Dr. Vithiananthan talks to patient, William J. Dukes III of Hempstead, following his bariatric surgery. Mr. Dukes opted for the procedure after years of failed diets and weight management regimens, with the hope of improving his overall health for himself and for his family.

According to Siva Vithiananthan, MD, Director of Winthrop's Surgical Residency Program and head of the Bariatric Surgery Program, obese patients are at increased risk of developing illnesses as well as death. "Men and women who are severely overweight can now be helped to lose weight by surgically modifying the anatomy of their stomach and small intestines," said Dr. Vithiananthan. "However, surgery is offered only after a patient fails a regular medical exercise program to lose weight."

Bariatric surgery promotes weight loss by closing off a portion of the stomach to make it smaller, so that it can hold only a small amount of food. Dr. Vithianathan explains that the most common surgical procedure is the Roux-en-y gastric bypass surgery (also known as a malabsorbtion operation). This procedure uses staples and sutures to create a small stomach pouch to limit food intake. The pouch is then reattached to the small intestine, which is rearranged into a y-shape, to allow food to bypass the lower stomach and first part of the intestine. This in turn reduces the amount of calories and nutrients that are absorbed by the small intestine into the body. This procedure has been shown to be the most successful for weight loss in the severely obese, with patients losing up to 80 percent of their excess weight. Long-term studies have also shown greater maintenance of weight loss.

Vertical Banded Gastroplasty is another weight loss surgery that creates a small pouch in the stomach using a synthetic band and staples. While this procedure limits food intake, it does not hinder the absorption of calories and nutrients as with roux-en-y gastric bypass surgery. Though shown to be successful for weight loss, long-term results are not as dramatic as with malabsorbtion operations.

Although dieting remains the most useful method of weight control for individuals who are mildly or moderately overweight, it is generally ineffective for the morbidly obese. Morbidly obese patients have been shown to have a reduction in life expectancy. In fact, morbid obesity is the root of many medical, physical, emotional, economic and social handicaps.

Dr. Vithianathan leads the first meeting of WinthropÕs bariatic surgery support group where patients discuss life before and after surgery.

Since obesity contributes to developing other diseases, many surgery candidates have medical problems such as diabetes, hypertension, hiatal hernia, gallbladder disease, shortness of breath, among others. Obesity surgery not only helps patients control their weight over many years, but can also help prevent or control the progression of these weight-related problems.

"A body mass index (BMI) above 40, which usually means at least 100 pounds overweight, indicates a person is eligible for surgery," said Dr. Vithiananthan. "Most if not all-secondary conditions such as hypertension, diabetes, back pain and heartburn can be greatly improved by undergoing surgery."

Winthrop's Bariatric Surgery Program is dedicated to the care and treatment of patients with clinically severe obesity refractory to non-operative treatment.

The surgical procedures are performed by highly trained, board-certified surgeons with special training in obesity surgery. Bariatric surgery offers several procedures that each act differently on a person's digestive system. Winthrop uses a full multi-disciplinary approach to the treatment of obesity including a full complement of pre and post-operative surgical support services, including gastroenterology, endocrine medicine, psychiatry, rehabilitation services and nutritional sciences.

"The treatment goal for severe obesity should be an improvement in health achieved by a durable weight loss that reduces life threatening risk factors and improves a person's daily life," continued Dr. Vithiananthan. "But the surgery is only effective when a patient makes a positive lifestyle change."

As another service to the surgical patients, Winthrop held its first monthly bariatric support group meeting in June in the Hospital's conference center. The meeting was attended by patients who have recently undergone the bariatric surgery and others who are considering surgery in the future.

For further information about bariatric surgery, contact Winthrop Surgical Associates at (516) 663-3300 or 1-516-663-0333.