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Doctor Profile |
Michael Trahan, MD
Martha Jefferson Hospital
Michael Trahan joined Martha Jefferson after six years as a surgeon and assistant professor of surgery at the Center for Weight Management, University of Texas Medical Branch (Galveston, Texas). He received his Bachelor of Science degree from Lamar University (Beaumont, Texas) and his medical degree from Texas Tech University Health Sciences Center (Lubbock, Texas).
One proven effective way of gaining long-term control of weight is bariatric surgery. There are a number of different surgical options for use in controlling body weight, and each has its risks and benefits. One operation may be effective for one person, while that same operation would not work out so well for another. Candidates for bariatric operations must be screened very carefully. Bariatric surgery is always an elective operation. There is time to carefully analyze a patient's history, physical status, laboratory data, radiology studies and other evaluations to determine which, if any, bariatric operation would help them the most.
Candidates for bariatric surgery are those who meet the definition of extreme or morbid obesity. Using minimum weight criteria alone, this is a body mass index of 40 kg/m2 or roughly 100 pounds over ideal body weight. It is commonly accepted that at this level of obesity, end organ damage and development of serious medical problems are inevitable. If a person already has medical problems such as type II diabetes, hypertension or high cholesterol, the BMI criterion is reduced to 35 kg/m2. Also important for consideration are the prior efforts made to control weight, the ability to make a commitment to a lifelong behavioral change, maturity, social support system and the potential for end organ damage such as heart failure or cirrhosis that may place the person in a risk category that fails to justify the benefits of the operation.
Bariatric surgery began about a half-century ago with a very effective but extremely morbid operation called jejunoileal bypass. What has followed for the next several decades have been numerous investigations and different modifications of the gastrointestinal tract with the intent of producing sustained weight control, while minimizing risk and side effects. Bariatric surgery today is much safer than it was in the early years. continued ...