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Cleveland Clinic Weight Loss Surgery

Cleveland Clinic Study Shows High Remission Rates Of Diabetic Kidney Disease Five Years After Bariatric Surgery

Doctor turns to Cleveland Clinic for new weight loss surgery

Newswise SAN DIEGO, CA JUNE 20, 2012 In many obese diabetic patients, one of the most dreaded complications of Type 2 diabetes can be put into remission or prevented entirely with bariatric surgery, according to a new study* from the Cleveland Clinic presented here at the 29th Annual Meeting of the American Society for Metabolic & Bariatric Surgery .

The study found that nearly 60 percent of obese patients with diabetic nephropathy, the leading cause of end-stage kidney disease, no longer had the condition five years after surgery. Additionally, only 25 percent of obese diabetics without nephropathy at the time of surgery eventually developed this complication. Researchers noted this incidence rate after surgery is about 50 percent less than what occurs in the non-surgically treated diabetes population. The five-year remission and improvement rates for Type 2 diabetes were 44 percent and 33 percent, respectively.

When we started this study, we thought bariatric surgery may just halt the progression of diabetic nephropathy, instead over half of the patients who had diabetic nephropathy prior to undergoing bariatric surgery experienced remission. This is a remarkable finding that warrants greater consideration of bariatric surgery in this patient population, said lead study author Helen M. Heneghan, MD, a bariatric surgery fellow at the Cleveland Clinic Bariatric and Metabolic Institute in Ohio.

Q: Who Is A Candidate For Bariatric Surgery

A: There are two leading authorities on bariatric surgery: The American Society for Metabolic and Bariatric Surgery and the International Federation for the Surgery of Obesity and Metabolic Disorders . The two organizations published their latest guidelines in 2022. They recommend bariatric surgery be considered for:

  • Adults who have a BMI of 35 or higher .
  • Adults with a BMI of 30 to 35 who also have type 2 diabetes.
  • Adults with a BMI of 30 to 35 who have not been able to achieve substantial or durable weight loss or obesity disease-related improvement by other means.
  • Children and adolescents who are living with a BMI of 40 or higher .
  • Children and adolescents with class II obesity and a major obesity-related condition.
  • This is an expansion to previous guidelines published in the early 1990s. Those suggested bariatric surgery be reserved for people with more severe forms of obesity.

    Dr. Aminian hopes the expanded guidelines will help more people access bariatric surgery and its benefits.

    The field of metabolic and bariatric surgery has progressed considerably, Dr. Aminian says. I hope these guidelines can open the doors for some people who did not have access to bariatric and metabolic surgery by the old, outdated guidelines.

    Find A Weight Management Provider Near You

    Receiving support from different healthcare professionals can be helpful when you try to manage your weight. Want to find one in your area? Select your country from the list below and you’ll be taken to your local Novo Nordisk obesity disease awareness site. From there, you can find and contact local weight management providers or a weight management clinic near you. The list will continue to grow, so keep a look out for your country.

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    Q: Is Bariatric Surgery Effective

    A: Bariatric surgery has helped millions of people treat obesity and related conditions.

    Bariatric surgery is currently the most effective tool we have to improve the lives and the health of people living with obesity, Dr. Aminian says. After bariatric surgery, people typically lose 20% to 40% of their body weight and sustain it over decades. On average, bariatric surgery can provide six years of additional life for people with obesity.

    Types Of Weight Loss Surgery

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    We offer several types of weight loss surgery options, including minimally invasive and non-invasive options. These minimally invasive procedures are performed through tiny incisions in the skin and can shorten your recovery time and significantly reduce pain and scarring. More importantly, risks of infection or bleeding are much lower with smaller incisions. This also helps us provide better pain control.

    Our weight loss surgery patients are typically up walking in the hallway and able to start sipping on water three hours after surgery. Most of our patients are ready to go home after one or two nights, depending on the surgery they choose.

