Celebrated Physician: Ivanesa Pardo, MD, FACS

It’s hard to say whether Ivanesa Pardo, MD, FACS, chose surgery as her medical specialty, or if surgery chose her. An attending surgeon in Advanced Laparoscopic and Bariatric Surgery at MedStar Washington Hospital Center, Dr. Pardo had already set her sights on becoming a physician while growing up in her native Venezuela. And after her first surgical rotation in medical school, Dr. Pardo was convinced she had found her future.

But more important was the fact that Dr. Pardo also had a knack for manipulating the advanced laparoscopic and robotic technologies increasingly used for minimally invasive procedures.

“All I know is that it just came easy to me,” she says, “and the more training I got, the more I wanted to learn.”

After receiving her medical degree from Universidad Centroccidental Lisandro Alvarado, in Barquisimeto, Venezuela, Dr. Pardo completed her general surgery residency at Indiana University School of Medicine, where she also served as a research resident. Because bariatric surgery offered opportunities to apply her skills with advanced minimally invasive technology, Dr. Pardo focused on that specialty during her fellowship at Albany Medical Center in New York.

Why MedStar Washington Hospital Center?

The Hospital Center offers the best of all worlds, Dr. Pardo says, as it also provides an academic setting for pursuing another professional passion, surgical education. She has written and contributed to articles in peer-reviewed publications, and spoken before professional audiences across the country.

But being a good teacher requires Dr. Pardo to be a perpetual student, which means keeping up with near-continuous advancements in minimally invasive bariatric surgery.

Keeping Up with Minimally Invasive Bariatric Surgery

“It is a fast-changing field,” she says. “New procedures are developed, but not performed very often as they are often considered experimental for a long time. So it’s only in places like the Hospital Center where you get the opportunity to perform and evaluate those kinds of cases.”

“Obesity is an epidemic that involves and complicates so many other health issues,” she says. “It’s good that surgical options are available, but not everyone has access to them.” And even if a patient is a good candidate for surgery, Dr. Pardo adds, a bariatric procedure is only one facet of treating the condition.

“The drive for surgery comes from the patient,” she explains. “A successful outcome involves adopting and maintaining significant lifestyle changes, and the patient needs to understand and prepare for them. Fortunately, we have the resources to help them through that process, before and after surgery.

Dr. Pardo adds that by evaluating patient outcomes and comparing them with the professional standard, “we are better able to identify areas where we can improve.”

Outside the Hospital

Away from the Hospital Center, Dr. Pardo devotes her attention entirely on her family. She and her husband have two children, a three-year-old girl, and 21-month-old boy. “At those ages, they’re pretty much the center of everything we do,” she says with a laugh. “But like surgery, there’s always something interesting going on.”

How to reduce risk of kidney stones after bariatric surgery

The Centers for Disease Control and Prevention (CDC) reports that 22.1 percent of adults in Washington, D.C., are obese. Though that’s lower than the national obesity rate of 36.5 percent, it still means more than one in five adults in our area has a serious weight problem.  

Many people who can’t lose enough weight through diet and exercise turn to weight loss surgery, or bariatric surgery. Bariatric surgery is a great option to help people lose weight. But we’ve noticed that patients who have bariatric surgery have a greater risk for kidney stones than people who haven’t had this procedure.  

Kidney stones are a significant medical problem, and they can increase your chance of developing serious issues like kidney damage and recurrent infections. We can work to identify and lower your risk for having kidney stones after your weight loss surgery.  

The relationship between bariatric surgery and kidney stones

In one study, researchers looked at a group of obese patients who had bariatric surgery and compared them to a group of obese patients who didn’t have surgery. These two groups had similar rates of developing kidney stones at the start of the study.  

But afterward, 11 percent of the patients who had surgery developed new kidney stones within six years of their surgery, compared to 4.3 percent of the patients who didn’t have surgery. Put another way, the patients who had bariatric surgery were over 255 percent more likely to develop new kidney stones than the patients who didn’t have surgery.  

This happens because bariatric surgery causes changes to patients’ urine that make kidney stones more likely. The kidneys filter waste products from the bloodstream that are absorbed in the food we eat. Some of the urinary changes we commonly see after bariatric surgery include:

  • Decreased amounts of urine, which is caused by dehydration and can concentrate waste products to form kidney stones more easily
  • Increased levels of a compound called oxalates
  • Increased levels of calcium, which enters the bloodstream when a diet is too high in salt, or sodium  

#BariatricSurgery causes changes to patients’ urine that make #kidneystones more likely. via @MedStarWHC

Having high levels of calcium and oxalates in concentrated urine increases the risk of developing calcium oxalate kidney stones, which are the most common type of kidney stone.

