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Weight loss puts lives back on track

David Schroeder and his team at Wellington's Surgical Obesity Clinic love nothing more than giving their patients a second chance at life.

Dr Schroeder, an experienced laparoscopic abdominal surgeon, has performed thousands of obesity operations over almost two decades.

He performed the first laparoscopic gastric bypass in New Zealand in 2000 and has gone on to perform many more weight loss surgeries, including gastric banding and sleeve gastrectomy.

The procedures can produce varying results, with patients losing between 40 and 80 per cent of excess weight within a year.

And with weight loss comes a new lease of life, says Dr Schroeder, who says that is the most rewarding part of his job.

"The emphasis with all surgery is it is helping people, it's only a tool but it helps people to change their life habits around to a much healthier lifestyle," he says.

One patient says: "I knew I had to say farewell to my old body or face serious health issues. Weight loss surgery is the price of a good, second-hand car or an overseas trip.

That put it in perspective for me – I was investing in a healthy future."

Obesity is becoming an increasing problem the world over, Dr Schroeder says.

New Zealand Health Information Service figures indicate that 25 per cent of the population is considered obese. New Zealand has the third highest rate of obesity among the Organisation for Economic Co-operation and Development countries.

"It's a worldwide epidemic, simply because there's too much high-calorie food available, though genes do have something to do with it as well," he says.

Obesity results in a large number of medical conditions, typically type 2 diabetes, high blood pressure, high cholesterol and arthritis.

There is also an increased cancer risk and reduced life expectancy. Prejudice and social isolation are huge problems too, and the inability to relate normally with loved ones because of immobility and low self-esteem can be devastating, he says.

He outlines a common scenario – a 45-yearold woman who has gradually increased in weight with the birth of each child, who is now up to 125 kilograms and doesn't do any physical activity because it hurts.

She's too embarrassed to go out, she's becoming a recluse at home, she doesn't see any great hope for the future, she's getting depressed with all this and really feels that life isn't what she expected it to be at this age.

But after weight loss surgery, this woman immediately feels better about her body, she regains her self-confidence, she becomes more sociable, she wants to exercise, and she regains the life that she had hoped she would have.

"The commonest comment is not thank you for getting rid of my diabetes or lowering my blood pressure, it's thank you for giving me my life back," says Dr Schroeder.

"It's that incredible feeling people have of being released from a bondage that they felt they couldn't get away from."

Dr Schroeder is also proud of the fact that he's been "responsible" for many babies, with a steady stream of b

"That's the other group I really love, people that were told they were infertile, then are able to get pregnant after they've lost the weight."

After a referral from a family doctor, patients undergo five consultations, during which the surgical options, risks and complications are outlined. The surgical options include: Laparoscopic Gastric Banding (LAP-BAND?), the simplest and safest obesity operation.

A silicone band with a balloon is implanted around the top of the stomach. This can be inflated via a port under the skin. The operation works mainly by switching off the desire to eat and removing hunger. The expected weight loss is on average 60 per cent of excess weight and it requires lifelong changes to lifestyle and eating.

Laparoscopic Roux-En-Y Gastric Bypass (REYGB), is performed laparoscopically (keyhole surgery with a telescope) and is commonly known as stomach stapling. This type of bypass operation has proven to be an effective, consistent way of losing weight and of keeping it off, but it also requires lifelong changes to lifestyle and eating. Considered the "gold standard" of weight loss surgery, a small stomach pouch is created, restricting the amount of food that can be eaten initially, but long term, the operation also works by switching off the desire to eat. It also helps rid patients of type 2 diabetes. Initial weight loss at one year of 80 per cent of excess weight is expected.

Laparoscopic Sleeve Gastrectomy, whereby two-thirds of the stomach is removed laparoscopically. This severely restricts intake for the first year. The advantages are that there is less malabsorption of minerals and vitamins. People do sometimes get reflux for prolonged periods afterwards. Weight loss after a year is about 67 per cent of excess weight, but there is a tendency to regain weight after this.

Although surgery is powerful and can give positive results, Dr Schroeder says it can be beaten by habits.

"There seems to be a myth out there that weight loss surgery cures the weight problem, unfortunately, we know that isn't the case, it's a step towards the total solution." To ensure patients maintain healthy lifestyle habits afterwards, the clinic includes nurses, a dietician, psychologist and psychotherapist, counsellor and physiotherapist who are all just as essential in getting a good result that lasts. "One of the reasons people eat is because it releases nice chemicals in the brain that help cope with the problems of life. aby photos arriving at his office.

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