April 1, 2023

Bariatric surgery is not just about the weight you lose; it is about the life you gain. Obesity is a complex metabolic disease, not simply a weight problem. Bariatric surgery can counteract the metabolic changes helping individuals feel full and satisfied after a small meal. Bariatric surgery is regarded as the most effective treatment for people with obesity. However, it takes multidisciplinary approaches required from pre-surgery education to long-term management, all of which Methodist is equipped to provide.
Methodist Hospital | Atascosa, in partnership with Methodist Hospital | Metropolitan in San Antonio, now offers surgical weight loss options to Atascosa County residents. Their new weight loss center in Atascosa provides patients with a multidisciplinary and comprehensive approach. Each patient who participates in the program experiences an individualized care plan designed just for them. This is essential to maintain weight loss and improve the quality of life after bariatric surgery.
According to Lacy Fisher, Director of Rehabilitation and Multispecialty Clinic at Methodist Hospital | Atascosa, through this partnership, patients have access to surgery performed by board-certified surgeons at Methodist Hospital | Metropolitan in San Antonio and the convenience of all pre and postoperative appointments and other services in Atascosa. Fisher states that patients get the best of both worlds while saving time and money.
Nilesh Patel, MD, FACS, Methodist Hospital | Metropolitan’s, is a nationally recognized and fellowshiptrained bariatric surgeon and board-certified general surgeon with more than 21 years of experience. He has performed almost 7,000 weight-loss surgeries with laparoscopy. He is an expert in LAP-BAND, Gastric Bypass, Gastric Sleeve, Gastric Band, and Revision surgeries. He received his Medical Degree from Robert Wood Johnson Medical School – Piscataway, NJ. He completed his Surgical Residency at Allegheny General Hospital – Pittsburgh, PA, and continued further with the university to do fellowship training in minimally invasive weight-loss surgery.
Dr. Patel is a myth buster about bariatric surgery. Dr. Patel states that bariatric surgery has evolved since the first laparoscopic gastric bypass was done around 1999. The surgeries are now minimally invasive in most cases, leaving no significant scars. Recovery from the surgery, he said, is surprisingly fast.
Dr. Patel said that in its early years, the surgery was associated with the stigma of obesity and that the characterization of patients who would benefit from the surgery was a stereotype that wasn’t necessarily medically or ethically correct. “We were ostracizing patients of size because they were deemed or perceived as being too lazy to exercise and just eating incorrectly. Across the last 20 years or more, particularly in the last five to seven years, we’ve realized that obesity is just a symptom within a disease complex, which many of us call metabolic syndrome.”
“If we were to put it into that perspective, bariatric surgery has evolved not just for weight loss, but as a metabolic procedure,” said Dr. Patel. “I think this evolution and thought process will lead us to be able to help more patients.”
Dr. Patel says they don’t like to refer to it necessarily as weight loss surgery because it is metabolic surgery. “If we look at metabolic syndrome, multiple disease complexes are involved in it, such as diabetes, high blood pressure, sleep apnea, fatty liver, high cholesterol, and obesity is just one of those factors, not the defining factor,” said Dr. Patel. “And to put that in perspective, we can have patients that walk into our office that are only 30 to 50 pounds overweight, 60 pounds overweight, who have diabetes, but patients who are 400 pounds that walk into the office, don’t have a lick of diabetes and the labs are normal. Yet they both suffer from metabolic syndrome because they qualify with other disease complexes that they suffer from being a patient of size or having metabolic syndrome. I think the evolution in bariatric surgery is not just technique but also understanding the disease complex we’re operating upon.”
Dr. Patel states that The American Heart Association, American Endocrinology Society and Diabetes Associations have bariatric surgery as an indication for specific disease conditions. He says that 90% of diabetes will go away with bariatric surgery.
Dr. Patel says to think about bariatric surgery as a journey, not a destination.
“When patients ask me, ‘Will I be successful?’ I tell folks that it is a three-way love triangle, the surgeon, the patient, and the procedure. The procedure is done; it’s always going to be there, the surgeon and the patient have to stay connected to the procedure.
