Most people may not spend much time thinking about their stomachs, but some people need to be attentive to this part of their body to stay healthy and avoid potentially fatal conditions.

Each month, Dr. Meng-G Martin Lee has two seminars to better educate prospective patients of the Butler Health System on the specifics of bariatric surgeries, which helps patients struggling with obesity to lose weight.

The seminars are at Butler Memorial Hospital. The first is for patients considering surgery, followed by the second meeting, which is a support group for post-operation patients.

The next bariatric seminar is 6 to 7 p.m. May 21, and the support group is immediately after until 8:30 p.m.

Lee is certified by the American Board of Surgery as a general surgeon, performing a variety of surgeries, but he specializes in bariatric surgery.

Lee said the majority of gastric surgeries he performs are bariatric, followed by surgeries for acid reflux and gastric cancer.

He typically does three types of bariatric surgery: gastric bypass, gastric sleeves and laparoscopic gastric banding. All three limit a person’s digestive ability.

The bypass surgery involves stapling the stomach to make a smaller pocket, which limits food intake. This also reroutes the intestines to allow food to skip the normally used first portion, which limits a person’s ability to absorb food.

Rather than stapling the stomach, the gastric sleeve surgery removes a portion of the stomach, making it smaller and reducing the production of the hormone ghrelin that makes a person feel hungry.

Laparoscopic gastric banding, known as lap banding, is the least invasive because incisions and organ rearrangement are not necessary.

Instead, an adjustable band is placed around the top part of the stomach, shrinking it through a fluid-pressurized band.

The adjustability allows a physician to alter the band during follow-up procedures.

Lee said none of the three surgeries is better than the other. He said choosing a procedure is a judgment made to fit each patient’s needs.

“Each procedure has its own benefits, and each has its own downsides,” Lee said.

A patient’s qualification for surgery depends on his body mass index, which is the determining factor in obesity classification. The BMI is a calculation that considers height and weight.

Lee said a patient with a BMI of 35 to 39 needs also to have additional health problems linked to obesity to qualify, while those above a BMI of 40 do not need to have any other obesity-related problems.

These qualifications may also impact insurance coverage.

According to an article published in March 2009 by the National Institutes of Health, the average cost of bariatric surgeries range from $20,000 to 25,000.

“Medical insurance coverage varies by state and insurance provider,” the article said.

Lee said the lap band procedure is slightly less costly than the other two, but that most insurance companies cover all three.

He said the surgery’s cost is not considered when choosing the type of surgery to do on a patient, and it is not what a patient should base his decision on. Rather, the patient should gauge his level of determination to having a healthier lifestyle.

Lee said surgery is always a last resort, and patients are placed under physician supervised exercise regiments and diet plans for six months to prove their condition cannot improve through traditional weight-loss methods. This also makes it hard for someone to intentionally disregard fitness advice and demand the surgery out of laziness.

Lee said his dietary suggestions to patients before and after surgery are to focus on eating proteins, carbohydrates and fatty acids, while staying away from sugary items.

“I always tell my bariatric patients to not drink carbonated drinks at all,” he said.

Lee said patients’ effort before the procedure instills trust that they will continue to put in effort after the surgery, when they must maintain similar dieting and exercise, which will be essential to achieving the best results.

He said there is only so much a surgeon can do for someone struggling with self-discipline, and that results require patients to overcome themselves as obstacles.

“The surgery isn’t a cure for obesity. It’s a tool,” Lee said. “The patient has to be willing.”