Losing weight isn’t always possible through diet and exercise alone. Sometimes, surgery is necessary to improve quality of life and overall health. Bariatric surgery may be an option.
Dr. Cyrus Moon discusses Mercy Bariatrics Program and candidacy for bariatric surgery.
Bariatric Weight Loss Surgery at Mercy Hospitals
Featured Speaker:
Towards the end of undergraduate school Dr. Moon made the decision to pursue a career in medicine, which would allow for a career involving science as well as direct interaction and service to others. He went on to pursue his medical degree at the University of Texas Southwestern in Dallas, Texas.
Dr. Moon completed his surgical residency at the University of California San Francisco, Fresno program. During residency he has found particular interest in the techniques of minimally invasive surgery as well as the benefits that it offered for surgical patients, in terms of faster recovery and decreased pain, discomfort and morbidity.
Dr. Moon therefore went on to complete a fellowship in Minimally Invasive Surgery at UCSF Fresno, with mentors that are world renowned in the field of bariatric surgery. He has been practicing surgery in the Central Valley ever since completion of his training in 2013; first in Delano where he is still Bariatric Surgical Director, and now in Bakersfield since the fall of 2016. He is currently one of the only fellowship-trained bariatric surgeons practicing in Kern County.
Learn more about our physicians at www.dignityhealth.org/ourdoctors.
Cyrus Moon, MD
Cyrus Moon, MD was born and raised in Cincinnati, Ohio. He moved to Houston, Texas for high school. He then went on to receive his Bachelors of Science degree in biomedical engineering and computer science at Johns Hopkins University in Baltimore, Maryland.Towards the end of undergraduate school Dr. Moon made the decision to pursue a career in medicine, which would allow for a career involving science as well as direct interaction and service to others. He went on to pursue his medical degree at the University of Texas Southwestern in Dallas, Texas.
Dr. Moon completed his surgical residency at the University of California San Francisco, Fresno program. During residency he has found particular interest in the techniques of minimally invasive surgery as well as the benefits that it offered for surgical patients, in terms of faster recovery and decreased pain, discomfort and morbidity.
Dr. Moon therefore went on to complete a fellowship in Minimally Invasive Surgery at UCSF Fresno, with mentors that are world renowned in the field of bariatric surgery. He has been practicing surgery in the Central Valley ever since completion of his training in 2013; first in Delano where he is still Bariatric Surgical Director, and now in Bakersfield since the fall of 2016. He is currently one of the only fellowship-trained bariatric surgeons practicing in Kern County.
Learn more about our physicians at www.dignityhealth.org/ourdoctors.
Transcription:
Bariatric Weight Loss Surgery at Mercy Hospitals
Bill Klaproth (Host): Obesity is a major problem according to the most recent study from the NIH more than one in twenty adults are considered to have extreme obesity and bariatric surgery is one of the most effective ways of helping people lose the weight and regain their life. Here to talk with us about bariatric weight loss surgery at Mercy Hospitals, is Dr. Cyrus Moon, a bariatric surgeon at Dignity Health. Dr. Moon, thank you for your time. Let’s start at the beginning. What is bariatric weight loss surgery?
Cyrus Moon, MD, FACS (Guest): Bariatric essentially means weight loss and it’s for people who are dealing with morbid obesity and any medical problems associated with the weight and it’s a surgery that essentially helps with weight loss. It used to be considered to only be for weight loss, but as science has discovered in the past decade or so it also improves really the way the body basically metabolizes things as well. So, that’s why when we talk about a bariatric surgery, as bariatric surgeons, we also mention the metabolic effects as well.
Bill: So, who is a good candidate then for this weight loss surgery?
Dr. Moon: So, in 1991, the National Institute of Health actually created criteria that they thought would be good for people who are pursuing weight loss surgery and that would be a body mass index of over 40. Body mass index is a measure of your weight over your height and you can go to Google and anyone can find out or calculate their body mass index or their BMI. So, criteria would be a BMI over 40, or a BMI of over 35 with associated medical problems that are caused by weight and for better or worse, this is still criteria we use today even twenty years later and that’s what insurance usually uses as criteria to determine who qualifies for it.
