At 18, Clyde Brown was a professional wrestler known as Buddy Boy Brown.
By 24, he was pulling in the crowds here as Little Gorgeous George.
But at 67, Clyde Brown is pinned to an easy chair as his health deteriorates while he waits for stomach surgery he hopes will help prolong his life.
Brown, who weighs 384 pounds, is diabetic, has kidney problems, congestive heart failure and sleep apnea. He “needs” three of those medical conditions to be eligible for bariatric (weight-loss) surgery.
Weight-loss surgery is growing in prevalence here as the number of morbidly obese adults continues to rise.
Just 320 bariatric surgeries were performed in 2004 in Arizona, according to a report, “Obesity in Arizona: Prevalence, Hospital Care Utilization, Mortality,” published in September 2006 by the Arizona Department of Health Services.
By 2005, the number of surgeries for obesity had nearly quadrupled here, to 1,130.
About a dozen hospitals in Arizona, including Northwest Hospital and Carondelet St. Joseph’s in Tucson, provide the surgery.
Tucson Medical Center doesn’t provide it nor does it cover bariatric surgery under its employee health insurance plan, according to spokeswoman Julia Strange, who says the procedures are still considered experimental.
The American Society for Bariatric Surgery sets standards for bariatric surgery programs in the United States. It requires a facility to have at least two surgeons experienced in weight-loss surgeries.
Surgery could save life
For Brown, bariatric surgery could save his life.
He has been disabled for years by an industrial accident that damaged his spine. His surgically repaired knees can’t support his weight for long, so he can’t exercise to lose weight.
In January, Brown, a Medicare patient, arrived in Phoenix to begin a six-month intake process at a hospital that will lead to Medicare-approved stomach-banding surgery.
Medicare covers bariatric surgery, but only after a six-month waiting period in which the patient is expected to diet and exercise to lose weight.
And it covers only facilities with high success rates and low death rates in bariatric surgery.
Only three facilities in Arizona — two in Phoenix and one in Scottsdale — provide Medicare and Medicaid-covered bariatric surgery.
No facility in Tucson has been Medicare-approved.
Brown heard about the bariatric surgery program at Carondelet St. Joseph’s Hospital and had been meeting with its bariatric surgeon but could not wait for it to become a Medicare-approved Center of Excellence in bariatric surgery.
As his health worsened, Brown and his wife, Joanne, who helps care for him around the clock, chose to get help from the surgeons at the Medicare-approved Scottsdale Bariatric Center, which operates at Scottsdale Healthcare Shea Campus Hospital in Scottsdale.
Degrees of surgery
Brown says his cardiologist has given her approval for noninvasive (laparoscopic) surgery that will insert a band to reduce the size of his stomach but leave his small intestine intact.
The stomach band can be adjusted externally with a saline-pump device inserted in the abdomen, Joanne Brown says.
More invasive bariatric surgery cuts out part of the small intestine and surgically reduces the stomach. It requires cutting open the abdomen, a riskier procedure for obese people with multiple medical issues.
Brown says he is eager to undergo surgery and begin “to get my life back.”
He wants to be able to walk easily next door to visit his granddaughter.
“If I could just get rid of this,” he says, placing his hands on his belly.
Most weight-loss procedures not covered
While Brown’s surgery will be covered by Medicare, most such procedures are not.
In Arizona in 2005, 66 percent of bariatric surgeries were paid for by private insurance, 9 percent were paid by Medicare and 4 percent were paid by the Arizona Health Care Cost Containment System.
The cost of the surgery, an estimated $18,000 and up, depending on the type of surgery, is a fraction of the lifetime cost of care for diabetes, kidney failure and chronic heart disease, the common complications of morbid obesity.
The “Obesity in Arizona” report details the high cost to hospitals that provide general medical care for men and women with diseases associated with obesity.
In 2005, the gross charges for all inpatients with a mention of morbid obesity in their diagnosis exceeded $320 million.
More surgeries are expected as the number of clinically obese adults (at least 100 pounds over what doctors consider an ideal weight for a person’s height) continues to rise.
That number in Arizona is up 31.5 percent from 2000 to 2005 — from an estimated 644,333 adults to 847,266 — according to Brian Bender, survey center manager for the Arizona Department of Health Services.
Obesity, death rates move together
As more Arizonans become obese, the death rate rises as well.
A total of 262 deaths in Arizona in 2005 were related to obesity, according to the report. In 2000, there were just 24.
Yet, the risks accompanying surgery appear acceptable for many. Tucson resident Allison Johnson had surgery for obesity last year and is thrilled with the outcome.
Johnson, 46, says she struggled with weight all her life. The 5-foot-4-inch computer technology analyst had high blood pressure and “a lot of aches and pains from being so overweight.”
She decided on bariatric surgery instead of another failed diet. Her employee health insurance didn’t cover weight-loss surgery but she was able to pay the $18,000 herself.
“It’s simply an investment in my health,” she says.
Johnson weighed 244 pounds when she had weight-loss surgery at Carondelet St. Joseph’s on July 18, 2006. She is already down to 183 pounds.
She had a Roux-en-Y procedure, which reduces the size of the stomach and the small intestine. Now she goes to the gym a couple of times a week and walks twice a day.
“I feel like a completely different person and I’m not done yet,” she says. “It’s amazing how wonderful I feel. It has given me my life back. I want to get out more. Before, I just sat at home.”