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Two University of Florida surgeons are collaborating with UF physicians from numerous disciplines to create a bariatric surgery center of excellence that addresses all aspects of care for morbidly obese patients seeking weight-loss surgery.

“Obesity has reached epidemic proportions in the United States, with more than 15 million American adults considered morbidly obese,” said Kfir Ben-David, MD, UF College of Medicine assistant professor of surgery. “Such extremes are directly related to increased incidences and severity of co-morbidities such as diabetes, hypertension and sleep apnea, all of which combine to drastically reduce life expectancy of morbidly obese people.

Ben-David, director of the UF Bariatric Weight-Loss Surgery Program at Shands at UF, emphasizes the necessity of a multidisciplinary approach to surgical weight loss, which is the only proven, reliable and long-term weight-loss solution for morbid obesity.

“Our approach is unique in that we take care of the whole patient and the entirety of their health problems—not just their surgery,” said Ben-David. “Although the program is driven by the surgical team, our collaboration with UF experts from psychology, cardiology, pulmonology, medicine, nephrology and nutrition strives to identify and resolve the extensive co-morbidites associated with morbid obesity, both before and as a result of the weight-loss surgery.”

Ben-David, who earned a combined fellowship in laparoscopic and bariatric surgery from Duke University College of Medicine, and Juan Cendan, MD, UF assistant professor of surgery, provide the full range of advanced laparoscopic surgical options for weight loss, including Roux-en-Y gastric bypasses, lap-banding procedures, sleeved gastrectomies, biliopancreatic diversion (duodenal switch) procedures, and complicated revisionary work. Ben-David has performed more than 200 laparoscopic bariatric procedures with excellent outcomes, and noted that the program at Shands has all of the necessary elements to become a bariatric center of excellence.

Ben-David says that, while not a cure, weight-loss surgery is a rapidly growing intervention for the management of morbid obesity, and patients that have undergone bariatric surgery have decreased their overall mortality, better maintain their weight loss, and have remarkable resolution of co-morbidities.

“All of this contributes to an improved survival rate and reduction in health care costs for morbidly obese patients.”

For more information on the UF Bariatric Weight-Loss Surgery Program at Shands at UF, visit www.surgery.ufl.edu/bariatrics, or Shands.org.

Facts about morbid obesity in the United States

• ~15 million adults are morbidly obese (i.e.,have BMI > 35)
• Between 1991 and 2001, morbid obesity increased from 12 to 21 percent of the population
• 2^nd leading cause of death (behind smoking) from a modifiable behavior/risk factor
• Between 100,000 and 300,000 Americans die annually from factors attributed to morbid obesity (more than from breast cancer and colon cancer combined)
• Bariatric procedures have increased ten-fold since 1995 (from 20,000 to 200,000)
• Less than one percent of morbidly obese patients opt for bariatric surgery

Information gathered from US Department of Health and Human Services (2003)

Common co-morbidities of morbid obesity

• High blood presure
• Diabetes
• Elevated cholesterol
• Sleep apnea
• Arthritis
• Urinary incontinece
• Reflux
• Impaired fertility
• Low back pain
• Metabolic syndrome

Resolution of co-morbidities following bariatric weight-loss surgery

Percentage of patients in which:

Type 2 diabetes resolved Abnormal cholesterol improved High blood pressure normalized Obstructive sleep apnea resolved

76.8 70.0 61.7 85.7

Source analysis of 136 studies involving 22,094 patients who underwnet bariatric sugery, published in the Journal of the American Medical Association, 2004.

Photo credit: Sarah Kiewel, UF Health Science Center photographer