Q&A Topic: Thinking About Bariatric Surgery?

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Mitchell S. Roslin, MD, FACS, FASMBS

Q. Why can’t obese patients lose weight by dieting and exercise?

A. While a healthy diet and exercise are great for preventing weight gain, they’re not very effective tools for people who are already obese. If you’re obese and have lost a small amount of weight through diet and exercise, you’ve likely found keeping it off to be extremely challenging. The truth is, once you stop following an intense diet, your body will fight to get back to where it’s comfortable, at a higher weight. According to The National Weight Control Registry, if you’re obese, it takes a nearly superhuman effort to lose a significant amount of weight and keep it off.

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Q. What is bariatric surgery?

A. It’s a reliable treatment for men and women who are obese. By removing part of the stomach, we change the gastrointestinal tract so people get full faster, experience far less hunger, and therefore lose weight. Though surgery does replace lifestyle changes, including healthy eating and exercise, it can be a jumpstart to a much healthier lifestyle for people with obesity. Aside from newfound confidence and less joint pain, my patients are happy to lower their risk for basically every chronic disease including, heart disease, diabetes, hypertension, high cholesterol and sleep apnea.

Q. How do you decide on the type of bariatric surgery for a patient?

A. My patients and I decide together. At NWH, we may do a Vertical Sleeve Gastrectomy, or VSG surgery, which makes your stomach 80 percent smaller, like a banana. Because of the reduced size of the stomach, you’ll get full after eating four ounces of food, rather than a huge portion. We also offer Roux-en-Y Gastric Bypass, in which we create a small pouch from the stomach and connect it directly to your small intestine. After surgery, food will bypass most of your stomach and you won’t absorb as many calories. Another popular option? The Modified Duodenal Switch, essentially a combination of VSG and Bypass, offers the highest weight loss and the best resolution to weight-related medical issues, like diabetes.

Q. Does bariatric surgery always work?

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A. Unfortunately, obesity is a chronic disease, so, while bariatric surgery helps to reset your weight, you may outgrow the mechanisms we put in place and experience weight regain. In this case, we may do a surgical revision. Other reasons for revision include chronic reflux, heartburn, or vomiting after surgery. Revision simply means a second surgery where we try a different mechanism. Everyone is different. What works for one person, might not work well for another. For example, if VSG didn’t work for you in the long-term, we might try Roux-en-Y.

Q. What makes NWH stand out in the field of bariatric surgery?

A. I’ve operated all over the world and Northern Westchester Hospital’s surgical sophistication is what appeals to me as a surgeon. Because of the minimally-invasive technology and surgical protocols implemented at NWH, my patients are up and walking as soon as they’re out of recovery, they are on less pain meds, and they are back to their lives sooner. Ultimately, happy patients make me a happy surgeon. The Bariatric Surgery Program at NWH was recently re-accredited as a Comprehensive Center with Adolescent Accreditation from the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program. This certification further affirms the outstanding quality of our Bariatric Surgery Program, where standards far exceed national benchmarks.

Learn More about Dr. Roslin
Director, Bariatric Surgery
Northern Westchester Hospital

Northern Westchester Hospital is a proud member of Northwell Health.

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Read Past Topics from Dr. Roslin:
Sleep Apnea and Obesity
Benefits of Weight-Loss Surgery
Metabolic Syndrome
Obesity, Weight Loss, and Bariatric Surgery
Obesity and Women’s Health
Men and Obesity
A Parent’s Guide to Childhood Obesity

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