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Doctors differ over weight loss surgery procedures

Dr. Brad Watkins interviews Lisa Mathis at the Cincinnati Weight Loss Center in West Chester Twp. on Nov. 5. Mathis has an adjustable gastric banding system placed around her stomach and was in the office to have the band tightened.

Staff photo by Gary Stelzer Dr. Brad Watkins interviews Lisa Mathis at the Cincinnati Weight Loss Center in West Chester Twp. on Nov. 5. Mathis has an adjustable gastric banding system placed around her stomach and was in the office to have the band tightened.

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By Tiffany Y. Latta, Staff Writer Updated 4:39 PM Monday, November 23, 2009

In June 2007, Lisa Mathis desperately wanted to lose weight.

She was the heaviest she’d ever been, tipping the scale at 368 pounds.

“I was like, ‘Woo, I have to do something,’” said Mathis, 39, of Christiansburg. “I had tried everything: Atkins, Weight Watchers, Diet Workshop.”

Then she became pregnant with her son, and her weight continued to balloon.

An increasing number of Americans are battling obesity, a condition affecting 25 percent of adults in nearly half the states nationwide, including 28.6 percent of adult Ohioans.

Mathis considered gastric bypass surgery, but opted instead for a less invasive procedure known as Lap-Band.

The surgery involves doctors placing an adjustable strip of silicon around the upper part of the stomach and filling it with saline solution to tighten it.

The band creates a small pouch around the stomach and limits the amount of food Mathis can eat. The surgery costs about $16,000 and is not covered by many insurance companies.

“(The Lap-Band) physically won’t allow you to go crazy and eat as much as you can,” said her surgeon, Dr. Brad Watkins of Cincinnati Weight Loss Center in West Chester Twp. “It changes the way you think about food.”

Mathis lost 230 pounds with the help of the Lap-Band before becoming pregnant with her second child, who is now 3 months old. She said her battles with knee pain, lack of energy and high blood pressure are gone, too. Her goal is to weigh less than 200 pounds

“To me, it’s more of a health thing than I want to be a size 4 or look like one of the (Real) Housewives of Orange County.”

In 1999, Steve Horstman was out of control and willing to try anything.

He was 6-foot and nearing 600 pounds. His body mass index, which is determined by calculating a person’s height and weight, was 77.4 and more than double what’s considered morbidly obese.

“I was a train wreck,’’ Horstman, now 43, said. “I could eat seven or eight sandwiches and three or four large fries. I could go to CiCi’s (Pizza) and they would put me out because I would get eight plates, 10 plates.’’

Horstman had tried all kinds of diets and had once lost 300 pounds on the Atkins diet.

But after packing on about 110 pounds in two years, Horstman turned to the Cincinnati Weight Loss Center in West Chester for the Lap-Band bariatric surgery. He had the procedure done in 2008 when he weighed 369 pounds. He’s now 219 pounds and says life has never been better.

“I feel incredible,” Horstman said. “It’s been life-changing.”

Bariatric surgeries such as gastric banding and gastric bypass have grown in popularity as the number of Americans battling obesity skyrockets. Obesity is affecting 25 percent of adults in nearly half the states nationwide, including 28.6 percent of adult Ohioans.

Nationwide, about 220,000 people underwent bariatric surgery in 2008.

That’s up more than 100 percent since 2003 when about 103,200 people had the surgery, according to the American Society for Metabolic and Bariatric Surgery.

Gastric banding involves restricting food intake with an adjustable silicon ring without cutting and rerouting the intestines as in gastric bypass.

Risk of death following both procedures has dropped to 0.3 percent, and complications such as blood clots, repeat surgeries or hospital stays longer than 30 days after surgery are also low, according to a recent study funded by the National Institute of Health.

But Dr. Brad Watkins of the Cincinnati Weight Loss Center refuses to perform gastric bypass surgery, calling the procedure too risky. Gastric bypass causes malabsorption, which is the decreased ability to absorb calories and nutrients from food, he said.

