Friday, July 21, 2006


And yet another story down the hatch- about obesity!

This has not been published yet, but will be soon in a magazine in Northwest Indiana. Can't wait to see how they illustrate it!

By Paul Eisenberg

In 1947, Europe was recovering from the continent-wide ravages of World War II. Paris, just a few years removed from Nazi occupation, was regaining its foothold as one of the world’s great cities with the help of local fashion designer Christian Dior.
Dior’s revolutionary “New Look,” in a drastic change from the severity of wartime fashions, emphasized a feminine look, which included a constricted waist. Suddenly, all over the world, girdles and other mechanisms with which to bind up bulging bellies were in vogue.
Fast forward to 2006: Indiana is entrenched as one of the country’s fattest states, consistently ranking in the top 10 in terms of obesity. But two European doctors my have taken a cue from Dior’s fashion sense to devise a new procedure that can help the severely overweight tackle their problem.
Donna Kettle, bariatric coordinator at Methodist Hospitals, compared the area’s problem with obesity to an epidemic.
“We’re currently raising the first generation of children who have a lower life expectancy than their parents,” she said. “And the reason is obesity.”
It’s scary news, but there’s a simple remedy for the problem: diet and exercise. But for some, that’s not enough. That’s when doctors can recommend bringing out the big guns. Gastric bypass surgery, a procedure which involves rerouting the digestive organs, has been around for a while, and is an invasive and moderately painful process. But a new procedure known as Lap-Band surgery, is a relatively new alternative that promises less invasive techniques and side effects that aren’t as severe as those associated with gastric bypass surgery.
Lap-Band surgery was pioneered by doctors Guy-Bernard Cadiere of Belgium and Franco Favretti of Italy, and was introduced to Northwest Indiana by the Methodist Hospital's Center for Weight Loss Surgery in 2003. Unlike gastric bypass, Lap-Band is an outpatient procedure that involves constricting the upper part of the stomach with an inflatable ring. The ring limits the amount of food the stomach can contain, while allowing food to flow from the smaller stomach area to the rest of the digestive tract normally.
That allows patients to feel comfortably full from a small amount of food, while the controlled release of food from the stomach to the digestive tract keeps patients feeling full for longer amounts of time, reducing the urge to eat between meals.
Lap-Band surgery involves about five tiny incisions in the abdominal wall of about five to 10 millimeters, and leaves the digestive organs intact, as opposed to gastric bypass, which involves rerouting intestines. With Lap-Band surgery, there is no cutting or stapling of the stomach.
“It’s significantly less invasive,” Kettle said.
And Lap-Band surgery can be tailored to the needs of each patient, as the inflatable ring can be adjusted to allow more or less food in the stomach. Plus, the Lap-Band is removable.
While the Lap-Band sounds like a miracle cure for obesity, Kettle said those considering the surgery must still be prepared to make changes to their lifestyle. In fact, to even be eligible for the surgery, one must meet body mass index criteria that equate to being about 100 pounds overweight or be experiencing serious medical problems related to obesity, such as severe diabetes or heart disease.
And patients must also adhere to an extensive followup program once the procedure is completed, lasting as long as 18 months to three years. That program includes exercise and nutrition classes. One of the points driven home in the classes is that eating high-calorie food can defeat the Lap-Band. Patients also receive a regimen of nutritional supplements, vitamins and calcium, which help make up for anything lost by eating less food.
Patients are also warned against returning to old eating habits, Kettle said.
“If you overeat, it can be painful and cause you to vomit” she said.
But the results speak for themselves.
“We had one gentleman come in to talk (to new patients), and about 14 months out of surgery, he had lost 115 pounds,” she said. “We’ve had others who have lost more than 100 pounds, but in nearly every case, they were highly motivated.”
The drawback to Lap-Band surgery as opposed to gastric bypass or other weight loss surgeries is the longer timeframe involved. With gastric bypass, weight loss is rapid, while with the Lap-Band, “weight loss is slower but steady.” On the positive side, patients can eat nearly anything they want to with the Lap-Band, while gastric bypass patients who eat sugary foods may invite an onset of the aptly-named “dumping syndrome.”
Since performing the area’s first Lap-Band procedure in 2003, Methodist Hospitals have performed about 100 more, Kettle said. Initially, getting insurance companies to cover the costs was difficult.
“Over the last three years, insurance companies have been more responsive,” she said. “Still, though, most insurance companies require a patient to attempt more conventional weight loss strategies first. Most won’t cover it initially.”
Prospective patients also must undergo a psychiatric evaluation designed to detect such obesity causes as eating disorders.
Still, Kettle said the Lap-Band surgery is a new weapon in the war against the growing problem of obesity, and it’s arriving just in time. The battle against fat is a hard one because of the very nature of our society.
She said it’s worse, even, than the fight against smoking tobacco.
“People don’t have to smoke, but they have to eat,” she said. “Everything about our society is food-related. We celebrate with food. If you threw a birthday party and didn’t provide any food, everybody would probably leave.”
It’s a battle that needs to be fought, she added, because the problem can be devastating to those who suffer through it.
“Obesity touches people in so many ways,” she said. “It can cause psychological problems, social and relationship problems, and health problems.”
To that end, the hospital offers informational seminars on weight loss surgeries throughout the area several times a year.
Had the information and procedure been around in 1957, Christian Dior, whose designs may have inspired the Lap-Band pioneers, may not have died overweight of a heart attack at age 52.
More information on Lap-Band surgery and other weight loss techniques is with the Methodist Hospitals Center for Weight Loss Surgery at 219-738-3500.

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