34 LISTENER JUNE 8 2019
by Nicky Pellegrino
HEALTH
ThisLife
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IMAGESwith weight their whole life, resulting
in hypertension, joint pain and back
problems. Yo-yo dieting may have
become normal. And they have a
fatty liver, which may not have been
diagnosed, but I see it when I do the
surgery.”
Studies have shown that although
people can lose about 10% of their
body weight through diet and exer-
cise, the body’s mechanisms work to
return it to a set point, so most will
regain the lost kilos. For many, that
struggle becomes even harder as the
years go by.
“The natural history of BMI is that
it increases over time,” says Ulmer.“Our metabolic requirements drop
with age, but if the amount you’re
eating doesn’t drop, too, then gradu-
ally you’ll put on weight.”K
eyhole surgery has revolutionised
weight-loss procedures, reducing
the risks and hospital care
needed, making it more accessible.
Gastric sleeve surgery is now the
most common procedure worldwide.
In recent years, it has overtaken gas-
tric band and bypass surgeries because
it is viewed as the most effective,
least invasive option with the lowest
chance of long-term complications.
A gastric sleeve reduces the size ofLosing it
Weight-loss surgery is
becoming more common,
but lifestyle and attitude
changes are needed for
long-term success.
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Stephanie UlmerS
urgery was once considered a last resort
and fairly extreme treatment for obe-
sity. But the procedures, and attitudes
towards them, are changing.
“GPs are far more likely to refer
people now than they were when I
started 10 years ago,” says Auckland sur-
geon Stephanie Ulmer. “It was very unusual then
for GPs even to discuss it with their patients.”
Today, bariatric surgery is no longer seen as a
solution only for what Ulmer calls “the-tip-of-the-
iceberg people” – super-obese patients with major
lifestyle-related illnesses.
“It’s also for people you wouldn’t look twice
at on the street. A body mass index (BMI) of 30
is the lowest I will offer
surgery for. That’s not
someone you would
think of as having an
obesity issue, but
they can benefit
just as much as
those with a BMI
of 60-65 who
can’t tie their
shoelaces.
“They may
have struggled