By Jane Bokun
My friend Ashley Brecka knew she wanted to make a change.
For years, the 20-something Highland, Ind., woman had been going to doctors to find out how to lose weight. After a doctor recommended the bariatric sleeve, she was convinced it would help.
Now, Brecka has lost more than 100 pounds using this latest technology.

According to WebMD, sleeve gastrectomy is a procedure in which the stomach is reduced by about 15 percent of its original size. After that, the stomach looks like a sleeve or tube-like structure.
The procedure is generally performed through laparoscopy (where work is completed through an incision in the navel).
How did Brecka find the procedure?
“It was painful,” she said at a Whole Foods Market in Indiana.
The procedure permanently reduces the size of the stomach, although there could be some dilation of the stomach later in life.
The sleeve is the latest in a line of bariatric surgeries. It was originally performed as a modification to another bariatric procedure, the duodenal switch, and then later as the first part of a two-stage gastric bypass operation on extremely obese patients.
Sleeve gastrectomy is a fast-growing weight loss option in North America and Asia.
In many cases, but not all, sleeve gastrectomy is as effective as gastric bypass surgery.
Bariatric surgeons are becoming more popular. Typically, a physician will complete a residency in family medicine, internal medicine or general surgery, then pursue additional education to become board certified in bariatric medicine.
Bariatricians practice weight loss medicine, treating patients who need to lose excess weight.
They may prescribe a specific weight loss regimen, a specific diet or prescribe medications that can assist with the process.
For bariatric surgeons, a general surgery residency is completed, which may be followed by a fellowship with specialty training in bariatrics. This advanced training provides experience in performing weight-loss surgeries and should be considered essential when looking for a surgeon to perform the procedure.
Dr. Gerald A. Cahill, of the Midwest Bariatric Institute at Franciscan Health Dyer, is a well-known area bariatric surgeon.
He said the gastric sleeve has gained in popularity since 2010, when it first was covered by insurance.
Patients must be about 100 pounds overweight or a have body mass index of 40.
There is one caveat, Cahill said, the weight can come back after the surgery. There also are hormonal changes along the way.
“All it does is change the stomach,” he said.
For the most part, he said, the surgery is successful.