The clinical data attesting to the benefits of bariatric surgery as an effective treatment for obesity continues to grow. This is good news for those individuals considered morbidly obese an estimated five to 10 million Americans – that may be contemplating weight loss surgery.
With the increase demand for weight loss surgery comes a growing array of treatment options for patients, in addition to gastric bypass surgery, the gold standard of care. These include a laparoscopic banding procedure to reversibly reduce the size of a patients stomach, and laparoscopic sleeve gastrectomy, where the stomach is permanently reduced in size by 60-75 percent. Just this past June, at the annual meeting of the American Society of Metabolic & Bariatric Surgery, we presented our first mid-term data on the efficacy of laparoscopic sleeve gastrectomy for the treatment of morbid obesity. In a retrospective study of 130 Cleveland Clinic patients, who ranged in age from 12 to 79, the mean weight loss at 24 months post-surgery was approximately 90 pounds. We found sleeve gastrectomy to be both a safe and effective surgical option to weight loss. This procedure is particularly attractive because it is less radical and does not create malabsorption of certain nutrients while still achieving significant weight loss. At the present time, sleeve gastrectomy is still considered Investigational, however, due to the lack of long term data. In another retrospective review, this time looking at 30 Cleveland Clinic patients with type 2 diabetes that underwent laparoscopic sleeve gastrectomy, 63 percent had a resolution of their diabetes and no longer required medication. The study, also presented at this years ASMBS meeting, supports data from other centers across the country showing bariatric surgery to be an effective, though controversial, treatment for type 2 diabetes. The Bariatric and Metabolic Institute at Cleveland Clinic in Florida is currently participating in the EMPOWER clinical research study to evaluate the safety and effectiveness of a new minimally invasive treatment for weight loss. The implantable, investigational device is intended to block signals carried on the vagus nerve between the brain and the digestive system that control sensations of hunger, satisfaction and fullness. Laparoscopically-implanted electrodes deliver high-frequency, low-energy electrical impulses to block the signals conveyed through the vagal nerves. The therapy is designed to be reversible, programmable and non-invasively adjustable. Cleveland Clinic is also one of just four U.S. centers investigating the safety and efficacy of a new removable weight loss device that is implanted endoscopically for up to three months in patients who are candidates for bariatric surgery to help them lose weight prior to surgery. The gastrointestinal liner consists of an impermeable sheath that lines the first two feet of small intestine as it leaves the stomach and prevents food from making contact with the intestinal wall or from mixing with the digestive enzymes, thus aiding weight loss. Today 97 million Americans, more than one-third of the adult population, are overweight or obese. Obesity becomes “morbid” when it reaches the point of significantly increasing the risk of one or more obesity-related health conditions, including type 2 diabetes, high cholesterol, hypertension, osteoarthritis, and heart disease. Specialists in the field of bariatric and metabolic surgery are working hard to bring new, less-invasive treatment options to bear against the growing obesity epidemic.