"Simply put, obesity is an epidemic," says Dr. Soans. "It may not be a contagious disease, but it's a serious public health issue affecting over 40% of our population. It's also not just a matter of willpower. A large number of obesity cases are influenced by genetics and socioeconomic factors. Despite changes in diet and exercise, many people are unable to reduce their weight to a healthy level and it has a significant impact on our overall health."
Obesity's negative effect on health is something that became clear to Temple patient and Philadelphia-native, Shiranda Jones.
"Me and my family have had many health issues that are related to being obese," says Jones. "I lost my sister and aunt to cancer, and my mom and grandma also had it. I've had diabetes and high blood pressure and I know others in my family have had similar health problems".
Indeed, there's strong evidence that obesity can cause many complications if left untreated. According to Dr. Soans, "Studies show that people who are overweight or obese are at higher risk for serious conditions. These include high blood pressure, high cholesterol, type 2 diabetes, heart disease, stroke, sleep apnea, osteoarthritis and many types of cancer. These conditions can sometimes cause organ damage, and it can be hard for people with obesity to qualify for an organ transplant. In fact, untreated obesity can make many other procedures a higher risk for the patient."
Reversing the effects of obesity
Fortunately, the impact of obesity isn't written in stone.
"Losing just 5% to 10% of your body weight can help reduce the health risks of obesity," says Dr. Soans. "Some of these benefits can include reduced blood pressure, improved sleep, and a lower risk of developing diabetes. With more weight loss, we even see remission of type 2 diabetes, a lowered risk for heart disease and even obesity-related cancers. This doesn't even touch on the fact that treating obesity makes it much safer to conduct other types of surgery and help patients receive the care they need for other unrelated conditions. Quality of life has also is improved and it has a big impact on our patients."
It's a large reason why many people pursue bariatric surgery, including Shiranda Jones.
"I remember thinking, 'I'm in my 40s and I want to live my best life. Enough is enough. The time is now," recalls Jones.
At the time, her weight was at its peak, at 245 pounds. She was acutely aware of her family's struggle with weight, and was motivated by her cousin's recent gastric bypass surgery.
"Since I have a strong history of cancer in the family, I wanted to do everything I could to lower my risk," says Jones of her decision to look into and ultimately have bariatric surgery. "I also really wanted to cut down on medication for my high blood pressure and diabetes. Ideally, the surgery would get rid of those completely."
Jones had been working with her primary care doctor, Temple's Dr. Susan Gersh, to treat her diabetes. Blood tests initially showed that Jones had severely elevated levels of blood glucose, putting her at risk for heart attack, stroke and other dangerous conditions.
In order for Jones to qualify for surgery, she needed to lower her blood glucose levels. She was referred to an endocrinologist to find a treatment that would help her levels reach an acceptable range. Jones was prescribed a medication which helped lower her blood glucose to a less dangerous level. These efforts helped prepare Jones for the best possible results from her weight-loss surgery.
Dr. Soans explains, "Patients in the obese category don't have a lot of options. In many cases, they need surgery to help them resolve chronic medical problems and get a clean bill of health. We work hard as a team to qualify patients for these procedures, because, after surgery, it's like a 180-degree difference."
In the time since her gastric sleeve surgery, Shiranda Jones has lowered her weight to 179 pounds, her blood glucose levels have normalized, and her blood pressure has improved.
"When I look at where I am today, I'm so thankful I made the decision to have surgery," says Jones. "Since my surgery, I'm more mindful of what I eat. I do less emotional eating. And I actually enjoy going out and taking walks!"
Jones continues to attend the bariatric support groups offered at Temple. She says that it helps her and others remember that they're not in this alone.
"It's encouraging to see people on a similar path as me," says Jones.
The fact that Shiranda Jones had a primary care doctor, endocrinologist and bariatric surgeon all working together was not unusual for Temple. It's become common practice for Temple's bariatric team to work together with other medical specialists when treating their patients.
This means that if a patient's obesity is contributing to a separate condition like heart disease or non-alcoholic fatty liver disease, the patient receives collaborative care between doctors from multiple specialties.
"At most hospitals, specialists stay in their silos. But at Temple, we've formalized the collaborations between bariatrics and other departments. By looking at the patient as a whole, we're seeing much better results in areas like reduction of diabetes medications and improved management of GERD symptoms following bariatric surgery," says Dr. Soans.
When Dr. Soans joined Temple Health's bariatric team, he realized that treatment shouldn't focus only on obesity. It was important that related conditions be considered at the same time, and this was only possible when bringing together doctors from other specialties.
"Any time we have a patient with multiple conditions, we discuss their case in front of a committee. The committee is made up of doctors from various specialties and we meet regularly. This approach ensures patients receive treatment that factors in conditions beyond their obesity, improving their overall health outcomes," says Dr. Soans.
"We're proud that our bariatric program is helping patients with more than obesity. With these partnerships in place, we're opening the door to treating patients in a holistic manner where we are actively addressing all medical problems. Without bariatric surgery, so many people are permanently stuck with serious medical issues without any hope of getting rid of them. Some don't qualify for transplant surgery or they would suffer from conditions like arthritis and heart failure forever. If there's anything I'd want people with obesity to know, it's that bariatric surgery could be the key to unlocking a lifetime of better health," says Dr. Soans.