Understanding Bariatric Surgery’s Role in the Wellness Revolution
Unfortunately, some people don’t have the physical or emotional resources to succeed at wellness programs based on diet and exercise alone. People who have struggled with severe (or morbid) obesity throughout their lives may need more.
Options such as bariatric surgery have an important place in the wellness revolution when all other alternatives have been exhausted. For the morbidly obese, it may be the difference between life and death.
Many health insurance programs now include bariatric surgery, but employers may not understand its benefits or how to help employees find and evaluate bariatric program options.
The problem we face
Obesity rates have been rising steadily for the last 20 years. Today, two-thirds of adults in the United States are classified as overweight as measured by Body Mass Index (BMI). BMI provides a reliable indicator of body fatness for most people. A healthy BMI will range from 19 to 25. A BMI over 30 is considered obese, and a BMI of 40 or higher is morbidly obese.
Morbid obesity is associated with more than 30 illnesses and medical conditions, including Type 2 diabetes, heart disease, stroke, hypertension, cancer, asthma, arthritis, joint degeneration, acid reflux, liver disease and sleep apnea. Traditional treatments for morbid obesity focus on easing the symptoms it creates rather than solving the fundamental problem—the need to eliminate the condition of morbid obesity.
The effects of these ailments on any business can be profound: Absenteeism, higher insurance premiums, lower productivity, missed opportunities and workplace safety concerns are just a few of the potential issues.
Bariatric surgery programs
For people struggling with morbid obesity, surgical options are not only life changing, they are life saving. The public perception is that bariatric surgery is strictly elective. We don’t see it that way. Without surgical intervention, many patient lifespans will be significantly shortened by obesity and its complications.
The bariatric surgery we believe has the best long-term outcomes is the Roux-en-Y bypass. We perform this surgery laparoscopically. Using a fiber-optic camera and small incisions, we reduce the stomach to the size of a golf ball, dramatically restricting the volume of food a person can eat before feeling full. The length of small bowel through which food travels is shortened. The surgery is both restrictive, meaning the stomach’s capacity is reduced, and malabsorptive, which means the absorption of food is decreased.
Bariatric surgery is not a “quick fix” or “easy way out.” To be eligible for the Ingham program, patients must have a BMI of 40 or more and be at least 100 pounds overweight, or have a BMI 35-39.9 with two or more serious medical conditions. They also must complete a minimum of three months of prework that includes diet counseling, physical and psychological evaluation and more.
The evaluation process is rigorous because gastric bypass is a life-changing procedure. Patients need to drastically change their eating behaviors and lifestyle habits. The surgery is only one step in the process. We tell each of our patients “Our job is to give you the tools, but you have to build the house.”
Benefits for Business
We already know that healthy is good for the bottom line. Former morbidly obese patients typically experience dramatic health benefits within the first year.
A study of 22,000 bariatric surgery patients published in the Journal of the American Medical Association in 2004 showed improvements in the following obesity-related conditions:
- Type 2 diabetes was eliminated or improved in 86 percent of patients.
- Hypertension was eliminated or improved in 78 percent of patients.
- Obstructive sleep apnea was eliminated in 86 percent of patients.
- High cholesterol levels were decreased in more than 70 percent of patients.
- Average weight loss was 61 percent for all patients.
Most of our patients are able to reduce or eliminate what is typically a long list of prescription medicines. Also, because smoking delays healing and creates other potential problems, patients who smoke must quit smoking for the rest of their lives.
We also reconnect them to regular medical checkups. Morbidly obese patients often avoid doctors, and their consultation visit may be the first time they have been to a doctor in years.
All of our patients participate in a six-week pre-surgical program called New Beginnings. After surgery, most are exercising within two weeks and are back to work within four weeks. And we expect them to continue meeting with us for up to five years of post-operative checkups.
Their loss is your gain
We have the privilege of helping people create their own miracles. One of our patients wrote a letter listing all the things she wanted to do as a result of her surgery. They were things that most of us take for granted, like riding a bike, crossing her legs and playing with her grandkids.
Within one year, she was able to do all of them.
People who are considering bariatric surgery are literally reaching out to save their own lives. By understanding the issues of morbid obesity and creating an environment that supports all aspects of wellness, employers have the opportunity to help change people’s lives in meaningful and profound ways.
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Mindy Lane, DO and Melissa Richardson, DO are surgical associates with Mid-Michigan Physicians and board-certified bariatric surgeons working with Ingham Regional Medical Center.