Reduce your risk of kidney stones after weight loss surgery

Reducing the risk of kidney stones is important for everyone, but it’s especially important for patients who have had bariatric surgery. Drinking enough water, decreasing salt intake and eating less animal protein are a few things everyone can do to lower their risk.

Related reading: Kidney stone diagnosis and treatment

But there are specific steps I recommend that patients who have had bariatric surgery take to reduce their risk. These steps relate to the levels of oxalates and calcium in a patient’s urine.

Oxalates

People who have had bariatric surgery need to reduce the levels of oxalates in their diets to avoid kidney stones. Oxalates are found in a wide variety of fruits, vegetables and grains. Oxalate levels in food can vary depending on many factors, including where they’re grown and when they’re harvested.

People who have had #bariatricsurgery need to reduce the levels of oxalates in their diets to avoid #kidneystones. via @MedStarWHC

Your doctor can help you determine which foods to avoid. But in general, the following foods tend to be high in oxalates:

  • Spinach
  • Tea
  • Cola
  • Soy
  • Nuts

I also recommend that you talk to your doctor if you take a vitamin C supplement. One study showed that men who took a 1,000-milligram vitamin C supplement on a regular basis had double the risk of calcium oxalate kidney stones over men who didn’t take a supplement. This may be because the body disposes of excess vitamin C in the form of oxalates, which end up in urine.  

Calcium

Oxalate levels in the urine aren’t just tied to oxalate-rich foods. Calcium levels also play a role in the amount of oxalates that end up in urine. A lack of calcium in your diet can increase the amount of oxalates that make their way to the kidneys.

All of our bariatric surgery patients are instructed to take calcium supplements following their procedures. We recommend that patients take at least 1,500 milligrams of calcium per day. Taking calcium citrate supplements as opposed to calcium carbonate may help, as people with low levels of citrate are at increased risk for kidney stones. Citrate is a compound found in citrus fruits like lemons and oranges.  

Getting the calcium you need in your diet is the best option. Foods that are rich in calcium include:

  • Watercress, kale and arugula
  • Green beans 
  • Low-fat cheeses, milk and other dairy products

Reducing salt is important for maintaining healthy calcium levels. Salt, or sodium, causes the body to lose more calcium than normal. That calcium ends up in urine. Most people get far too much salt in their diets in the form of processed foods, so watch for sodium levels on nutrition information when you shop for groceries.  

What to watch out for after bariatric surgery

It’s a good idea to ask your bariatric surgeon about the risk of kidney stones. We work closely with our bariatric surgeons to minimize patients’ risk after surgery.

Make sure to watch for the signs of kidney stones if you’ve had bariatric surgery. These symptoms include:

  • Blood in your urine
  • Loss of appetite
  • Nausea or vomiting
  • Sudden, severe pain in the side or mid-back  

You may also notice a fever or chills along with any of these symptoms. This can be a sign of an infection. Request an appointment with one of our urologists if you notice any of these symptoms.  

Bariatric surgery can be life-changing—not to mention lifesaving—for many patients who struggle with obesity. But it can increase your risk of kidney stones. Making smart decisions about your diet after surgery can help you reduce this risk so you can focus on living a healthier life. 

Will I encounter digestive problems after gastric bypass?

The headlines may sound alarming: “Weight loss surgery tied to lasting digestive issues.” “After gastric bypass surgery, many experience eating difficulties.”  

The stories were in response to a December 2016 study published in the British Journal of Surgery that followed 249 patients who had laparoscopic Roux-en-Y gastric bypass. It found that two years after surgery, gastric bypass patients were far more likely to suffer from digestive problems, such as indigestion, diarrhea and flatulence, as well as an inability to tolerate certain foods than the control group, which did not have the surgery.  

However, these results aren’t that surprising. They simply highlight what we bariatric surgeons already know. Gastric bypass changes the way your body absorbs and processes food. Before surgery, patients spend months learning about the diet and lifestyle changes to which they must commit after surgery to mitigate the effects of how their bodies will change during surgery.  

