Dr. Dr. Dallal is vice chair of the department of surgery and a bariatric surgery specialist. He has performed thousands of laparoscopic gastric bypass procedures and maintains some of the lowest complication rates and some of the highest patient satisfaction rates in the country.
Perspectives: Why did you initially become interested in bariatric surgery?
Dr. Dallal: Bariatric surgery has been around since the 1950s and ‘60s, but laparoscopy dramatically increased patients’ interest in the procedure. The surgery’s popularity grew immensely with the first laparoscopic procedure in the early ‘90s, which happened to be when I was studying. But beyond that, I’ve always found it to be a fantastic field of medicine, really unlike any other. It’s a field in which you cure diseases, eliminate medications, improve quality of life, and use cutting-edge medical expertise. Plus, it’s a discipline in which you have an incredibly satisfied patient population. And all those things create a wonderful camaraderie among my team members and with our patients.
Honestly, I’m high-fiving and hugging patients all day long. The life-changing potential of this work is incredible—and incredibly gratifying. I can’t understand why anyone would choose to specialize in anything else.
Perspectives: What have you learned about laparoscopic bariatric surgery after performing the procedure thousands of times that you didn’t know the first 100 times you operated?
Dr. Dallal: My understanding of the disease of obesity—the behavior and the physiology that accompanies it—has continued to grow with every patient I see.
Most people—some doctors included—think obesity is a disease of the weak-willed or uneducated; I find that offensive. Obesity is a biological and environmental disease with complex origins. I have great sympathy for those who suffer from it and feel a strong connection with my patients that has only grown over the years. I continue to learn about them.
“There is nothing more valuable than your health and wellness, and you have to take charge of it in any way you can. No one else will do it for you.”—Ramsay Dallal, MD
Perspectives: A few years ago, you began taking your own advice about exercising and eating well, and you lost weight and improved your health without surgery. What precipitated that decision?
Dr. Dallal: I was a busy doctor with three children, and I felt I had no time for exercise. My weight climbed, my cholesterol was high, and I had heartburn. But five or so years ago, I decided I needed to practice what I preached to my patients. I began biking and running regularly, and watching what I ate. I lost weight. But it wasn’t an easy task, let me tell you. Every day, now many years later and with a marathon and an Ironman under my belt, I still have to focus on making healthful decisions. My personal journey has certainly made me much more sympathetic to my patients.
Perspectives: Did your patients treat you any differently after you lost weight?
Dr. Dallal: Some would say to me, you did it without surgery and now you’re recommending surgery to me—are you judging me? I made it very clear that that wasn’t my position, that my sympathies for their situations only grew. But I did have that conversation more than once. And the upshot always was: There is nothing more valuable than your health and wellness, and you have to take charge of it in any way you can. No one else will do it for you.
Perspectives: Have you noticed an increase or decrease in the stigma associated with weight loss surgery?
Dr. Dallal: The rise in numbers of bariatric procedures done over the last two decades is partially due to the fact that patients have had peers who’ve had surgery. And the more patients who’ve had a successful and positive experience, the more likely more people will have it done. So I think there’s less of a stigma associated with it. But that doesn’t mean there’s absolutely no bias against it. Some people, for instance, persist in believing that bariatric surgery is dangerous, when the rate of complications for bariatric surgery is less than that for gallbladder surgery. We still have a long way to go.
Perspectives: What sort of advances do you foresee for bariatric surgery in the future?
Dr. Dallal: There are always new procedures and devices in development, but we’ve done so well with what’s been available to us—the gastric bypass and the gastric sleeve—that the bar is set very high for newer innovations hoping to improve upon what we do today. Robotic surgery is being pioneered, as are other endoscopic surgeries. But none are immediately on the horizon.
Perspectives: What’s on the horizon for Einstein Bariatrics?
Dr. Dallal: We are continuing to expand our presence in Montgomery County with our offices in Einstein Medical Center Montgomery—we’re working hard to improve our name recognition with referring doctors there. And we’re continuing to build on what has already made us successful—our patient safety and satisfaction rates. Both of which are excellent, but we are always, always trying to be better.