Your Men’s Health Playbook

People who seek medical help for weight management are used to hearing that results take time. Imagine the surprise of some patients with type 2 diabetes when their blood sugar improves meaningfully within days or weeks of bariatric surgery.

It happens—and it’s a dramatic sign of the benefits bariatric surgery holds for many patients, said Dr. Fritz Jean-Pierre, a board-certified bariatric surgeon and national leader in minimally invasive and robotic techniques for the treatment of obesity and metabolic disorders.

When changes in blood sugar following bariatric and metabolic surgery were first observed in the 1990s, the reason was a mystery. But today, medical experts know more about the hormones that regulate hunger and insulin production. They also know more about how bariatric surgery affects the same hormones.

Understanding type 2 diabetes: It starts with insulin resistance

Insulin is a hormone that regulates blood sugar. Insulin resistance happens when muscle, fat and liver cells fail to respond to insulin, causing the pancreas to overproduce the hormone. Eventually, blood sugar rises. Patients may develop prediabetes or type 2 diabetes.

Another hormone that affects weight is GLP-1. It’s naturally produced in the gut after eating. GLP-1 helps regulate blood sugar by:

• Stimulating insulin
• Suppressing glucagon, a hormone the pancreas produces that raises blood glucose levels
• Slowing digestion

Many recognize GLP-1 today because of the class of weight-management drugs such as Ozempic, Zepbound and Wegovy. These medications mimic and amplify the effects of the GLP-1 hormone.

How bariatric surgery affects hunger hormones and improves health

Several types of bariatric surgery are performed at Wellstar. While each procedure alters the digestive system differently, all appear to influence the hormones that regulate hunger and blood sugar.

Hormones, such as GLP-1, that promote fullness and insulin sensitivity increase after surgery. The liver produces less excess glucose, and the body becomes more sensitive to insulin. Other hormones—like ghrelin, which signals the brain that the stomach is empty—decrease after surgery.

“We've known since the early 2000s that after bariatric surgery, you have a boost in GLP-1 hormone production,” said Dr. Jean-Pierre. “Patients notice improvements in their blood sugars and that feeling of fullness.”

As a result of hormonal changes triggered by surgery, patients who are not yet on insulin replacement therapy may enter diabetes remission relatively soon, according to Dr. Jean-Pierre.

“The patient may have lost only 5 or 10 pounds yet their blood sugars have become normalized,” he said. “Their diabetes is completely controlled without medication after surgery. That’s the best-case scenario.”

For other patients, improved blood sugar may take longer. Still, clinical trials show that bariatric surgery leads to diabetes remission in 33% to 90% of individuals at one year after bariatric and metabolic surgery.¹

“These surgeries are not just changing or shrinking the patient’s stomach,” Dr. Jean-Pierre said. “We're changing their metabolisms in a way that will help improve a lot of related health conditions like high blood pressure, abnormal cholesterol and fatty liver disease.”

Long-term health benefits of bariatric surgery

There are many health risks of type 2 diabetes and obesity. Those include high blood pressure, high cholesterol, sleep apnea and joint pain. Unmanaged diabetes can lead to damage to nerves, kidneys, eyes and heart. Stroke risk is also higher in people with diabetes.

Physicians have more treatment options for obesity than ever, including surgery, medications and lifestyle changes. Wellstar Center of Best Health is a comprehensive weight management clinic with clinicians, dietitians, psychologists and exercise physiologists who work collaboratively with surgeons.

Together, they learn about each patient’s situation and develop a personalized treatment plan with the best chance of success. Some patients may benefit from both surgery and medication.

“Obesity is a chronic, relapsing, multi-variable disease process that we have to approach from different angles in order to best treat it,” said Dr. Jean-Pierre. “You must approach it comprehensively, including nutrition and exercise. Medication itself is not a magic bullet. Surgery is not a magic bullet.”

Wellstar’s weight loss teams support patients throughout their healthcare journey. The goal is to see patients reach their goals and return for follow-up care in even better health.

“It’s amazing when all of these treatment options fire in the right direction and we see the health improvements that come along with surgery,” such as:

• Better diabetes control
• Lower blood pressure
• Less joint inflammation and pain
• End of the need to use a CPAP for sleep apnea

“Most surgeons fix something, then you don't see your patient again. With bariatric surgery, it's a very different relationship,” Dr. Jean-Pierre said. “We see our patients for a long period of time afterward. We get to share in their successes and see their accomplishments as they lose that weight.”

Learn more about obesity medicine at Wellstar and make an appointment to see an obesity specialist at one of our locations.

Northwest Georgia Oncology Centers in Cartersville
June 5
1 PM to 3 PM
65 Cloverleaf Drive, Cartersville
Contact Mary Ellen Smither at [email protected] or (678) 858-1146.

Wellstar Cobb Medical Center
June 5
12 to 2 PM     
4040 Hospital West Drive, Austell
The event will be held in the parking lot across from Tranquility Hospice located at 4040 Hospital West Drive.
Contact Ashley Dapremont at [email protected] or (470) 732-4523.

Wellstar Douglas Medical Center
June 6
11 AM to 1 PM
6167 Prestley Mill Road, Douglasville 
Douglasville First United Methodist Church 
Contact Diane Harris at [email protected] or (470) 644-5411.