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    Why We Use A Team Approach

    The Cleveland Clinic Endocrinology and Metabolism Institute’s Medical Weight Management Program uses a team of highly trained and specialized interdisciplinary professionals who work together to help patients achieve their health-related goals. This team includes Board Certified in Obesity Medicine physicians, endocrinologists, internal medicine specialists and nurse practitioners, dietitians, exercise physiologists, pharmacists, psychologists and a social worker. These experts focus on 5 pillars of weight management – nutrition, exercise, appetite control, sleep, and stress management. Our team will balance all these areas to optimize your weight loss and make sure your success is sustainable.

    No Insulin Needed After Bariatric Surgery

    CLEVELAND – Every year in the United States, 1.5 million people over the age of 18 are diagnosed with type two diabetes, which is sometimes managed with insulin. Now, researchers at the Cleveland Clinic are studying the impact of bariatric weight loss surgery.

    Theyre focusing on people with type two diabetes and are detailing the health benefits years after.

    Father George Treff has been an ordained priest in the Romanian Orthodox Church since 1979.

    I just knew that the path I was going on was not a good one and the outcome was not going to be good, said Father Treff.

    Father George isnt talking about his faith, but his weight. At his heaviest, Father George weighed 240 pounds and was diagnosed with type two diabetes.

    Even if I was in the gym every day at three hours a day and doing all that Im supposed to, nothing was changing. Father Treff said.

    Thats when his doctor recommended bariatric surgery. Cleveland Clinic researcher Doctor Ali Aminian was a co-investigator of the Stampede Trial, a randomized trial of 150 patients comparing bariatric surgery with medical therapy for the treatment of type two diabetes.

    We showed that both surgical procedures, gastric bypass, and sleeve gastrectomy were superior in terms of weight loss and diabetes control compare with medical management, said Dr. Aminian.

    And they see me at events, and some will say, ah, you lost more weight!

    to report a typo.

    Copyright 2022 WAFB. All rights reserved.

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    Why Is Bariatric Surgery Done

    Bariatric surgery is the most successful long-term treatment for class III obesity. According to the National Institutes of Health , it is nearly impossible for people with class III obesity to sustain weight loss through diet and exercise alone. Once your body has registered your higher weight as normal, it continues to try to return to that weight. Bariatric surgery works by changing how your body manages what you eat, allowing healthy diet and lifestyle changes to be effective for sustained weight loss and health.

    Center For Human Nutrition

    Cleveland Clinic Bariatric Weight Loss Procedure Online Seminar

    Cleveland Clinic’s Center for Human Nutrition is the largest multidisciplinary nutrition team in the country. Our Registered Dietitians are nutrition experts and leaders in the field of dietetics.

    We provide comprehensive nutrition care to individuals with various needs including surgical and non-surgical weight loss or management of chronic diseases such as diabetes, heart disease, and digestive diseases, among many others. Additionally, the Center is involved with a multitude of programs to promote health and wellness.

    Please call 216.444.3046 to schedule an appointment or to receive more information. Our services are offered at several areas of Cleveland Clinic’s Main Campus and the following regional hospitals and family health centers: Avon – Richard E. Jacobs Health Center, Independence Family Health Center, Lorain Family Health and Surgery Center, Lutheran Hospital, Medina Medical Office Building, Solon Family Health Center, South Pointe Hospital, Strongsville Family Health and Surgery Center, Twinsburg Family Health and Surgery Center, Willoughby Hills Family Health Center, and Wooster Family Health and Surgery Center.

    Nutrition Therapy

    The Nutrition Therapy program provides an opportunity to work with a Registered Dietitian in one-on-one appointments, Shared Nutrition Appointments, Shared Medical Appointments and Virtual Visits.

    For Cleveland Clinic Employees

    • For more information on offerings, please email .

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    Common Myths About Bariatric Surgery

    • That surgery is a last resort. Bariatric surgery is the most effective long-term treatment for class III obesity. When studied scientifically, diet and exercise alone or in combination with medications are much less effective over the long term.
    • That surgery is the easy way out. Bariatric surgery can be thought of as a tool that allows a healthy diet and lifestyle to lead to sustained weight loss. Often, patients have made these changes before without long-term success. Surgery allows those changes to be effective.

