Submitted by Illinois Bariatric Center
Both the World Health Organization and the American Medical Association now recognize obesity as a chronic, progressive disease that requires lifelong treatment and control. It’s not just a matter of carrying a little too much weight due to overeating and no self-control. It is a disease and needs to be treated as such.
Like many other diseases, obesity has stages at which different treatment options are preferable. The overall goal is to reset the barostat so that the person feels full prior to overeating. In the overweight (pre-obesity) stage, the most common treatment is diet and exercise. For early stages of obesity, medication prescribed by a physician to help curb the patient’s appetite may be added into the mix.
Sometimes, patients fall into a gap in which the best treatment option isn’t obvious. For example, a severely obese person may still have some success with diet and exercise, but weight still creeps up slowly over time. Surgery may not be warranted at this point, but temporary and intermittent treatment, such as that offered by a gastric balloon, may be a good option.
“A gastric balloon, such as ORBERATM, is often used for lower-BMI obese patients who possibly haven’t had the disease as long but are creeping up into the BMI range,” explains Dr. Sidney Rohrscheib, a board-certified general surgeon and founder of the Illinois Bariatric Center. “This person has likely had success with dieting and exercise until recently.”
The ORBERA non-surgical procedure will help patients lose three times the weight versus diet and exercise alone. Following a simple 20-minute procedure, the balloon is placed in the stomach to encourage portion control and eating of smaller meals. Patients will also receive nutritional counseling while the balloon is in place and after it is removed.
“It’s removed at six months, but if the patient re-gains weight, it can be inserted again,” explains Dr. Rohrscheib. “In fact, regardless of the weight loss procedure, if someone regains weight or doesn’t reach their goals, additional procedures are available. For example, if someone has had a gastric bypass procedure and has regained some weight, they now have additional options available to them.”
Gastric bands, such as the LAP-BAND®, are used for a different, yet similar, purpose. “Gastric bands and gastric balloons are two different treatments to help fight obesity; they are used for different purposes and at different stages of the disease,” says Dr. Rohrscheib.
A gastric band is used to treat chronic, progressive morbid obesity. This treatment is for a patient who has tried everything, including diet, exercise, weight loss medication, perhaps even a gastric balloon, but these strategies no longer have an effect in combating the disease. At this point, the patient may also be experiencing one or more consequences of being obese — joint pain, sleep apnea, diabetes, heart disease, or other serious complication.
Gastric bands are intended to be a permanent, lifetime therapy for modification of hunger. Inserted under general anesthesia similar to gall bladder surgery, the band is adjusted on a monthly basis. It typically takes 12 to 18 months of adjusting the band to create behavior modification. The band restricts the amount of food in the stomach and delays emptying. When the band is adjusted tighter, the patient feels full sooner. When the patient feels hunger, the amount of food it takes to feel full is much less, so hunger is suppressed.
Other surgical options, such as gastric bypass and sleeve gastrectomy, are options for obese patients, however, they are very invasive, and the risk may not justify the results — especially when patients can be successfully treated with bands and balloons.
Unfortunately, in spite of the success of these treatments, we, as a society, are still doing an “abysmal job” of treating this disease. Obesity gets harder to talk about as it affects more and more people and becomes “average.”
Anyone with a BMI of more than 40 should be counseled for surgery. Gastric banding has been universally covered by insurance for more than 10 years, largely because the savings in other medical expenses are recouped in two to four years.
Patients who have had weight loss surgery say that they are not as hungry, they feel full faster and with less food, and they stay full. This is exactly the process that will reset their barostat, thus changing their hunger patterns.
If you can change the person’s hunger, you can change the disease.
For information on the ORBERA™ Managed Weight Loss Program or LAP-BAND® surgery, you may contact Dr. Sidney Rohrscheib at the Illinois Bariatric Center at 217-935-7037. Illinois Bariatric Center is one of the few practices in Central Illinois that is qualified to offer the ORBERA™ non-surgical procedure. The practice provides a unique multidisciplinary program dedicated to the management and treatment of obesity.