When you have gastric bypass, the surgeon reduces the size of the stomach and reconnects the small intestine to the new stomach, bypassing the original stomach and several feet of the small intestine. This will make you feel full sooner, meaning you’ll eat less, but it also affects how food is processed and the amount of nutrients including vitamins and minerals that your body absorbs.  

Our patients are usually excited to follow their dietary recommendations to the letter before and immediately after the surgery. However, as they heal and time goes on, some of them fall off the wagon a little. They pay less attention to what they eat or try to push their diet a little further than they should. That’s usually when we begin to see gastrointestinal (GI) problems surface.  

Common side effects of weight loss surgery

Dumping syndrome

This is one of the most common complications patients face after bariatric surgery. Dumping syndrome occurs when food, especially sugar, moves too rapidly from the stomach into the small intestine. This can result in diarrhea, nausea and abdominal cramps.  

Dumping syndrome can be avoided by eating smaller meals and limiting foods high in sugar, as well as not rushing through your meal. We educate our patients about this syndrome, so they can recognize it. Patients often tell us that after it happens once, they learn pretty quickly what triggered it so it doesn’t happen again.  

Small bowel bacteria overgrowth

Everyone has a certain amount of bacteria living in their intestines. However, in rare cases, gastric bypass can cause bacteria to grow unchecked. This excess bacteria may eat up the nutrients your body needs and can cause bloating, cramping, gas and diarrhea.  

In severe cases, small bowel bacteria overgrowth can inhibit the body from properly absorbing nutrients, leading to malnutrition and vitamin and electrolyte deficiencies, such as anemia.  

Small bowel bacteria overgrowth usually can be successfully treated with antibiotics.  

Food intolerance

The study found that 71 percent of gastric bypass patients developed intolerance for fried foods, pastries and carbonated drinks. However, only 14 percent of those people said the intolerance was very bothersome.  

We stress to our patients the importance of avoiding and cutting back on foods high in fat and sugar because the body just doesn’t process them as well after surgery. You’ll still be able to eat these foods, just not as often and in moderation. This is good advice for anyone, not just people who have had weight loss surgery!  

We also see some patients who “develop” lactose intolerance after surgery. They most likely were mildly lactose intolerant before surgery, but the surgical changes caused it to surge. When they switch to lactose-free products, the problems go away.    

How to reduce complications after gastric bypass

In rare cases, complications from gastric bypass, such as small bowel bacteria overgrowth, can result in GI problems. But these problems usually are related to diet.  

Our patients go through on average six months of education before surgery to learn about the diet and lifestyle changes they’ll need to make. In the weeks and months after surgery, they go through a diet progression: from liquids only, to thicker liquids, to soft food, then to solid food.  

The most important thing you can do to prevent gastrointestinal problems is to follow the dietary guidelines. They may seem overwhelming at first, but you’ll likely find they become a part of your daily routine. And don’t rush to advance your diet or experiment with new foods before your dietitian gives you the OK.  

A few general tips:

  • Eat small portions.
  • Eat slowly and chew food thoroughly.
  • Limit foods high in sugar and fat.
  • Keep a journal documenting food and portions.
  • Drink water between meals to avoid dehydration. 

Following dietary guidelines is the best way to prevent gastrointestinal problems after #bariatricsurgery. via @MedStarWHC

We’ll test your vitamin and mineral levels six months after surgery, at a year, then yearly after that. This helps us catch potential nutritional deficiencies early and address them before they become a serious problem.  

If you experience persistent gastrointestinal or eating difficulties, see a doctor. We can check for surgical complications and discuss your dietary habits. This is where a food journal can come in handy. By examining what you’re eating and how much, we usually can pinpoint the culprit and solve the problem. Even if you do experience GI symptoms at some point, for the majority of my patients, the overall benefits of the surgery outweigh them.  

Bariatric surgery is not just about weight loss. It’s about improving your overall health and reducing the risks of life-threatening conditions caused by obesity, such as diabetes, hypertension and high cholesterol. By sticking to a healthy diet and lifestyle, you can reap the many health benefits of weight loss surgery and prevent or reduce potential complications.

3 precautions to take if you choose to travel for weight loss surgery

It’s difficult to pin down the exact number of people who travel abroad to access medical services, but the Centers for Disease Control and Prevention (CDC) estimates that thousands of U.S. residents do so each year. And Patients Beyond Borders, a consumer source of information about medical tourism, says weight loss surgery is among the most-sought specialties, along with cosmetic surgery, dental work and cancer and heart treatments.

