Weight Loss Surgery: Resolution of Comorbidities | Can Bariatric surgery help?

Feb. 25, 2022 - Weight Loss Surgery: Resolution of Comorbidities - Can Bariatric Surgery Help? This bariatricfriday, Kemal Erkan, Chairman of American Surgery Center, sat down with Dr. Isaias Irgau of Christiana Institute of Advanced Surgery (CHRIAS) to participate in a conversation regarding various types of bariatric surgeries within the bariatric surgery journey. Dr. Irgau is the President of CHRIAS and has practiced the specialty of weight loss surgery, also known as bariatric surgery, for twenty years. Erkan begins by acknowledging the team of professionals at American Surgery Center, including Dr. Gail Wynn, Dr. Michael Peters, Dr. Rahul Singh, Dr. George Ibrahim, and Dr. Sachin Vaid, as well as Registered Dieticians Fran Taccone, Beth Wright, Amy Wilcoxon, and Amy Scott. Today’s topic discusses bariatric surgery and the impact on related illnesses. Dr. Irgau introduces the topic of obesity. He states, “obesity is not just a question of carrying extra weight that adds burden to the quality of life of that individual… every day-to-day activity becomes very difficult when the weight is so much more”. He explains the healthcare issues that coincide with obesity; this includes the direct correlation between obesity and potentially life-threatening illnesses. He expresses those individuals of a much higher weight could lessen the likelihood that they reach their life expectancy. Dr. Irgau mentions studies that have concluded that many people who have a higher body mass index tend to not reach their expected age; “clearly obesity is a threat to one’s life,” he proclaims.

The pair then go on to cover the related illnesses to obesity. The first discussed can be considered the most important and widespread, type two diabetes, an illness in which an individual’s blood sugar is too high for the body to manage. Bariatric surgery patients of American Surgery Center are commonly found to have type two diabetes. This topic leads to the mention of high blood pressure. According to Dr. Irgau, “three out of four people who have high blood pressure happen to be obese as well, so obesity is clearly related to high blood pressure”. High blood pressure can go undetected because there are no visible symptoms, and yet, it can lead to other life-threatening issues. Another obesity-related illness is sleep apnea; this occurs because excess fat gathers in the neck, back, and throat that can prevent air flow while sleeping. “Fifty percent of our patients who are obese actually have sleep apnea,” he states. This can be quite dangerous and affect the circulatory system. Erkan poses the question, as a patient, when reading all of these studies and statistics out there, would they be able to conclude that there is a successful outcome from morbid obesity and will these coinciding issues dissipate. Dr. Irgau responds by saying when he asks patients what they expect from bariatric surgery, they answer with “I want those illnesses to go away”; he also states “they are clearly understanding that there is an integral connection between the weight and the illness… we want our patients to become thinner, happier, more confident, have a better quality of life, but most importantly we want to liberate them from many of those illnesses”.

The significant reduction of weight, reduced by bariatric surgery, breaks the patient from this vicious cycle and ultimately leads to an overall improvement in their quality of life. Erkan brings up a fascinating point: the standalone ailments of depression, diabetes, hypertension, and other cardiovascular issues are commonly treated; however, when analyzing an individual’s body mass index, if it is extremely high, the patient should consider to address the root of the problem, morbid obesity, with bariatric surgery. As Chairman Kemal Erkan mentions depression and other mental health disorders, Dr. Irgau explains the correlation between those and obesity. The stigma of obesity strongly affects the individual struggling with it which can lead to the development of mental illnesses. After consistent attempts to lose weight, one can start to feel hopeless. As an individual’s feelings exponentially increase, doctors may prescribe medication to help counter these negative emotions; however, these medications can often lead to more weight gain caused by hormonal changes. Dr. Irgau states how this cycle can get “worse and worse over time…that is the trap we want to break with bariatric surgery”. “How about cancers,” Dr. Irgau brings to light, “we now know that there are many cancers that are directly related to obesity”. Obesity is a platform in which cancer can infiltrate. Life expectancy is shortened amongst individuals who are obese, not only from the weight but from the correlating issues that can come with it. “The nice thing about what we do is when we are doing our business we are helping people… you are actually touching other people’s lives,” Kemal Erkan proclaims, “we have a tangible, meaningful impact.”

When a patient weighs the pros and cons of undergoing the procedure of bariatric surgery, it is human nature to think of the immediate concerns prior to the long term effects. Bariatric surgery does have risks, but as a patient it is important to understand all of the facts and take into consideration how they want to live their life. In reference to the patient's decision making, Dr. Irgau states, “what we have to do is present our case, make sure they are educated, make sure they understand, and at the same time adopt a healthy lifestyle to try to at least control the increase of obesity to some extent, but as we know… the vast majority of patients with morbid obesity who try to lose weight with non surgical means fails”. This decision takes time, and it is perfectly acceptable. The pair make it clear that obesity is the root of many of the illnesses touched on today. “We cannot turn a blind eye to the main issue,” Dr. Irgau expresses. Erkan explains what their program has done for patients and thanks Dr. Irgau by saying, “I feel privileged to do this program with someone who is one of the most experienced bariatric surgeons in Delaware, and perhaps, the United States”. The session concludes with an explanation from Kemal Erkan stating these riveting discussions are why he does Bariatric Friday’s every week. Dr. Irgau leaves us with this final statement, “Obesity is not just a weight burden only; it is not a question of appearance and comfort, but it is a central health issue as well. Many of the illnesses related to obesity are very serious, life- threatening conditions that can be resolved completely with adequate weight loss that bariatric surgery can provide”.