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Obesity Surgery is not Just About Surgery

Bariatric Surgery provides safe and effective solutions

Canadians looking for a safe, effective and long-term solution to weight loss are turning to bariatric surgery in large numbers. Bariatric surgery is often recommended by physicians for patients who are morbidly obese.

Morbid obesity is an abnormal obesity defined as the condition of having body weight over 100 lbs over an ideal body weight or having a body mass index (BMI) of 40 or higher. A recent report from Statistics Canada on Adult body mass index, indicates that in 2008, 17.2% of Canadians aged 18 or older, roughly 4.2 million adults, reported height and weight that classified them as obese. The report also notes that from 2003 to 2008, obesity among men rose from 16.0% to 18.3%, and among women, from14.5% to 16.2%. This finding confirms the trend cited by physicians across the country that Canadians are getting fatter. Numerous scientific studies have linked overweight and obesity with increased risk for a broad range of illnesses, including:  Type 2 diabetes, dyslipidemia, insulin resistance, gallbladder disease, obstructive sleep apnea and respiratory problems, cardiovascular disease (e.g., coronary heart disease and ischemic stroke), hypertension, osteoarthritis, some types of cancer (e.g., breast, endometrial, colon, prostate and kidney), psychosocial problems, functional limitations and impaired fertility.

Across Canada, provincial governments are taking notice of the increasing number of patients who are morbidly obese.  Obese patients with co-morbidities place an enormous strain on the healthcare system. Over the past few months, a number of governments have come to recognize that bariatric surgery is an effective procedure in addressing co-morbidities.

In British Columbia as with most other provinces, LAGB is not an insured service covered under the Medical Services Plan.  Therefore patients are required to pay for the surgery. Some extended health plans may pay for a portion, which can then be counted as a tax deductable as a medical procedure.  While the cost of the surgery and the pre and post surgical program is significant, it should be remembered that it provides a permanent solution. In comparison to other common weight loss programs, LAGB surgery is good value.  Other savings includes less reliance on prescription medicines to treat co-morbidities.

But first, what is bariatric surgery, and what does it involve?

An increasingly common procedure is Minimally Invasive Laparoscopic Surgery utilizing an Adjustable Gastric Band. A Laparoscopic Adjustable Gastric Band (LAGB) is an inflatable silicone device that is placed around the top portion of the stomach, via laparoscopic surgery, in order to treat obesity. Laparoscopic surgery includes operations within the abdomen or pelvis.

The recovery after banding is relatively short. Patients are often released from hospital the next day and could return to regular routine within days or a week. More importantly, the procedure achieves good long-term results including weight-loss maintenance, reduction of co-morbidi­ties and improvement of quality of life versus other weight management programs.

In a February, 2008 published article entitled “Obesity surgery is not just about surgery”, Dr. Arya Sharma, MD, PhD, FRCPC notes, “Our results have shown that patients with Type-2 diabetes often experience a reduction, or total elimination of their condition after undergoing bypass surgery.”

Dr. Arya Sharma, MD/PhD, FRCPC is Professor of Medicine & Chair for Cardiovascular Obesity Research and Management at the University of Alberta, Edmonton. He is also the Medical Director of the Edmonton Capital Health Region’s interdisciplinary Weight Wise Program. He is also a member of several scientific associations, including the Canadian and International Societies of Hypertension. He is a fellow of the Council for High Blood Pressure Research of the American Heart Association and on the editorial board of several academic journals.

Dr. Sharma notes, “Obesity surgery is not just about surgery. In fact, even the most enterprising bariatric surgeons will readily agree that the actual surgery is just a small (but important) technical piece in the overall treatment plan.”

“With the “sensational” results of obesity surgery being publicized in the media,” he continues, “it is not surprising that expansion of bariatric surgery is receiving increasing support. In light of these developments it may be time for a word of caution. “

No doubt, good surgical outcomes require well-trained experienced surgical teams but we know that much of the long-term outcome depends on what happens before and after surgery.

“Done in the wrong patients with no or little long-term follow up, what could be a life saving operation can become a disaster – and weight regain is perhaps the least that can go wrong. Much more severe and potentially devastating are the nutritional deficiencies and the psychological and social consequences that are common after surgery” Dr. Sharma states.

Dr. Sharma warns that, “if we hope to see the spectacular results from the published studies on bariatric surgery replicated in daily practice, we must start bringing primary care providers up to speed on counseling, preparing and following their patients.”

“For surgery to produce good long-term results it is absolutely essential that as access to surgery expands, so does the pre-surgical selection and education process as well as the access to life-long post-surgical monitoring,” concludes Dr. Sharma.

Head of the Weight Loss Surgical Program is Dr. Andy Kluftinger, Fellow of the Royal College of Physicians and Surgeons of Canada.  Dr. Kluftinger is an honors graduate of the University of British Columbia Medical School. Dr. Kluftinger has been practicing for over 17 years and has successfully completed over 1,000 advanced laparoscopic surgeries.

Kelowna’s iQuest Healthcare and Fitness Centre offers a comprehensive weight loss program including nutrition and dieting, health assessments and emotional & disordered eating counseling. With the latest surgical offerings in weight loss management, iQuest takes a multidisciplinary approach to evaluation and care designed to help our patients through all stages of the process to ensure a successful long-term outcome and help patients regain control of their lives.

iQuest is also pleased to offer the Realize Adjustable Gastric Band. The Realize Adjustable Gastric Band is one of the banding options available in Canada. The REALIZE™ Band-C offers a streamlined, curved design, an expanded adjustment range to accommodate larger patients and a re-lockable closing mechanism for intra-operative repositioning.

Kelowna

While the procedure will have the biggest impact on the patient’s life, it is the post-surgery program that determines long-term success. Along with the Realize Adjustable Gastric Band comes the REALIZE mySUCCESS™ interactive website. The site provides support to the patient before and after surgery.  The REALIZE mySUCCESS™ site allows patients to remain constantly connected to their health care providers, who also have access to the site.

The REALIZE mySUCCESS™ program extends the continuum of care through a web-based interactive, one-of-a-kind support system that guides patients on a path of lifestyle changes to help them sustain weight loss.

The program is an integral element of the REALIZE Personalized Banding Solution through which patient and bariatric practice may stay connected pre and post-surgery to help develop and manage conditions specific to each patient.

The comprehensive solution helps identify the root cause of obstacles to success, as well as providing tools to overcome them. In addition, the bariatric practice has access to the patient’s information between appointments to help monitor progress. The practitioner can step in when necessary to provide guidance to help keep the patient on track and ensure a successful outcome.

In British Columbia as with most other provinces, LAGB is not an insured service covered under the Medical Services Plan.  Therefore patients are required to pay for the surgery. Some extended health plans may pay for a portion, which can then be counted as a tax deductable medical procedure.  While the cost of the surgery and the pre and post surgical program is significant, it should be remembered that it provides a permanent solution. In comparison to other common weight loss programs, LAGB surgery is good value.  Other savings includes less reliance on prescription medicines to treat co-morbidities.

Patients are encouraged to speak to a physician before seeking advice on weight loss surgery.

In addition, all clients will have full access to the realize band web site, which provides a wide range of tools and supports to assist clients in their journey. http://canada.realizeband.com/dtcf/pages/mysuccess.htm

For more information on the iQuest Healthcare Surgical Weight Loss Program, please see the iQuest web site @ http://www.iquesthealth.ca, or call iQuest Healthcare directly at 250-860-3413.