Why Is Bariatric Surgery More Effective For Long Term Weight Loss Than Diet And Exercise?

A bariatric surgery can be complex, but when done by the right hands, the results equal perfection. As a bariatric and minimally invasive surgeon, Dr. Sepehr Lalezari, believes the procedures he performs at his practice Lalezari Surgical,  is as much about the lives that are positively affected as it is about the weight loss or surgery itself. Dr. Lalezari completed a bariatric and minimally invasive surgery fellowship (specialty training) at Johns Hopkins Medicine in Baltimore, MD, and is now opening an advanced bariatric and minimally invasive general surgery practice in Los Angeles where he grew up.

At Johns Hopkins, he learned the most cutting-edge procedures such as single-site surgery, robotic and endoscopic surgery truly incision-less surgery, he called it. Training at JHU was an honor and has put him in a unique position when starting a private practice.

Born in Iran, Dr. Lalezari moved to California with his family at age 4. With the help of a highly influential primary school teacher, he overcame early difficulty with learning the English language to become a high achiever, eventually graduating magna cum laude, and two years early from UCLA with a Bachelor of Science in neuroscience.

For his clinical training, Dr. Lalezari trained throughout the United States, including Florida, New York, California, and at Minnesota’s prestigious Mayo Clinic. Although he studied neuroscience as an undergrad, he steered his career toward bariatrics and minimally invasive surgery after seeing the long-term effects that his care could provide, as well as the long-term relationships he could develop with patients similar to that of his primary care doctor growing up who first inspired him to pursue a career in medicine. “With bariatric surgery, I love the relationships you develop with the patients,” he said. “They’re looking for a way out of their current situation, they’ve been fighting their entire lives, and you help them meet their goals. In the end, they’re so happy. The relationships that develop with patients over time is why I got into medicine in the first place.”

In surgery, his success is now measured in the magnitude by which his patients’ lives are changed.

Haute Beauty interviewed Dr. Sepehr Lalezari and discussed his expertise on performing bariatric procedures.

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HB: How does a Bariatric operation affect long term weight loss?

Less than 20% of patients who try diet and exercise successfully keep the weight off. Whereas this number jumps to greater than 80% for those that undergo bariatric surgery.

HB: What is a Bariatric operation?

Bariatric surgery is any of a range of operations which help people who have fought with obesity their entire lives lose and maintain long term weight loss. The most popular operations these days is the laparoscopic sleeve gastrectomy and laparoscopic gastric bypass. All operations are minimally invasive which help speed recovery, minimize pain and scaring as well as improve outcomes.

HB: How does a Bariatric operation work?

Depending on the operation bariatric surgery is can fall into a category of restrictive, malabsorptive or both. All bariatric operations also have a component of metabolic effects as well. This is thought to be from decreasing levels of the hunger hormone ghrelin. The long term success associated with surgery over medical weight loss is thought to be in part due to the decrease of this hormone.

bariatric surgeryPhoto Credit: Courtesy o Shutterstock

HB: What is Ghrelin?

Ghrelin is called the “hunger hormone.” It is responsible for the hunger drive you feel. As we lose weight levels of this hormone increase thus the drive to eat increases as well. If you’ve ever wondered why after you gain weight after dieting your weight gain usually goes above the level you were at when you originally started dieting, it is because of this hormone. Levels increase higher as you lose weight and decrease as you regain weight but do not shut off until after you have reached your bodies original set point for your weight. Bariatric surgery typically cuts out this effect (pun intended). Thus, not only does it add a component of restriction and malabsorption to help you lose weight, it changes your bodies hormones to help you maintain long term weight loss.

HB: Who qualifies for a Bariatric procedure?

Usually this is determined by body mass index (BMI). Generally people who are >100 lbs over their ideal body weight, BMI>40 or BMI>35 with an underlying obesity related medical condition. These conditions may include diabetes, obstructive sleep apnea, acid reflux (GERD), high blood pressure, chronic knee or back pain, high cholesterol and many more. Gastric sleeve or gastric bypass are great solutions for weight loss in these patients.

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