The Obesity Crisis
Obesity affects about 78 million Americans, and has been linked to more than 40 diseases including type 2 diabetes, heart disease, stroke, osteoarthritis and cancer. It’s a problem that is especially prevalent in the South/Central Bronx, where nearly 40 percent of adults are considered obese.
The SBH Center for Bariatric Surgery offers a comprehensive and patient-focus approach to this problem. All patients must first see a registered dietitian and undergo a psychological assessment with a mental health profession to determine if weight loss surgery is right for them. Patients are closely monitored before surgery and for years following surgery. Patient’s primary physicians are consulted throughout the process.
“We’re not interested in five- or 10-year outcomes, but in lifelong alterations,” says Dr. Nissin Nahmias, the medical director of the center. “This is not a quick fix solution. It can be a fantastic operation, but transformation happens over a long period of time and not everyone is right for it.”
What is weight loss surgery?
Weight loss surgery is a surgery to help you lose weight. It works by making your stomach smaller. Some types of surgery also change the path the food takes which can cause your body to take fewer calories and nutrients.
Who can have Bariatric Surgery?
Doctors use a measure called Body Mass Index or BMI to decide who is a candidate for weight loss surgery. Your BMI will tell you whether your weight is normal for your height.
Bariatric surgery at SBH is appropriate for people who have not been able to lose weight through other means and who:
- Have a BMI greater than 40
- Have a BMI between 35 and 40 and also have related medical problems (also called comorbidities) such as diabetes, high blood pressure, and heart disease.
- Weigh no more than 350 pounds
What Bariatric Surgeries are Performed at SBH?
We currently perform two types of surgery:
Gastric bypass is also known as “roux-en-y” gastric bypass. This is where, the bariatric surgeon closes off part of the stomach leaving only a small pouch for food. Then a new connection is made from the new stomach pouch to the small intestine.
Gastric bypass leads to the most weight loss and works the fastest, but it involves a more serious surgery. It can cause problems in how your body can absorb nutrients. As a result it can lead to nutritional deficiencies, meaning that the body is missing important nutrients. You may need to take vitamins for the rest of your life.
Gastric sleeve is also known as vertical sleeve gastrectomy. For this surgery, part of your stomach is removed, leaving behind a narrow stomach shaped like a banana.
Sleeve gastrectomy is safer than gastric bypass because it does not involve cutting and reattaching the intestines. Sleeve gastrectomy is less likely to cause problems with how you absorb nutrients.
All surgeries are done laparoscopically. This means the surgeon inserts a narrow tool that has a tiny camera on the end into the abdomen with a small incision. This is called a “laparoscope.” This allows the surgeon to see inside the abdomen without opening it all the way up. The surgeon can then continue to do the surgery using other tools that fit through small openings in the abdomen and can be controlled from the outside.
How Do I Know Which Surgery is Best for Me?
The decision about which surgery to have is very important. Your doctor will discuss the choices and work with you to make the best decision based on the following:
- About how much weight can I expect to lose with each option?
- How long would it take me to lose the weight?
- What are the risks?
- What changes will I need to make to my diet and lifestyle with each option?
What are the Benefits of the Surgery?
In addition to helping you lose weight, surgery can help improve or even get rid of certain health problems, including:
- High Blood Pressure
- High Cholesterol
- Sleep Apnea (which causes you to stop breathing for short amounts of time while you sleep)
- Gastro-Esophageal Reflux Disease (a condition that causes heartburn)
What are the Risk of Surgery?
The risks of surgery are different depending on the type of weight loss surgery you have; whether your surgery is open or laparoscopic; your age and overall health. Risks can include:
- A blockage or tear in the intestines
- Problems with your heart or lungs
Will I Need to Change my Diet?
Yes. Our dietitian will help you learn more about your diet. She will discuss with you the importance of choosing foods high in protein and low in fat and calories. Eating the wrong food can hinder your weight loss. If you have gastric bypass, you will need to avoid certain foods that can make you sick. Gastric bypass can make it hard for your body to absorb all the nutrition it needs. You must keep taking vitamin and mineral supplements for the rest of your life.
SBH Center for Bariatric Surgery – The Specialists
Dr. Nissin Nahmias, who is bilingual, is fellowship-trained in advanced laparoscopic and bariatric surgery. He has performed more than 1,000 bariatric procedures and has one of the lowest complication and highest patient satisfaction rates in the country. He is recognized by The American Society of Metabolic and Bariatric Surgery as a “Bariatric Surgeon of Excellence.” His scientific work includes several peer-reviewed publications, two book chapters and over 15 presentations in national and international meetings.
He received his medical degree magna cum laude from the Anahuac University School of Medicine in Mexico City. He did his residency at Albert Einstein Medical Center in Philadelphia and his fellowship in minimally invasive and bariatric surgery at Virginia Commonwealth University in Richmond, Virginia.
He is a diplomat of the American Board of Surgery and a fellow of the American College of Surgeons and ASMBS.
Rebecca Koch is a Registered Dietitian-Nutritionist and Certified Nutrition Support Clinician. She has over five years of experience in clinical nutrition. In her most recent position, Rebecca was a metabolic support specialist for the metabolic support service in the cardiothoracic ICU at Maimonides Medical Center in Brooklyn. Before Maimonides she was the lead clinical dietitian for Sodexo at White Plains (NY) Hospital. She earned a B.S. degree in nutrition and completed a dietetic internship at Cedar Crest College in Allentown, Pennsylvania. In her spare time Rebecca enjoys training for marathons and is a registered yoga instructor.