Bariatric Surgery: The Latest from a Renowned Expert

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Interest in bariatric surgery has grown tremendously over the past few years, but many questions still remain. Am I a candidate? What are my weight loss surgery options? Will I need cosmetic surgery after this procedure? These are just a few of the questions you will hear answered in this Patient Power program as Dr. Alan Geiss, a national leader in Lap-Band surgery, joins host Andrew Schorr to explore these issues. Dr. Geiss is Director of the Laparoscopy Center and Laparoscopic Bariatric Center at the Center for Surgical Specialties at Syosset Hospital, which is part of the North Shore-Long Island Jewish Health System. He recently performed his 2,000th Lap-Band surgery—more than any other U.S. Surgeon.

The program begins with Dr. Geiss discussing what he observes as a general lack of sensitivity for morbidly obese patients in our culture. He explains many people do not understand these patients have a chronic debilitating medical disease that is further complicated by their environment. For those patients who have exhausted all other options, Dr. Geiss offers hope as he speaks to the growing number of treatment options for morbidly obese patients. During the program, he discusses gastric bypass surgery (or Roux-en-Y gastric bypass), laparoscopic adjustable gastric band operations (with both the Lap-Band and REALIZE™ band), and the gastric sleeve resection.

Listen as Dr. Geiss details the initial evaluation, the procedure and the aftercare involved in any bariatric surgery. He answers listener questions, particularly related to what doctors know about the long-term effects of these surgeries and how they impact patients as they get older. For many patients, their success is, in-part, connected with the support group they surround themselves with. Dr. Geiss explains what it means to be a Center for Excellence and the importance of having a multidisciplinary team in place to help you throughout the process. There is tremendous research and progress into the management of obesity right now. The most important thing for patients to remember is that each situation is distinctly different, but there is hope for everyone. If you or a loved one is exploring the possibility of undergoing bariatric surgery, this Patient Power program gives you the opportunity to hear the latest from a leading medical expert in the field.

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Produced in association with North-Shore Long Island Jewish Health System

Transcript

 

Andrew Schorr:

Hello, this is Andrew Schorr back with an edition of Patient Power sponsored by the North Shore Long Island Jewish Health System. One of the areas that people are really talking about these days is whether to have surgery if they are very overweight, obesity actually, and it is an option that many people are considering and many people have taken it. One of the leading experts in the country is at Syosset Hospital, part of the North Shore Long Island Jewish Health System, so I'd like you to meet as we discuss and learn all about the various approaches to bariatric surgery and what comes next, the director of the Laparoscopic Bariatric Center at the Center for Surgical Specialties at Syosset Hospital, as I said part of North Shore LIJ, Dr. Alan Geiss.

Dr. Geiss, thank you so much for being with us.

Dr. Geiss:

Thank you very much Andrew for the invitation, and I'm delighted that I can participate in this interview.

Andrew Schorr:

Dr. Geiss, America has a weight problem, and there are a lot of approaches getting us exercising and watching our diet, but for some people whether for family reasons, emotional reason, illness, whatever happened, people can be 100 pounds or more overweight, and their health is at risk. Is that when surgery can be considered sometimes even a lifesaving option?

Dr. Geiss:

Oh yes. When your body weight exceeds a certain limit and you are classified as a morbidly obese patient, this becomes a lifesaving surgery. The classifications of morbid obesity are, and we use a term called body mass index, BMI, which is a ratio of one's height to weight. The BMI needs to be at least 40 or above or in the range of 35 to 39 with associated comorbidities or complications of the morbid obesity, some of which the most common being diabetes, hypertension, and sleep apnea.

So once a patient is in that particular classification and has failed multiple times at medical regimens to lose weight, they are indeed a candidate that can be evaluated for surgery.

Andrew Schorr:

I'm sure the people who you see, and I know you've done over 2000 bariatric surgeries so you're one of the most experienced people in the world. These people have tried everything, haven't they? I mean there's no shortage of ads on TV or gyms you can go to or diets you can try. These are people who have really tried, right?

Dr. Geiss:

Absolutely. I think unfortunately Andrew that a morbidly obese patient today in spite of all the education that's available today on TV, websites, and so forth, the press for one, there's still a bias against the obese patients in the United States in sort of a lack of sensitivity. The bottom line is that these people unfortunately have the disease, a chronic debilitating medical disease that is genetically originated as an inborn error of metabolism complicated by our environment; the cultural aspects of our environment which are food-based; the emotional aspects of eating, you know emotional eating, we all eat for depression and anxiety; and a certain psychological factors that we call psychologic cues that remain in people from childhood where food is used as a reward.

In bariatric surgery we usually state that "Genetics loads the gun and the environment pulls the trigger." So these are people who really do not have metabolically control of their appetite and because of that their satiation point is not realized, and they take in significant calories above and beyond their daily metabolic needs that results in a life-threatening disease.

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Page last updated on May 1, 2018