March 2007

Individuals who are more than 100 pounds overweight and who have not been successful in permanently reducing their weight through other methods may have new hope to improve their health: PAMF's Weight Loss Surgery Program.

The program, offered by the Department of General Surgery, provides bariatric surgery to eligible candidates. PAMF uses the Roux-en-Y gastric bypass procedure, named after the Swiss surgeon who developed the technique of joining the stomach pouch to the small intestine and creating a "Y"-shaped intestinal junction. By reducing the size of the stomach, gastric bypass surgery severely restricts the amount of food an individual can consume, leading to weight loss.

Patients are carefully screened to determine eligibility and must attend educational classes aimed at helping them make lifestyle changes prior to surgery. Candidates for obesity surgery, which is not reversible, must be more than 100 pounds overweight and have a body mass index (BMI) greater than 40. Patients may also be eligible for surgery if their BMI is greater than 35, and they have two or more obesity-related illnesses, such as diabetes, arthritis, heart disease, hypertension, gastroesophageal reflux disease, depression and/or sleep apnea.

"The operation is a major medical procedure and a last resort for obese individuals," said Haroon Anwar, M.D., PAMF's weight loss surgeon. "It is a tool that must be combined with healthy lifestyle behaviors in order for people to be successful. Long-term, sustained weight loss requires a major commitment."

The program includes a three- to six-month period of nutritional counseling prior to having weight loss surgery. The six-month period begins when the patient attends a comprehensive nutrition class led by a registered dietitian. Patients also receive a packet that provides comprehensive information about the nutrition and diet guidelines that accompany weight loss surgery. After attending the initial class, patients have individual nutrition counseling sessions once a month. These sessions focus on making small lifestyle changes to achieve overall healthier nutrition and long-term weight management. Exercise is strongly encouraged.

Long-term success of the procedure depends on the patient making these permanent lifestyle changes, including diet, fitness and emotional well-being, said Dr. Anwar. Patients who experience emotional difficulties after the operation, including concerns about their body image and relationship with food, may find support at monthly group meetings with a mental health specialist and other weight loss surgery patients.

"Our goal is to help people achieve optimal health and reduce their reliance on medications for the treatment of chronic illnesses. We give patients the tools they need to lose weight and attain better health," Dr. Anwar said. "It is critical to an individual's success to follow the diet and exercise guidelines presented in the program. Many people feel this program helps them get their life back, and this is the greatest reward for all of us."

For more information, visit PAMF's Weight Loss Surgery Web site at www.pamf.org/wls. To schedule a consultation, e-mail the program coordinator at wls@pamf.org or call (650) 853-2985.