Bariatric surgeon speaks at Great Britain conference
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| Dr. Keith Boone |
British doctors were eager to hear statistics they could share with politicians to change the way their socialized medical system uses weight-loss surgery – especially for adolescents, said Dr. Boone. He was one of the keynote speakers at the annual meeting of the Association of Upper Gastrointestinal Surgeons for Great Britain and Ireland (AUGIS) held in Cardiff, Wales, the last week in September.
“Ten years ago when Dr. (Kelvin) Higa and I started lecturing on bariatric surgery, no one knew where Fresno was. Now everybody knows,” said Dr. Boone, referring to his partner. “Fresno is on the map for bariatric surgery.”
Dr. Boone warned physicians across the Atlantic that they may soon see more and more teenagers seeking surgical fixes for obesity. “It was pretty eye-opening for them,” he said.
“They’re 10 years behind us in obesity trends. We lead the way with Australia a close second. Canada and Great Britain are tied for third… Because of obesity, this is the first generation that will not outlive their parents. And that's pretty significant.”
American pediatricians and weight-loss surgeons have established strict guidelines teens being considered for surgery to radically shrink their stomachs. Teens must have reached their full physical maturity (usually 13 in girls and 15 in boys), have tried a supervised weight-loss program for six months without success, have strong family support and the maturity to handle lifestyle changes that come with such surgery.
“Patients have to be mature enough to know what they’re getting into,” Dr. Boone explained. “I’ve said yes to a 15-year-old and no to her 17-year-old sister because she was too immature.”
Dr. Boone said he and Dr. Higa have had great success with the 67 patients between ages 13 and 18 they’ve operated on. “It’s amazing how they blossom. All of a sudden they feel good about themselves. They do better in school. They become more social and active. It’s been exciting to see,” he said.
During his second day at the Wales conference, Dr. Boone lectured on the best operations for obese patients who are also diabetic. Recent international attention has been drawn to the significant affects bariatric surgery has on diabetes and other metabolic disorders.
“We like to use the word cure but the better word is remission,” Dr. Boone said, describing the nearly immediate affects on diabetes after some weight-loss procedures. “About 80% of patients stop their diabetes medicine the day of their surgeries.”
More than 75% of diabetics receiving bariatric surgery see dramatic results with their blood sugar returning to normal levels even before they lose significant amounts of weight, according to studies published in the Annals of Surgery and the Journal of the American Medical Association.
“The Roux-en-y gastric bypass is best for getting rid of diabetes,” Dr. Boone said, referring to a procedure that turns the stomach into a small pouch and bypasses the top section of the small intestine. “Some procedures get rid of diabetes better but the risks are greater.”
A group of international doctors treating metabolic disorders say there is increasing evidence that surgically shrinking the stomach and removing sections of the small intestine not only achieves rapid weight loss, but it also alters, at a cellular level, the way the body converts food into energy. Dr. Boone said some studies are being done in animals to find out the exact mechanism that makes that happen, and in South America there are trials now using bariatric surgery strictly to treat diabetics.
This story was reported by Erin Kennedy. She can be reached at ekennedy@communitymedical.org.