Doctors and patients are increasingly choosing less-invasive surgeries to help people lose weight, but the core message remains: Eat healthy and get moving.

The latest data from the Centers for Disease Control and Prevention attest to alarming rates of obesity in America.

It's a serious health problem, and there is no fix, according to doctors and dietitians across the Tristate. But there are techniques, both new and old, surgical and non-surgical, to shedding pounds and living healthier.

At the Jewish Hospital Weight Management Center, the message is "more than a diet." The comprehensive treatment includes a balance of smart eating, attitude and activity to manage weight.

As the number of overweight and obese Americans continues to rise, so does the prevalence of weight-loss surgery. For people considered extremely obese who have been unable to lose weight through lifestyle changes, it's a viable option.

How it Works

Patients at UC Health and its hospitals are eligible for weight-loss surgery if their BMI is higher than 40, or above 35 with at least two serious health problems related to obesity, like diabetes and heart disease.

The most common form of weight-loss surgery to date has been the gastric bypass, according to Dr. Tayyab Diwan, bariatric and transplant surgery specialist at UC Health. Gastric bypass surgery reduces the size of the stomach and re-routes food to bypass part of the small intestine. Within six months, patients experience significant weight loss, often in the hundreds of pounds."The bypass has been considered the gold standard of weight-loss surgery," Diwan says. "It reduces the amount of food the person can eat at one time, leading to significant weight loss."

Less Invasive

But more patients at UC Health are skipping the bypass in favor of the sleeve gastrectomy, according to Diwan. Data has shown the newer bariatric procedure to be nearly as effective when it comes to long-term weight loss, with less risk of complications.

Like the bypass, the sleeve gastrectomy involves permanently removing a large portion of the stomach. Unlike the bypass, however, the portion left behind is a slim "sleeve" naturally connecting to the intestine, making it less complex. The sleeve gastrectomy is performed laparoscopically, meaning the incisions made in the patient are small.

This less-invasive approach has led to growing popularity among both surgeons and patients across the U.S., and the Tristate is no different. In fact, the sleeve gastrectomy has become the primary weight-loss procedure recommended to patients at UC Health.

"When results indicate that long-term weight loss is the same, people will gravitate toward the simpler procedure with less risk," Diwan says.

Reduced Risk

The only major risk, he says, is a three percent chance of the new, sleeve-like stomach developing a leak, adding that the chances of complications following the gastric bypass are significantly higher.

The only disadvantage, he adds, is that the gastric sleeve has less long-term data, compared to the bypass, to determine its effectiveness.

In June, the gastric sleeve was further validated when the Centers for Medicare and Medicaid Services (CMS) approved the procedure for insurance coverage. When the CMS endorses a procedure, most primary insurance providers will follow, says Diwan.

Improves Transplant Options

At UC Health, the sleeve gastrectomy is helping patients overcome medical battles beyond just obesity. Late last year, the sleeve was first implemented as a means of spurring dramatic weight loss in patients who otherwise would be considered to be too overweight for kidney transplants.

Obesity in transplant patients has been associated with substantially greater risk for complications, according to Dr. Steve Woodle, chief of transplant surgery at UC Health.

In the past, extremely obese patients in need of a new kidney would be placed on the transplant list and told to lose weight, but only one percent of patients would actually achieve weight loss significant enough for transplant surgery.

As a result, a decade ago, UC Health became an early pioneer in utilizing weight-loss surgery to prep patients for transplant surgery. Until recently, the gastric bypass was primarily used. The sleeve is now replacing that procedure.

"It doesn't make sense to give a patient a transplant and not address the death risk associated with obesity," Woodle says. "And in a small percentage of patients, they see their kidney function improve so much post-weight loss surgery that they no longer need the transplant."

Lifestyle Changes

The weight-loss procedure itself is only one aspect of curbing a patient's obesity, according to Diwan.

"Many patients are 40 or 50 years old, and they've been eating a certain way their whole lives," he says. "The procedure is meant to jump-start a healthier lifestyle. It's up to the patient to maintain that lifestyle and live a healthier life."

Easier said than done for many. But the key to maintaining a healthy lifestyle isn't a trendy diet or fitness regime. It's old-fashioned calorie management, according to Lauren Niemes, executive director of the Nutrition Council in downtown Cincinnati.

"As a society, we're taking in more calories than we're burning," Niemes says. "That has to change."

Although Niemes admits hormones, genetics, and even certain bacteria can play a role in a person's weight, she says calorie balance is the primary driver. Nutrient-dense foods. including fruits, vegetables and whole grains are the core components of a healthy diet, she adds.

One of the simplest ways for a person to lose excess weight, according to Niemes, is by eliminating sugary drinks and going for brisk-paced daily walks.

Fad approaches to weight loss like the South Beach Diet and Atkins are not the answer, she maintains. While they may seem effective in the early going, Niemes sees them as a quick and unsustainable fix to a lifelong issue.

Instead, she recommends that a person define a diet and exercise regimen that can be sustained for life.

"Maintaining a healthy weight is a complex issue, and each person's management style is going to be different," she says. "Weight-loss surgery is an option. But as a dietitian, I would like to see more of a focus on prevention."