Obesity Dangerous as Cancer? on Arkansas Medical News Inc.

Obesity Dangerous as Cancer?

By: BECKY GILLETTE

Josh Roller

According to some recent studies, obesity is as dangerous as cancer.

“If you are 50 years old and obese, you have the same chance of dying from it at that point as if just diagnosed with a solid cancer,” said Josh Roller, MD, Roller Weight Loss and Advanced Surgery, Fayetteville. “That right there changes the landscape on how patients and doctors should view obesity. This disease kills people, but it doesn’t have to. It is every bit as dangerous as cancer. If you had a cancer you could operate on, would you operate? Yes. So, why not operate for obesity? It is just as dangerous. We have to get people to understand that obesity is a disease, and it is deadly. Obesity kills more people each year than breast cancer and colon cancer combined.”

Studies have shown that bariatric surgery pays for itself in less than two years in most cases with diabetic patients. Roller advocates weight loss surgery should be used more often especially for diabetics, because research has shown that bariatric surgery resolves diabetes in 77 percent of the cases. It can also prevent the need for expensive and sometimes risky interventions such as heart surgery, back surgery and knee and hip replacements.

“Arkansas is the eighth heaviest state in U.S.,” Roller said. “We have people who die from this disease, and it is preventable if they can have bariatric surgery.”

Roller, who was trained in bariatric surgery at Duke University, has performed more than 1,200 minimally-invasive bariatric surgeries with a less than one percent major complication rate.

Starting this month in January 2012, the State of Arkansas will be doing a four-year pilot program covering bariatric surgery for state employees, including teachers. Roller is optimistic that this will not only be good for state employees, but will have a ripple effect convincing other employers that this is a cost-effective procedure that should be covered by medical insurance.

“It’s going be a great benefit for teachers and other state employees to have access to this kind of surgery,” Roller said. “When people have weight loss surgery, they become more productive at their jobs and with their families. The benefits are tremendous.”

Roller said it is important for patients to be operated on by doctors who have special training in bariatric surgery and have a lot of experience. He frequently sees patients who are coming to him because they have had surgeries elsewhere that haven’t been successful. Specifically, there are many patients who are having bariatric surgery in Mexico without understanding the need for regular post-operative care.

“You get only one chance to do this and do it right,” Roller said. “Post operative care is very important. Our aftercare includes visits with nutritionists and doctors. This helps safeguard the patient, and helps them optimize their chances for success. People who get this surgery in Mexico think their doctors will take care of them after surgery and that there is no need to see a bariatric surgeon for follow-up care. I have seen some of the most disastrous complications you could even imagine by patients going to Mexico. Doctors in Mexico aren’t telling them how important the aftercare is and that aftercare is critical to long-term success and for prevention of complications. Mexico doesn’t have same rigorous hospital protocols as this country. Patients have no recourse with surgery out of the country. Yes, it is cheaper down there, but you don’t get the quality of care and long-term commitment from the bariatric surgeon and team that is needed to be successful.”

There are several different types of bariatric surgery. In addition to the Lap band, other options are the gastric bypass and sleeve gastrectomy. Roller said the best type of surgery depends on the patient. He feels surgeons who offer only one type of surgery may be doing a disservice to patients who would do better with one of the other types.

“If you go to a surgeon who only does one type of surgery, and ask that surgeon what procedure is best, which answer do you get?” Roller asks. “There are patients who might not do that well with that particular procedure. It is extremely important for patients to find surgeons that offer patients all three procedures and make an experienced decision with the patient on which procedure will be best. There is not just one surgery that is right for all patients and every patient is different. It is important for patients to be counseled on all three procedures and make an informed decision with the bariatric surgeon as to which surgery offers them the best chance at beating obesity. It drives me crazy to see surgeons out there not informing patients of all the options, especially when they don’t perform the other surgeries.

Roller finds his work gratifying because so many patients who have suffered for years from being overweight get a new lease on life.

“It is very rewarding to see patients get their lives back,” Roller said. “When I ask patients if they have any regrets about the surgery, the most common response is that their only regret is not having done it sooner. They just didn’t understand prior to surgery how much they were withdrawing from society, how much they had missed out on by being obese, and that they were headed down a path to an early death. I wish we could do more bariatric surgeries and keep people from suffering from of all of the complications of related to obesity, like diabetes, sleep apnea and heart disease. The biggest problem right now is access to care and employer’s insurance not covering it. The insurance will cover diabetes medicine, heart procedures, and joint surgery, but it they don’t cover what causes all of these problems in the first place, obesity.”