January 26, 2022

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Fit And Go Forward

Year-long program to change the eating patterns of diabetics


Doctors who treats patients with type 2 diabetes encourage them to eat healthy to reduce the risk of blood sugar spikes, which exacerbate the condition.

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Weight loss surgery, some say, dates back to the 10th century when the King of Leon in Spain was dethroned because he was too overweight to ride a horse or pick up a sword.

But a more documented, well-known surgery in the medical community first took place in 1954.

The ultimate goal: to lose weight and treat the comorbidities that come with obesity, including diabetes.

Bariatric surgery, also known as weight-loss surgery, has evolved from a procedure that involves making a large incision in a person’s abdomen, to today’s latest development: a non-surgical approach that’s performed endoscopically.

Endoscopic procedures

Doctors at the University of Miami Division of Bariatric Surgery will soon launch an Endo Bariatrics program that will consist of two procedures — both done endoscopically. The doctors at the helm of the program are Dr. Sunil Amin, the director of endoscopy at the Lennar Foundation Medical Center, and Dr. Michelle Pearlman, who specializes in bariatrics, including medication and lifestyle modification approaches.

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Dr. Sunil Amin, director of endoscopy at the Lennar Foundation Medical Center, University of Miami

The first of the two procedures will be an endoscopically performed gastric sleeve, which is already widely used, but usually requires several laparoscopic incisions. The gastric sleeve stitches up part of the stomach, therefore making it smaller, which in turn makes a person feel full with less food.

12-month lifestyle modification program

The other approach is more involved, in part because it means an entire lifestyle modification that starts with a 12-month initiative. Doctors insert what’s called a gastric balloon down the esophagus and into the stomach. They then inflate the balloon, fill it with saline solution and seal it off.

A temporary gastric balloon is placed into the stomach in the latest non-surgical endoscopic procedure designed for weight loss. The balloon is filled with saline solution and is removed after six months. Courtesy University of Miami

The balloon stays there for six months and then it’s removed. That’s the key — it’s temporary.

“Some people just need a little kickstart,” said Amin, “And then they can take it from there.” That’s what doctors and medical device developers are betting on.

The University of Miami program enrolls patients into an initial six-month educational and diet-altering initiative before placing in the balloon. The idea is to equip patients with the right tools to get on track, and then, once the balloon is placed, it stays in there for another six months while patients continue their journey.

They are supported by staff such as nutritionists and mental health providers. At the end of the 12 months, the balloon is removed, again endoscopically, and the goal is that patients continue with their exercise regimen and their new healthy eating habits.

“There’s a lot of places that will just place the balloon — but we’re the only ones [in South Florida] that offer a comprehensive program,” said Amin.

The benefits of a non-surgical approach are many, including fewer complications. Now, doctors are relying on medical data and studies to guide them and their patients to success.

Not everyone is a good candidate for the procedure, said Amin. Stress eaters, for example, are people who won’t listen to their body’s signs of satiety.

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Dr. Michelle Pearlman, who specializes in bariatrics, including medication and lifestyle modification approaches, University of Miami. BiomeUMiami

Pearlman says a lifestyle change is paramount. While unwilling to disclose her own diet — because she says few will be able to follow it — she exercises religiously, independent of her busy schedule.

“When patients tell me they don’t have time [to exercise], I show them my 4 a.m. workout videos,” she said, laughing.

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