NJ Top Docs: Weight-loss Surgery and Which Procedure May Be Best for Someone Like You

bariatric surgery(BPT) – According to the American Medical Association, approximately one in three Americans are obese, leaving at least one third of the country at risk for many health problems including type 2 diabetes, high-blood pressure, high cholesterol and sleep apnea.1

A growing body of medical evidence shows that bariatric surgery can be an effective option for the treatment of obesity and related diseases such as type 2 diabetes, 2,3 yet, only a small percent of people who are eligible choose to have surgery. Most patients who could benefit are reluctant to have bariatric surgery because of lack of information and uncertainty about the procedure. People usually want to know three things– will it help someone like me? Will it help with other obesity-related diseases? Will it help keep weight off long term?

1. Will bariatric surgery help someone like me lose weight?

Weight loss is different for everyone – some diets or exercise programs work for some people, while the same program might not work for someone else. People may wonder the same about bariatric surgery. An online educational tool, called the Ethicon Bariatric Surgery Comparison Tool (www.realize.com/bsct), allows people considering bariatric surgery to compare the experiences of other patients similar to them who have already undergone the procedure. Users anonymously enter information such as their height, weight, ethnicity, age and gender, and then see results people similar to them have had with different types of bariatric surgeries (gastric band, gastric bypass, and sleeve gastrectomy). The personalized tool provides users with a side by side comparison of the bariatric surgery options and possible outcomes, including average results such as total weight lost up to two years, or medications that users stopped taking following the procedure.

Dr. Elliot Fegelman, a surgeon with nearly 20 years of practice and Medical Director for Ethicon, a company that makes devices used across surgical procedures including bariatric surgery, said, “It can be difficult for people to make an important decision like having bariatric surgery. But research shows that, the longer a patient waits, the less they will benefit from the surgery. The Bariatric Surgery Comparison Tool helps patients understand what results could look like for someone like them down the road, and gives them a starting point to bring up with their doctor, getting them one step closer to making this important decision. In fact, in an initial pilot test, patients who visited the Bariatric Surgery Comparison Tool were three times more likely to search for a local surgeon in their area.”

2. Will weight-loss surgery help with other obesity-related diseases for people like me?

Bariatric surgery has been shown to improve many different obesity-related diseases and conditions such as type 2 diabetes and high-blood pressure. One example of this evidence includes the STAMPEDE (Surgical Therapy And Medications Potentially Eradicate Diabetes Efficiently) trial, sponsored by Ethicon and conducted by the Cleveland Clinic. The study showed that people with uncontrolled type 2 diabetes who had surgery lost weight and also decreased their dependency on diabetes medications almost immediately following bariatric surgery. The study also showed patients had a decreased need for or no longer required cardiovascular medications to control high blood pressure and high cholesterol.4

The Bariatric Surgery Comparison Tool offers a more personalized perspective on the effects of surgery on comorbidities and medications. This tool shows patients the percentage of people like them who demonstrated a reduced need for or no longer required medication to control obesity-related diseases following their bariatric surgery.*

3. Will the surgery help keep weight off long term?

People trying to maintain weight loss often experience disappointing results. Despite best efforts, diet and exercise programs may work at first but fail in the long run.5 In March 2014, the Cleveland Clinic published long term results of the STAMPEDE trial, which showed that, for three years, people who underwent bariatric surgery alongside drug therapy were able to keep weight off and had better control of their diabetes compared to people who relied on a medically monitored diet and exercise regimen with drug therapy.4

Bariatric surgery is an approved procedure for treating obesity, and now is available as a minimally invasive procedure, meaning it carries a similar amount of risk as some of the most common surgeries, such as gall bladder surgery.6,7 There is increasing evidence that bariatric surgery is not only an effective option for addressing obesity, but that it may also help control type 2 diabetes and other obesity-related diseases.

If you are thinking about bariatric surgery, consider starting with the Bariatric Surgery Comparison Tool, and speaking with your physician. Having the information at hand can help kick start a conversation with your doctor about the best treatment option for you.

Bariatric surgery is used in severely obese adult patients for significant long term weight loss. It may not be right for individuals with certain digestive tract conditions. All surgery presents risks. Weight, age, and medical history determine your specific risks. Ask your doctor if bariatric surgery is right for you.

Elliott J. Fegelman, MD, FACS, is Director of Medical Affairs for Ethicon with responsibility for the minimally invasive procedures and metabolics/obesity platforms. The STAMPEDE study was funded by Ethicon, part of the Johnson & Johnson family of companies, through its Metabolic Applied Research Strategy (MARS) program.

* The tool was developed by Ethicon, a company that makes medical devices used across surgical procedures including bariatric surgery. The tool cannot predict specific outcomes for any individual, so it is important to consult a physician or other health care provider to determine whether or not bariatric surgery is right for you and for guidance on expected outcomes, benefits, and risks.




1 American Medical Association Web site. http://www.ama-assn.org/ama/pub/physician-resources/public-health/promoting-healthy-lifestyles/obesity.page. Accessed May 13, 2014.

2 American Society of Gastrointestinal Endoscopy and American Society of Bariatric and Metabolic Surgery. A pathway to endoscopic bariatric therapies. Surgery for Obesity and Related Diseases. 2011; 7(6): 672-682. http://www.soard.org/article/S1550-7289(11)00687-3/pdf. Accessed May 13, 2014.

3 Schauer PR, Kashyap SR, Wolski K, et al. Bariatric surgery versus intensive medical therapy in obese patients with diabetes. N Engl J Med. 2012 Apr 26;366(17):1567-1576. http://www.nejm.org/doi/full/10.1056/NEJMoa1200225#t=articleTop. Accessed May 13, 2014.

4 Schauer PR, Bhatt DL, Kirwan JP, et al. bariatric surgery versus intensive medical therapy for Diabetes – 3-Year Outcomes. N Engl J Med. 2014 Mar. http://www.nejm.org/doi/full/10.1056/NEJMoa1401329#t=articleTop. Accessed May 13, 2014.

5 Sumithran P, Prendergast LA, Delbridge E, et al.Long-term persistence of hormonal adaptations to weight loss. N Engl J Med. 2011 Oct;365(17):1597-1604. http://www.nejm.org/doi/full/10.1056/NEJMoa1105816. Accessed May 13, 2014.

6 American Society for Metabolic and Bariatric Surgery Web site. http://asmbs.org/obesity-and-surgery-learning-center/bariatric-surgery-misconceptions. Accessed May 14, 2014.

7 Dolan JP, Diggs BS, Sheppard BC, Hunter JG, et al. The national mortality burden and significant factors associated with open and laparoscopic cholecystectomy: 1997–2006. J Gastrointest Surg. 2009 Dec;13(12):2292-301. http://link.springer.com/article/10.1007%2Fs11605-009-0988-2. Accessed May 14, 2014.