Surrounded by plenty of marketing and media exposure, San Antonians have heard a lot about obesity and weight–loss surgery. What they may not know is where to go when it’s time to commit to a dramatic, life–changing procedure. According to the American Society for Bariatric Surgery, about 15 million people in the U.S. suffer from morbid obesity, which is associated with more than 30 illnesses and medical conditions, including type–two diabetes, coronary heart disease, strokes, most types of cancer, joint degeneration, gastroesophageal reflux disease (GERD) and sleep apnea.
As the first and most experienced weight–loss surgery practice in San Antonio, New Dimensions Weight Loss Surgery has led changes in bariatric techniques and patient care that improve longterm success for patients who must lose a significant amount of weight. Since its founding in 1983 in San Antonio, the practice has provided follow–up care for weight–loss surgery patients for over two decades. The practice is comprised of five surgical partners who specialize in laparoscopic (minimally invasive) procedures: Drs. Terive Duperier, John Pilcher, Dana Reiss, Mickey Seger andLloyd Stegemann.
“Patients have access to more knowledge than ever,” says Pilcher, who has been performing bariatric surgery since 1995. Pilcher adds that by the time most patients discuss surgery with their primaryphysician, they have visited websites, attended informational seminars and talked informally with people who have had weight–loss surgery. Armed with so much information, they’re now asking their doctor to help them with a referral.
According to Pilcher, several criteria are critical to making the right choice. Here’s how he recommends cutting through the marketing hype:
Procedures: The New Dimensions surgeons believe that in most cases, patients should choose which procedure they prefer to have based on their individual physiology and personality. Because of this, the practice offers both the gastric bypass and Lap–Band® procedures, while actively investigating new procedures, such as sleeve gastrectomy. Members of the practice regularly advise on and participate in national research projects for future bariatric surgery procedures.
The gastric bypass is the most common weight–loss surgery in the U.S. and is the “gold standard” for surgical weight–loss intervention. The stomach is surgically reduced to a tiny size and bypassedto the small intestine, dramatically reducing the amount of food a patient can consume. The bypass produces significant health benefits through dramatic and rapid weight loss.
The Lap–Band® is less invasive and uses a plastic belt or band to close off a small portion of the patient’s stomach. The band is periodically adjusted to provide progressive intake restriction. Weight loss results are slower and steadier compared to bypass, but the procedure also involves less risk and the band is removable.
Experience: In surgical specialties, experience counts. According to Pilcher, the New Dimensions surgeons have collectively performed more than 3,000 weight–loss surgeries. Several of New Dimensions’ surgical partners also perform a range of general surgeries from hernia repair to anti–reflux surgery.
Philosophy: Each patient should be treated as an individual. “Weight–loss surgery is not a ‘cookie cutter’ operation, and surgery alone does not guarantee success,” says Stegemann, a New Dimensionspartner and founder of the Texas Association of Bariatric Surgeons. Not every overweight person is a candidate for surgery. “Extensive psychological and physiological evaluations are key to discovering the reasons a patient became obese and determining appropriate medical interventions,” says Stegemann. Patients must prepare for an emotional journey. “For many patients, surgery is just the beginning. Accepting and changing behaviors and attitudes about food is the greater challenge.”
Results: Success rates are crucial when choosing a surgeon. Duperier says that New Dimensions’ success is attributed to severalkey factors: a team approach, comprehensive pre–and post–surgicalcounseling, check–ups and support. New Dimensions provides two surgeons to each patient during surgery. “Patients benefit from the experience and perspective of two experienced surgeons instead of one,” says Duperier. “This improves surgical outcomes and increases patient safety.”
“Weight–loss surgery changes a person’s entire life,” says Reiss, one of the few female bariatric surgeons in Texas. “It’s important that we’re here as surgeons and as medical advisers throughout the process, and not just showing up to scrub in the day of the surgery. We take the time to build relationships and form trust with patients because they will be our patients long after the physical scars heal.” New Dimensions’ clinical infrastructure is built on resources and support groups that are essential to long–term success. Patients have access to dieticians, fitness centers, counseling and support groups tailored to where they are in their weight–loss goals. “Our patients connect with people who understand their challenges and their needs, and they find a true community here,” says Reiss.
Commitment to San Antonio: The New Dimensions team has deep roots in San Antonio. “Our clinic is here; our surgeons and staff all live here, and we raise our families here,” says Pilcher.
Education and advocacy: The New Dimensions surgeons invest time studying new procedures and in mentoring other bariatric surgeons; they are also featured keynote speakers and educators on the topics of obesity, obesity therapy and other related issues. Seger, who serves as treasurer of the Texas Association of Bariatric Surgeons, sees improving patient access to weight–loss surgery asa key challenge. Although more insurance companies now cover weight–loss surgery, there are still many employers that do not offer it as a benefit. “The medical cost of morbid obesity in the UnitedStates is estimated at $75 billion a year, not including the cost of lost workplace productivity,” says Seger. “That number hits us all. If we ignore it, that number will keep rising; we all pay the price in higher taxes and insurance premiums.”
