Stanford Medicine Newsletter Updates For the Local Community

 

Bariatric surgery let rabbi take control

Procedure is a tool in the battle with excess weight

Regular exercise is part of Rabbi Nat Ezray's weekly routine.

   

Rabbi Nat Ezray’s decades-long struggle with weight began early. He joined Weight Watchers in the fifth grade. Over the next 30 years, he lost and gained weight several times over, each time putting on a bit more, until his 5-foot-6-inch frame carried 280 pounds.

“I felt hostage to it and powerless in the face of it, even though I did diet after diet,” said Ezray, now in his 16th year as rabbi of Congregation Beth Jacob in Redwood City.

He tried to keep fit by jogging and playing racquetball, but his body was breaking down. He developed sleeping problems, high blood pressure, high cholesterol, acid reflux and diabetes—ailments that commonly afflict people who are seriously overweight

In 2002, he had a heart attack. He was just 42.

Surgery as a tool

Ezray fit a profile shared by many others struggling with weight: In spite of his best efforts, the pounds he lost always came back.

A physician friend recommended that he consult with John Morton, MD, MPH, director of bariatric surgery at Stanford Hospital & Clinics. What Morton tells anyone interested in gastric surgery is that it is “no magic bullet.”

“We can’t operate our way out of the obesity problem,” he said. “It’s part and parcel of a lifestyle change. These surgeries are simply tools.”

Stanford follows the bariatric surgery guidelines established by the U.S. National Institutes of Health. That organization recommends surgery for people with a body mass index (BMI) of 40 or more and for people with a BMI of 35 who also have serious health issues related to their weight, such as type 2 diabetes or high blood pressure.

   

Stanford’s Bariatric Surgery Program is the only one in Northern California recognized by the American College of Surgeons as a Level 1A Center for Excellence. Morton has performed more than 1,500 bariatric surgeries, with no serious postsurgical complications.He also is part of a surgical team, led by Craig Albanese, MD, MBA, chief of pediatric general surgery at Lucile Packard Children’s Hospital, that performs adolescent bariatric surgeries.

Rapid recovery

Ezray decided to have a gastric bypass, one of the most frequently performed bariatric surgeries. Surgeons staple off all but a small portion of the stomach and connect that section directly to the intestines, reducing caloric absorption and -exposure to hormones that physicians suspect influence appetite and blood sugar.

He underwent the operation in the summer of 2007. He was home about four days later and recovered quickly. Just as quickly, his high blood pressure and cholesterol levels dropped so that he was able to reduce the amount of medication he required for these conditions. And he no longer needs any diabetes medication.

Now he rises early several days a week to stretch and do 45 minutes on his elliptical exercise machine. He frequently adds weight training to his routine to develop his core muscles.

“I had a lot of energy before, but boy, do I have a lot of energy now!” he said. “I didn’t realize how much energy it took to fight the daily fight with food.”

His congregation gave him great support when he told them about his surgery, he said. “I didn’t realize how much anxiety people felt about my health.”

And he has realized something else. “I don’t have to hold on to the fear that I was going to die young.”

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