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It’s not like Mike Jovanovich to eat just one piece of pizza. A couple of years ago, when he weighed 350 lbs, the former CFL offensive lineman would consume a whole pizza for lunch. Now, after having had bariatric surgery two years ago, he says he can barely eat a slice. And he loves it that way!
Bariatric surgery is what Jovanovich credits for helping him to lose 100 lbs. With obesity rates on the rise, and the realization that diets just don’t work for a lot of very heavy people, bariatric surgery (the proper name for weight-loss surgery) is seen as a last resort in the fight to control weight’s calamitous consequences: Diabetes, hypertension, heart disease, fatty liver disease, some forms of cancer, fertility problems, and degenerative arthritis.
The World Health Organization estimates that 300 million adults on the planet are obese; in Canada, that means approximately one out of every four people. WHO also predicts that by 2015, the world’s obese will number 700 million.
(Obesity can be measured by body fat percentage, so-called ideal weight, as measured by the Metropolitan Life tables, or BMI or body mass index. A BMI greater than 30 is considered to indicate obesity – higher BMIs pose potentially serious health problems.)
According to Dr. Laz Klein, patients admitted to the bariatric program at Toronto’s Humber River Regional Hospital, have a BMI of 40. “If your BMI is over 40, the risk of dying prematurely on a given day is two and a half times higher than a healthy person. We do this surgery for one reason alone: To reduce premature death from obesity.”
But even if your BMI indicates that you could be a candidate, what does weight-loss surgery involve? There’s definitely some confusion given the fact that there are several different kinds of procedures, each with their own risks and benefits, and that some are covered by provincial health plans while others are not.
Gastric bypass is the most popular, and the gold standard. In it, the upper portion of the stomach is stapled, creating a small pouch that is less than an ounce in volume. As Dr. Klein explains in The Complete Weight-Loss Surgery Guide & Diet Program, a recently published book he co-authored with registered dietitian Sue Ekserci, the remainder of the stomach is not removed but stapled shut, separated from the pouch, and a bypass constructed to deliver the food farther along the digestive tract than is normal.
Two other procedures are also available: The Laparoscopic Adjustable Gastric Band (the procedure which was chosen by Mike Jovanovich) in which the stomach is made smaller by the insertion of a band which constricts part of the stomach’s size to very small; and the vertical sleeve gastrectomy, in which a portion of the stomach is actually removed.
Dr. Klein’s new book is an excellent mini-course in the anatomy of digestion and clearly explains the various surgeries, what to look out for, and what to expect before and after. The book’s recipes are vital to anyone needing to address any post-surgical nutritional challenges; and there’s an important section on mindfulness eating.
Surgery has a weight-loss success rate of up to 85%, says Dr. Klein. (Compare that to the dismal two percent success rates for diets.) But surgery alone is not the solution, he warns. “It’s part of a comprehensive program and you need to look at it as part of a long-term process. Surgery will help someone to eat less, but it will not force them to eat less.”
Helping him to eat more wisely is what Mike Jovanovich achieved through his surgery: “I used to eat a 12 oz. steak. Now I’m satisfied with a small four oz. one. It’s two or three potato chips rather than a whole bag now.” Though a “healthy big boy” before the surgery, his doctor told him it was just a matter of time before his weight would cause serious problems.
“We’ve seen people who can barely walk across the room when they first meet us — people who are on insulin, and who have to sleep with a machine because of their obesity-related sleep apnea,” says Dr. Klein. “A year after surgery, they are off the meds and back to work. It’s a testament to how successful the surgery is and how morbid obesity really is.”
Size matters
Up until 2009, there were only a few hundred surgeries done annually in Ontario and many patients went to the U.S. for surgery. Today the Ontario Bariatric Network (one of the few provincial bodies to keep a database) anticipates that by the end of this year, nearly 2,800 surgeries will have been performed in this province alone. But the annual need is really closer to 4,000, says Dr. Klein.
Do your research
While weight-loss surgery is successful, there are still risks involved, and lots to learn about what happens pre- and post-surgery. Learn what’s right for you:
The Complete Weight-Loss Surgery Guide & Diet Program, by Sue Ekserci and Dr. Laz Klein
www.ontariobariatricnetwork.ca
www.obesitysurgery.ca
www.lapbandcanada.ca
Did you know?
Life expectancy is reduced by two to four years if your BMI is between 30 and 35. It is reduced by eight to 10 years if your BMI is between 40 and 45.
Source: http://www.ottawasun.com/2011/10/05/a-cure-for-obesity
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