Vim & Vigor - Summer 2018 - University of Virginia - 54

"Bariatric surgery is going
to help with almost
everything associated
with being overweight.
Diabetes is probably the
most impactful one."
-Peter Hallowell, MD

WEIGHT-LOSS
SURGERY OPTIONS
There are two main types of weight-loss (bariatric) surgery:
gastric bypass and gastric sleeve.

Gastric bypass has been

around since the 1960s but wasn't
commonly done until the late
1990s, when a less invasive laparoscopic option became available. "Over
the last 10 to 15 years, with refinement in
technique and safety, we've seen complication and mortality rates plummet to where
we are today," says Peter Hallowell, MD,
director of the Bariatric Surgery Program
at UVA Health System.
With gastric bypass, most people lose
100 pounds initially but gain back about
50 pounds. Still, that is enough to help alleviate many obesity-related health problems, including arthritis pain and infertility, and
most importantly, diabetes. Bypass tends to have better outcomes than the sleeve for
severe diabetes, Dr. Hallowell says. "But both surgical options are better than medical
treatment for severe diabetes." In patients with significant GERD (gastroesophageal
reflux disease), bypass is usually the better option, Dr. Hallowell adds.

Gastric sleeve was intro-

duced around 2005 and has
since largely replaced what is
known as the gastric band. "The
gastric sleeve is a little bit less technically
difficult, requires a shorter hospital stay,
and has a little bit quicker recovery than
a gastric bypass," Dr. Hallowell says. The
sleeve has drawbacks, though: Its long-term
outcomes are unknown, and it tends to
result in less weight loss than a bypass.

SU M M ER 2 0 1 8

Tom Murden, 51, of Woodstock,
Virginia, was always the "life of the
party." But after years of abusing
his body with smoking, alcohol and
excessive eating, he found himself on disability and with a failing
liver. He was headed toward a liver
transplant but couldn't get on the
transplant waitlist with his weight
topping 460 pounds. He finally got
fed up with feeling sorry for himself.
He gave up drinking and smoking
and turned to a surgeon to help
him combat obesity. In April 2013,
Murden underwent a gastric sleeve
surgery done by Peter Hallowell,
MD, at UVA Health System.
Murden has since lost more than
200 pounds by adhering to a diet
of mostly yogurt, fruits, sautéed
vegetables and a small amount of
meat. He was able to get off disability and go back to owning his
own construction company. His
liver function has returned to normal. At first he had concerns about
resorting to surgery for weight loss
but now says, "I wish I would have
done it sooner." Read more about
him in his hometown newspaper
at nvdaily.com/news/2015/02/asecond-chance-at-life.

WEBSITE

Considering
Surgery?
To learn more about the UVA
Bariatric Surgery Program and
the type of patients who make
the best candidates for it,
go to uvahealth.com/
surgeryforweightloss.

ILLUSTRATION BY GETTY IMAGES

Because of the nature of obesity, about 10 percent of bariatric procedures are revisions. "I like to tell patients," Dr. Hallowell says, "obesity is a chronic disease and, as
such, it may require additional procedures over one's lifetime. The simple view that
you go in, get surgery, and it cures the whole thing is not the model that this disease is
going to follow."

A Dire
Situation

http://www.nvdaily.com/news/2015/02/a-second-chance-at-life http://www.nvdaily.com/news/2015/02/a-second-chance-at-life http://www.uvahealth.com/surgeryforweightloss http://www.uvahealth.com/surgeryforweightloss

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