There are a number of reasons people travel to get these procedures, but two of the most common are:

  • Lower costs: Surgical procedures in some countries can cost up to 80 percent less than in the U.S.
  • Broader eligibility criteria than in the United States: We follow National Institutes for Health guidelines to determine who is eligible for bariatric surgery. It’s not done purely for cosmetic reasons. This isn’t the case in some countries, so people who might not qualify in the U.S. may be eligible elsewhere.

Not everyone who travels for medical care crosses the U.S. border. When a procedure or treatment isn’t available locally, some patients may need to go to a distant city or state to get it.

I’ve never had a patient ask me for advice before going abroad for bariatric surgery, but I have seen patients over the years seeking follow-up care or treatment for complications. Before you travel to get a procedure, such as gastric bypass or sleeve gastrectomy take these precautions.

1. Thoroughly research the doctor and facility

Each country has its own standards that healthcare providers and facilities must meet, and these can be very different from the United States. Check the qualifications of your doctor and facility and learn how they compare to those in the U.S.

You also can check with international accrediting organizations, which require facilities to meet a list of standards to be certified. The CDC recommends ensuring your facility is accredited by the Joint Commission International,  DNV GL - International Healthcare Accreditation or the International Society for Quality in Health Care.

Ask about your doctor’s experience. How many surgeries have they performed and what are their success rates?

Get in writing the specific treatment, supplies and care covered in the costs. You don’t want to be surprised when you arrive or get the bill.

2. Arrange for before- and after-care close to home

Bariatric surgery doesn’t start and end in the operating room. It’s not just an anatomical change; it changes how you’ll live the rest of your life. This type of change requires support–before and after surgery.

Procedures, such as gastric bypass, change how your body processes and absorbs food. They require major lifestyle and dietary changes. If you don’t understand what you can eat, when you can eat it, and how much of it you can eat, you can suffer from digestive problems or vitamin deficiencies.

Pre-surgery education and long-term follow-up care are essential components to a successful bariatric surgery outcome. Weight loss surgery patients in the United States go through, on average, six months of preparation and education by dietitians and other healthcare providers. After surgery, we recommend ongoing dietary supervision and regular appointments the first year and then yearly afterward, to monitor for nutritional deficiencies and other complications.

If you travel for surgery, it’s likely not feasible—or even an option—to spend months before and after surgery in that destination for education and follow-up care.

Form a relationship with a local bariatric surgery program to receive pre- and post-surgery education and care. Remember to check with your insurance company. If you’re having surgery outside the country, this care may not be covered by your plan. But as I said, this support is crucial to achieving your goal of long-term weight loss.

"If you must travel to get bariatric surgery, establish a plan for before- and after-care close to home." via @MedStarWHC

3. Plan for language barriers and potential complications

If you receive care in a country where you do not speak the language fluently, determine how you will communicate with your doctor and care team. While foreign language interpreters may be commonplace in U.S. healthcare facilities, don’t expect every place to have them. It’s vital that you are able to effectively communicate with your team, so there are no misunderstandings about your care.

Complications can arise, and you must be prepared for them. For instance, you may need to stay longer than anticipated to recover. If the problem is severe, you may need to return to the U.S. for more advanced care.

If you or a loved one has to be transferred from one hospital to another, you know how involved that move can be–even within the same city. Now think about the difficulty involved in transferring a patient to another country.

Keep in mind that flying after surgery has its own risks, including deep venous thrombosis (blood clots) and pulmonary embolism (blockage of an artery in the lung). To help prevent these complications during your flight:

  • Get up and walk around every two hours
  • Move your legs while sitting
  • Stay hydrated
  • Wear compression stockings

Bariatric surgery can be a lifesaver for people who struggle with severe obesity and the complications that can accompany it, such as diabetes and hypertension. But it’s more than surgery; it’s a set of lifestyle changes that requires education and continuous support. When possible, it’s best to get this care close to home. But if you must travel, whether to the next town or overseas, make the preparations necessary to optimize for a successful outcome.

 

Schedule an appointment to talk with our bariatric surgery team about pre- or post-surgery support.

6 frequently asked questions about bariatric surgery

Medical Intel Podcast: Dr. Timothy Shope Discusses Bariatric Surgery Methods

Bariatric surgery has been available in the U.S. for more than 50 years, and surgeons are doing more every year. In fact, our team performed 336 of these procedures in 2016, compared with 257 in 2013.