Wellstar Kennestone Regional Medical Center
June 5
11:30 AM to 2:30 PM
320 Kennestone Hospital Blvd., Marietta
Cancer Center
Contact Leena Augustine at [email protected]. 

Wellstar North Fulton Medical Center
June 6
2 to 4 PM
3000 Hospital Blvd., Roswell
Main lobby in hospital
Contact Sarah Bentley at [email protected] or (770) 751-2556.

Wellstar Paulding Medical Center
June 7
2 to 4 PM
144 Bill Carruth Parkway, Hiram
Atrium
Contact Kellie Mitchell at [email protected] or (470) 644-8106.

Wellstar Spalding Medical Center
June 5
12 PM to 2 PM
608 South 8th St., Griffin
Cancer Center
Contact Sherry Connell at [email protected] or (470) 935-5526.

Wellstar West Georgia Medical Center
June 5
10 AM to 12 PM
111 Medical Drive, LaGrange
Enoch Callaway Cancer Center
Contact Stephanie Hand at [email protected].

Learn more about cancer care at Wellstar.

Annual lung cancer screenings are recommended preventive screenings—much like mammograms and colonoscopies. Yet in Georgia, fewer than 14% of patients who are eligible for lung cancer screenings get them.

Why the hesitation?

According to Dr. Daniel Fortes, a board-certified thoracic surgeon at Wellstar, the reasons for hesitation may include:

• Guilt: “I smoked. If there’s a problem, I caused it.”
• A lack of awareness about screening and insurance coverage
• Fear that screening will find something abnormal

It's important for current and former smokers age 50 and older to champion their health and stay up to date on lung screenings. When caught early, lung cancer is more treatable and likely curable.

“Wellstar puts our patients at the center of their care,” Dr. Fortes said. “We do everything to minimize patient anxiety and maximize the speed at which they travel through the system, so that we can get them to their treatment as quickly as possible.”

What is lung cancer screening?

Lung cancer is the leading cause of cancer deaths among men and women. For many years, most cases were not detected until the disease was already advanced.

That began to change about 20 years ago. Research revealed that screenings with low-dose CT scans were finding cancer earlier, at a stage that is far more treatable. Today, we know that annual low-dose CT screenings for individuals at high risk have been shown to reduce lung cancer deaths by about 20%.

“That was a breakthrough,” Dr. Fortes said. “It was the first time we knew that there was something we could do to decrease the mortality of lung cancer proactively.”

The U.S. Preventive Services Task Force, a government agency, added annual lung cancer screenings to its list of recommended screenings. Medicaid, Medicare and most private insurance plans began covering the costs for patients over 50 whose smoking histories put them at risk.

The screening is painless and fast. Sometimes, the CT scan reveals a lung nodule, or a small, round growth. But not all nodules are cancerous. Old infections, scarring or inflammation can cause benign (non-cancerous) nodules. If the scan is abnormal, the patient will be referred to a Wellstar STAT Clinic for Lung Cancer.

Shorter time from diagnosis and treatment

At Wellstar, STAT Clinics (short for Specialty Teams and Treatments) provide dedicated guidance and help shorten the time from diagnosis to treatment. Within the STAT Clinic for Lung Cancer, the multidisciplinary care team may include a surgeon, pulmonologist, medical oncologist, radiation oncologist and a nurse navigator.

Before a patient visits the STAT Clinic, their team meets to review their scan and develop an initial plan. The patient and their family then meet with the appropriate team members on the same day. Their nurse navigator provides education, support and advocacy from diagnosis through treatment and recovery.

“This takes away a lot of anxiety from patients who are running from one office to another without an answer,” Dr. Fortes said. “They have a defined plan, and we expedite everything. Things happen much faster. Our average is about four to six weeks total from when we first identify a problem to the time a patient receives treatment. That’s compared to four months nationwide—and we’re trying to decrease the time even more.”

Advancements in lung cancer treatment

For patients with early-stage lung cancer, surgery to remove the affected portion of the lung and surrounding lymph nodes is often the center of the treatment plan.

“Many patients with early-stage cancer are candidates for minimally invasive techniques, either by video techniques or robotics,” Dr. Fortes said. “These techniques require small incisions in the chest without much disruption or trauma to the chest wall.”

As a result, patients have less pain after surgery and recover faster. They often leave the hospital after a day or two.

“There have been so many advancements that have changed lung cancer care,” Dr. Fortes said. “When we find lung cancer at the earliest stages and patients have surgery, they have up to an 85% chance of being cured.”

Who should get annual lung cancer screening

If you are 50 or older, currently smoke or smoked in the past, ask your healthcare provider if you should have lung cancer screenings.

The American Lung Association and the U.S. Preventive Services Task Force recommend annual screening for adults 50 to 80 who have a 20 pack-year smoking history. That could mean one pack a day for 20 years or two packs a day for 10 years.

The guidelines apply whether you still smoke or have quit within the past 15 years. You do not need to have symptoms to be screened.

Remember: Finding cancer early, when no symptoms are present, increases your chances of being cured or living longer with lung cancer.

Take the next steps toward screening

• Learn more about lung cancer screening at Wellstar.
• Call (470) 793-4AIR to learn more about eligibility, financial assistance or to schedule a screening.
• Read about a patient whose lung cancer screening results showed cancer in an early stage.
• Need a doctor? Find a Wellstar provider and book an appointment.