麻豆传媒

News — Obesity is nothing new. In fact historical reports document cases dating back to medieval times. But today obesity has reached epidemic proportions - with statistics showing as much as 39% of the global population being obese - partly because treating it, experts say, can be quite difficult. 

Seventy years ago this year, the first bariatric surgery was performed in 1954, according to the National Library of Medicine. Known as the jejuno-ileal bypass, the surgical procedure removed much of the small intestine, where most absorption of food takes place. 

In the years since, there have been many modifications of this initial surgical bypass - including the and . These new laparoscopic and often robotic assisted procedures are minimally invasive so there is less chance of infection, less time spent in the hospital. The faster recovery allows patients to resume their normal lives quicker. 

But with the advent of new weight loss drugs, what’s next for this weight loss intervention and how will doctors decide which is the best approach for their patients?

"Weight management is not one size fits all," said Hans J. Schmidt, MD, chief of Bariatric Surgery and director of the Center for Weight Loss and Metabolic Health at Hackensack University Medical Center. "Patients may need a program that integrates more than one approach to achieve the best results. Like with any chronic disease, it is crucial to receive the right diagnosis and explore all treatment options.”

Dr. Schmidt, who treats patients with both medication and surgery at the Center for Weight Loss and Metabolic Health, says the current buzz and popularity of weight loss drugs may actually increase the number of patients coming in for surgery. 

“These new weight loss drugs mimic the end result of bariatric surgery,” he explains. “They work by increasing levels of the digestive hormones that control appetite and insulin production but you must stay on them for life and the higher the dose, there can be an increased risk of uncomfortable, gastrointestinal side effects.”

“I struggled with my weight for years,” says 67 year old Steve Sussmann, who at the height of his weight of more than 280 pounds had diabetes, asthma, pain in his hips and ankles, and sleep apnea. “I used to look at these things as separate conditions and then I realized that all of the issues I had were symptoms of obesity.” 

More than 10 years ago, Sussmann underwent a bariatric sleeve procedure followed by  personalized nutrition and fitness guidance. “I’m glad I chose this option,” says Steve, who no longer needs to take blood pressure or asthma medications and says he’s grateful that the procedure jump started him into forming healthier habits for the long term. “Whether it be surgery or weight loss drugs, whatever helps someone to lose the weight and keep it off, is fine by me.”

Ultimately, Dr. Schmidt says the question shouldn’t be one of drugs vs. surgery but rather how the two modalities can work together moving forward. 

“Both are proven methods with proven benefits,” he says. “I think looking ahead, the drugs will be used to help minimize the risk of surgery complications and alternatively, for patients who have surgery but experience weight gain down the road, the medication will help them maintain their weight for the long term.”

About the Center for Weight Loss and Bariatric Health:

Hackensack University Medical Center has established the , an integrated program to help people who have struggled to lose weight to achieve and maintain their weight loss goals. The program brings together specialists from different areas to offer multiple weight loss techniques, with each patient's personal plan customized to their needs. 

"Weight management is not one size fits all," explained Hans J. Schmidt, MD, who leads the Center. "Patients may need a program that integrates more than one approach to achieve the best results." 

Each patient starts with a pre screening evaluation to assess their medical history and metabolic health, survey their prior weight loss techniques, and screen for sleep apnea. They then meet with a healthcare professional matched to their individual needs, who customizes a plan of care that may include services such as:

• Nutritional counseling
• Weight loss medications
• Weight loss surgery
• Exercise guidance
• Dietary supplements

Patients may benefit from the expertise of endocrinologists, bariatric surgeons, registered dietitians, sleep medicine experts, cardiologists, and fitness experts, among others — all through one center. At monthly visits, each patient's progress is assessed as well as their ability to make the recommended behavioral and dietary changes.

People with a BMI of 27 or more who have tried unsuccessfully to lose weight on their own are eligible to participate in the program. Overweight and obese patients with weight-related medical conditions such as diabetes, high blood pressure, high cholesterol, and heart disease are also eligible. For more information or to book an appointment with the Center, .