Bariatric_WomanwithWeightsTo help meet a growing need for medically necessary weight-loss surgery, The Ohio State University Wexner Medical Center has recruited physician-leader, patient advocate and bariatric surgeon Stacy Brethauer, MD.

This brings Ohio State’s experienced bariatric surgery team to three full-time surgeons. Together, they offer the full range of bariatric procedures, including new endoscopic techniques and complex revision surgeries.

A regional referral center

Ohio State’s bariatric surgical volume averages 450 cases a year — and that number is expected to increase to 600 or more annually.

“Part of the reason our program is in such high demand is because we take cases many other centers can’t accommodate,” says Dr. Brethauer, who is also vice chair of quality and patient safety in the Department of Surgery and medical director of supply chain management. “Some of our patients have comorbidities that make them high-risk for surgery, while others need revision surgeries that should only be performed by experienced surgeons.”

Having collectively performed more than 10,000 surgeries, Dr. Brethauer and his colleagues can manage even the most challenging cases. These include patients who have:

  • Undergone organ transplant surgery
  • Received a left ventricular assist device
  • Experienced ulcers, chronic obstructions or other complications following their original weight-loss surgery
  • Regained weight and need a second surgery to achieve additional weight loss

Ohio State is also one of the few medical centers in the region to offer advanced endoscopic techniques to treat bariatric surgery complications or implant new devices that promote weight loss. Procedures include intragastric balloon placement and endoscopic sleeve gastroplasty.

All these surgical capabilities are offered alongside comprehensive medical services, from providers who specialize in psychology, nutrition, exercise physiology and endocrinology.

A champion of change

When he’s not performing surgery, training residents or conducting research, Dr. Brethauer — who came to Ohio State from Cleveland Clinic in March 2019 — is actively involved in professional organizations that aim to advance the field of bariatric surgery.

Not only did he serve as president of the American Society for Metabolic and Bariatric Surgery from 2016 to 2017, he currently co-chairs the quality committee for the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program.

Through these and other roles, Dr. Brethauer has advocated for new health insurance guidelines to improve patient access to life-changing  and, in some cases, lifesaving — bariatric surgery.

“In most states, people with a body mass index between 35 and 40 qualify for bariatric surgery if they have at least one obesity-related medical condition such as sleep apnea or type 2 diabetes,” he explains. “I’m part of an international group of physicians that’s pushing to move that threshold down to 30 for people who have diabetes.”

Dr. Brethauer, a professor – clinical at the College of Medicine, says that during the last decade, around a dozen randomized clinical trials confirmed that bariatric surgery is superior to medical care for diabetes treatment in patients who are obese. Based on that evidence, the American Diabetes Association released new guidelines suggesting that patients with a BMI between 30 and 35 who have poorly controlled diabetes should be considered candidates for bariatric surgery.

“Ohio’s Medicaid program recently changed their policy to cover bariatric surgery in this specific population,” Dr. Brethauer adds. “I’m hopeful that health plans around the country will soon follow suit. There is a huge amount of people who have this chronic, progressive disease, who are only going to get sicker over time without proper treatment. And research shows bariatric surgery can significantly change the trajectory of type 2 diabetes.”

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