MOULTRIE — The effects of obesity are profound and easily can erode away a person’s life.

Dr. Howard Melton of Surgical Associates of South Georgia in Moultrie has taken the challenge of reversing the destruction by bringing the lap-band system to the community.

In 1990, 10 to 14 percent of Georgia’s population had a body mass index of 30 or more, which is obese. By 2005, that figure doubled.

According to the Surgeon General’s Call to Action to Prevent and Decrease Overweight and Obesity report, the estimated cost of obesity in the U.S. was $117 billion in 2000. This estimate includes the direct costs associated with obesity and its related co-morbidities, such as preventative, diagnostic and treatment services, as well as indirect costs including the value of income lost from decreased productivity or lost days of work, said a press release from Allergan, Inc., the maker of the lap-band system.

Obesity appears to have a stronger association than smoking or problem drinking with chronic medical conditions, reduced health-related quality of life and increased health care and medication spending.

The lap-band system was approved by the FDA in June 2001 for severely obese adults with a body mass index (BMI) of 40 or more or for adults with a BMI of at least 35 plus at least one severe obesity-related health condition, such as Type 2 diabetes, hypertension, asthma, sleep apnea or joint problems.

“There is a great deal of interest, and we have not advertised, because we’re just starting up the program,” Melton said.

Internist Dr. Clyde Lamon, also of Moultrie, pushed for Melton to offer the lap-band as a means to reverse debilitating diseases such as diabetes, which is prevalent in this community, Melton said. Quoting a study published recently in the New England Journal of Medicine, the surgeon said the lap-band could resolve 83 percent of Type 2 diabetes.

“We treat a lot of things in medicine that we treat and we treat and we treat. It’s uncommon for us to find something in medicine that we cure,” he said. “... A large percentage with diabetes come off of their medications completely. That’s a very impressive thing to me.”

Other conditions can be improved, including 82 percent resolution of asthma, 52 percent resolution of hypertension, 41 to 76 percent resolution of degenerative joint disease, 63 percent resolution of high cholesterol problems, and 74 to 98 percent of obstructive sleep apnea resolution. Sleep apnea can lead to hypertension and heart failure, he said.

With several years of medical information on lap-band surgery available, the procedure has proven to be much safer than laproscopic bariatric surgery, he said. Also, it has the same overall weight loss success at a three-year window as the bariatric surgery.

“You lose weight a little more slowly with lap-band,” he said, “… This is a procedure that safer and gives the same results over time,” Melton said.

The lap-band squeezes a point at an indentation between the stomach and the esophagus. The pouch left above the ban fills up quickly, satiating hunger faster, so you eat less. The overwhelming benefit is that it’s a less invasive procedure, and it’s adjustable and removable.

“It’s safer. It’s an easier operation for the surgeon to do and, therefore, for the patient to undergo. It’s a lot quicker operation than the other, more invasive procedures so you’re not asleep as long, you’re not in the hospital as long. It is reversible. You can take this thing out,” he said, listing other bariatric surgeries which are major and not reversible.

But the lap band is not a silver bullet, he said. It requires education and preoperative evaluation (including psychological, physical therapy and exercise tolerance evaluations plus pulmonary, cardiology and dietary consultations). It also requires lifelong follow-up. Melton also is working in conjunction with the YMCA, Colquitt Regional Medical Center and the hospital’s physical therapy and nutrition departments.

“The surgery is a relatively minor part of the whole process,” he said. “The lap band is a tool the patient uses to lose weight and then to manage the weight for the rest of their lives.”

In the best studies all over the world, at two to three years a patient should expect to lose 65 percent of excess weight. But as the patient loses weight, it motivates him to exercise and eat better.

More and more insurance companies are covering lap-band surgery. For those whose insurance doesn’t cover the procedure, there is a cash option financing plan.

“The insurance company is realizing, ‘Hey, we’re spending $1,250 a month covering this guy’s medications for diabetes, for hypertension, his arthritis medicine’ ... Then it gets to be pretty easy for them to start realizing this makes good fiscal sense,” he said. “The insurance company winds up saving money in the long run, and the patient winds up saving money in the long run.”

Overall cost of the procedure is $18,000 to $20,000 (comparable to surrounding communities) for a cash payment patient plus adjustments for the device for a year. That cost does not include pre-op work-up. That amount may seem like a lot, but given the potential to reduce expense dramatically in medication or other surgeries due to the strains of obesity and in food savings, Melton believes the benefits, fiscally and physically, far outweigh the cost.

Some patients have gone as far as Mexico in search of cheaper bariatric surgeries than what they might find in the U.S., Melton said. Doing so might be cheaper but can end up a regrettable choice. Melton told of a case of a Memphis woman who had gone to Mexico for a lap band placement. The woman experienced complications, and when the band was removed, it was found to be a sample.

“She got a knockoff, which was a sample, and was put on a plane and sent home. There was no pre-op education whatsoever. They had no post-op follow-up, and then they had to come home and find somebody to take care of them,” he said.

No procedure is without risk, Melton said, but lap band placement with no cutting or stapling or intestinal rerouting is much safer than gastric bypass. Gastric bypass carries a mortality risk of one in 200. With lap band, that is reduced considerably to one in 2,000, and most of these complications are the result of a pulmonary embolism, he said. Other less severe risks include slippage of the band.

An informational patient seminar will be held at 7 p.m. today, May 27, at the Sunset Country Club for those interested in the procedure. Contact Surgical Associates of South Georgia at 985-1080. Prospective patients are asked to bring a support person with them to the seminar.