“Malabsorption, that’s a disease,” Watkins said. “To give somebody malabsorption to lose weight is like saying, ‘Hey, lets give people cancer, because cancer patients lose weight. It’s crazy. It’s insane.”

Surgeon Dr. Lisa Martin Hawver of UC Physicians and American Society for Metabolic and Bariatric Surgery officials agree that gastric banding surgeries such as Lap-Band have fewer complications than gastric bypass surgery.

But they also noted that patients who undergo gastric bypass tend to be heavier and suffering from major health problems such as heart disease, diabetes and high blood pressure.

They also said Lap-Band patients can lose about 50 percent of excess body weight, while patients who undergo gastric bypass typically lose about 70 percent of excess body weight.

But Watkins said weight loss after both surgeries depends on whether the patient and their physician address the cause of the weight problem, work on nutrition education and use the surgery as a tool to keep the pounds off.

Martin said she performs both surgeries equally, but typically suggests the gastric bypass for heavier patients.

But Watkins said physicians should move away from doing gastric bypass surgery as they have stomach stapling.

“We want people to lose weight. That’s why they’re sick,” Watkins said. “With bypass, they lose muscle. Bone. Teeth. Hair.”

Body mass index

Obesity is determined by your body mass index or BMI, a calculation based on your height and weight. To calculate your BMI, divide your weight in pounds by your height in inches squared. Then multiply that number by 703:

18.5 to 24.9 is considered normal

25 to 29.9 is considered overweight

30 and above is obese

Types of bariatric surgeries

Gastric banding: Gastric bands create a pouch around the top of the stomach to limit food intake at any one time.

Gastric bypass: Gastric bypass also creates a pouch and redirects food around most of the stomach and part of the small intestine, limiting the absorption of food.

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“Recently, I lost 85 pounds and I don’t know how to describe how great I feel! I am loving the new me along with everyone and everything around me! All of my dreams are now possible! Thank You!” This is a comment which I received last week. By following the guidelines in the book Lose Weight Using Four Easy Steps from www.bbotw.com anyone will achieve spectacular weight loss results.

Todd29
4:18 PM, 12/23/2009

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The best xmas present for anyone who is serious about getting control of their weight is the book Lose Weight Using Four Easy Steps from www.bbotw.com If nothing else, get the book for yourself, leave it laying on your coffee table, and borrow it to a friend. They will be forever grateful to you!

Todd29
6:06 PM, 12/13/2009

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Hi I just wanted to let all know that surgery is just a tool and should only be thought of that way! I had the Gastro-Bypass surgery in Nov of 05 and I used to weight nearly 600lbs. I like to offer free help to any of the readers on my web site as I sell nothing! I have a great story and if the Journal would like to talk to me about this I would love to do a interview as I have been called Cincinnati's Biggest Loser and I guess that's ok..Lol www.myownweightlossnow.com

Anthony Reed
9:13 AM, 12/4/2009

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I would like Drs to make it known to their patients that the DS wls is available.

This wls has a 98% chance of stopping diabetes.
You can eat like a normal person if you wanted to but most who have had the deuodenal switch
still eat protein first then vegetable, etc.

The DS surgery is specialized so not every Dr is willing to be trained for this. A Dr. can do about 7 RNY gastric bypasses in the time it takes a Sr to do 1 DS.

Ann
1:50 AM, 12/1/2009

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Wow. This doctor forgot the mention all the potential complications with the lap band, like the fact that the body can reject it since it is a foreign object in the body, it can cause erosion of the stomach and esophagus, it can slip out of position and need to be replaced, etc. I read somewhere that 80% of people with lap band need to have it removed in less than 8 years, which means another major surgery. I sure wouldn't want one. I'm quite happy with my RNY gastric bypass.

Kelly
2:13 PM, 11/30/2009

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