Surgical Weight Loss Offers Options

Nik Brkic

Would you be willing to give up 75 percent of your stomach to lose weight? This and other methods of weight loss were addressed in a lecture speech given on weight loss surgeries in SB 243 on Sept. 28.

In the speech, Dr. Ara Keshishian spoke about various surgical procedures for weight loss. The three he addressed were gastric bypass, the lap band and gastric reduction duodenal switch.

The gastric bypass is a procedure that changes where the food travels. Instead of the normal route of going through the stomach this procedure cuts the stomach so that only a small pouch is left. Then the small intestine is cut and rerouted so that it is reconnected to that small pouch. The remaining part of the stomach is no longer used.

The lap band involves a ring being placed toward the top of the stomach. The goal is to reduce the size of the opening to the stomach, forcing patients to eat slower and eat less food.

The last method Keshishian talked about was the duodenal switch. This involves removing 75 percent of the stomach and bypassing the small intestine. The goal of this procedure is to lower the amount of food the patient can eat, thereby allowing fewer calories to be absorbed. To offset the loss of nutrients, patients must take supplements.

Keshishian is a proponent of the duodenal switch and is opposed to lap bands. He used multiple graphs in his presentation to show the success rates with the duodenal switch. He said success is about 85 percent, as opposed to 60 percent for lap bands. Success was measured by how many pounds the patient had lost three years after the surgery, relative to the amount of excess weight the patient had lost before the procedure. One astounding statistic Keshishian gave was that lap band patients had an 88 percent chance of having complications, such as the band giving way to one side causing an enlarged stomach pouch.

Keshishian repeatedly described obesity as a disease during his lecture. He compared how obesity is viewed medically and by the public. Medically, it is looked at as an onset disease rather than a disease that is caused by the patient. He said that in our society obese people are looked at as lazy, and are asked questions like, “Why don’t you try to lose that weight?”

The doctor called obesity an epidemic. He said that obesity for many isn’t caused simply by poor diet and exercise but rather a combination of factors like genetics, environment and ethnicity. “If diet and exercise worked, I would be out of a job,” he said.

Keshishian addressed some misconceptions regarding obesity. He said obesity actually causes depression and a lower metabolic rate. This means when someone becomes obese they fall into a vicious cycle of feeling depressed and giving up on looking for solutions for weight loss. He said the myth of the size of the stomachs of obese individuals being larger than others is not true.

Keshishian was a student at GCC from 1988 to 1990. He received his bachelor’s degree from the University of Southern California. He then received his doctorate from the American University of the Caribbean. He was a chair member of the Department of Surgery at Delano Medical Center in Delano, Calif. He is now a practicing bariatric surgeon at Verdugo Hills Hospital.