Golden Opportunities

As the weight of Americans has skyrocketed, so has the popularity of bariatric surgery. But should those who are over 50 opt for this “heavy” duty procedure? Here to “weigh-in” on the debate is Cathy Crouse, bariatric program coordinator at Akron General Medical Center.

Question: How common has bariatric surgery become?

Answer: The number of bariatric surgeries has doubled every year for the past few years. Now over 100,000 have the surgery each year.

Question: Are there different types of surgeries?

Answer: Yes. Akron General performs two different kinds. The gold standard is the Roux-y-en Gastric Bypass surgery, where part of the small bowel is bypassed and the stomach is made smaller.
The other kind is the lap band surgery. This was approved by the FDA in 2001, but has had success in Australia and elsewhere for 10 years.

Question: What kinds of results can be expected?

Answer: Weight loss happens quickly with the more traditional gastric bypass surgery- reaching its peak in 12-18 months. 85 percent of patients will lose at least 50% of their excess weight. So if you are 150 pounds overweight, you will lose at least 75 pounds. And the clincher is- you'll keep it off the rest of your life.
With the lap band surgery, you don't lose as much weight initially with this surgery, and weight comes off more slowly, peaking after 3 years.

Question: Is one better than the other?

Answer: It's a choice to be made between you and the surgeon, and a lot depends on what kind of eater you are. For example, if you like sweets, you'd do better with a gastric bypass. With that surgery, eating sweets often causes cramps and diarrhea, so you are deterred. However, you won't have that kind of side effect with the lap band surgery.
If you like meat and potatoes, or if portion control is your main problem, you'd do better with the lap band surgery.
Prior to bariatric surgery, the surgeon will take an extensive history, both of any medical conditions and of your weight loss/diet history. Surgery options would be discussed at this time.

Question: Can seniors have bariatric surgery?

Answer: We find that people in their 50s are better candidates because they are less prone to caving to what friends are eating. Typically, we look at patients between the ages of 18 and 65. Those 65 and over are considered on a case-by-case basis.
If you are over 50, there are certain extra requirements. You need to have a screening colonoscopy, women must be up-to-date with their mammograms, and patients with diabetes or a heart condition must pass a stress test.
At Akron General, 90% of the surgeries are done laparoscopically, with 6 small incisions. That means less pain and a shorter recovery. Lap band procedures take 1 -1 ½ weeks for recovery. Gastric bypasses take 2-3 weeks.

Question: Any follow-up needed?

Answer: We see patients several times the first year, and then once a year for the rest of their lives.
We also offer support groups for those who have had the surgery, and informative groups for those who are considering it.

Question: Is this surgery covered?

Answer: It depends on your medical plan. Your employer may be able to choose a rider that will cover it.
It is covered by Medicare. In February, they announced that morbid obesity is considered a disease and they will cover both surgeries offered at Akron General.

Question: Last year, over 100,000 people had bariatric surgery.  Is this the magic bullet for everyone who is battling the bulge?

Answer: No. Only if 100 lbs or more over weight. There are risks to any surgery: damage to organs, bleeding, infection, heart attack.

Tired of that excess weight? Take the first step and consult with a doctor. Give Akron General a call. The number's next. My thanks to Cathy Crouse.