Surgeons Offer Hope with Bariatric Surgery

Imagine carrying a 200-pound backpack 24-hours a day, seven days a week, and not being able to take it off.

That is what Rebecca Rincon experienced—only it was not a backpack but excess weight that Rincon was unable to lose.

Rincon is one of many individuals suffering from morbid obesity who has come to GRMC for obesity surgery, also known as bariatric surgery.

David Coster, MD, of Surgical Associates, was Rincon’s surgeon, and is one of four surgeons listed by the American Society of Bariatric Surgeons, who performs this type of surgery in Iowa.

Rincon weighed 341 pounds before her surgery and has battled with being overweight all of her life.

"For the past four years I would exercise three to four times a week and eat a healthy diet but would make little weight loss progress," Rincon says. "I would lose 15 pounds and my weight loss would stop. It was very frustrating. I tried all of the diets from Weight Watchers to Slim Fast but nothing seemed to help me take the weight off and keep it off."

Rincon was referred to Coster by her family physician in Des Moines.

What is morbid obesity?
Morbid obesity is when you are so overweight that it is life threatening.

"It is a disease in which your body takes in too much food energy," Coster says. "Obesity can occur if you eat normal amounts of food but still gain weight or if you eat more food than your body needs."

"This excess energy is stored as fat and when it builds up it is harder to be active. With less activity, more fat builds up, and this is when weight gain can lead to serious health problems," Coster says.

Thirty-three percent of Americans are morbidly obese. The harm of being morbidly obese is simply not just cosmetic. Extra weight can lead to:

• Diseases such as Type 2 diabetes or certain cancers.
• Heart and circulation problems, including high blood pressure and stroke.
• Sleep apnea and other breathing problems.
• Problems with skin, urination, or menstruation.
• Depression or other mental health problems.

Coster and his staff also work with insurance companies to see if they will cover the cost of the surgery.

Like with any surgery there are risks involved with obesity surgery, which for Rincon were less risky than remaining overweight.

"I wanted to be healthy and to be able do things with my children," Rincon says.

What is bariartric surgery?
Bariatric surgery is designed to cause rapid weight loss with the goal of helping you lose over half of your excess weight. The most common type of obesity surgery that Coster performs is Roux-en-Y Gastric Bypass. This surgery is an improved technique and has a much higher success rate than the old procedure of stomach stapling, which was popular 20 years ago.

"With the Roux-en-Y Gastric Bypass surgery, a small stomach ‘pouch’ is created with staples," Coster explains. "A section of the small intestine is attached to this ‘pouch’ and the shortened intestine absorbs less food and as a result, you eat less food and absorb less of the food that you eat."

Rincon underwent gastric bypass surgery at GRMC. She spent fours days at GRMC and missed work for three weeks.

Rincon’s stomach, like most of Coster’s patients, was reduced to hold one tablespoon of food compared to 10 cups of food prior to the surgery. Eventually, six to eight months after the surgery, the stomach can stretch to hold one cup of food.

Because the stomach has been drastically reduced, eating habits must be altered.

"Right after surgery you will just drink low-sugar liquids, like tea or broth," Coster says. "During the first month you’ll be able to eat low-fat pureed or semisolid foods (baby food) and over time you will be able to eat a range of foods in small amounts."

Living After Your Surgery
Since the surgery Rincon has had to adjust to her new "stomach."

"You have to have the right mind-set," Rincon explains. "I eat what my family eats but to help I eat from tea cup plates. Psychologically, the plate is full. I count my calories very carefully, keep a food diary, exercise three to five days a week with a cardiovascular and weight training program, and I chart my weight loss. And I stay as far away from fast food as I can."

Rincon takes a daily dose of vitamin supplements, which she will take for the rest of her life. "After surgery, your body may not be able to absorb all the vitamins it needs so a multivitamin is necessary to increase your vitamin intake," Coster says.

Many of Coster’s patients experience a 20 to 30 pound weight loss the first month after their surgery. The surgery helps many of Coster’s patients lose 80 percent of their excess weight, eight to 12 months after their surgery

Nine months after Rincon’s surgery she lost 103 pounds.

"Dr. Coster, the nurses, nutritionist, and facilities were great and I left the hospital understanding what to do," Rincon says. "The surgery is not a miracle cure for obesity. You still have to work hard by exercising and eating correctly but it is worthwhile when you feel the weight dropping off and you can see your body start to look more like a normal person."

If you would like more information about gastric bypass surgery, please call Surgical Associates at 641-236-4323.