Tucsonan Luis Zavala believes bariatric surgery saved his life.
“If I didn’t have surgery I wouldn’t be here in the next five years,” said Zavala, 51, who has lost 180 pounds and is off all medications since undergoing a gastric sleeve procedure in April 2012.
“Before, I would have to stop three or four times walking out to my gate in front of my house. Now I can work again and I have energy.”
Bariatric surgery can be a powerful tool in the growing battle against obesity. In 2013, obesity officially was declared a disease by the American Medical Association. Physicians voted overwhelmingly to label it a disease that requires a range of interventions to advance treatment and prevention. The decision has spotlighted the need for more resources for a public health crisis that affects one-third of the United States and costs the healthcare system an estimated $190 billion annually.
Zavala has been overweight since he was 3 years old. Obesity runs on both sides of the family, and he craved tacos, enchiladas and tortillas, the favorite foods of his childhood. The pounds crept up and Zavala weighed more than 240 when he started high school.
While he kept active through the weight gain – working in construction and auto body repair –
Zavala ultimately weighed in at 550 pounds. Morbid obesity started to take a devastating toll. He developed hypertension and type 2 diabetes and he relied on supplemental oxygen therapy. He no longer could work and was placed on medical disability.
Zavala tried medically supervised diets and exercise, but the weight loss was minimal. He knew that if he continued on the same path, he would not survive.
Bariatric surgery was recommended, but some physicians turned him away, saying he was too ill to recover from the procedure.
Then Zavala attended a seminar presented by Carlos Galvani, MD, director of minimally invasive and robotic surgery in the University of Arizona Department of Surgery and program director at The University of Arizona Medical Center’s Surgical Weight Loss Center. He started working with Dr. Galvani and his staff, who felt they could help him lose weight.
“He was a very sick guy when I first met him,” Dr. Galvani said.
By the time he met Dr. Galvani, Zavala weighed 480. He was required to lose weight before surgery. Working with a nutritionist and psychologist at the UAMC Surgical Weight Loss Center, Zavala lost 68 pounds and was approved for surgery.
After six weeks on a liquid diet, he underwent a sleeve gastrectomy, a procedure in which the left side of the stomach is surgically removed. This results in a smaller stomach, which is about the size and shape of a banana. Since this operation does not involve reconnecting the intestines, it is a simpler surgery than gastric bypass.
Almost instantly, Zavala’s hypertension and diabetes were cured as a result of hormonal changes. Within two weeks, he was off oxygen therapy.
Zavala, who had been on eight medications, now takes only vitamins. His joints that once ached from arthritis no longer hurt. He does all of his own cooking, and eats small amounts of ground turkey, fruits and vegetables, bread, an occasional egg and other carefully prepared meals. He eats very slowly, to not upset his stomach.
Now weighing in at 232, and with a 36-inch waist that’s down from 52 inches, Zavala is a new man. He’s walking and swimming for exercise, and is nearly at his ultimate goal of 220 pounds – a total weight loss of 330 pounds from his heaviest.
He is back at work, driving for a transportation service for people who cannot drive. “I used to be a client because getting behind the wheel was hard,” he said. “Now I’m working there.”
Dr. Galvani said surgery was the right decision for Zavala. He “showed a great deal of commitment,” Dr. Galvani said. “He had serious conditions and the extra weight would not favor a long life, that’s for sure.”
Dr. Galvani said the decision to have bariatric surgery is not an easy one. “Surgery is for people who have tried everything they can on their own,” he said. “It is usually the last resort.”
Patients must be well-informed about surgical options, have family support, take responsibility for their health and eat properly before and after surgery, Dr. Galvani said. Excess food – and the wrong kinds of food – can make patients ill and cause the weight to return.
“If you take this as the easy way out, it will not work,” Dr. Galvani said, adding it is important for patients to seek a comprehensive program – like the one at the UA.
“It’s important to have a program with experience in complex cases, and a program that has a psychologist, a nutritionist, well-trained surgeons and a hospital that can accommodate difficult cases,” Dr. Galvani said. “That’s what we have here.”