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incontinence is another problem women face as a result of being overweight. And then of course there's a higher risk of cancer, primarily endometrial cancer, in obese women. Other co-morbidities, for both men and women, include coronary artery disease, cancer, diabetes, and sleep apnea. Fatigue, gastrointestinal reflux, urinary incontinence, knee and ankle pain are also related to obesity. In fact, recent research indicates that obesity compromises every organ system. "Unfortunately, 97 percent of patients who try to lose weight by diet and exercise alone fail to lose 10 pounds and sustain that loss for one year," says Dr. Saber. "Weight loss surgery, on the other hand, offers patients a greater than 90 percent success rate in losing the majority of their excess weight and keeping it off." And co-morbidities are dramatically reduced, if not completely alleviated. As a result, an increasing number of patients who meet the NIH qualifications are opting for bariatric surgery. Weapons of 'Mass' Destruction Dr. Saber and Dr. Khaitan offer a full spectrum of weight loss procedures at UH. All are done laparoscopically, unless a patient has had extensive prior surger- ies which make minimally invasive surgery difficult. Roux-en-Y gastric bypass involves separating the stomach into two cham- bers: one golf-ball size and one much larger. Part of the small intestine is then connected to the small chamber, which restricts the amount of food that can be eaten and decreases the number of calories absorbed. On average, patients lose 50-75 percent of their excess body weight. Adjustable gastric banding is a purely restrictive operation. True to its name, the procedure involves fastening an Dr. Alan Saber is director of the Bariatric Surgery, Metabolic & Nutrition Center, which is part of the University Hospitals Digestive Health Institute and director of Bariatric & Metabolic Surgery at UHCMC. He is one of the first in the area to perform robotic-assisted bariatric surgery. adjustable band around the upper stom- ach to create a small pouch. The band is tightened or loosened by the addition or subtraction of saline solution through a small access port below the skin. On average, patients lose 40-50 percent of their excess body weight. Gastric sleeve is another restrictive operation. It involves removal of the lateral 90 percent of the stomach to restrict food intake. It also decreases production of the hormone ghrelin, which results in decreased appetite after surgery. Like adjustable gastric JULY-AUGUST 2012 ■ MDNEWS.COM ■ MD NEWS Cleveland-Akron-Canton | 25