Still, bariatric surgery is still not well understood, and many people have questions about it.

I’ve heard many. Two of the most frequent ones I get are, “Is bariatric surgery safe?” and “Will I be left with a lot of flabby skin?”

Bariatric surgery, such as gastric bypass or sleeve gastrectomy, can be a lifesaver for people struggling with obesity and its side effects. So let’s get to the truth of some of the most common questions.

Is bariatric surgery dangerous?

Patients often tell me that friends and family worry they will die during bariatric surgery and try to discourage them from getting a procedure. I suspect this fear is a holdover from when the surgery was new.

As with any surgical procedure, the risks from bariatric surgery were much greater when it was first developed. But with the advent of minimally invasive techniques, such as laparoscopic and robotic surgery, which come with fewer complications, the procedures’ safety has dramatically improved.

In fact, the latest data show that bariatric surgery is safer than having your gallbladder removed. The mortality rate for bariatric surgery is 0.25 percent compared with 0.7 percent for gallbladder removal.

And don’t forget that obesity also is dangerous, increasing the risk of life-threatening conditions, such as diabetes and hypertension, and even decreasing lifespan.

"The latest data shows that bariatric surgery is safer than having your gallbladder removed."

Will I be left with a lot of excess skin after bariatric surgery?

This is a complex issue and it’s specific to every individual. The bigger you are and the more weight you lose, the more excess skin you’ll have. But most patients find they have less excess skin than they expected.

The best advice I can give to avoid excess skin is to maintain and increase muscle mass, giving the skin lean tissue to contract over. I’m not saying you need to become a body builder or look like a star athlete. But developing a fitness routine that promotes healthy muscle tone will help reduce excess skin.

If you do have sagging skin that bothers you, you can explore body contouring, which is an umbrella term for procedures, such as tummy tucks and lifts to the upper arms, midsection, back, thighs, buttocks and hips.

Will I just regain  the weight after weight loss surgery? 

Everyone seems to knows someone who had bariatric surgery and gained all the weight back. But in reality, that’s pretty rare. A 2016 study found that only 3 percent of study participants who had gastric bypass regained most or all of the weight they lost after 10 years.

Weight loss after bariatric surgery occurs on a curve. Weight drops rapidly right after surgery and continues for 18 months to two years. A little weight gain is expected after that, but then it should plateau. This is normal, and we’re talking about a few pounds, not a massive amount of weight (usually about 5 percent).

When a patient does regain a considerable amount of weight, we first try to determine whether there was a problem with the surgery. For example, in gastric bypass, the surgeon reduces the size of the stomach and reconnects the small intestine to the new stomach, bypassing the original stomach and several feet of the small intestine. One rare complication of this surgery is gastrogastric fistula, in which food goes into the old stomach instead of the new stomach pouch, causing weight gain.

Most weight gain can be traced back to dietary habits. People don’t come back for after-care appointments or follow diet recommendations, or they simply fall back into old habits. And while someone might go through all the pre-surgery education, their psychological relationship with food may not change post-surgery.

Regaining all the weight can happen, but it’s rare. We’ll work with you and a dietitian to help you get back on track before you regain too much of the weight you worked so hard to lose.

Is having weight loss surgery the easy way out?

I’m amazed that in this day and age some people still think of surgery as the easy way out. There is nothing easy about bariatric surgery. People who have these procedures prepare for six months on average and then must change their lifestyle and diet after surgery. It’s a lot of work.

Attend our free information sessions to see if bariatric surgery is right for you.

The National Institutes of Health recognizes bariatric surgery as the only effective way to treat severe obesity and maintain long-term weight loss.

Losing weight through diet and exercise can be extremely difficult. Many people experience the yo-yo effect, in which they lose and gain weight multiple times. This can wreak havoc with a person’s metabolism, making losing weight even more difficult. In fact, less than 5 percent of people who lose weight by diet and exercise are able to maintain long-term weight loss.

And weight loss medications come with their own problems. Along with potential side effects, they only work as long as you take them. There’s no long-term weight loss effect.

Will I develop a vitamin deficiency after weight loss surgery?  

Vitamin deficiencies are a real concern after bariatric surgery. Your body will not be able to absorb them, as well as it used to. However, taking a daily multivitamin and following your dietary recommendations should ward off potential problems.