    Whats Involved In Preparation For Bariatric Surgery

    Before scheduling your bariatric surgery, your healthcare provider will want to ensure that youre physically and mentally fit for the surgery. Youll meet with a team of specialists who will counsel you about the risks and benefits while evaluating your physical and mental health.

    You may need to pass medical screening tests to make sure the surgery is safe for you. If you use tobacco, drugs or excessive alcohol, youll be required to quit before qualifying for surgery. Your healthcare team can help you with this.

    Your surgeon may also ask you to follow a pre-bariatric surgery diet for a few weeks to prepare for your operation. This is to reduce the fat inside your abdomen, where the operation will take place, making the operation safer and reducing the risk of complications. Your surgeon will give you specific guidelines to follow.

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    Heart Vascular & Thoracic Institute

    Cleveland Clinic’s Heart, Vascular & Thoracic Institute offers programs and clinics within their Preventive Cardiology & Rehabilitation Section geared towards helping you get heart healthy again through weight management, nutrition, exercise and knowing your risk factors.

    Dietary Adjustments After Bariatric Surgery

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    With their smaller stomachs, people who have had the surgery need to eat very slowly and take tiny bites.

    One of the hardest adjustments for patients is that they cannot drink liquids while eating, says Dr. Cha. Patients should drink their fluids at least 30 minutes before or 30 minutes after eating, but it doesnt take long for most people to adjust.

    Those who have had the surgery also take vitamins and supplements recommended by a nutritionist who counsels patients after the procedure. Your nutritionist may also recommend meal plans and a specialized diet after your surgery.

    From weight loss to overall health benefits, talk to your doctor if youre a candidate for bariatric surgery and how you can be on your way to a healthy lifestyle.

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    Other Approaches To Risk Stratification

    Noninvasive markers for advanced fibrosis and the development of novel pharmacologic agents that affect natural progression of advanced fibrosis, present an opportunity for PCPs to identify patients at high risk. Although there is no preferred approach to risk stratification, the guiding principle is to rule out advanced fibrosis using simple, noninvasive technology such as FIB-4 scoring, followed by transient elastography in patients at intermediate or high risk. Currently, FIB-4 scoring is one of the best noninvasive biomarkers, and its performance is enhanced by combining it with elastography in a sequential manner. The combination was found to be cost-effective in addition to providing high diagnostic accuracy,, and it represents an opportunity for PCPs to develop a partnership with a gastroenterology or hepatology practice and avoid unnecessary referrals.

    Substantial Weight Loss Can Reduce Risk Of Severe Covid

    Successful weight-loss intervention before infection associated with 60% lower risk of severe disease in patients with obesity

    Cleveland Clinic

    Wednesday, December 29, 2021, 11 am ET, CLEVELAND: A Cleveland Clinic study shows that among patients with obesity, prior weight loss achieved with bariatric surgery was associated with a 60% lower risk of developing severe complications from COVID-19 infection. The research was published in the journal JAMA Surgery.

    Numerous studies have established obesity as a major risk factor for developing serious illness from an infection of SARS-CoV-2, the virus that causes COVID-19. Obesity weakens the immune system, creates a chronic inflammatory state, and increases risk for cardiovascular disease, blood clots, and lung conditions. All of these conditions can complicate COVID-19.

    The aim of this study was to examine whether a successful weight-loss intervention in patients with obesity prior to contracting COVID-19 could reduce the risk of developing a severe form of this disease.

    A total of 20,212 adult patients with obesity were included in this observational study. A group of 5,053 patients with a body mass index of 35 or greater who had weight-loss surgery between 2004 and 2017 were carefully matched 1:3 to non-surgical patients, resulting in 15,159 control patients. Compared with those in the non-surgical group, patients who had bariatric surgery lost 19% more body weight prior to March 1, 2020 .

    Journal

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    What Are The Risks Of Bariatric Surgery

    When weighing the pros and cons of bariatric surgery, its important to consider the risks of the operation itself as well as the possible side effects that may occur afterward.

