Lancaster County is about to shed some serious weight.

In March, Lancaster General will open a new surgical weight-loss center — and not a moment too soon. Without running a single ad, the patient waiting list is already up to 75 or so.

There's little question of need, according to bariatric surgeon Dr. Alan H. Brader, who came on board at Lancaster General Hospital in October to head the new Lancaster General Bariatrics.

In 2007, according to The Trust for America's Health, a research group that focuses on disease prevention, Pennsylvania ranked 23rd in the country in number of obese adults, and Lancaster County's heavier-than-state-average adults weigh heavily in that ranking.

"In any public area, you can just stop and look at any 20 adults and children and see the percentage of people suffering from this illness in this community," Brader said Tuesday. "You don't need any medical education to determine someone has this disease. You can just see it. A 4-year-old can tell someone has this illness."

Brader said bariatric surgery hasn't been available in the county since June, when Heart of Lancaster Regional Medical Center discontinued it at the Lititz hospital. Even before that, patients considering the procedure often traveled to hospitals in York, Harrisburg, Reading or Hershey for long-established programs.

"As far as the county goes, we're the only show in town," Brader said. "Are we getting into it late? You could probably have 10 additional facilities and it wouldn't meet the need out there for patients that might statistically be candidates for this surgery. Many (bariatric) centers have six-month waiting lists and not because they're such fine facilities, but because there are so few doctors caring for this community."

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Brader, who was born in Lancaster and grew up in York, said he expects to see up to 450 surgery candidates a year and perform up to 200 bariatric surgeries annually at Lancaster General Hospital as the new center gets on its feet. At his last position at the Barix Center in Langhorne, he performed up to 460 surgeries a year.

The new center will offer various forms of weight-loss surgery, including laparoscopic Roux en Y gastric bypass, laparoscopic adjustable gastric band (or Lapband) and laparoscopic revisional bariatric surgery.

Brader, 51, also is medical director of Lancaster General Healthy Weight Management Program, which offers various nonsurgical weight-loss programs as well. Those options might be preferable to people who have heard horror stories about weight-loss surgery that sometimes give the discipline an air of controversy, even among members of the medical profession.

"Anytime I walk into a group of doctors and tell them what I do, the room is immediately divided," Brader said. "They hear the success stories and see the changes in patients, but everyone knows someone who had the surgery and something bad happened or someone died. There are enough of those stories to put caution in the wind."

But Brader said the surgery's success lies in the details: Who was the surgeon? Was it an established program with long-term patient support? Was the patient committed to the drastic lifestyle changes required to make postsurgical life safe?

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Since October, Brader has met with area physicians to "disengage the nightmare stories out there" and reinforce Lancaster General's commitment to grounding its program for good outcomes so they will be inclined to refer patients to Brader.

Even then, candidates will have to get past Brader's screening. As dangerous as obesity is — it can cause stroke, heart disease, diabetes, some cancers and hypertension, among a host of other ailments — bad bariatric surgery outcomes often start with a poorly chosen candidate, Brader said. And with more insurance carriers covering the surgeries, which can cost upward of $30,000, more candidates can afford the financial plunge even if they aren't mentally prepared for the physical challenge.

"Sometimes people are so desperate to get the surgery they'll just say anything to get it, thinking it will take care of all their problems," Brader said. "I'm pretty good at picking out those patients, but sometimes you still get fooled. They feel this surgery is (a health insurance) benefit they're entitled to. They're working under the idea that the surgery cures the problem."

Brader said what distinguishes bariatric surgery from others is the extensive lifestyle changes required not only to make it work, but also to make it safe. It physically alters a person's digestive tract to restrict food intake and slow digestion. Patients must follow restricted diets after surgery and make lifestyle changes that promote weight loss, including exercise.

"There's a time commitment a patient must make to make this successful," he said. "Even at established centers, 15 percent fall off the wagon because of their lack of commitment. And when they fall off the wagon, any number of things can happen. This is about more than just one day in the operating room. (Obesity's) never cured. It has to constantly be treated."

The American Society for Metabolic & Bariatric Surgery estimated that 205,000 morbidly obese Americans tried to beat the bulge with bariatric surgery last year. That leaves nearly 14.8 million obese Americans.

"There's a generalized acceptance of this illness," Brader said. "We just accept it as a normal way of American life. That's hard to resolve."

Still, Brader said he is expecting a rapid pace at Lancaster General Bariatrics, almost from the start.

"I don't think we'll have any problems getting patients."

E-mail: slindt@lnpnews.com