I think follow-up is the key, so when someone asks me, I say, ‘Listen, I can do the operation as well as I could do it and that only contributes to 30% of your success; the remaining vast majority is dependent upon your compliance and coaching. This is a lifelong commitment to a lifestyle change, and we all fall off the wagon now and again and you have to go back to your coach. With bariatric weight loss surgery, nobody’s born to know how to live with this operation and how to be able to maintain this operation; it takes lifelong coaching. And by having a local center in Atascosa Co., it helps make that lifelong commitment more attainable.”
Dr. Patel says that patients must choose surgeons and hospitals with a high volume of experience in bariatric surgery.
“Choose a surgeon and a hospital that is experienced and highly accredited. Bariatric surgery is what Metropolitan does; it’s one of the busiest service lines. It has every certificate of excellence currently available for bariatric surgery. So, between the national designation and every common insurance company, we hold a certificate for each one of those for excellent outcomes and quality of surgeons. There are other facilities in town that have some, but we are the ones that have all of them.”
Dr. Patel said that Metropolitan is also a Leapfrog Grade A hospital, which means they have a top score for patient safety. “I think there are only 50 in the country. We are also one of the few facilities where we have nurses nationally accredited by the American Society of Metabolic Bariatric Surgery to take care of patients, so that’s one extra level of training, one extra certificate that most facilities can’t say they have.”
Jennifer Group, BSN, RN, CBN, Bariatric Program Manager, Methodist Hospital | Metropolitan in San Antonio, said that the hospital focuses on upholding the highest standard of care with personalized treatment plans. She said she is proud that The Methodist Weight Loss Center is designated as an American Society for Metabolic Surgery Bariatric Surgery Centers of Excellence®. The center is recognized as a Bariatric Center of Excellence with OPTUM-UHC, Aetna, and Blue Distinction Center Facilities with BlueCross BlueShield. It is also accredited by The Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program.
Group also said that Methodist Hospital | Metropolitan weight loss surgeons provide excellent and compassionate care for patients, offering various bariatric surgery options to ensure the best option for each patient.
Surgical options include:
• Roux-en-Y gastric
bypass (RYGB)
• Sleeve gastrectomy
• Adjustable gastric
band surgeries
• Duodenal Switch
• Intestinal pylorussparing (SIPS)
• Robotic-assisted
bariatric surgery
“There’s a spectrum of surgeries available and it’s best to pick out a surgeon that offers all of the options to pick the one that’s best for the patient,” said Dr. Patel. “The patient and surgeon have to have the conversation regarding what would be best for them, and I think that’s another good thing about Metropolitan and that we offer all the surgical procedures available.”
“All the procedures are done laparoscopically or minimally invasively; in my hands, the procedures are usually under an hour, recovery is a week to 10 days on the long end and we use different pain management techniques now to be able to get recovery to be even faster,” said Dr. Patel. “We’ve done outpatient sleeves when you come in the morning and leave with your sleeve the same day, and so it has become that progressive. It just requires the right facility, the right nursing and the right surgical expertise to be able to execute that. We also offer robotic technology where some advantages and recovery can be expedited from that perspective.”
Methodist Hospital | Atascosa supports patients before, during and after weight loss surgery making it much more convenient than continual trips to San Antonio. They offer:
• Behavioral health
• Dietary specialists
• Lab work
• Outpatient physical
• Radiology exams
• Support groups
• Weight loss seminars
The bariatric seminars are designed to help individuals learn more about how to lose weight safely. The free bariatric support group gives individuals a safe place to receive encouragement and establish resources for their weight loss journey.
Methodist physicians work closely with nurses, dietitians and other care team members to ensure weight loss surgery patients receive quality care in a patient-centered environment. They encourage the involvement of loved ones as a support system for making lifelong changes as part of the weight loss journey.
Methodist recognizes that being overweight may also cause individuals to experience other conditions. Methodist’s team can also help with:
• Degeneration of
weightbearing joints in hips,
knees, ankles and feet
• Diabetes
• Gastroesophageal
reflux disease (GERD)
• High blood pressure
• Obstructive sleep
apnea, breathing
• Sleep apnea
• Cardiovascular disease
To learn more about the bariatric/weight loss surgery please call a weight loss specialist about the right next step for you at (830) 769-5947 or use QR Codes below.
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