    Surgical complications

    All surgeries involve certain risks. Longer and more complex operations may involve more. Risks include:

    Weight Loss With Bariatric Surgery Cuts The Risk Of Developing Cancer And Death From Cancer

    Cleveland Clinic Weight Loss Surgery Virtual Seminar
    Date:
    Cleveland Clinic
    Summary:
    A new study shows that among adults with obesity, weight loss achieved with bariatric surgery was associated with a 32% lower risk of developing cancer and a 48% lower risk of cancer-related death compared with adults who did not have the surgery.

    A Cleveland Clinic study shows that among adults with obesity, weight loss achieved with bariatric surgery was associated with a 32% lower risk of developing cancer and a 48% lower risk of cancer-related death compared with adults who did not have the surgery. The research is published by JAMA.

    Approximately 42% of American adults have obesity, according to the Centers for Disease Control and Prevention . Obesity increases the risk of developing 13 types of cancer that account for 40% of all cancers diagnosed every year in the United States, according to the CDC.

    Ali Aminian, M.D., lead author of the study and director of Cleveland Clinic’s Bariatric & Metabolic Institute, said that bariatric surgery is currently the most effective treatment for obesity. “Patients can lose 20 to 40% of their body weight after surgery, and weight loss can be sustained over decades. The striking findings of this study indicate that the greater the weight loss, the lower the risk of cancer,” said Dr. Aminian.

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    Cleveland Clinic Study Finds Weight Loss Surgery Cuts Risk Of Heart Issues Death

    For people with obesity and diabetes, theres growing evidence of the benefits of weight-loss surgery.

    A new study published Monday in the “Journal of the American Medical Association” details findings from Cleveland Clinic researchers.

    Their study revealed that in patients with both obesity and uncontrolled diabetes, weight loss surgery is associated with a 40% reduction in heart issues and death. This is in comparison to the usual recommendation of lifestyle changes and medications.

    In absolute terms, weight-loss surgery is associated with an 8% reduction in risk of death over 8 years.

    Both obesity and diabetes are chronic conditions and in some patients, we basically cannot control their metabolic disease and their diabetes, and thats why they need more. They need a stronger tool, a stronger management, said Cleveland Clinic bariatric surgeon Dr. Ali Aminian.

    Aminian says that the positive effects stem from the weight loss itself, but its also about the hormonal changes that happen in the body after weight-loss surgery because of the re-routing of the GI tract.

    This was an observational study so it cant show cause and effect, but Metrohealth obesity medicine specialist Dr. Eileen Seeholzer says that it adds to the mounting evidence behind weight-loss surgery.

    Also, Seeholzer notes that theres a likely difference in motivation between the surgical and non-surgical patients.

    Insurance & Financial Eligibility

    Insurance coverage varies for weight loss surgery procedures. It is crucial that you call your insurance provider to determine if your policy covers surgical weight loss. As an integral part of our team, a financial counselor can answer questions and give you guidance when working with your insurance company to acquire approval.

    It is a team effort between you and our financial counselor to ensure we do everything possible to gain an approval for surgical weight loss procedures such as laparoscopic gastric bypass surgery.

    Our navigation team will verify your benefits and assist you in understanding insurance requirements. Once you are accepted into the program, you will be assigned a personal navigator to assist you in your pre-operative weight loss journey.

    We understand the importance of surgical weight loss procedures and will work with you every step of the way.

    Cleveland Clinic Florida accepts most major insurance carriers, including Medicare and Medicaid. Cash pay and financing options are also available.

    If you have any further insurance or financial questions regarding surgical weight loss procedures, please call:

    Weston 954.659.6274

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    Q: Is Bariatric Surgery A Last Resort

    A: You may have heard bariatric surgery mentioned as a sort of backup method to other obesity treatments, like diet and exercise. Dr. Aminian encourages a change in that thinking, though.

    For people with heart disease, we dont wait to treat them until they experience a heart attack. For people with cancer, it is always better to start treatment in the earliest stage. A similar concept is true when we consider weight-loss surgery to treat obesity, Dr. Aminian says. Surgery shouldnt be viewed as the last resort or only for patients with extremely high BMIs.

    In other words, its safer and more effective to intervene when obesity is in its earlier stages, rather than waiting until you experience severe complications.

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