One of the first things that T. Javier Birriel, MD, of St. Luke’s Weight Management Center in Stroudsburg and Phillipsburg tells his patients is that their inability to lose weight is not their fault and that he and his team are ready to help them change their life.

“I have patients in my office who tell me their story,” he said. “Often, they’re doing everything they should be. I tell them, don’t give up. We’ll help you get to a point where you’re happy and renewed.”

Dr. Birriel decided to specialize in bariatric and metabolic surgery while a surgical resident at St. Luke’s Bethlehem Campus. He completed a rotation with St. Luke’s Weight Management Center in Allentown, where the patients left a great impression on him.

“I knew the surgery was making huge differences in their health and quality of their lives,” he said. “That was something that I wanted to do.” So, he completed a bariatric and metabolic surgery fellowship at the Cleveland Clinic. When the opportunity arose, he returned to St. Luke’s.

Dr. Birriel explained that losing weight involves factors that are hard to modify, such as metabolism, genetics and chronic illnesses. They are complicated by behaviors, culture and lifestyle choices. Besides, as we age, we replace muscle with fat, slowing metabolism. Decreased estrogen in women and testosterone in men can also cause weight gain. Work and family balance can decrease activity and change dietary habits.

Dr. Birriel stressed weight loss surgery is not vanity, but an intervention to improve the patient’s overall health.

“We like to call it metabolic and bariatric surgery because we’re treating diseases, such as diabetes, heart disease, high blood pressure, acid reflux, sleep apnea and hormonal imbalances, brought on by weight,” he said. “The incredible thing about bariatric surgery is you lose the weight, and that’s the driver to treat these diseases. Surgery reduces the risk of death from those diseases and cancer. So globally, it’s extremely beneficial.”

Medicare and most commercial insurance plans cover weight loss surgery. Must insurers base eligibility on body mass index (BMI), the height-weight ratio. Patients with a BMI over 40, or 35 to 39.9 and a weight-related medical condition, usually quality.

Immediately following surgery, many patients come off medications, such as some drugs that treat diabetes. As patients lose more weight, their health improves, and may no longer need medications.

The success of maintaining weight loss after bariatric surgery is much higher than traditional weight loss. Dr. Birriel explained for most of humankind’s existence, food has been scarce, so the body fights weight loss. When you drop a few pounds, your body thinks you’re starving. So, it slows your metabolism and increases your appetite.

Conversely, about 90% of surgical weight loss patients keep the weight off. It is very safe, usually requiring only an overnight stay. But to be successful, Dr. Birriel stresses patients must fully commit to lifestyle changes involving food, vitamins, minerals, exercise and medical follow-up. Before surgery, they must have a thorough evaluation, attend support group meetings and make dietary and exercise lifestyle changes.

One of the most common weight loss surgeries performed at St. Luke’s is Roux-en-Y gastric bypass, in which a small pouch is formed from the top part of the stomach, bypassing a portion of the small intestine. Another popular surgery is sleeve gastrectomy, which reduces the size of the stomach by creating a small sleeve or banana-shaped pouch, resulting in less food absorption. Other options are available, including those that repair prior surgeries.

Also, surgery affects gut hormones to decrease hunger and minimizes digestion of consumed food. Some studies suggest it may reset the body’s metabolism as well. All of which contribute to success.

Dr. Birriel recalls one patient who needed hip replacements and could only walk with a walker. After bariatric surgery, she lost enough weight to qualify for bilateral hip surgery. When he saw her a year later, she was able to run after her grandchildren.

“I love my job, interacting with our patients and seeing and hearing how much they’ve changed their lives. Bariatric surgery is a tool for patients to improve their health – a second chance at life.”