Bill: And Dr. Moon, you mentioned people that have medical problems as well. What does this extreme weight, what are the problems that are caused by this? Obviously, the weight is a huge issue, but what are some of the other physical problems that this extra weight causes?
Dr. Moon: So, yeah, there are a number of problems really from head to toe. But the most common problems have to do with the endocrine system and the cardiovascular systems. So, diabetes is the major problem associated with weight. The extra weight cause insulin resistance and then there’s issues with high blood pressure, high cholesterol, the weight causes strain on the joints and can cause osteoarthritis and then there are other problems associated with the weight really ranging from reflux, to infertility problems, to cancer as well.
Bill: So, bariatric surgery really can be a lifesaver for many people. So, what are the different types of bariatric surgery options are there?
Dr. Moon: So, there are a number that are being done in the world. In the United States, there are really four particular surgeries being done most commonly. The most commonly done surgery nowadays in the United States is the sleeve gastrectomy followed by the Roux-en-Y gastric bypass that used to be the most common surgery and it was previously considered the gold standard of bariatric surgery, but now the sleeve has surpassed that surgery. And then the gastric band is still being done occasionally, but it’s really fallen out of favor because of its inconsistent results and then the most “powerful” surgery for weight loss still being done right now is probably the duodenal switch which causes the greatest amount of weight loss, but it does have side effects that keep it from really being done very commonly.
Bill: So, with these main four options, how do you consult with potential candidates to help them choose or find out what is the best option for them?
Dr. Moon: So, that involves really a face-to-face conversation about what they are dealing with and what kind of medical problems they are having trouble with. No two people are alike. So, most commonly, as long as there aren’t particular indications to not have one surgery or the other; most people end up getting a sleeve gastrectomy because it’s pretty straightforward and the side effects are the lowest. But, occasionally you will meet someone who has sever medical problems that might for instance push them more towards having a duodenal switch or if they have a particular problem with side effects of the sleeve, I might recommend a gastric bypass.
Bill: So, with advances in technology and techniques, usually this is what an overnight stay but then you have them up and around right away generally, isn’t that right?
Dr. Moon: That is correct. These surgeries are done laparoscopically meaning through small five to ten millimeter incisions and no one ever feels the work that is actually being done on the actual gastrointestinal tract because that tissue does not have the same sensory nerves as like the skin so when someone wakes up from the surgery, they may feel bloated from the CO2 that is used to kind of insufflate to belly for the laparoscopic surgery, but otherwise, they just feel the little small five millimeter incisions that were created and the soreness from that and most people are comfortable walking the same evening as surgery.
Bill: So, it sounds like there’s not a lot of pain with this. So, what about long-term success. Can you tell us about the efficacy of bariatric surgery?
Dr. Moon: So, most people will lose anywhere from basically to 100 pounds on average over the year. Now long-term efficacy has a lot to do with how a patient is going to react to the surgery from a genetic standpoint or hormonal standpoint as well as, how they eat and exercise afterwards long-term. Now these surgeries are not magic bullets that will keep people skinny for the rest of their lives. It really is almost like a tool to help them lose the weight but keeping it off long-term is really also a responsibility of the patient too so and most people I would say at least 50% of people will keep their weight off long-term. Out of the other half that have trouble, you usually see kind of return to bad habits most of the time like eating a lot of carbs or processed sugary foods and that kind of thing.
Bill: So, diet and exercise is really important after the procedure as well and can you tell us about the Mercy Bariatrics Program and what makes it so special and unique?