Severe vitamin deficiencies don’t develop overnight, and we have processes in place to catch them early. We check your vitamin levels six months after surgery, at a year, then yearly after that. If your levels are low, we’ll work on it before it becomes a problem.

Will I still be able to eat dessert or drink alcohol after bariatric surgery?  

Yes. Because your body will process and absorb foods differently after surgery, we recommend that you not eat foods high in sugar and fat immediately after surgery or drink alcohol for two years. But after a while, you can have a piece of cake at a wedding or a glass of wine for your anniversary. You’ll need to eat and drink these items in moderation, but you can have them for special occasions. This is also a good guideline for people who just want to live a healthier lifestyle.

If you have heard something fishy about bariatric surgery, don’t hesitate to ask your doctor. We’ve heard it all, and we won’t think your question is silly. If you’re considering bariatric surgery, it’s your right—and our job—to make sure you understand the ins and outs before you commit to preparing for and maintaining a healthier weight.

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Springing Back from Obesity

Susan, 48, of Prince Frederick, Md., spent the last 25 years morbidly obese, reaching 360 pounds. After gastric sleeve surgery in March 2014 and excess skin removal 18 months later, she’s now at 170 pounds and still losing. But gaining so much more.

“I don’t hide anymore,” she says. “I’m not depressed. I can spend time with the five grandchildren I just inherited when my son got married.”

Susan says she was a closet eater as a child, hiding food under her bed, but was never overweight. Once she became pregnant in her 20s, everything changed. “I gained 150 pounds with my first son,” she says, and another 60 pounds with her second.

Sleep apnea and high blood pressure followed, as did depression. “I was so ashamed,” she recalls. “If I needed to go shopping, I waited in the car until no one was standing in front of the store, so I could slip in without being seen.”

Two things gave Susan the will to turn her life around. First, she needed knee replacements because of the arthritis, but the surgeon refused until she lost weight. And, her mother-in-law’s reply to Susan, when Susan offered to help with her declining health, was “How can you take care of me, when you can’t take care of yourself?” Susan says, “I knew I had to do something.”

The pivotal moment: “I was sitting in my car in the grocery store parking lot,” she recalls, “and I heard a radio ad for bariatric surgery. I said to myself ‘I have to call right now or I won’t do it.’” From her car, she made the appointment with MedStar Washington Hospital Center’s bariatric surgery program.

At the bariatric surgery orientation, Susan learned she’d need to lose some weight first, attend nutrition classes and undergo diagnostic tests. Her husband and sons were very supportive. Five months later, in March 2014, having dropped about 90 pounds after following the program’s diet, Timothy Shope, MD, performed gastric sleeve surgery, a minimally invasive procedure that reduces the size of the stomach.

After surgery, she lost another 100 pounds. But excess skin was a problem.

“I was hoping that five nights a week at the gym would allow me to avoid plastic surgery,” she says. “But I didn’t like what I saw.”

Praful Ramineni, MD, a Hospital Center body contouring plastic surgeon, said Susan was a great candidate for surgery. She had to wait another six months to ensure her weight had stabilized before he removed excess skin from her belly, arms, back and thighs. Two months later, her scars are fading. “I am so happy,” she says. “On vacation, I got the first tan ever on my stomach! But the best part? I can do things with my family. Now I can go to my grandchildren’s football games, instead of hiding. I’ve even  been horseback riding with my niece.”

Susan’s advice to others: “If you are considering surgery, please do it. My whole life is evolving in a good way. My relationships, my mental health, everything.”

Considering weight-loss surgery? There are several options to help you learn more:

Celebrated Physician: E. Alexandra Zubowicz, MD

A healthy lifestyle is all about balance, according to E. Alexandra Zubowicz, MD, a general and advanced laparoscopic and bariatric surgeon at MedStar Washington Hospital Center. Eat healthy and stay active, she says, and you can indulge yourself every so often. In Dr. Zubowicz’s case, weekend triathlons and gardening merit an occasional afternoon with a classic novel.

But when patients still struggle with weight loss or uncontrolled medical issues, Dr. Zubowicz is focused on finding an optimal solution. 

“Obesity is one of the most serious medical problems facing our country today,” she says. “Fortunately, huge innovations in laparoscopic and robotic surgery have brought enormous benefits to patients’ postoperative care. That’s why I strive to stay abreast of the most innovative surgical tools out there, and work closely with patients to find a strategy that meets their needs and wishes.”

Helping people runs in Dr. Zubowicz’s family, as both her father and grandfather were physicians. 

