SUMMER 2016
Treatment and Resources to Address Obesity
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inally, she decided things needed to change. She needed to find a way to lose weight and keep it off.
“It was May 2014 when I decided to really get serious about weight loss,” said Schreder-Guhl, who is employed as a pediatric nurse practitioner at Lancaster General Health’s Roseville Pediatrics. She consulted with Lancaster General’s Healthy Weight Management Center and considered all the options the center offered. Eventually, even though she had begun losing weight again through diet and exercise, she decided that bariatric surgery was right for her. “My problem had always been that I could get it started and lose a significant amount of weight, but then I’d fall off the wagon and the weight would come back on,” Schreder-Guhl explained. “After a lot of thought, I decided that weight loss surgery was the right step for me.” In March 2015, Schreder-Guhl underwent sleeve gastrectomy surgery, a procedure that staples the stomach into a tube about the size of a banana. She has lost 135 pounds, 60 of which was before surgery.
It requires significant effort to stay on track, Schreder-Guhl said, but the results are worth it. “My high cholesterol is no longer an issue, and my blood pressure is good,” she said. “I feel a lot better and my self-confidence has skyrocketed. I’m a lot happier than I was.” Schreder-Guhl is one of hundreds of people who elect to have bariatric surgery in Lancaster County each year. In addition to Lancaster General Health, physicians at WellSpan Ephrata Community Hospital and Heart of Lancaster Regional Medical Center also perform the surgeries. The three most popular types of bariatric surgery are: gastric bypass, adjustable banding, and sleeve gastrectomy. All of these surgeries can be done laparoscopically. »Gastric bypass – Performed since the 1960s, gastric bypass limits food intake and absorption of calories by decreasing the size of the stomach and allowing food to bypass part of the small intestine, where most of the calories are absorbed. »Adjustable banding – In this surgery, the stomach is divided by a gastric band, which
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reduces the size of the stomach and limits the amount of food that can be consumed at one time. The band can be adjusted, as needed. »Sleeve gastrectomy – The stomach is stapled into a tube or sleeve, limiting the ability to consume large quantities of food. The procedure also removes a part of the stomach that produces a hormone responsible for hunger, meaning that patients feel full for longer periods of time. In addition to these procedures, Lancaster General is looking to offer duodenal switch surgery, a complex procedure sometimes recommended for severely obese patients. Duodenal switch surgery has been proven to be even more effective than gastric bypass in weight loss and reversal of Type 2 diabetes. It comes with greater risks, however, said Dr. James Ku, a bariatric surgeon at Lancaster General. It is important that each patient is carefully evaluated prior to surgery to assess medical history, behavioral history, weight and diet history, and other factors, Ku explained. Also, patients should be informed about how particular surgeries work and what they entail. Continued on page 18