Weight-loss surgery helps patients get a new lease on life
by Melissa Martin
When Gary Martin looks in his closet these days, it’s like flipping through the pages of a memory book – a story of where he’s been, where he’s headed and, most importantly, where he wants to be.
Front and center is the wardrobe he wears currently – athletic shorts, T-shirts, a few dress shirts and a handful of work pants he pulls out for special occasions or when he has to go into the office for his job as a software solutions architect.
Next to them rests a line of polo shirts and dress pants he wore almost a decade ago now. Still in excellent condition from not wearing them long, those pieces happen to be among the smallest sizes he’s worn in his entire adult life.
In between the two sections, he admits, lies the most difficult struggle of his life.
“I realized I am failing myself and my family by living in denial that I desperately need help and I need it now,” the 51-year-old father of three said.
Like so many, Martin has struggled with his weight from the time he was a child. To deal with the ups and downs of life, food has always been his drug of choice. He knows that he’ll likely never have six-pack abs or a pinup-worthy physique. What he wants is to be healthy – to get off the blood pressure medication, possibly the antidepressants, to overturn his sleep apnea diagnosis and, most importantly, to be here for his wife, children and, one day, grandchildren.
“Without change I am destined to be gravely ill and incapable of being there to support the people I love in the manner I want to be capable of,” he said. “Without change I will slowly become a burden, sidelined and unable to participate in almost all physical aspects of my family’s life experiences.”
This past December, Martin decided he wasn’t going to let his ever-expanding waist size and declining health get the best of him any longer. At 416 pounds, he elected to make a change and pursue bariatric weight loss surgery through the Cleveland Clinic.
It’s not the first time he’s made the decision, though, as he underwent a similar procedure in 2013. However, complications during surgery prevented his surgeon from completing the full procedure. Instead of having a full gastric bypass known as a “roux en y,” Martin ended up with a gastric sleeve, which research has deemed less successful than more extensive bariatric surgeries due to the fact that the stomach’s pouch can expand over time.
Though he was able to shed more than 100 pounds with the gastric sleeve, Martin said his physicians knew from day one that maintaining the weight loss long-term was undoubtedly going to be a struggle. They informed him that he would likely need a second surgery in the future as his stomach would likely expand again over time.
“It was disappointing news for sure. And, unfortunately, they were right,” Martin said, noting that his weight began creeping steadily back up three years post-surgery and peaked in the last year thanks to some unsavory lifestyle changes brought on by the COVID-19 pandemic.
To get back on track, Martin plans to undergo a weight loss procedure known as a duodenal switch, which is a far more aggressive procedure than his first. Not only does it induce weight loss via a sleeve gastrectomy, but an accompanying intestinal bypass results in a decreased absorption of food and improved weight loss.
Studies show that patients who undergo a duodenal switch are the least likely to gain weight back among those who undergo bariatric procedures. Most patients who undergo a duodenal switch, according to the latest research, maintain their weight loss results five years after surgery, possibly even longer.
“I am hoping to effectively use this as part of a more comprehensive approach to shedding the excess weight and keeping it off,” Martin said. “My past experience and mistakes have shown that I need more than just this surgery, so I am also focused on the physical fitness and mental health aspects of leading a healthier and more active lifestyle this time around.”
Unlike other elective surgeries, however, making the decision to pursue surgery is only half the battle. Patients, including Martin, have to convince not only their physicians that they are committed to making a lifestyle change, but they also have to convince their health insurance providers as well.
“In other words, it isn’t as easy as just saying, ‘sign me up, doc,” Martin said.
In addition to meeting with physicians and surgeons, bariatric patients undergoing procedures typically also have to meet with an entire team of health professionals from psychologists to nutritionists, multiple times, before the request for surgery can even be submitted to the insurance company. They must a body mass index of 40 or higher or a BMI of 35 to 40 with a related health condition, such as high blood pressure, diabetes or sleep apnea, to qualify for surgery. But, they also have to show they have been making active lifestyle changes.
For Martin, this has translated into several months’ worth of doctor visits, x-rays, counseling appointments, group therapy and more. He’s also been required to keep a daily food journal, change his diet and increase the amount of exercise he gets on a daily basis. In the process, he’s shed more than 40 pounds already and hopes to be cleared for surgery by the end of the year.
“Weight loss surgeries are a tool, and like any tool, they can help you complete the task more efficiently than you could without them,” he said. “Like most any tool, though, if it is abused or used improperly, the ultimate outcome can be worse than the original condition.”
Martin said it is important for bariatric patients to become educated on life changes after the surgery or the outcome could literally be destructive their bodies, possibly even fatal.
“A comprehensive approach is important to help people like me solve other underlying issues that are contributing to weight gain,” he said.
Though the idea of surgery can be a scary proposition, Martin believes it is necessary to help him realize his health goals and encourages others who are suffering from excess weight to consider doing the same.
“Even scarier than surgery is realizing your life could end prematurely if you continue the path you’re on,” he said. “This surgery along with a commitment to continued, comprehensive care will help me live out the rest of my life being involved and actively helping my family and others instead of being on the sidelines cheering them on but desperately wishing to be in the game.” ∞