(Reprinted from American College of Sports Medicine Fit Society Page -
Summer 2004)
Al Roker has done it.
Carnie Wilson has done it. So have American Idol’s Randy Jackson and Ozzy
Osbourne’s wife Sharon. What do these celebrities have in common? They have
all lost weight with the help of bariatric, or weight loss, surgery. The term
“bariatric surgery” encompasses all types of weight loss surgeries, including
Roux-en-y Gastric Bypass and Adjustable Gastric Banding. With today’s
increasing obesity rates, the number of bariatric surgeries being performed
across the country is skyrocketing. According to the New England Journal of
Medicine, bariatric surgery has increased in numbers from 16,000 a year in the
early 1990s to 103,000 last year. What is contributing to this dramatic
increase? The rates of overweight and obesity in the United States are rising
at an unprecedented rate. First, an estimated 64.5 percent of Americans are
overweight, and an estimated 30 percent of Americans are obese. Secondly, the
surgery is beginning to get much more attention in the media. Practically
every day, there is a television news story, a magazine article, or a
newspaper headline about weight loss surgery.
Who Qualifies?
This surgery is not for everyone who has had trouble dropping a few pounds. It
is intended for those defined as “morbidly obese.” Think about what that
means. Morbid means “death.” Obesity means “severely overweight.” It means
that these people are at risk of dying because of their excess weight.
According to the National Institutes of Health, to qualify for bariatric
surgery, patients must have a BMI, or Body Mass Index (a measure of weight in
relation to height) of 40 or above. In order to have a BMI of 40, a 5’5” woman
must weigh 242 pounds and a 5’10” man must weigh 282 pounds. Patients may also
be eligible for surgery if they have a BMI of 35 or above with co-morbid
conditions such as type 2 diabetes, hypertension, heart disease, or sleep
apnea.
Types
of Surgery
The most commonly performed bariatric surgery is the Roux-en-y Gastric Bypass.
The American Society for Bariatric Surgery refers to this procedure as the
“gold standard” of weight loss surgeries. In the Roux-en-y operation, the
stomach is completely separated into two parts, forming the small pouch that
will hold approximately one ounce of food, thereby greatly reducing the amount
of food consumed. A portion of the small intestine is also bypassed, which
reduces the amount of calories absorbed by the body.
A newer operation, approved by the
Food and Drug Administration in 2001 and quickly gaining in popularity is the
Lap-Band (Adjustable Gastric Banding). A small adjustable silicone band is
placed around the upper part of the stomach. This restricts the amount of food
eaten and causes the patient to feel full more quickly. Benefits of the
band include that it is less
invasive than gastric bypass, adjustable, requires no cutting or stapling, and
is reversible. However, it produces slower weight loss than gastric bypass.
Risks and
Benefits With
any surgery, there is a risk of complications. Up to 10 percent of patients
who undergo weight loss surgery require followup operations to correct
complications. There is also the
risk of leaks, infection, bleeding, severe nausea and vomiting, and
potentially fatal blood clots.
Approximately one in 200 patients dies as a result of weight
loss surgery. The benefits for appropriate patients are numerous. At a recent
bariatric surgery support group meeting, one young mother shared that she is
now able to run and play with her kids since losing 130 pounds in nine months.
Another lady in her 50s informed the group that her daily medication regimen
has been reduced from 16 different medications daily prior to surgery to only
her vitamin supplements four months later. Many patients agree that small
quality-of-life improvements, like being able to fit in an airplane seat,
being able to tie their shoes, or shopping in regular size clothing stores,
are huge benefits in their daily lives. Impressive medical benefits
include control or reversal of type 2 diabetes, control of high blood
pressure, reduction in cholesterol levels, reduction in sleep apnea problems,
and improvement in joint health.
Long Term
Considerations
Weight loss surgery is not a “quick fix.” Patients who choose to have
bariatric surgery must make lifestyle changes in order to be successful. The
surgery is intended to be a tool, not a cure. The patient must dramatically
change eating habits, eating small amounts of food, while focusing on eating
enough protein. They must learn not to graze continuously throughout the day.
They must exercise. They must follow up with their surgeon and with a support
group. And, they must learn to deal with emotions that they previously ignored
by eating. Bariatric surgery is not an easy road, but for many morbidly obese
patients, it may be a life-saving journey.
More Articles are coming! Stay tuned and check
back often!
Types
of Surgery
With
any surgery, there is a risk of complications. Up to 10 percent of patients
who undergo weight loss surgery require followup operations to correct
complications. There is also the
risk of leaks, infection, bleeding, severe nausea and vomiting, and
potentially fatal blood clots.
Approximately one in 200 patients dies as a result of weight