Dr. Moon: Well the best part about it being in Bakersfield is that people in Bakersfield will have access to it and bariatric surgery is not a one and done kind of surgery where you get it and then you never see your medical provider again. You have almost a lifelong relationship with your bariatric surgeon. Even if everything is going well, you kind of want to check in once a year to make sure everything is going well, and your eating habits are well, you are not having any GI problems so our bariatrics surgeons that go to Mercy, we are all local. So, it’s very critical that you have access to your bariatric surgeon almost at least within 24-hours if you have a major problem and at least within a few days if the problem is minor. So, the beauty of having surgery in Bakersfield is you can see your surgeon whenever you need to when a problem arises.
Bill: So, it’s almost like a partnership then, I mean you are with that patient on that weight loss journey together, which is great. And Dr. Moon, if you could wrap it up for us. What else doe we need to know about bariatric surgery?
Dr. Moon: So, I would say even among the medical community, there has been a pretty bad stigma against bariatric surgery for a while. I would say ten to twenty years ago; bariatric surgery was actually much more dangerous than it is now. The technology we have for laparoscopic surgery has made bariatric surgery very safe and the understanding that we have of how the surgery works really show us really a myriad of benefits to having surgery, not just about the number you see on the scale. It’s about really getting healthier overall. So, I think anyone who has any hesitations really should just come in and talk to either the bariatric program people or talk to a bariatric surgeon about what kind of benefits they can get from bariatric surgery.
Bill: Great information Dr. Moon and thank you so much for talking with us today about bariatric surgery. For more information please visit Dignityhealth.org/Bakersfield/
Bariatric Weight Loss Surgery at Mercy Hospitals
Bill Klaproth (Host): Obesity is a major problem according to the most recent study from the NIH more than one in twenty adults are considered to have extreme obesity and bariatric surgery is one of the most effective ways of helping people lose the weight and regain their life. Here to talk with us about bariatric weight loss surgery at Mercy Hospitals, is Dr. Cyrus Moon, a bariatric surgeon at Dignity Health. Dr. Moon, thank you for your time. Let’s start at the beginning. What is bariatric weight loss surgery?
Cyrus Moon, MD, FACS (Guest): Bariatric essentially means weight loss and it’s for people who are dealing with morbid obesity and any medical problems associated with the weight and it’s a surgery that essentially helps with weight loss. It used to be considered to only be for weight loss, but as science has discovered in the past decade or so it also improves really the way the body basically metabolizes things as well. So, that’s why when we talk about a bariatric surgery, as bariatric surgeons, we also mention the metabolic effects as well.
Bill: So, who is a good candidate then for this weight loss surgery?
Dr. Moon: So, in 1991, the National Institute of Health actually created criteria that they thought would be good for people who are pursuing weight loss surgery and that would be a body mass index of over 40. Body mass index is a measure of your weight over your height and you can go to Google and anyone can find out or calculate their body mass index or their BMI. So, criteria would be a BMI over 40, or a BMI of over 35 with associated medical problems that are caused by weight and for better or worse, this is still criteria we use today even twenty years later and that’s what insurance usually uses as criteria to determine who qualifies for it.
Bill: And Dr. Moon, you mentioned people that have medical problems as well. What does this extreme weight, what are the problems that are caused by this? Obviously, the weight is a huge issue, but what are some of the other physical problems that this extra weight causes?
Dr. Moon: So, yeah, there are a number of problems really from head to toe. But the most common problems have to do with the endocrine system and the cardiovascular systems. So, diabetes is the major problem associated with weight. The extra weight cause insulin resistance and then there’s issues with high blood pressure, high cholesterol, the weight causes strain on the joints and can cause osteoarthritis and then there are other problems associated with the weight really ranging from reflux, to infertility problems, to cancer as well.
Bill: So, bariatric surgery really can be a lifesaver for many people. So, what are the different types of bariatric surgery options are there?
Dr. Moon: So, there are a number that are being done in the world. In the United States, there are really four particular surgeries being done most commonly. The most commonly done surgery nowadays in the United States is the sleeve gastrectomy followed by the Roux-en-Y gastric bypass that used to be the most common surgery and it was previously considered the gold standard of bariatric surgery, but now the sleeve has surpassed that surgery. And then the gastric band is still being done occasionally, but it’s really fallen out of favor because of its inconsistent results and then the most “powerful” surgery for weight loss still being done right now is probably the duodenal switch which causes the greatest amount of weight loss, but it does have side effects that keep it from really being done very commonly.
