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Weight-Loss Surgery

We are here to offer hope

Obesity is a complex, chronic disease that affects nearly one out of every three American adults, or about 60 million people, according to the American Obesity Association. Nine million Americans are severely (morbidly) obese.

Factor in weight-related illnesses like diabetes, hypertension, sleep apnea, liver disease, and arthritis, and obesity becomes an even more alarming national health issue, accounting for some 300,000 preventable deaths each year.

Locally, statistics from the Hawaii Department of Health indicate that in Windward O‘ahu alone, more than 10,000 adults are obese or morbidly obese — a disproportionately large number compared with other parts of the state. And this number is growing by about 2 percent, or 200 people, annually.

Better health through weight loss

Bariatric (or weight-loss) surgery has proven to be the best solution for morbidly obese patients aiming for sustained weight loss. Even a 10-percent reduction in body weight, if maintained, can reduce many obesity-related health risks.

Though Castle has a long-standing, individualized weight management program, the Hawaii Center for Metabolic and Bariatric Surgery was established to help patients who are morbidly obese manage the health risks of obesity through a comprehensive, multidisciplinary approach.

The team consists of skilled professionals who are all involved in assessing your health issues and developing an individual weight management plan. Your team includes:

A bariatric surgeon

A registered dietitian

A nurse coordinator

A psychologist

A fitness specialist

If an obese patient is struggling with life-threatening health risks and unable to lose weight through dieting, medication, behavior therapy, exercise, and other medical treatments, bariatric surgery may be recommended.

Bariatric basics

Bariatric surgery, which modifies the stomach or intestines to restrict the amount of food one eats or the amount of calories and nutrients the body absorbs has been around since the 1950s. It is only in the last 10 years, though, that the number of surgeries has grown significantly, due in large part to the development of safer, less-invasive procedures. Nonetheless, the procedures are not without risk, and Castle’s bariatric team carefully evaluates the risks and benefits for each patient, as well as each person’s readiness to make the lifestyle changes that are part of the program.

Generally, the program evaluates candidates for weight-loss surgery if they are between the ages of 18 and 65.

Meet Steven Fowler, our bariatric surgeon

Dr. Steven, is a bariatric surgeon and the medical director of the Hawaii Center for Metabolic and Bariatric Surgery. Board-certified in surgery with a focus in laparoscopic surgery, Dr. Steven is a graduate of Boston University School of Medicine and completed his residency at Cedars-Sinai Medical Center in Los Angeles.

“We offer three types of bariatric procedures at Castle, all of which are performed laparoscopically through small incisions using a camera and instruments,” Dr. Steven says. These minimally invasive procedures are less painful, result in quicker recovery and fewer complications, and don’t leave large incision scars.

Rewards, but with lifestyle changes

Dr. Steven emphasizes that none of the three bariatric procedures is a guarantee of weight loss.

“Patients can still ‘cheat’ by continuing to eat,” he says. “To keep the weight off, patients must be willing to make lifestyle changes. That’s why any bariatric surgery program worth its salt is a comprehensive program with physical therapy, psychological and nutritional components.”

Regardless of which procedure is used, patients can see a dramatic improvement in obesity-related health risks within the first month, including a reduction in medicines for hypertension and diabetes and less sleep apnea. Within a year, 80 to 90 percent of these associated diseases are significantly reduced, if not gone completely, Dr. Steven says.

On the road to better health

Weight-loss surgery brings radical changes to an individual — both physically and psychologically — and it’s important that patients are equipped with the tools they need to sustain their weight loss and live successfully in their communities.

Following surgery, patients in the program receive 12 months of follow-up care that includes group and individual counseling sessions, nutrition counseling and cooking demonstrations, fitness classes designed specifically for program patients, and peer support groups that help address emotional, behavioral, and other issues. Patients can always get additional support beyond the 12 months.