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When will power isn’t enough - Advanced surgical options for a healthy weight

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As a petite dancer and college cheerleader, Julie Travis never imagined she would someday consider weight-loss surgery to help her lose weight. But like so many people who battle with their weight, Julie tried everything without success: "People who struggle with their weight know how complicated it is. In the end, it goes beyond will power."

Statistically, will power is rarely enough: Only 15 percent of dieters are able to keep off the weight they lose. Travis met with surgeon Adam Goldstein, DO, FACS, to learn if surgery was right for her. First, he ensured that she had exhausted her options: "Weightloss surgery is a viable option for severely obese patients who've tried everything under the sun, supervised or unsupervised."

Why surgery … and what type?
"The only reason to consider weight-loss surgery is the improvement of overall health," says Dr. Goldstein. Obesity is the leading cause of preventable health problems. He says weight loss decreases health risks like diabetes, heart disease, high blood pressure, sleep apnea and acid reflux.

Virtua surgeon Seth Kipnis, MD, underscores that potential health improvements are hard to ignore.

"After weight-loss surgery, there is a 50 percent lower risk of death caused by cardiac incidents and a 90 percent drop in diabetes-related deaths."

When surgery is the best option, the most common choices are laparoscopic gastric bypass and laparoscopic banding or "Lap Band" surgery. Gastric bypass surgically reconfigures the stomach to restrict size and divert food ingested, while Lap Band surgery reduces the stomach cavity with the insertion of a small, adjustable ring. Travis chose Lap Band surgery and has experienced dramatic results losing almost 90 pounds in 18 months. But achieving this level of success can't be done with surgery alone.

Keeping it off
"Surgery is the technical piece to bring about weight loss. But we know that emotional, nutritional and physical support is essential to success," says Virtua Health surgeon and laparoscopic gastric bypass expert Christopher Boynton, MD.

Dr. Boynton helped create Virtua's New Beginnings, an intensive pre- and post-operative support program required for all weight-loss surgery patients at Virtua. "Research in medical journals shows that weight-loss surgery is most successful when done in conjunction with a program of long-term support for the patient," says Dr. Boynton.

The staff at New Beginnings includes a behavior therapist, nurses and dietitians who work closely with patients to provide ongoing support. Supervised exercise training sessions are an optional element, provided at Virtua's state-of-the-art William G. Rohrer Center for HealthFitness. The proof that it works is in the numbers. A recent survey of Virtua's gastric bypass patients showed that weight loss at 12 months was 122 pounds, or 93.3 percent of excess body weight.* And for patients who had gastric bypass surgeries more than one year ago, 95 percent of lost weight was maintained. Dr. Boynton notes the benefit of a program that's convenient. "Offering these resources right here in South Jersey helps patients stay committed," he says. "But the program is so effective, we have many patients who travel to join it."

Support along the way
Eighteen months after her surgery, Travis still attends the support group led by a behavior therapist. "Even though the surgery makes it physically difficult to overeat, I couldn't have done this without the support of everyone at New Beginnings," she says. Anyone considering surgery should begin by talking to the experts. Virtua makes it easy with monthly information sessions hosted by New Beginnings. Drs. Goldstein and Kipnis are frequent speakers at the sessions, sharing valuable information and addressing a wide range of questions.

Meet the Physicians

Christopher Boynton, MD, is a boardcertified general surgeon who has performed more than 400 gastric bypass procedures. He earned his medical degree from the University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School. He completed an internship and surgical residency at Hahnemann University Hospital.

Adam Goldstein, DO, FACS, is a boardcertified, fellowship-trained, general surgeon specializing in bariatric and minimally invasive abdominal surgery. He has performed more than 300 weight-loss operations. He received his medical degree at the New York College of Osteopathic Medicine and completed his internship, residency, and fellowship at the University of Illinois in Chicago.

Seth Kipnis, MD, is a board-certified, fellowship- trained surgeon specializing in bariatric and minimally invasive surgery, including Lap Band and laparoscopic gastric bypass. He earned his medical degree at the State University of New York (SUNY) in Syracuse and completed his internship and residency at University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School. He completed his fellowship in bariatric and minimally invasive surgery at Penn State Hershey Medical Center.