Bill: So, with these main four options, how do you consult with potential candidates to help them choose or find out what is the best option for them?
Dr. Moon: So, that involves really a face-to-face conversation about what they are dealing with and what kind of medical problems they are having trouble with. No two people are alike. So, most commonly, as long as there aren’t particular indications to not have one surgery or the other; most people end up getting a sleeve gastrectomy because it’s pretty straightforward and the side effects are the lowest. But, occasionally you will meet someone who has sever medical problems that might for instance push them more towards having a duodenal switch or if they have a particular problem with side effects of the sleeve, I might recommend a gastric bypass.
Bill: So, with advances in technology and techniques, usually this is what an overnight stay but then you have them up and around right away generally, isn’t that right?
Dr. Moon: That is correct. These surgeries are done laparoscopically meaning through small five to ten millimeter incisions and no one ever feels the work that is actually being done on the actual gastrointestinal tract because that tissue does not have the same sensory nerves as like the skin so when someone wakes up from the surgery, they may feel bloated from the CO2 that is used to kind of insufflate to belly for the laparoscopic surgery, but otherwise, they just feel the little small five millimeter incisions that were created and the soreness from that and most people are comfortable walking the same evening as surgery.
Bill: So, it sounds like there’s not a lot of pain with this. So, what about long-term success. Can you tell us about the efficacy of bariatric surgery?
Dr. Moon: So, most people will lose anywhere from basically to 100 pounds on average over the year. Now long-term efficacy has a lot to do with how a patient is going to react to the surgery from a genetic standpoint or hormonal standpoint as well as, how they eat and exercise afterwards long-term. Now these surgeries are not magic bullets that will keep people skinny for the rest of their lives. It really is almost like a tool to help them lose the weight but keeping it off long-term is really also a responsibility of the patient too so and most people I would say at least 50% of people will keep their weight off long-term. Out of the other half that have trouble, you usually see kind of return to bad habits most of the time like eating a lot of carbs or processed sugary foods and that kind of thing.
Bill: So, diet and exercise is really important after the procedure as well and can you tell us about the Mercy Bariatrics Program and what makes it so special and unique?
Dr. Moon: Well the best part about it being in Bakersfield is that people in Bakersfield will have access to it and bariatric surgery is not a one and done kind of surgery where you get it and then you never see your medical provider again. You have almost a lifelong relationship with your bariatric surgeon. Even if everything is going well, you kind of want to check in once a year to make sure everything is going well, and your eating habits are well, you are not having any GI problems so our bariatrics surgeons that go to Mercy, we are all local. So, it’s very critical that you have access to your bariatric surgeon almost at least within 24-hours if you have a major problem and at least within a few days if the problem is minor. So, the beauty of having surgery in Bakersfield is you can see your surgeon whenever you need to when a problem arises.
Bill: So, it’s almost like a partnership then, I mean you are with that patient on that weight loss journey together, which is great. And Dr. Moon, if you could wrap it up for us. What else doe we need to know about bariatric surgery?
Dr. Moon: So, I would say even among the medical community, there has been a pretty bad stigma against bariatric surgery for a while. I would say ten to twenty years ago; bariatric surgery was actually much more dangerous than it is now. The technology we have for laparoscopic surgery has made bariatric surgery very safe and the understanding that we have of how the surgery works really show us really a myriad of benefits to having surgery, not just about the number you see on the scale. It’s about really getting healthier overall. So, I think anyone who has any hesitations really should just come in and talk to either the bariatric program people or talk to a bariatric surgeon about what kind of benefits they can get from bariatric surgery.
Bill: Great information Dr. Moon and thank you so much for talking with us today about bariatric surgery. For more information please visit Dignityhealth.org/Bakersfield/