Bariatric Basics: Obesity in America

Bariatric Basics: Obesity in America

Dr. Charles Moore

The Center for Disease Control (CDC) estimates 42.4% of adults have the diagnosis of obesity and 9.2% have severe obesity. In 2021, CDC ranked North Carolina 16th in overall obesity compared to the rest of the United States.  In 2022, 40.4% of adults in Lenoir County were clinically obese, 5% greater than the overall rate in North Carolina. Lenoir County residents live in one of the epicenters of the obesity epidemic. 

Multiple studies have shown the advantages of bariatric surgery, what most people think of as “weight loss” surgery, but studies have proven there are many other benefits as well.  So much so, that we now refer to bariatric surgery as “Metabolic Surgery.”  Studies have shown improvement or resolution of multiple obesity related diseases, including high blood pressure, obstructive sleep apnea (OSA), high cholesterol, and heart disease.  No wonder we now refer to these surgeries as metabolic!  

The American Society of Metabolic and Bariatric Surgery (ASMBS) estimates that 256,000 metabolic surgeries were performed in 2019.  Metabolic surgery is endorsed as a safe and effective way to lose weight by the American Endocrine Society, American Heart Association, and the American Diabetes Association.  

Metabolic surgery is the currently the most powerful tool to lose meaningful weight. Depending on the specific metabolic surgery, most have five-year weight loss outcomes between 50% to 80% of excess body weight. In comparison, most medication treatments and intensive medical therapy programs have weight loss outcomes of 5-15% of weight.  Most major insurances, including Tricare, Medicare, and Medicaid, offer metabolic surgery as a benefit to their members.  

UNC Health Lenoir has the most comprehensive weight loss program in eastern North Carolina boasting four types of ASMBS endorsed surgery:

  • Sleeve Gastrectomy- The surgery removes approximately 70% of the storage capacity of the stomach. Making a banana sized stomach.

  • Gastric Bypass- Performed by creating a tennis ball sized stomach and bypassing approximately 1/3 of the upper gastrointestinal tract to reduce the absorption of additional calories.

  • Single Anastomosis Duodenal Ileostomy with Sleeve (SADI-S)- This newest type of surgery takes advantage of the restrictive nature of the sleeve gastrectomy but also has a decreased absorption component that bypasses one half of the upper gastrointestinal tract.

  • Biliopancreatic Diversion with Duodenal Switch BD/DS.  The most powerful metabolic surgery. This surgery takes advantage of the restrictive nature of the sleeve gastrectomy but bypasses 2/3 of the upper gastrointestinal tract.

Over the last 30 years metabolic surgery has proven to be a safe and effective way to not only lose weight but reduce the severity of obesity related diseases that can severely affect quality of life and potentially lead to death.  Metabolic surgery is a safe and effective alternative to medication and often has better results. 

About Dr. Charles Moore:  Dr. Charles Moore is a General Surgeon with advanced training in Minimally Invasive and Bariatric Surgery.  He is Medical Director of the UNC Health Lenoir Weight Loss Program and practices at UNC Surgical Specialists at Lenoir.  In addition, Dr. Moore is Associate Professor of Surgery at Campbell University and Clinical Assistant Professor of Surgery at East Carolina University.  


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