Houston Methodist Sugar Land Hospital is leading medicine with a ground-breaking approach to weight-loss surgery.

Board-certified surgeon Aman Barkat Ali, M.D., is one of just a handful of surgeons in the U.S. who is specially trained to perform incision-less weight-loss surgical procedures – reducing post-surgical pain, improving recovery times and eliminating permanent scarring. That makes Houston Methodist Sugar Land Hospital the only hospital in Fort Bend and surrounding areas offering all three forms of advanced bariatric surgery – laparoscopic, robotic and now incision-less.

“Incision-less surgery is a major advancement in the treatment of obesity,” Ali said. “It’s a unique way of accessing the stomach to perform gastric bypass or gastric sleeve procedures that eliminates some of the hesitation many patients feel about weight-loss surgery. All of us at Houston Methodist Sugar Land are proud to be leading medicine in this important area.”

During the procedure, Ali uses a specially designed endoscope, inserted into the abdomen through the patient’s esophagus, to perform surgical procedures from inside the body. The endoscope carries a tiny camera and all necessary surgical instruments, allowing him to complete the surgery with no incisions made to the skin or outer layers of muscle. Ali has performed more than 100 abdominal surgical procedures using this novel technology.

“Any time you make a traditional incision, even in minimally invasive procedures such as laparoscopic surgery, you create scar tissue and reduce the elasticity around the skin,” Ali said. “Plus, an incision that goes through muscle will always be more painful after surgery and lengthen recovery times. Using the endoscope, I am still making incisions to perform bariatric procedures, but they are from the inside, without cutting through skin and muscle. The result is that patients have significantly less pain, often go home the day of surgery, and usually don’t need powerful pain medications post-operatively.”

Leading Medicine to Fight a Growing Epidemic

Incision-less surgery isn’t the only way Houston Methodist Sugar Land is leading medicine in the fight against obesity. The Houston Methodist Center for Weight Loss & Bariatric Surgery at Sugar Land, led by Ali, offers a comprehensive, multi-disciplinary program designed to provide encouragement, support and knowledge throughout the weight-loss journey.
From nutritional and emotional counseling and education to the full range of medical and surgical interventions, Houston Methodist Center for Weight Loss & Bariatric Surgery makes it possible for patients to lose weight and keep it off – while vastly improving their overall health.

“Most of our patients have been struggling for years – losing weight through dieting and then yo-yoing back multiple times,” Ali said. “Many of them have a body mass index (BMI) of 50 or 60, and research shows that having a BMI above 30 is a leading cause of many serious health issues – from diabetes and heart disease to sleep apnea, high blood pressure, high cholesterol and even an increased risk of many types of cancers. The good news is that losing weight immediately improves all comorbidities and getting to a BMI of under 30 can help patients live five to seven years longer on average.”

The increase in adult obesity is a rising epidemic across the U.S., and especially in Texas, where one in three adults is considered obese and 70 percent of the population is either clinically overweight or obese.

“This is a critical issue and one that is impacting other types of medicine directly,” Ali said. “Leading medicine against obesity is one of the best ways we can improve the health and quality of life of our community.”

Leading with Comprehensive Care

After an initial visit to Houston Methodist Center for Weight Loss & Bariatric Surgery at Sugar Land, patients undergo counseling with specially trained social workers and work with clinical dietitians and nutritionists who advise them – and often teach them – how to eat properly in any setting. Some patients undergo physical therapy to learn proper exercise techniques and begin the process of becoming more active.

The team also helps patients navigate insurance issues related to their care.

“We are very detail-oriented and accessible,” Ali said. “We do complete physical and psychological evaluations to understand our patients’ unique health profiles and motivations for change. By tracking a patient’s age, gender, height, body type and comorbidities, we can determine how much weight loss is needed to get below a 30 on the BMI scale, and that informs our treatment approach.”

Many patients at Houston Methodist Center for Weight Loss & Bariatric Surgery are finding success in lowering their BMIs below 30 through medical treatment, thanks to a growing class of medications known as semaglutides, prescribed under the brand names Ozempic and Wegovy, or with another drug, tirzepatide, sold as Mounjaro. Although originally developed to treat Type 2 diabetes, these relatively new medications were found to significantly help with weight loss along with diet and exercise. In fact, some patients report losing as much as one-third of their body weight.

“Although slightly different from each other, these medications work in the same fashion, by helping patients feel full more quickly when they eat and maintaining that ‘full feeling’ throughout the day,” Ali said. “And because they were originally designed to treat diabetes, they also improve insulin sensitivity, so the body responds properly after eating which also helps with weight loss.”

Ali stresses the importance of seeking guidance from a bariatric specialist if you are considering taking a drug, such as semaglutide. A specialist can help determine if this drug is the right choice for your weight loss goals. If you are prescribed them, the doctor will continue to monitor the drug’s effectiveness and address any potential side effects. “Weight loss isn’t achieved by medication alone,” Ali said. “Healthy eating habits and regular physical activity have to be integrated to achieve sustainable weight loss.”

Leading with Surgical Options

For patients who need to lose more weight than possible through medical therapies, Houston Methodist Center for Weight Loss & Bariatric Surgery at Sugar Land offers multiple types of bariatric surgery – including the new incision-less surgery – designed to reduce the size of the stomach so that patients eat less.

“We discuss the various types of surgery with our patients and make a decision based on the health and individual characteristics of each patient,” Ali said. “In some cases, it will still make sense to perform procedures laparoscopically or robotically. But we plan to utilize the new incision-less surgery as much as possible, and our patients are excited about the possibility of a less invasive approach.”

Leading with Follow-up Care and Support

Once surgery is complete, patients are placed on a bariatric full liquid diet, and Ali’s team helps manage issues such as diabetes or high blood pressure while the patient loses weight.
In about a month, most patients have returned to a regular healthy diet – no bulky meals but lots of fruit, vegetables, proteins and non-calorie dense foods.

“The metabolic changes that occur after surgery are often stunning,” Ali said. “Within days, patients have lower blood pressure, improved cholesterol levels, and a significant decline in blood glucose levels.”

Patients also have ongoing follow-ups with clinical staff and physicians to ensure they are staying on track.

“Our center is not just about surgery,” Ali said. “We stay with our patients long after they’ve lost weight. We’re available to them whenever they need us to help them stay healthy.”

Ali said the stigma around weight loss intervention often prevents people from taking control of their health.

“It’s very easy today to look around and say, ‘I don’t have a problem’ because you can always find others who are heavier,” he said. “But anyone who has a BMI of more than 30 is at risk for serious health issues and can benefit from medical or surgical intervention. The first step is to see a physician who specializes in helping patients begin that journey toward meaningful weight loss.”

The Houston Methodist Center for Weight Loss & Bariatric Surgery at Sugar Land is located
at 16651 Southwest Freeway, Medical Office Building 1, Suite 450, Sugar Land.
To make an appointment, call 281.903.5346,
or visit houstonmethodist.org/weight-management for more information.