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Advancing Medicine

New technology is helping people lose weight effectively

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HARTFORD, CT (WFSB) -

There have been a lot of advances in medicine, many of them targeting issues that individuals battle on a regular basis.

Weight loss is a struggle for many people, but with new technology in the medical field, there are opportunities to take charge to combat this struggle.

Ray D'Amato has been active since he was a child. He played flag football into his 50's, and played softball until his 50's, but then his knees gave out.

He has also been battling weight gain his entire life as well, up until he had weight loss surgery earlier this year.

"You gain five pounds, and 10 pounds and 20 pounds. The next thing you know, I went from 300 pounds to 365 before I knew it," D'Amato said, adding that he didn't realize how big he had gotten. "Your mind plays tricks on you. Even when you're that big, you don't think you're that big."

His mounting medical issues began to tell the real story.

"The next thing you know, my heart went into a fib. Then I got diabetes, and it just started to cascade and I said ‘you know, I want to retire in four or five years. I want to enjoy my retirement'," D'Amato said.

After consultations with doctors, he said he decided to have weight loss surgery, and visited Dr. Darren Tishler, Hartford Hospital's chief of Bariatric Surgery.

"I think the simplest view of how weight loss surgery works is to really think of it as giving you a smaller stomach," Tishler said.

Among the most common weight loss surgeries is gastric bypass, also known as the "roux en y procedure," where doctors first section off a small pouch from the stomach.

"We then bypass the rest of the stomach and the first part of the small intestines and then connect things up again further downstream," Tishler added.

In doing this, the body absorbs fewer calories leading to weight loss, but it also absorbs fewer nutrients, so supplements are important.

Another option is the gastric band procedure, that involves putting a small silicone band on the upper part of the stomach, Tishler said.

Then, there's the sleeve gastrectomy where about 80 percent of the stomach is removed.

"A patient has a smaller stomach and therefore they eat less food because they feel full faster," Tishler said. "But the other effect of the sleeve gastrectomy is one that's a little harder to understand and fully quantify. And that is the fact that after someone eats a meal, in between meals, they don't feel hungry."

There are people who question why people have surgery, and don't just stick with exercise and dieting.

"The typical very low calorie diet - something like an Atkins diet or a South Beach diet - you're able to lose weight in the short-term but over three to five year period, that weight usually comes back in more than 90 to 95 percent of patients," Tishler said, adding that after surgery "patients just don't feel hungry in between meals or even at meal time like they did before the surgery."

Earlier this year, D'Amato opted for the gastric sleeve procedure, after a comprehensive screening process.

"All of our patients need to see a psychologist, a nutritionist and a cardiologist before surgery," Tishler said.

D'Amato said he was put on a diet ahead of the surgery, and ended up losing 45 pounds, and days before the operation his pre-surgery blood work showed his potassium levels were too low to move forward.

"One of the side effects of his medications he's on is that it can drive the potassium levels down. Now, low potassium level is, and can be, a very life-threatening problem when it comes to surgery," Tishler said, adding that D'Amato was admitted to the hospital the weekend before and his potassium levels were back to a safe range.

D'Amato had his surgery on Monday, March 17, and Tishler said the procedure was done laparoscopically through five small incisions, and it took about one hour.

While the majority of patients do very well after weight loss surgery, there are some who have a harder time keeping the weight off long-term. There are the issues of what factors cause this to happen, which are being investigated at the Institute of Living.

"We're trying to investigate factors that will predict success of bariatric surgery," said Dr. Pavlos Papasavas, who is a bariatric surgeon and director of research for Hartford Hospital.

He has teamed up with Dr. Godfrey Pearlson at the Institute of Living and they're involved in a study that they hope will give them information that will help future bariatric surgery patients.

They're working with current bariatric surgery patients, who undergo a functional MRI or fMRI before surgery and a year after surgery. While laying in the MRI machine, patients are presented with pictures of food. Brain signals are recorded when they see different kinds of foods.

The fMri will show what part of the brain is triggered when they see the images. They're presented with money challenges that address motivation.

"Some people may be kind of driven by just their inability to control their cravings. Other people may be driven kind of by momentary pleasures - 'this feels good right now, don't think about the future'. Other people may be more related to binge eating, which may be related to mood disorders," said Pearlson.

He added that someone can present with the same behavior, "but behind that behavior are very different motivations and different problems. And the more we can find that out, the more we can address a therapy that's tailored for that individual."

Now, 10 weeks after D'Amato's surgery, he is down another 35 pounds and said he has been eating smaller portions and now his medical issues pre-surgery are gone.

"I never took any diabetes medication since I left the hospital. Diabetes was gone," D'Amato said, adding that he is convinced the surgery was the right choice for him.

"It's the best thing you can do for yourself. It's really, it's worth it. It's life-changing," he added.

Another individual had weight loss surgery about five years ago, and has found a good, comfortable and healthy weight.

"I've been there steadily for about three, three-and-a-half years," Chris Kubick said, adding that at his highest weight he was 489 pounds.

Even after going through some hectic times, like welcoming two baby girls, Kubick said weight gain hasn't been an issue.

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