Obesity care options grow
By John George
Philadelphia Business Journal
Updated: 5:00 p.m. MT June 25, 2006
Treating obesity, a condition health officials have labeled an epidemic, has become a big business for Philadelphia-area medical schools and hospitals.
Last week, Temple University opened its $6.7 million Center for Obesity Research and Education headed by Dr. Gary Foster, an internationally renowned obesity researcher.
Next week, Pennsylvania Hospital is opening a minimally invasive surgical suite for laparoscopic gastric bypass surgeries. Surgeons at Pennsylvania Hospital, which is spending $2.5 million on the new suite, performed more than 400 of the weight-loss surgical procedures last year.
Next month, Abington Memorial Hospital expects to perform its first bariatric weight-loss surgery.
In gastric bypass and bariatric procedures, doctors surgically reduce a patient's stomach capacity so he or she feels full after eating less.
"Obesity is a major health problem in our country," said Meg McGoldrick, Abington Memorial executive vice president and chief operating officer. "We think this is a service we needed to be able to offer to our patients."
Foster, whose specialty is researching the behavioral and biological effects of dieting and weight loss, was lured to Temple's medical school from the University of Pennsylvania where he was the clinical director of Penn's Weight and Eating Disorders Program.
"For me this was an opportunity to create and lead an interdisciplinary center that is composed of people from across the various schools and colleges at Temple," Foster said. "Obesity is so complex. It's not appropriate to say it's just a medical problem or a social problem.
"There was considerable support and a lot of cooperation among the various deans at Temple for this to happen. We've been provided with 10,000 to 12,000 square feet of actual space, which is very rare in academia."
The Center for Obesity at Temple initially has a full-time staff of 15. That number is expected to double within the next six months. Foster, who brought $4.1 million in National Institutes of Health grants to support his research, is also looking to add five to 10 faculty members to the center over the next five years.
Most area hospitals have programs in place to help adults and children lose weight through behavior modification classes, group meetings, fitness training and nutrition counseling.
Nearly a dozen hospitals in the area offer, or are about to offer, bariatric surgery. The region is home to two Barix Clinics facilities, one in Langhorne and the other in Chadds Ford, that offer only weight-loss surgical procedures.
The number of weight-loss surgeries performed in the United States between 1998 and 2002 increased by almost 600 percent, according to a study released this week by the American Journal of Public Health.
Albert Einstein Medical Center has offered the surgery to patients for more than three years, but at the end of last year it decided to consolidate the program at its Elkins Park campus. Dr. Ramsey Dallal, who has performed nearly 1,000 laparoscopic gastric bypass procedures, was brought in from the University of Pittsburgh Medical Center to lead Einstein Bariatrics.
"We decided to put the program at Elkins Park because it's a more patient-friendly site in terms of parking and access," Dallal said.
He said the program has its own psychologist, nutritionist, physical therapist and dedicated OR teams and nursing staffs trained to meet the needs of bariatric surgery patients.
Dallal said bariatric surgery programs require significant resources to meet the needs of severely obese patients, and many hospitals that get into the service line don't stay committed.
"Nationally, you are seeing a lot of programs opening and closing," Dallal said.
Dallal said the Einstein program is averaging about six surgeries a week. He said the plan is to continue expanding the "comprehensive nature" of the program -- which includes research, novel operating techniques and nonsurgical approaches to treating obesity.
Last month, Hahnemann University Hospital's Center for Surgical Weight Loss hosted a free, interactive Webcast of an actual bariatric surgery.
The Webcast was part of an ongoing $200,000 marketing campaign designed to raise awareness of the 2-year-old center, which performed its 100th procedure earlier this year.
Laurie Durkin, Hahnemann's chief business development officer, said the campaign also includes community seminars in and outside of the hospital, print and television advertising plus enhancements to the program's Web site.
"Clearly, [obesity] is a health problem in our community with a population that's been underserved," Durkin said.
Hahnemann spent more than $30,000 to produce the bariatric surgery Webcast, which attracted almost 8,000 viewers -- 2,200 watched the surgery and the remaining number participated in a panel discussion and a question-and-answer session with the surgeon involved in the surgery.
Durkin said calls into the center have doubled since last month.
Abington Memorial recruited Dr. Fred Bonnani from Reading Hospital to lead the program, which has an initial staff of four.
McGoldrick said Abington Memorial invested more than $100,000 to create the center in its new Lenfest Pavilion. Expenses included OR equipment and supplies, some minor facility modifications and appropriately sized beds and chairs for patients.
Foster said while bariatric surgery is a "life transforming" procedure, it is recommended only for a small segment of the population: those who are more than 100 pounds overweight with a high body mass index.
"It has shown to be an effective treatment in terms of long-term outcomes, but it's appropriate for a relatively small percentage of patients," he said.
His research-focused center is studying everything from surgery to medicine to diets, including how what a person eats for breakfast affects what they eat the rest of the day, to determine the best approaches to care.
Another large part of the center's activities will be leading outreach programs targeting obesity in local communities and school systems.
Later this year, Foster will be leading a three-year National Institutes of Health-funded study gauging efforts to prevent obesity and reduce diabetes risk in 42 middle schools throughout the country that have a majority of particularly at-risk African-American and Latino students.
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