Perhaps no one understands the extent of the physical and mental complications associated with obesity more than leading bariatric surgeon Valeriu E. Andrei, MD, who’s been in practice since 1999 and is currently affiliated with RWJBarnabas Health and Morristown Medical Center.
Affecting some 15 to 30 million Americans (roughly 5% to 10% of the U.S. population), morbid obesity is a condition that can trigger a number of serious health problems. These include Type 2 diabetes, high blood pressure/hypertension, cardiac arrest, stroke, kidney failure, sleep apnea, infertility, arthritis, numerous types of cancer and more – some of which can prove fatal. Defined by a body mass index (BMI) of 35 or above with co-morbidities and/or being more than 100 pounds over one’s ideal body weight, morbid obesity also can lead to a range of psychological and emotional issues for those struggling with the reality of the disease.
Perhaps no one understands the extent of the physical and mental complications associated with obesity more than leading bariatric surgeon Valeriu E. Andrei, MD, who’s been in practice since 1999 and is currently affiliated with RWJBarnabas Health and Morristown Medical Center.
“Unfortunately, obesity isn’t considered a ‘real’ disease and people struggling with obesity are often stigmatized and perceived as weak or lacking in willpower,” Dr. Andrei shared. “But obesity is in fact a very serious and chronic disease that significantly impacts the quality of life and lifespan of a large number of patients. Obesity is comparable with cancer in terms of its potentially devastating health effects and it must be treated as seriously as one would deal with cancer,” he said. “The treatment of obesity shouldn’t be optional, but patients will often ignore or delay treatment.”
Surgical approaches have proven to be an effective tool and, according to the American Society for Metabolic & Bariatric Surgery (ASMBS), hundreds of thousands of Americans currently undergo bariatric surgery annually to help bring their weight issues under control. Among the most popular surgical options are:
- Vertical Sleeve Gastrectomy — one of the newer and most effective surgical weight-loss procedures, sleeve gastrectomy involves the removal of a large portion of the stomach, resulting in its resemblance to a sleeve-like structure.
- Gastric Bypass — once considered the ‘gold standard’ among bariatric weight-loss procedures, gastric bypass surgery involves the division of the stomach into two pouches and rearrangement of the small intestine to connect to both.
- Duodenal Switch — this procedure involves removal of a large portion of the stomach (similar to a sleeve gastrectomy) in combination with a bypass of the small intestine and can drive greater weight loss than the other procedures.
- Gastric Banding — this approach involves placement of an inflatable band around the stomach which can be tightened or loosened. It achieves weight loss through portion control and is only used in selective cases.
“In general, surgical weight-loss options such as the above typically help patients lose 60% to 80% of their excess weight and result in improvements of their co-morbidities (e.g., sleep apnea, diabetes, hypertension, etc.),” Dr. Andrei said.
A Robust Program
Based on his experience and expertise in the field, Dr. Andrei has developed a robust bariatric program that provides the utmost in education and support to patients before, during, and after their surgery to ensure that they enjoy the greatest chance of sustained success.
“Because obesity is a complex, chronic disease, its plan of care must take into account many factors before starting any form of treatment,” Dr. Andrei said. “This includes a comprehensive multidisciplinary evaluation/assessment of each patient before enrolling in our bariatric program to assess their dietary, psychological, medical metabolic and endocrine status. Along with our physicians, our team members include a registered dietitian, clinical psychologist, registered nurse, nurse practitioner and physician assistants and all are present on-site and available during extended hours daily and during weekends.”
“Our program helps provide a structure that works with each patient’s lifestyle and also offers support groups post-surgery to ensure that there’s a positive and open forum available to meet their ongoing needs.”
— Bariatric surgeon Valeriu E. Andrei, MD
“This comprehensive team approach is the only way to truly win the fight against obesity,” Dr. Andrei shared of a multifaceted treatment plan which represents a combination of nutritional, psychological, medical and surgical interventions. “While surgery is an important component of the treatment and is often critical to achieving long-term control of obesity, it’s only one part of the overall treatment, not the sole approach.”
Working with a dietitian in conjunction with a psychologist and nurse practitioner all at the same time as a patient, for example, “these individual sessions are designed to implement cognitive behavioral therapy in combination with nutritional counseling and the introduction of FDA-approved anorectic medications designed for the pharmacological treatment of obesity,” he explained. “These sessions are conducted before primary weight-loss surgery is considered and also for months or years post-surgery if there’s a need for a tune-up or if weight recidivism occurs.”
With more than 20 years of experience as a bariatric physician and surgeon, Dr. Andrei works tirelessly with patients based on the conviction that the chronic nature of obesity requires close surveillance and that its treatment may need to be adjusted based on patient response.
He also supports each patient’s individual needs. “In our program, patients who meet the qualification for weight-loss surgery must complete a minimum of four months of nutritional, dietary, cognitive behavior and medical sessions before being cleared for surgery,” he explained. “We need to get to know each other on many levels in order to achieve comprehensive medical insight of their condition and also to develop strong, lasting, and constructive relationships.”
According to Dr. Andrei, “combining nutritional counseling and behavior modification helps patients internalize the lifestyle tools needed to sustain their weight loss, such as how to handle smaller volumes of food, eat on the schedule required, and prepare healthy snacks,” he said. “In addition to meeting with me regularly to reinforce the program, we bolster their care plan with weight-loss medication and an exercise regimen to help boost weight loss and have also created a ‘faculty’ of eight of our previous patients who work with new patients to provide support and encouragement, answer questions, and help new patients overcome mindless or emotional eating. We hold monthly support group meetings, walks, and special events such as cooking classes to teach and motivate our patients and help them connect with staff members and other patients for lasting support and encouragement.”
Overall, he said, “our program helps provide a structure that works with each patient’s lifestyle and also offers support groups post-surgery to ensure that there’s a positive and open forum available to meet their ongoing needs.”
After surgery, patient surveillance and assessments will continue via regular meetings with team members, a beneficial process which can enable early corrections and reduce the likelihood of significant weight regain or the need for revision surgery. In those instances where patients struggle beyond the scope of the ‘new normal’ they experience following bariatric surgery, however, “we address this in a timely fashion and may opt for revisional surgery as necessary to ensure that the primary surgery remains an effective long-term tool in treating obesity,” he said.
Based on his expertise with the nuances of revisional surgery, Dr. Andrei’s program often receives requests for a second opinion from other physicians, surgeons, and patients. “I find myself regularly collaborating with other medical professionals on a patient’s behalf in order to provide the best assessment and revision based on their previous bariatric surgery history,” he said. “These are complex cases with very successful outcomes as long as we work as a team.”
A leading advanced laparoscopic/robotic bariatric surgeon, Dr. Andrei is located at 101 Old Short Hills Road in West Orange and can be reached by calling (800) 200-5553, emailing drandrei@bariatricassociates.com, or visiting bariatricassociates.com.
