Bariatric Surgery

Weight No More

By the time Andrew Gleason entered Dr. Louis Balsama’s office for the first time, he had had it with diets. “I’d tried them all, Atkins, South Beach, you name it,” the 43-year-old Medford resident said. “They didn’t work for me. In my opinion, you lose 20 pounds with them, but then you gain back 40.” At Dr. Balsama’s office, he found a way to lose weight and finally keep it off – bariatric surgery. “Usually, most of the people I see for weight loss surgery already are familiar with the procedure and Andrew was no exception,” Dr. Balsama, a surgeon and faculty member at the UMDNJ-School of Osteopathic Medicine, said. “In fact, it was obvious that he was going to be a very motivated patient.”

Gleason admits that he was “always heavy” when he was growing up, hitting about 220 pounds on his five-foot, ten-inch frame by the time he was in college. A knee injury while playing basketball sent Gleason to the sidelines and started him on a path of steady weight gain, with only brief interruptions caused by dieting.

By the time of his first appointment with Dr. Balsama, his weight had topped out at 330 pounds and was the underlying cause of several other medical conditions.

“My blood pressure was 176/120, my blood sugar was 125 and my cholesterol was 276,” Gleason said. “I knew that I owed it to my wife and two children to make a change.”

Last October, Dr. Balsama performed gastric bypass surgery. During this surgery, part of the stomach is closed off leaving a small pouch to receive food. The pouch is attached to the lower section of the small intestine causing food to bypass the section of the intestine that absorbs most of the calories and nutrients. Immediately after surgery, patients progress from a clear liquid to a full liquid diet, then to pureed and soft foods and finally to a low fat, heart healthy diet. In Gleason’s case, the change was dramatic. Just two weeks after surgery, his blood pressure was down to 130/90; his blood sugar was under 100; his cholesterol level had dropped to 136; and he was able to stop taking both his cholesterol and blood pressure medicines. Today, Gleason exercises regularly and, at 204 pounds, is closing in on his ultimate goal of 180 pounds.

“Because Andrew has been very committed to both weight loss and to an exercise program, his results have been a bit better than is typical,” Dr. Balsama said. “Still, with this procedure, we expect patients to lose 60 to 80 percent of their excess body weight within the first year.” Who should consider bariatric surgery?

According to Dr. Balsama, weight loss surgery is a consideration for anyone who falls into one of three categories: (1) at least one hundred pounds overweight; (2) has a body mass index (BMI) greater than 35 and who has medical issues related to their weight; or (3) has a BMI greater than 40, regardless of other medical issues.

“In our practice, we offer different types of weight loss surgery, depending on the patient’s needs and preferences,” Dr. Balsama explained. “Along with the traditional gastric bypass procedure, patients also have the option of a lapband procedure that involves placing a band around the stomach that limits the amount of food the stomach can hold. As a result, the patient eats less, which causes weight loss.”

The procedure uses small incisions to insert the Lap-Band System around the patient's stomach. Like a wristwatch, the band is fastened around the upper stomach to create the new stomach pouch that limits and controls the amount of food that can be eaten. This system allows the surgeon to change the stomach outlet size by adding or subtracting saline (salt water) inside the inner balloon through the access port that was placed beneath the skin during surgery.

Periodic adjustments can be done by the surgeon without any additional surgery.

To schedule an appointment with Dr. Balsama, please contact the Department of Surgery at the UMDNJ-School of Osteopathic Medicine at (856) 566-2700.