Jayaraj Salimath, D.O., B.S.N.
Board Certified General Surgeon |
Dr. Jay Salimath discusses gastric sleeve surgery for weight loss on HEALTH WATCH.
Health Matters with Jayaraj Salimath, D.O., B.S.N.
A National Problem:
Obese and Overweight Children
By Dr. Jayaraj Salimath
An overwhelming 61% of the American adult population is overweight. Even more alarming, our children are rapidly growing more obese and overweight too. Since the 70s, the percentage of overweight kids and adolescents in the U.S. has more than doubled, the same as for adults. Today, 25% of our children are overweight, with 10% between the ages of 2 and 5 and 15% between 6 and 19. On the whole, children are spending less time being "kids," i.e., playing outside and exercising - and spending more time the way most American adults do - in front of TV, playing video games or surfing the Internet. Added to the problem is the fact that most American families have less time to prepare nutritious meals and have become addicted to high-calorie sodas.
When the BMI for your child's age is between*...
95th percentile or above - obesity
85th and 94th percentiles - overweight
5th and 85th percentile - normal weight
below 5th percentile - underweight
*In addition to the above criteria, family history, eating habits, calorie intake and health conditions are considered. |
Facts on Obesity
Obesity is defined as an excessive accumulation of body fat, while childhood obesity is a weight-for-height in excess of 120 percent of the ideal. However, skinfold measures are more accurate determinants. Cutoff points on growth charts, established by the Center for Disease Control (CDC), help identify overweight and obese children.
Possible Cause
 “Energy is neither created nor destroyed” is a basic universal principle. Whenever there is an imbalance between energy intake and output, obesity or malnutrition result. And, just as with adult obesity, excessive weight in children involves many factors.
The most common cause is high calorie intake with lower calories used in the form of physical activity. As already mentioned, children are spending more time playing with electronic games and less time actively playing outside. In addition, watching television is a major contributor. An addiction to high-calorie fruit drinks and sodas and our nation's fast food also adds to high calorie intake. In fact, today's fast food suppliers tend to target advertising at children and conspire with Hollywood media to send them the wrong message. Other causes include family history and genetic factors. Studies show a higher risk of obesity among kids whose parents are obese, as well as the fact that genetic factors influence our pattern of fat distribution and response to overeating. On rare occasions, medical conditions like hypothyroidism and adrenal gland malfunction lead to obesity.
A Serious Problem
Overweight adolescents have a 70% chance of becoming overweight or obese adults. This increases to 80% if one or more parent is overweight or obese. Unfortunately, the effects of obesity are both physiological and psychological. The immediate consequence of excessive weight for many children is social discrimination, as evidenced by the lower chance of being picked forteam sports and class activities. In addition, children that are overweight often have the social stigma of being "dumb" and unable to enter the best colleges. These factors also contribute to poor self-esteem and depression. What may be more serious, however, is the fact that overweight and obese children often experience early development of Type 2 diabetes, metabolic syndrome (high cholesterol, abdominal obesity, insulin resistance and high blood pressure), sleep apnea, increased asthma symptoms, early puberty and menstrual irregularities and infertility, just to name a few of the physiological effects.
What Can We Do?
An "ounce of prevention is worth a pound of cure” seems appropriate when dealing with obesity. Everyone can attest that gaining the weight is so easy, but losing it is much more difficult. Once overweight, most people get stuck in a vicious cycle of losing and gaining it back, never seeing a big change and eventually giving up. We say children are the future of the nation. If this is true, then we must wake up and take action at a grassroot level to keep our nation from becoming more obese. The family is the building block of society, so the change must start there. Adults must set the example by making the right food choices.
- Starting at infancy, promote breastfeeding, recognize the of signals of satiety and delay introduction of solid foods.
- Teach children to drink water with meals, instead of juices and soda.
- As American schools get rid of junk foods from the cafeteria and school grounds, so too, they should also ban the use of video games.
- Physical education should be mandatory for all grades.
- Along with physical education, school should introduce nutrition education.
- Parents and media, too, should educate in regard to nutrition.
- Families should change their eating behavior, slowing the rate of eating, limiting the time and place for eating and cease using foods as rewards or incentives.
- Avoid buying high-calorie foods, just because they are cheap.
- Along with making better food choices, increase activities that involve the whole family in physical exercise that everyone enjoys.
- Provide a safe environment for children and their friends to play actively: encourage swimming, biking, skating, ball sports and other fun activities.
- Reduce the amount of time you and your family spend in sedentary activities, such as watching TV or playing video games.
- Limit TV time to less than two hours a day
When all else fails, medical or surgical treatment should be sought, with surgery being the last resort for children.
