MDNews - Long Island

COVER FEATURE Shifting Tides in Bariatric Surgery Rajeev Vohra M.D., FACS, Director of Minimally Invasive and Bariatric Surgery, and Gregory Nishimura M.D., FACS, minimally invasive bariatric surgeon, perform a bariatric surgery at South Nassau Communities Hospital with operating room (OR) team members. ACCORDING TO THE AMERICAN SOCIETY OF BARIATRIC SURGEONS, MORE THAN ONE- THIRD OF THE AMERICAN POPULATION IS OBESE. THAT FIGURE IS FORECASTED TO RISE CATACLYSMICALLY, AS THE NUMBERS OF THE NATION'S OBESE YOUTH CONTINUE TO GROW. NEARLY HALF A CENTURY AFTER ITS INTRODUCTION AS A VIABLE TOOL TO FIGHT SEVERE OBESITY, SURGICAL INTERVENTION FOR OBESE PATIENTS HAS MADE GREAT TECHNOLOGICAL AND CURATIVE STRIDES. D EFINEDASHAVING a body mass index (BMI) of 35 or greater with associated comorbidities, severe obesity carries with it potentially fatal consequences. According to Rajeev Vohra, M.D., FACS, Director of Minimally Invasive and Bariatric Surgery at South Nassau Communities Hospital in Oceanside, NY, the reality is that severe obesity is a disease and should be treated as something beyond the patient's control. For patients who have unsuccessfully tried to lose weight through traditional means, such as diet and exercise, bariatric surgery can effectively reverse weight gain and resolve many associated comorbidities. Since 2001, Dr. Vohra has led the mul- tidisciplinary team of bariatric surgeons, 6 | Long Island MD NEWS s MDNEWS.COM physician assistants, clinical psycholo- gists, registered dietitians and support staff at South Nassau Communities Hospital's Center for Weight and Life Management. These providers take a pro- active role in patients' weight-loss needs, providing holistic care for patients preop- eratively, through a range of minimally invasive surgical procedures — including gastric bypass, sleeve gastrectomy, and LAP-BAND surgery — and in postopera- tive care and follow-up. "I read about a gentleman who said, over the course of his lifetime, he'd lost the equivalent of a Volkswagen, which weighs about 2,000 pounds," Dr. Vohra says. "What that means is that we, as physicians, need to have a more proactive role in our patient's weight management. As physicians, we need to treat obesity with the same zeal and conviction as other diseases, such as diabetes and hypertension. We need to be actively involved in treating patients' obesity, whether by nonsurgical means or surgical intervention." To assess a patient's commitment to weight loss, Dr. Vohra and his team supervise patients in an extensive weight management protocol consisting of a low-calorie diet, exercise and education about how to make healthful food choices and read nutritional information on food labels. If successful, patients may choose to continue these measures in lieu of surgery.

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