“Even as a little girl, I’d play doctor while other girls my age played with dolls,” she says. “Being in such a ‘medical’ family instilled a tremendous amount of respect for physicians and what they achieved. Especially my grandfather—a Russian physician who was living in Warsaw when World War II erupted, and then risked everything to come to America and start all over.” 

Dr. Zubowicz learned long ago that compared to the U.S., many countries don’t have access to medical technology. She has participated in several mission trips to Ecuador and the Philippines, where she assisted in surgical procedures.

Dr. Zubowicz received her undergraduate degree from Boston College, and her medical degree from the University of Texas Health Science Center at San Antonio’s School of Medicine. She completed her residency at the Hospital Center in the department of Surgery, where she served as chief administrative resident. 

“This may sound like a cliche but I love helping people get better,” she says. “I want help any patient with a surgical issue—from hernias to major abdominal surgery to lumps and bumps.”

And when it comes to bariatric surgery, Dr. Zubowicz finds it particularly rewarding to watch the resulting positive changes in her patients’ physical and mental health.

“I love the idea of someone with a problem coming to us, so that we can fix it and improve their quality of life,” she says.

Have any questions?

We are here to help! Contact us for more information about bariatric surgery or to schedule an appointment. Call us at 202-877-3627.

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Why Choose Us – Bariatric Surgery

Bariatric Surgery
MedStar Washington Hospital Center - Why Choose Our Bariatric and Weight Management Department

Thinking about weight loss surgery? At the top of your “to do” list is choosing the very best hospital—and an experienced medical team. At MedStar Washington Hospital Center we’ve been successfully performing weight loss surgery—also called bariatric surgery—for decades. Our team’s experience and expertise translates into your positive outcome—and improved quality of life.

We put you at the center of our care and provide all the information you need to better understand your treatment options and make a full recovery.

Washington Hospital Center - The Best Choice for Bariatric Surgery:

  • Our program is an American Society for Metabolic and Bariatric Surgery (ASMBS) Center of Excellence and is fully accredited by the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP).
  • Our board-certified surgeons have extensive experience in minimally invasive and robotic bariatric surgical procedures, which translate into shorter hospital stays, less pain and a faster recovery.
  • You will be cared for by a multi-disciplinary bariatric team that includes a bariatric surgeon, gastroenterologist, nurse program coordinator, dietician and exercise physiologist.
  • All of the comprehensive resources of the MedStar Washington Hospital Center are available if you need them.
  • A free educational program before surgery helps prepare you for the procedure and your recovery.
  • Extensive follow-up care, including a support group of your peers, provides all you need to stay healthy long after your procedure.

 

Patient Success Stories

As Tyrone Harrison gained weight, his diabetes spiraled out of control. He was afraid he would lose a leg or go blind. Bariatric Surgery saved Tyrone's life. View his story below.

See other MedStar Washington Hospital Center Bariatric Surgery patient success stories.

Location Information

To find a bariatrics specialist, call 
844-333-DOCS (3627).

MedStar Washington Hospital Center POB
106 Irving St NW,
Physician Office Building, Suite 301 South
Washington DC 20010

 

Information Sessions and Support Groups

This is your first step in the bariatric surgical process. Come join us and you will:

  • Meet the bariatric surgeons and patient care team
  • Learn about surgical options
  • Learn about the process
  • Learn about insurance requirements and the authorization process 

Alternative Online Seminar: Click here to learn more about the Bariatric Information Session offered online. 

Supporting Documentation: If you choose to register for our online session, please download the following information: 

Meet Our Team

  • Dr. Timothy Shope: Bariatric and General surgeon
  • Dr. John Brebbia: Bariatric and General surgeon
  • Dr. Timothy Koch: Gastroenterologist
  • Dr. Elizabeth Zubowicz: General surgeon
  • Dr. Ivanesa Pardo: Bariatric and General surgeon
  • Marsha Brown, RN: Clinical Nurse
  • Catherine Hite, CRNP: Nurse Practitioner
  • Anyea Lovette MS, RD, LD: Bariatric Program Coordinator 
  • Andrea Goergen, MHS, RD, LD, Clinical Dietitian
  • Kristen McGill RD, LD, Clinical Dietitian
  • Administrative team:
    • Lenique Hammond, MA
    • Natalie Bryant, MA
    • Catina Wood, MOA
    • Janice Abrahams, MOA