Changing lives with compassion

Patients come to Christopher Eagon, M.D., having suffered a lifetime’s worth of indignities. Severely obese, they are forced to pay for two seats on airplanes, shop for clothes in special stores and endure stares, derisive comments and other reminders that they don’t fit in.

Eagon specializes in weight-loss surgery, also known as bariatric surgery. The technique he uses most frequently reduces the stomach from the size of a football to that of an egg and shortens the length of the intestine. This so-called gastric bypass surgery helps patients lose weight by decreasing the number of calories they can consume and absorb. Eagon has performed more than 900 such surgeries since 1999, giving many patients a new lease on life.

“For people who are severely overweight, gastric bypass can make a profound difference in their lives,” says Eagon, assistant professor of surgery and surgical director of Washington University’s Weight Management Center. “The stories my patients tell me really pull on my heartstrings because they are so dramatic.”

He recalls one patient whose life’s aspiration was to be a police officer. The man was extremely obese, and his weight kept him from reaching his goal. He also had a passion for motorcycles but was far too big to ride.

Eagon performed a gastric bypass, and the patient’s weight stabilized at near normal. Several years later, he visited Eagon at the clinic.

“He came on his motorcycle — it was a little street rocket — and he had applied for and entered the police academy and was ecstatic to finally be a police officer.

“It is incredibly gratifying to follow these patients as they move on with their lives,” Eagon says.

When patients first come to see Eagon, they typically have been through numerous failed diets and their self-confidence is quite low. Many have faced some type of discrimination or bias. Eagon, although tall and thin himself, tries to understand all that his patients have experienced. They are quickly drawn to his calm, caring manner.

“Dr. Eagon is one of the most compassionate people I have ever worked with,” says Donna Marin, R.N., who has worked with him for six years. “This is a very vulnerable population with numerous physical, psychological and emotional needs, and he treats each patient with the utmost respect and concern. Their well-being is his top priority.”

Demand for gastric bypass surgery has grown dramatically in recent years as obesity has become one of the nation’s most pressing health problems. Today, about 30 percent of American adults are obese, including about 3 percent who are morbidly obese. Morbid obesity is defined as a body mass index (BMI) of 40 or more, and gastric bypass is generally limited to these patients. A 5-foot-9-inch person would have a BMI of 40 at 271 pounds.

In addition to long-term weight loss, the surgery can quickly reverse the complications of obesity, including Type 2 diabetes and high blood pressure, as well as remedy breathing problems such as sleep apnea, improve quality of life and reduce the risk of premature death.

Eagon’s interest in obesity and digestive maladies has its roots in research he did as a Harvard medical student. With NASA funding, he and his colleagues studied motion sickness with a special focus on developing a cure for the nausea that unexpectedly develops in nearly a third of astronauts as they hurtle through space.

Through this experience, he learned a lot about gastrointestinal motility — the way food moves through the digestive tract. In obesity surgery, gastrointestinal motility is altered, thereby decreasing hunger and promoting weight loss.

Eagon completed a general surgery residency at Washington University, where he was also chief resident. During his training, he became interested in outcomes research as it relates to particular surgical procedures.

“I was interested not only in whether patients live or die but their quality of life, recovery time, side effects and the cost of their care,” he says.

Eagon’s adviser, Steven Strasberg, M.D., encouraged him to follow his interest in medical informatics, a growing field that uses computers to gather and analyze patient information so that doctors can make better decisions about their care. Eagon spent two years at the University of Utah completing a fellowship in medical informatics before returning to Washington University in 1997 as a faculty member in the section of hepatobiliary-pancreatic and gastrointestinal surgery.

“Dr. Eagon was one of our most outstanding chief residents, both in terms of clinical judgment and technical excellence,” says Strasberg, now Pruett Professor of Surgery and head of the Division of Hepatobiliary and Gastrointestinal Surgery. “He is an industrious physician with a keen analytical mind, great skill in open and laparoscopic surgery and (has) a sensitive, caring nature.”

Eagon says the ability to do clinical research in addition to maintaining a surgical practice is what drew him back to St. Louis. “What impressed me most about Washington University is the strong focus and interest on academic medicine,” he says. “I felt like the faculty’s commitment to academic medicine was stronger here. And this is one of the reasons why I continue to feel passionate about my work.”

Eagon returned to St. Louis shortly after Samuel Klein, M.D., the Danforth Professor of Medicine and Nutritional Science, established the University’s Weight Management Center. The center helps patients lose weight through traditional means — diet and exercise — but Klein also was interested in offering weight-loss surgery to patients for whom medi-cal weight management is not effective.

Strasberg saw in Eagon a skilled surgeon with a background and interest in gastrointestinal motility and outcomes research, and tapped him to spearhead the bariatric surgery program.

When Eagon started doing bariatric surgery, little was known about complications associated with the procedure or its long-term success. His training in medical informatics has helped him analyze outcomes of his patients and predict how individual patients will fare.

Last year, Eagon and his colleague Valerie Halpin, M.D., assistant professor of surgery, performed 155 gastric bypass surgeries. Nearly three-fourths were laparoscopic, using small incisions and tiny instruments guided by miniature cameras. This technique reduces the risk of complications, including wound infections, postoperative pain and hernias at the site of the incision, and also shortens the hospital stay.

Benefits of gastric bypass are quite dramatic. The average patient loses about 70 percent of his excess body weight in the first year, Eagon’s research shows, and patients keep 55 percent of excess weight off 15 years later. For example, a patient who is 200 pounds over his ideal body weight of 180 will lose about 140 pounds in the first year. He will typically regain 30 pounds over the next four years but remain 110 pounds below his original weight 15 years later.

Eagon often handles complicated cases, including patients that are extremely heavy, who are referred to the University because they don’t meet the criteria set by other institutions. “Our program has experience with very difficult cases, and if we can do the difficult cases well and have good outcomes, we can handle the easier ones.”

When he is not with his patients, Eagon savors time spent with his family, including five children who range in age from 8 to 21. His younger two are boys, and last year Eagon was the assistant coach of their hockey team. He is also an avid skier, and especially enjoys downhill ski racing.