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When Surgery is an Option

A Conversation with Dr. Marc Zerey

Dr. Marc Zerey
Dr. Zerey is a board certified physician at Sansum Clinic specializing in bariatric weight loss surgery and advanced laparoscopic surgical techniques. Dr. Zerey has published extensively, including journal articles in American Surgeon, American Journal of Surgery, American Journal of Surgical Research and Surgical Innovation and is an ASMBS Bariatric Surgery Center of Excellence® designee.

When is Surgery an Option to Lose Weight?

It is a question I am asked by both patients and healthcare providers.

We are lucky at Sansum Clinic to have several resources available to help us achieve a healthy lifestyle: our doctors, registered dieticians, Doctors' Weight Management Program, and, most recently, an employee initiative to help us shed some pounds.

Patients who seek surgery have typically been battling obesity their entire lives and have tried several diets with good short-term success. Unfortunately, the weight often comes back over time, especially in people who have more weight to lose. They may place very high expectations on themselves to succeed or have unrealistic goals. When those expectations are not met, they become discouraged and may give up on dieting despite having lost weight. The pounds re-accumulate and they may weigh even more than before. For people who are 10 or 15 pounds overweight, this is not much of an issue but in people who have 70 pounds or more to lose, it is. There is convincing evidence that as people become heavier the incidence of health problems (high blood pressure, high cholesterol, type II diabetes) increases substantially. As a result, obesity is now considered a disease, and rightly so.

It is at this point that patients (and their referring physicians) should consider weight-loss surgery. Here are the current National Institutes of Health criteria:

AGE: 18 years or older

BODY MASS INDEX: 40 or greater; OR 35 or greater with one of the following comorbidities: hypertension, type II diabetes, high cholesterol, metabolic syndrome, sleep apnea, or infertility.

To check your BMI ask your healthcare professional or visit our website and use our BMI Calculator at:

Physician or Professionally Supervised Programs

The patient must have participated in a physician or professionally supervised weight-loss program over a prolonged period of time and has been unable to achieve sustained weight loss.

Several studies have shown that bariatric surgery is more effective than diet and exercise alone in long-term weight loss, reversal of health problems caused by obesity, and long-term survival. I always tell patients that surgery is a tool, not a cure to obesity. Like all other modalities, people can regain weight; although patients tend to be more compliant with recommendations knowing they have undergone the Lap Band, gastric bypass, or the sleeve gastrectomy. They appreciate that they can eat regular food and that many of their medications for chronic diseases can be stopped within the first year or earlier aside from daily multivitamins and Calcium with vitamin D.

Surgery is not for everyone even if they meet the basic criteria. Like any surgical procedure, there are risks involved in Bariatric Surgery and these should be considered when making one's decision. We organize a monthly information session on Obesity and Weight-loss Surgery at Sansum Clinic Pueblo and invite anyone who is interested in learning more to attend.

For more information or to register for our free Bariatric Surgery Orientation visit:
Sansum Clinic, Bariatric Surgery
317 West Pueblo Street
Santa Barbara, CA 93105
(805) 898-3472


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