to post-operative dietary restrictions, 75 percent of excess body weight will be lost within one year following surgery. Eventual success with any bariatric surgery is highly dependent on the adaptation of a new lifestyle in which patients play an active role and when eating habits are carefully modified and controlled.
Primary care providers play a central role in managing patients with morbid obesity and preparing them for bariatric surgery. Prior to consideration for surgery, each candidate must undergo a mandatory and extensive preoperative evaluation to minimize risks associated with weight-loss surgery. These include:
In some cases, insurance carriers insist on medically supervised weight-loss therapy prior to authorizing surgery. Primary care providers may offer the necessary supervision for these patients.
For more information, contact the Physician Referral Service at UCSF Medical Center:
|Phone||(888) 689-UCSF or (888) 689-8273|