Dr. Jayaraj Salimath, a Board certified surgeon at Mid Illini Surgical Associates in Peoria, is the Medical Director of the Methodist Medical Center's Weight Loss & Surgery Center
By: Sarah Storey Smiles, Methodist Medical Center
Reprinted by permission of Healthy Cells Magazine
There is an “obesity epidemic” in this country, according to a multitude of experts. The prevalence of obesity is blamed on a sedentary lifestyle and high-fat diet, a poor metabolism, or a combination of both. But while many people can lose weight through a balanced diet and regular exercise, some struggle to maintain a healthy weight no matter how hard they try. These individuals may consider weight-loss surgery, also called bariatric surgery, to achieve their health goals.
There are different types of bariatric surgery used to treat obesity, including procedures that alter the anatomy of the digestive system. Dr. Jayaraj Salimath, D.O., medical director of the Methodist Weight Loss and Surgery Center, describes another option: the sleeve gastrectomy. The procedure was conceived of in the mid-1990s and refined in the past 3 years.
People with a body mass index (BMI) over 35, or approximately 100 pounds or more overweight, usually qualify for a sleeve gastrectomy, Dr. Salimath says. Prospective candidates undergo a screening process that includes patient education and a psychological evaluation.
How a Sleeve Gastrectomy Works
The sleeve gastrectomy is a procedure in which the stomach is trimmed into a narrow tube, about the size and shape of a banana, by permanently removing most of the stomach. Dr. Salimath explains, “It is a purely restrictive procedure, meaning it restricts the amount of food you can eat. By removing the majority of the stomach, we reduce the amount of appetite-producing hormone called ghrelin (produced by the stomach). Since stomach volume is greatly decreased, the average person will be able to eat only two to three ounces of food at a time.”
How is a Sleeve Gastrectomy Different from Other Procedures?
Dr. Salimath notes that the operation leaves the pyloric sphincter—a ring of muscle at the end of the stomach that contracts when the stomach is full—intact. “The pyloric sphincter naturally acts as a band to prevent quick gastric (stomach) emptying, or dumping (into the small intestine),” which can cause vomiting and bloating.
Because the sleeve gastrectomy does not reroute the small intestine (like gastric bypass surgery), or insert a foreign body (like the Lap-Band), Dr. Salimath states this procedure has resulted in “very few” complications. And since most of the body’s absorption of nutrients, vitamins, minerals, and water occurs in the small intestine, leaving the digestive organ’s anatomy unaltered makes malabsorption (poor absorption) and resulting malnutrition less likely. Many patients who are not candidates for other types of bariatric surgery often qualify for the sleeve gastrectomy because it is less invasive, he adds.
“People with a body mass index (BMI) over 35, or approximately 100 pounds or more overweight, usually qualify for a sleeve gastrectomy.”
Possible Benefits
The chronic health problems that commonly accompany obesity can often be reversed when a patient loses 80-100 pounds following surgery, Dr. Salimath explains. Many patients with diabetes, high blood pressure, elevated cholesterol levels, sleep apnea, and joint and back pain have shown marked improvement after weight loss. “Because of all this, they have a lot more energy and time to do other things (they enjoy).”
For more information, call 1-866-599-6398.
A New Way to Fight Obesity
reprinted by permission of The Peoria Woman
by Sarah Storey Smiles, Methodist Medical Center
Walking across a parking lot, tying shoes, getting in and out of a car—lugging around an extra 20 or 30 pounds of body weight can make such everyday activities a chore. But being 100 or more pounds overweight can make the tasks many of us take for granted almost impossible. People who have struggled to lose weight (and keep it off) can seek medical treatment from a physician who specializes in bariatrics, a field of medicine that focuses on the treatment of obesity and diseases associated with obesity. Individuals with a body mass index (BMI) over 35, or approximately 100 pounds or more overweight, may qualify for bariatric surgery.
Traditional Weight-Loss Surgery
Dr. Jayaraj Salimath,D.O., Medical Director of the Methodist Weight Loss & Surgery Center and a specialist in minimally invasive and bariatric surgery, describes the two traditional types of weight-loss procedures: gastric bypass and Lap-Band.
Gastric bypass surgery makes the stomach smaller, making a person feel full more quickly and thus less likely to consume excessive calories. The surgery also causes food to bypass the first section of the small intestine, resulting in fewer calories being HEALTHabsorbed. However, Dr. Salimath points out that fewer nutrients are also absorbed, which can lead to malnutrition.
In Lap-Band surgery, a silicone band is placed around the upper stomach to restrict food intake. Dr. Salimath explains, “You’re putting a foreign body into the human body.”
Leading-Edge Weight-Loss Surgery
In addition to the gastric bypass and Lap-Band procedures, Dr. Salimath offers an alternative surgical approach to weight loss called the sleeve gastrectomy, currently available only at Methodist. In the sleeve gastrectomy, a procedure refined in the past three years, most of the stomach is removed, reducing not only its volume but also the level of appetite-producing hormones secreted by the stomach.
“You lose as much weight with the sleeve gastrectomy as you do with the gastric bypass,” Dr. Salimath says. “But there is no dumping syndrome (vomiting and diarrhea caused by rapid emptying of the stomach) and no malabsorption (poor absorption of nutrients) because we do not alter the anatomy of the small intestine, where most absorption occurs. With the sleeve gastrectomy, there is no rerouting of the small bowel.”
