Surrounded by plenty of marketing and media exposure, San Antonians have heard a lot about obesity and weight loss surgery. What they may not know is where to go when it’s time to commit to a dramatic, but life-changing procedure. According to the American Society for Bariatric Surgery, about 15 million people in the U.S. suffer from morbid obesity, which is associated with more than 30 illnesses and medical conditions including: Type 2 diabetes, coronary heart disease, stroke, most types of cancer, joint degeneration, gastroesophageal reflux disease (GERD) and sleep apnea.

As the first and most experienced weight loss surgery practice in San Antonio, New Dimensions Weight Loss Surgery has led changes in bariatric techniques and patient care that improve long-term success for patients who must lose a significant amount of weight. With its history in San Antonio dating to 1983, the practice has experience in follow-up care of weight loss surgery patients for longer than two decades. The practice is comprised of five surgical partners who specialize in laparoscopic (minimally invasive) procedures: Terive Duperier, John Pilcher, Dana Reiss, Mickey Seger and Lloyd Stegemann.

“Patients have access to more knowledge than ever,” says John Pilcher, M.D., who has been performing bariatric surgery since 1995. Pilcher adds that by the time most patients discuss surgery with their primary physician, that person has visited Web sites, attended informational seminars and talked informally with people who have had weight loss surgery. Armed with a lot of information, they’re now asking their doctor to help them with a referral.

According to Dr. Pilcher, several criteria are critical to making the right choice. Here’s how he recommends cutting through the marketing hype:

Procedures: The New Dimensions surgeons believe that in most cases patients should choose which procedure they prefer to have, based on the individual’s physiology and personality. Because of this, the practice offers both the gastric bypass and Lap-Band® procedures, while actively investigating new procedures, such as sleeve gastrectomy. Members of the practice regularly advise on and participate in national research projects for future bariatric surgery procedures.

• The gastric bypass is the most common weight loss surgery in the U.S. and is the “gold standard” for surgical weight loss intervention. The stomach is surgically reduced to a tiny size and bypassed to the small intestine, dramatically reducing the amount of food a patient can consume. The bypass produces significant health benefits through dramatic and rapid weight loss.
• The Lap-Band® is less invasive and uses a plastic belt, or band to close off a small portion of the patient’s stomach. The band is periodically adjusted to provide progressive intake restriction. Weight loss results are slower and steadier compared to bypass, but the procedure also involves less risk and the band is removable.

Experience: In surgicalspecialties, experience counts. According to Dr. Pilcher, the New Dimensions surgeons have collectively performed more than 3,000 weight loss surgeries. Several of New Dimensions’ surgical partners also perform a range of general surgeries, from hernia repair to anti-reflux surgery.

Philosophy: Each patient should be treated as an individual. “Weight loss surgery is not a ‘cookie cutter’ operation, and surgery alone does not guarantee success,” advises Dr. Lloyd Stegemann, a New Dimensions partner and founder of the Texas Association of Bariatric Surgeons. Not every overweight person is a candidate for surgery. “Extensive psychological and physiological evaluations are key to discovering the reasons a patient became obese and determining appropriate medical interventions,” says Dr. Stegemann. Patients must prepare for an emotional journey. “For many patients, surgery is just the beginning. Accepting and changing behaviors and attitudes about food is the greater challenge.”

Results: Success rates are crucial when choosing a surgeon. Dr. Terive Duperier says that New Dimensions’ success is attributed to several key factors: A team approach, comprehensive pre-and post-surgical counseling, check-ups and support. New Dimensions provides two surgeons to each patient during surgery. “Patients benefit from the experience and perspective of two experienced surgeons instead of one. This improves surgical outcomes and increases patient safety,” Dr. Duperier explains.

“Weight loss surgery changes a person’s entire life,” says Dr. Dana Reiss, one of the few female bariatric surgeons in Texas. “It’s important that we’re here as surgeons and as medical advisers throughout the process, and not just showing up to scrub in the day of the surgery. We take the time to build relationships and form trust with patients because they will be our patients long after the physical scars heal.” New Dimensions’ clinical infrastructure is built on resources and support groups that are essential to long-term success. Patients have access to dieticians, fitness centers, counseling and support groups tailored to where they are in their weight loss goals. “Our patients connect with people who understand their challenges and their needs, and they find a true community here,” says Dr. Reiss.

Commitment to San Antonio: The New Dimensions team has deep roots in San Antonio. “Our clinic is here; our surgeons and staff all live here and we raise our families here,” says Dr. Pilcher.

Education and advocacy: The New Dimensions surgeons invest time studying new procedures, mentoring other bariatric surgeons, and are featured keynote speakers and educators on the topics of obesity, obesity therapy and other related issues. Dr. Mickey Seger, who also serves as treasurer of the Texas Association of Bariatric Surgeons, sees improving patient access to weight loss surgery as a key challenge. Although more insurance companies now cover weight loss surgery, there are still many employers that do not offer it as a benefit. “The medical cost of morbid obesity in the United States is estimated at $75 billion a year, not including the cost of lost workplace productivity,” says Dr. Seger. “That number hits us all. If we ignore it, that number will keep rising; we all pay the price in higher taxes and insurance premiums.”