Herzliya Medical Center
Obesity is measured by body mass index (BMI). Morbid obesity is defined when BMI is over 40 or between 35-40 with accompanying obesity-related diseases, the common in them being: type II diabetes, hypertension, heart diseases, sleep apnea, deficient fertility and more. Likewise, there’s a direct link to increased mortality. Obesity has been defined as a plague whose causes are many and complex: improper diet, genetics, environment, psycho-social, economic. The disease’s complexity determines the treatment’s complexity. It’s been proven that the most effective long term treatment is surgical treatment. A multidisciplinary staff significantly improves the results and reduces the risk of complications and increases the chances for success after the surgery and for the long term.
All bariatric surgeries are included in the health basket. In general, success is defined when there’s a reduction of 65% of the excess weight (the weight above the ideal weight). The minimally invasive technique is mostly performed:
In Israel, bariatric surgeries have been performed in Israel for many years, since 2005, centers in Israel began performing laparoscopy of gastric bypass and sleeve gastrectomy, thousands of bariatric surgeries are performed a year in Israel. In the world: more than 300,000 bariatric surgeries are performed every year in the world today, 220,000 of which in the US alone. The most common surgery in the US is a gastric bypass, compared to Australia – band surgery is the most common.
The center operates in the multidisciplinary frame with a professional and leading staff comprised of 3 doctors, 4 psycho-social and 4 dietitians, a physiologist and a clinical pharmacist, convening assessment committees to approve the surgery in accordance with the ministry of health regulations, but most resources and attention are directed at patient follow-up and escort after the surgery within personal and group meeting over time in order to provide a comprehensive surrounding for the patients and aid in a permanent success of the surgery and changing the patients’ lifestyle.
After the surgery, support and escort follow up must be made to help change the lifestyle and aid in ensuring surgery success over time and thus preventing repeat weight gain. Within the follow-up, the Herzliya bariatric center staff will examine the data below:
Meetings with the patient:
First meeting – assessment and preparation for the surgery (committee): in this meeting, the staff assesses the patient’s fitness for the surgery in the clinical, psycho-social and dietary aspects and preparing the patient for surgery. During the meeting, introduction and making contact will be emphasized and the reasons to have the surgery – how the patient feels, what are the challenges in his life, difficulties, pleasures, reasons for weight gain (identification – focusing internal/external control, taking responsibility), events in the past that affected weight (diets, births, traumas and so on), evaluating quality of life – self evaluation, physical, social difficulties, employment, sex life, financial evaluation, evaluating addiction tendency, expectations – what is the expectation from the surgery, required behavioral changes, target weight, evaluating the time for weight loss, family support system, resistances, selecting and recruiting a chaperon/confidant, preparing the home for the recovery period.
Personal follow up meetings: the first follow up meeting is done at the Herzliya bariatric center after 10 days from the surgery, where the patient will meet for the second time the 3 staff members who saw him before the surgery, then the patient will be reexamined by them to assess his condition in terms of his physical feeling during the hospitalization and the recovery process and returning to routine, motivation and satisfaction from the results so far, comparing to goals set at the start of the process (a progress graph can be shown), evaluating the new quality of life – self evaluation, physical, social difficulties, employment, sex life, changes in the workplace and intimacy, family support, evaluating addiction, encouraging participation in support forums and groups, compliance with taking dietary supplement according to the financial condition.