Quality of Life Gains
Weight-related disorders, including diabetes, high blood pressure and elevated cholesterol, often diminish in severity or even disappear after patients drop a significant amount of weight with the help of bariatric surgery, Dr. Salimath explains. And women with infertility related to obesity are often able to conceive after losing weight.
Sleep apnea is also often resolved after surgery. “The first thing patients tell me after losing weight is, ‘Doc, I can sleep now,’ and this means increased energy to do the things they couldn’t do before,” Dr. Salimath says.
People who are not candidates for gastric bypass or Lap-Band may qualify for the sleeve gastrectomy because the newer bariatric procedure leaves the small intestine intact, which has resulted in “very few complications.”
For example, individuals who need knee or hip replacement surgery but do not qualify due to obesity are usually not candidates for a gastric bypass either. Dr. Salimath says these patients may qualify for the sleeve gastrectomy and lose enough weight to undergo joint replacement.
“People with congestive heart failure who are struggling to get around because of obesity (and do not qualify for traditional bariatric surgery) may also benefit from the sleeve gastrectomy,” Dr. Salimath explains. “And the newer procedure is a viable option for teenagers too, because the anatomy of the small intestine is not altered.” TPW
Mid Illini Surgical Associates Welcomes Dr. Jayaraj Salimath, Bariatric Surgeon
(Peoria, IL) Jayaraj (“Jay”) Salimath, D.O., B.S.N., a specialist in minimally invasive surgery and bariatrics, has joined the team of Board certified surgeons at Mid Illini Surgical Associates (MISA). The study of the causes, treatment and prevention of obesity, bariatrics has increased in popularity due to the rising numbers of people who are overweight. In fact, more than 60% of today’s U.S. population is currently overweight, with about 30% defined as obese.
“Obesity is a disease that has contributed to a variety of physical and emotional problems,” Dr. Salimath said. “I believe my training as both a surgeon and a nurse offers my patients a unique combination of expertise and sensitivity to address this disease.”
Bariatrics and Other Treatments Too
Certified by the American Board of Osteopathic Surgery, Dr. Salimath recently completed his fellowship in minimally invasive and bariatric surgery at Cleveland Clinic in Weston, Florida. In addition to skills as a physician and surgeon, he also offers his experience as a Registered Nurse.
“I look forward to providing minimally invasive surgery for a variety of conditions, as well as all the latest bariatric treatments,” Dr. Salimath continued. “Whether patients are looking for ways to battle their weight gain or desire the benefits of state-of-the-art surgery, I will provide the comprehensive clinical care and surgical therapy they need.”
Exclusive to the Area
As part of the MISA team, Dr. Salimath will offer the most contemporary weight-loss surgeries available in the Peoria area – including gastric bypass, lap band surgery, lap sleeve gastrectomy and revisional bariatric surgery – along with minimally invasive procedures using a laparoscope or endoscope. In fact, Dr. Salimath is currently the only surgeon performing the lap sleeve gastrectomy in this area.
Lap sleeve gastrectomies are typically safer and less problematic than other types of weight-loss surgeries. An operation in which the left side of the stomach is surgically removed, lap band gastrectomy results in a new stomach about the size and shape of a banana. Because it does not require rerouting or reconnecting intestines (like the gastric bypass) or inserting an artificial implant (like the lap band), this operation carries less risk and recovery time. By utilizing cameras or scopes with small incisions, Dr. Salimath can perform many surgeries on an outpatient basis, with less pain, earlier resumption of normal activities, fewer complications and less scarring. He also provides laparoscopic, minimally invasive treatments for appendicitis, gallstones and bile duct stones, gastric tumors, gastroparesis (a chronic medical condition resulting in delayed gastric emptying), heartburn or acid reflux, hernias, diseases of the spleen, swallowing disorders and small bowel/colon surgery.
Training & Expertise
Dr. Salimath completed his medical requirements at the Michigan State University College of Osteopathic Medicine in Lansing. A former Instructor for the Nursing Board Exams (1998-2001) at Kaplan Educational Centers, he also worked as a Registered Nurse in the Emergency Department at Ingham Regional Medical Center and in the Skilled Care Unit at Pines Health Care Center (1995-1997). Prior to coming to the States, Dr. Salimath served in India as a Registered Nurse in a Cardiothoracic Surgical ICU and as a Clinical Instructor for nursing students. For information or concerns related to any of these conditions, please call (309) 672-5975 and arrange a professional consultation.
MISA is an experienced team of physicians, nurses and support staff who provide patients with comprehensive surgical care. All our physicians are Board certified surgeons and have surgical privileges at Methodist, Pekin, Proctor, OSF Saint Francis and Kewanee hospitals. In addition, all MISA surgeons are active in teaching medical students from the University of Illinois College of Medicine at Peoria.
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