Is drastic weight-loss surgery like gastric bypass right for you?
Weight-loss (bariatric) surgery however drastic, is becoming increasingly popular for those who are looking for a permanent fix for obesity. According to the Agency for Healthcare Research and Quality (AHRQ), obesity surgeries for patients between the ages of 55 and 64 in the United States soared from 771 procedures in 1998 to 15,086 surgeries in 2004-a nearly 2,000% increase! Weight-loss surgery is both complex and costly. Average cost for gastric bypass ranges from $18,000 to $22,000. This does not include future medical costs for additional plastic surgery after bariatric surgery. Some of the additional procedures could include the removal of excess skin, a facelift, breast augmentation, breast lift, abdominoplasty, or liposuction. This surgery is not just a walk in the park however. Weight-loss surgery changes the anatomy of the digestive system to limit the amount of food that can be eaten and digested. The risks involved with this surgery are substantial and can be life threatening. But, the surgery promises to help people lose weight and lower the risk of medical problems associated with obesity. According to the National Institute of Health, 24 million U.S. adults are considered to be morbidly obese and may qualify for weight-loss surgery. This number is expected to rise to 31 million by 2010! The decision as to whether or not you qualify for bariatric surgery should be made by a team of professionals after medical and psychological screenings. The costs associated with weight-loss surgery may or may not be covered by your insurance company. Personally, I’m not in favor of surgery to remedy weight problems unless no other option is available and death is imminent without it. I have seen people lose 50, 60, even 103 pounds (and keep it off) by simply deciding to lose the weight and by following a plan of action for fat loss instead of resorting to weight-loss surgery. Surgery is not the only way to successfully lose weight and keep it off. TV shows like The Biggest Loser are so popular because they show that people can successfully lose tons of weight without having to alter their bodies with surgery. Many times it takes psychological counseling along with behavior modification and exercise. But it can be done. Maybe not easily but it can be done.
The most popular weight-loss procedure is Gastric Bypass (Roux-en-Y), which accounts for at least 94% of all weight loss surgeries. Others include LAP-BAND (adjustable gastric banding), Vertical Banded Gastroplasty and Biliopancreatic Diversion with Duodenal Switch. For now we’ll concentrate on the most popular-Gastric Bypass. Gastric Bypass Surgery People being considered for bypass surgery have a history of being unable to achieve or maintain a healthy weight through diet and exercise, are severely overweight, and who have health problems as a result.
How It’s Done 
A small pouch about the size of a walnut is created by a surgeon at the top of your stomach. A bypass around a segment of your stomach and small intestine is added. Your stomach is then stapled across the top, sealing it off from the rest of your stomach. This newly formed small pouch is physically separated from the rest of your stomach. Then, the surgeon cuts the small intestine and sews part of it directly onto the pouch. Walla……a little, bitty stomach sort of!
This connection redirects your food, bypassing most of your stomach and the first section of your small intestine, the duodenum. Food enters directly into the second section of your small intestine, the jejunum. This limits your ability to absorb calories and nutrients but the stomach continues to secrete digestive juices to mix with food in your small intestine despite food never entering the lower part of your stomach. Traditionally gastric bypass has been done as “open” surgery. More and more doctors are now using a device called a laparoscope, a small tubular instrument with a camera attached to see through small incisions into the abdomen. This cuts down on surgery risks and shortens the recovery period and hospital stay (3-5 days). However, not everyone qualifies for this less evasive procedure because of a prior abdominal surgery that caused dense scar tissue, inability to see organs or because of bleeding problems during the operation. Your doctor will decide if you’re a candidate for a laparoscope procedure. Surgery typically takes about 4 hours. Complete recovery can take 3-6 months. Recovery In order for the stomach to heal, you will not be allowed to eat for 1-3 days. Once eating resumes, you will progress from eating only liquids to soft food to lastly solid food. This step takes about 12 weeks. For about 6 months you have to watch out for eating too much and too fast. After all, your stomach is only about the size of a walnut. Initially your new stomach can only hold about 1 ounce, or 2 tablespoons! This is from a stomach which normally holds about 1 quart of food. Eating too much or too fast initially may cause vomiting and severe stomach pain. Over time your new stomach will stretch until it can hold 4 to 8 ounces, or about ½ to 1 cup at a time. This isn’t a lot of food. You will NEVER again be able to eat like you did before gastric bypass. Benefits You can expect to lose 50-60% of your excess weight. But, if you don’t closely follow dietary and exercise recommendations, you can put weight back on. So this surgery can’t guarantee you that you won’t regain some weight. Gastric bypass can improve or eliminate such health issues as diabetes, high blood pressure and high cholesterol. It might reduce your risk of dying from heart disease or cancer and improve your mobility. Physical Risks Again, gastric bypass is surgery with serious risks such as: • Death in about 1 in 200 to 300 surgeries • Blood clots in the legs • Leaking at one of the staple lines • Incision hernia • Narrowing of the opening between the stomach and small intestine • Dumping syndrome (nausea, vomiting, diarrhea, dizziness and sweating) • Vitamin and mineral deficiency • Dehydration • Gallstones • Bleeding stomach ulcer • Intolerance to certain foods • Kidney stones • Low blood sugar (hypoglycemia) • Collapsed lung • Enlarged heart As you can see, weight-loss surgery like gastric bypass truly isn’t just a walk in the park. Your body is permanently altered and you really can’t be sure what physical affects will result. Not only are there physical risks but there are psychological risks as well.
Psychological Risks ABC News reported recently that “After a five-year boom in gastric bypass surgery, many people who lost hundreds of pounds find they’ve now gained something else-an alcohol or drug problem.” In fact, about 140,000 people have weight-loss surgery each year, and it is estimated that somewhere between 5-30% of them pick up new addictive behaviors afterwards. This could be alcohol, drugs, gambling, shopping or exercise. For the obese there are serious emotional issues leading to food addictions which have to be addressed. Gastric bypass surgery will not solve these problems. The weight may be gone but until the underlying emotional issues are resolved, serious problems can remain. As a society too many times we look for the quick fix no matter what the cost. I’m concerned that weight-loss surgery will be viewed as such. It saddens me that obesity has become such a huge problem in the U.S. that weight-loss surgery is becoming commonplace to deal with it. With celebrity endorsements and heavy media advertising its’ popularity is certain to grow. Weight-loss surgery like gastric bypass does work. After all, you’ve got to lose weight with such a small stomach. If you are morbidly obese and considering surgery, you and your doctor will decide if bariatric surgery is right for you. Even with surgery, exercise and nutrition guidelines must be followed closely, or you will regain weight. Losing weight the old fashion way through proper nutrition, counseling and exercise is still the best way forward. Following a weight-loss plan and
will make the task easier. Yes, losing weight can be frustrating and usually takes longer than you like. By taking small steps and celebrating the victories along the way, you can succeed even if you have a serious weight problem.
There is always one unexpected little moment in life when a door opens to let the future in.
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