By: Jean Johnson for Reflux1 Bariatric surgery – major gastrointestinal operations that either seal off most of the stomach to reduce the amount of food one can eat or rearrange the small intestine to decrease the calories a body can absorb – is termed the “last-gasp solution to weight loss” by some observers.
Risks of morbid obesity
In part the metaphor is apt because aside from huffing and puffing at the slightest exertion, severely obese patients often suffer from sleep apnea, the life-threatening cessation of breathing during sleep. Other conditions that tend to be found in obese populations include high blood pressure, heart disease, diabetes, degenerative arthritis, and last but not least – psychosocial impairments in the parlance of the National Institutes of Health.
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Bariatric surgery might be right for you if:
Your BMI is over 40
You desire substantial weight loss
Obesity significantly impacts your quality of life
You fully understand the risks, benefits and limitations of surgery
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To learn more about bariatric surgery options, visit the
American Society for Bariatric Surgery.
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Candidates for the must be what the medical profession calls “morbidly obese,” which usually means 80 pounds overweight for females or in the case of males, 100 pounds of excess baggage. One woman’s quandary
A Seattle woman who is currently down 50 pounds from her high of 375, says she hopes not to have to resort to an operation. “I’ve done all the weigh and pay things, every diet in the books and counseling, but nothing helped until I started a 12-step recovery program in Overeaters Anonymous. Even that’s been up and down for me, though, although I can’t fault a 50-pound loss over a couple years. I really don’t want to have to go in and have my stomach stapled or a band put in or whatever they do.
“The truth is I feel so much shame about eating too much and the surgery won’t ever help that. Somehow, what I really want to do is come to terms with what keeps me in bondage to food. I don’t want to be a food addict, you know? That’s why Overeaters Anonymous holds the best hope overall for me because it gets right down to the brass tacks of the situation, and you work with others suffering from the compulsive disease, not just some therapist that doesn’t really know what the torment is all about.”
The band
The device called a Lap-Band is the latest approach to bariatric surgery and preferred since it is less invasive than bypass surgery, takes only a few days to recovery from and reduces the risk of death or serious complications by a tenth. The band squeezes off all but a walnut-size portion of the stomach so that a feeling of fullness arises more quickly. A small opening remains into the lower part of the stomach so that digested food can slowly make its way through the GI tract.
Lap-Bands, manufactured by a Santa Barbara company, Inamed, under a license from the mega-corporation Johnson & Johnson, are currently the only medical weight loss device approved by the Food and Drug Administration. Inamed said sales of the bands were up 40 percent last year, generating more than $88 million. Procedures to install bands in U.S. hospitals range from $15,000 to $40,000. Author of a 2003 research report reviewing emerging markets for Windhover Information, Mary Stuart, said, “Obesity is a multi-hundred-billion-dollar market ready and waiting for device developers to catch up with an enormous unmet need.”
The bucks
Indeed an industrial marketing firm, the Fredonia Group, toted up the bill for weight-control products and services including drugs, diet and exercise programs, as well as bariatric surgery at a whopping $15.3 billion in 2003. In the bariatric procedures field alone, according to the American Society for Bariatric Surgery, the figure was more than $3.5 billion in 2004 which amounted to 145,000 surgeries at an average of $25,000 per patient.
The outcome
Some patients who undergo bariatric gastrointestinal surgery lose more than 100 pounds in weight while there are cases in which losses of 200 pounds and more are reported. These success stories, some of famous people, are in part the reason demand is escalating. With the Lap-Band, many patients have lost 50 percent of their weight, although one study found that around 6 percent of the patients who get the band undermine its effectiveness by consuming high-calorie drinks that slip through the upper pouch of the stomach. Thus, for treatments to succeed, patients must be able and willing to change their eating habits to a fairly radical degree.
Side-effects like hoarseness, vomiting, acid reflux and nausea can also plague patients. More, according to the results of a RAND study published in the Annals of Internal Medicine in 2005, roughly 1 in 20 patients who had bariatric procedures suffered heart attacks, stroke or severe high blood pressure. And in a 2004 Journal of the American Medical Association article, researchers found that death rates associated with gastric bypasses was 1 for every 200 patients within 30 days of the surgery.
