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After bariatric surgery, Manuel Gomez lost 125 pounds and can now enjoy activities like playing football with his son, Evan. (Photo by Joe Howell)

Center works to shed fear, stigma of bariatric surgery

BY: MIMI ECKHARD

1/26/2012 - When patients come to the Vanderbilt Center for Surgical Weight Loss, they’ve often run out of options. They are, at a minimum, 100 pounds overweight or at least twice their ideal body weight, and diet and exercise simply didn’t work.

That was the case for 46-year-old Manuel Gomez of Madison, Tenn. After trying countless diets, he found himself at a size 48 with high blood pressure and diabetes. His doctors gave him two years to live if he didn’t lose the weight.

“That’s when I called Vanderbilt,” said Gomez.

Manuel Gomez, center, poses with family members before his bariatric surgery at Vanderbilt. He eventually lost 125 pounds.

Manuel Gomez, center, poses with family members before his bariatric surgery at Vanderbilt. He eventually lost 125 pounds.

After bariatric surgery, he lost 125 pounds, dropped to a size 29 and can now run and play with his son. He even helps coach his son’s soccer team.

Unfortunately, many people are unaware of or simply afraid of this course of treatment, although numerous studies prove the safety and long-term effectiveness of bariatric surgery as the solution to morbid obesity.

“We don’t face competition from other surgeons in the area; we face competition from ignorance and fear,” said Ronald Clements, M.D., director of the Vanderbilt Center for Surgical Weight Loss and professor of Surgery.

Clements attributes this to a general misunderstanding of the treatment. He explained that modern bariatric surgery is nothing like it was just 10 years ago. Physicians and surgeons now have a better understanding of the physiology of obesity, which has led to a better approach to treatment that includes the total well-being of the patient.

Ronald Clements, M.D.

Ronald Clements, M.D.

“Treatment with bariatric surgery no longer ends with the trip to the OR,” said Clements. “We now provide complete post-operative care, from outpatient follow-up to help with nutrition to psychological counseling,” Clements said.

This multidisciplinary approach has significantly improved surgical outcomes and general overall health of each patient, which is now tracked in the national registry of bariatric surgeries, the National Surgical Quality Improvement Program (NSQIP).

Advances in laparoscopic surgery have also considerably improved surgical outcomes, with fewer complications and shorter recoveries.
And surgery has also been shown to reduce some of the serious health effects of obesity.

A recent study published in the New England Journal of Medicine shows that within seven years of gastric bypass surgery, patients experienced sharp declines in the rates of death associated with cardiac disease, diabetes and cancer, by 50 percent, 90 percent and 60 percent, respectively.

“Clearly, it’s all related,” said Clements, “which is why we at Vanderbilt are working to educate patients on how surgery can improve their overall health.”

One such approach is the development of an online education seminar that prospective patients can take in the privacy of their own homes. Just as it was difficult a few years back for doctors to talk to their patients about the dangers of smoking, discussing a patient’s weight can be equally difficult.

The interactive seminar, however, opens the door to conversation. Prospective patients are encouraged to take the seminar and then schedule an appointment to learn more.

The online seminar also replaces the need for patients to make repeat trips to Vanderbilt from the surrounding areas. And because the seminar is broken up with brief quizzes, it also provides a means for the surgeons to assess each patient’s general understanding of both the disease of obesity and its treatments before their first appointment.

Clements is hopeful that the new online seminar will enable the clinic to reach more people caught in the overwhelming burden of obesity.

“Our goal is to take away some of the mystery surrounding bariatric surgery and dramatically improve the lives of so many battling the harmful effects of this disease,” said Clements. “Like with everything else, education is the key,” he said.

To learn more about bariatric surgery or to take the online seminar, go to www.vanderbilthealth.com/surgicalweightloss.

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