Surgeons tackle S.C.’s obesity problem

By Ashley Barker
Published Jan. 27, 2014

More than 65% of all adults in South Carolina are either overweight or obese, according to S.C. Department of Health and Environmental Control.

In 2009, more than 70% of adults were overweight in Berkeley County, and 63.5% were overweight in Dorchester County. Slightly more than half of adults in Charleston County were classified as obese or overweight, the department reported.

Dr. Neil McDevitt
Dr. Neil McDevitt
Lowcountry hospitals employ dietitians, psychologists, exercise physiologists and bariatric surgeons to help combat the growing problem.

Dr. Neil McDevitt opened Coastal Carolina Bariatric Center at Summerville Medical Center. Each year, the bariatric surgeon sees more than 200 new patients and performs around 125 weight loss surgeries.

“I see a lot of patients who are interested in surgery, some have had surgery elsewhere and are struggling, and some who see surgery as a life preserver,” McDevitt said.

McDevitt, who was on Gov. Mark Sanford’s obesity task force, has helped design studies about health insurance plans’ coverage of bariatric surgeries. For a person with no insurance, weight loss surgeries could range from $13,000 to $40,000, he said.

“We do total knee and hip replacements on 70-year-old people. They don’t go back to work after the surgery. Very few of the things we do have a benefit from the financial aspect,” McDevitt said. “Does it make financial sense for us to fix that hip? Probably not, but we do it because it’s the right thing to do. We can give them a better quality of life.”

He said eliminating obesity outweighs the cost of the procedure when you think about the number of days lost at work, the potential for diabetes and the danger of other health issues. Coastal Carolina Bariatric offers three procedures to overweight patients, and it takes about three months of visits to the office to determine the best option.

McDevitt said the laparoscopic adjustable band surgery, which involves placing a band around the upper portion of the stomach, is used to make the patient feel full faster and longer.

“We have a great success ratio with it,” McDevitt said. “It’s a very technique-driven surgery, and we don’t put it on people who are unlikely to succeed.”

When a patient chooses to have a gastric sleeve surgery, part of the stomach is removed once it’s stapled down to the size of the egg. The new stomach only holds about six to eight ounces, which limits the amount of food a patient can eat, McDevitt said.

“People lose weight from the surgery when we remove the stomach and then again through a good lifestyle if they can maintain it,” he said.

Because the procedure removes the part of the stomach that produces hunger hormones, McDevitt said surgeons are excited that it could help diabetic patients.

Though gastric bypass decreases the size of the stomach, the procedure leaves the remaining portion of the stomach inside the body. The intestines are rerouted so that food skips about a third of the intestines, he said.

“People lose a tremendous amount of weight within the first two years,” McDevitt said of the gastric bypass. “For the morbidly obese who are really immobile, this can finally get them moving if they commit to a healthy lifestyle.”

Each patient must maintain a food journal, pedometer log and visit a dietitian and physiologist regularly prior to the surgery and follow up often after to develop a new lifestyle.

“Some people pick it up very good, and some people aren’t immediately capable of changing,” McDevitt said.

In mid-January, 17 of his surgery candidates were trying to avoid the operating table. He said many patients go to the center without all the facts about leading a healthy lifestyle. Once they track their diet and exercise, they realize surgery isn’t as necessary as they thought.

“We want to help them avoid surgery through medical management. If they don’t commit to the lifestyle, the weight loss is doomed to fail. They have to understand that before the surgery and get on board with it,” he said.

Reach Ashley Barker at 843-849-3144 or @AshleyNBarker on Twitter.

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