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Ted Threadgill hesitated for years over whether to undergo weight loss surgery, the treatment option considered the most effective way for obese people to lose excess weight and, most importantly, not to.
On the one hand, the 54-year-old former college baseball player knew the dangers of tipping the scales at 350 pounds, the problems it caused just by playing sports. On the other hand, it seemed like a “pretty important procedure – removing a piece of your stomach, for Pete’s sake.”
Then Threadgill contracted COVID-19, which poses a higher risk of severity in obese people.
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Threadgill survived, but a few weeks were frightening: double pneumonia, a temperature of 104, difficulty breathing that made it difficult to just lie down, sleep that he woke up soaked in. Finally recovered, the decision to have bariatric surgery was a no-brainer, he said.
“COVID was the last straw, the ultimate sign that I am not bulletproof,” said Threadgill, CEO of a chemicals distribution company at The Woodlands. “I thought bariatric surgery would cause permanent weight loss, I determined that I wasn’t able to cope on my own.
Bariatric surgery, considered underused by doctors, is gaining popularity because of COVID-19, both among obese people who have already fought the disease and those who have not but want to improve their chances. In Houston and across the country, experts in the field have reported an increase in procedures and consultations on whether interested parties would make good candidates.
Research is already indicating the benefits of COVID-19 from the procedure. A study from the Cleveland Clinic this month showed that obese patients who had previously had bariatric surgery were 25% less likely to be hospitalized and required intensive care than obese patients who had not had the surgery.
Concrete data on the recent increase in the use of the procedure is difficult to find, especially among researchers, in part because weight loss surgery was one of the elective procedures stopped in the first months of the pandemic. When elective surgeries resumed, insurance company demands that patients first undergo weight loss generally meant that it could be months before a procedure could be performed. Many patients of this type are still being developed.
Still, data from insurance companies shows the trend. UnitedHealth’s Optum healthcare program saw a 25% increase in enrollment in bariatric surgery programs over the summer, and Cigna procedure authorizations increased 10% from June to August 2020 compared to 2019 , after having fallen by almost 40% in the spring. The increases have come despite fears of COVID-19 that have scared many patients from going to hospital, a phenomenon that has led to an increase in deaths from heart attacks and strokes.
“I have definitely seen an increase related to COVID,” said Dr Felix Spiegel, Memorial Hermann bariatric surgeon. “In May and June, I would say 10-20 patients came for consultations due to their apprehension of the disease, patients who specifically mentioned COVID.”
The latest theory is that COVID-19 is especially difficult for people with obesity because fat is packed with ACE2 receptors, proteins that the coronavirus uses to enter cells and replicate. In other words, the more fat a person has, the more COVID-compatible receptors they will have – and the more likely they are to have a high viral load.
On another level, COVID-19 affects the obese more seriously due to the downstream consequences of being overweight. It decreases lung capacity, the preferred battleground for COVID-19. It is associated with diabetes, hypertension and sleep apnea, which are also risk factors for COVID-19. It introduces harmful agents into the blood that reduce the immune function needed to fight viruses. And it predisposes people to blood clots, which COVID-19 can trigger.
Doctors didn’t have to hammer home lessons.
Dr Vadim Sherman, a Methodist bariatric surgeon from Houston, said two new reasons surfaced on a hospital form asking people why they’re interested in surgery: Seeing obese people die faster from COVID-19 was a “Alarm clock”. and the sedentary lifestyle caused by the lockdown led to weight gain and increased their risk.
“It made us go faster,” said John Burns, an industrial cybersecurity manager who underwent surgery, with his wife, Nicole, shortly after Memorial Hermann resumed elective surgeries. “We had already done all of the preliminary work required, and then there wasn’t much we could do during the lockdown – so we decided to go into the surgery like everything else in life.
Bariatric surgeons say the procedure is the appropriate answer for obese people who cannot lose or keep weight off. Surgery works by reducing the size of the stomach, limiting the amount of food that can be eaten, and curbing appetite by altering hormonal signals between the brain and the stomach. This is why patients lose their excess weight over a two-year post-surgical period.
The surgery had a checkered history, considered too risky by many in the early 1990s. But thanks to improvements, its safety profile today equates to natural childbirth, according to Dr Samer Mattar, chief of metabolic surgery and bariatric at Baylor College of Medicine. Twenty years ago, the risk of complications was 1 in 100; today it is 1 in 1,000.
Surgeons performed around a quarter of a million bariatric surgeries in 2018, the latest year for which data is available. But that’s less than 1 percent of those eligible.
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This number is expected to increase in 2020, even with almost two months of deferred surgeries.
Dr Jason Balette, the bariatric surgeon at Memorial Hermann The Woodlands who performed the Threadgill surgery, dismisses the suggestion that COVID-19 could be the focus he has given to weight loss surgery and people who lose weight. weight. But he recognizes that “any time is a good opportunity to talk about obesity and the different approaches to weight loss.”
No need to convince Threadgill and John and Nicole Burns, who have all lost almost 300 pounds between them. They say the pre and post surgical differences are like night and day.
“I don’t mean to downplay it, but it has felt surprisingly easy so far,” Threadgill said. “I feel good, I have more energy, I am able to do things that I haven’t done in years.”
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