The reality of weight loss surgery
*This post was originally made to the Health Connections blog for West Jefferson Medical Center. You can access this page here.
Obesity in America is a difficult subject. As a bariatric surgeon, my interactions with patients and families often confront the delicate balance between discussing the serious health risks of obesity and acknowledging the personal struggle with food, body image, and discrimination that goes hand in hand with an individual's weight.
What is clear, however, is that we can fight obesity and gain back years of life, productivity, and happiness that are lost in the battle against this disease. We can do this safely with weight loss (bariatric) surgery, far better than with diet, medication, and exercise and with excellent short and long-term results, and yet less than 1 percent of patients who are eligible for bariatric surgery ever obtain that treatment.
What is bariatric surgery?
Bariatric or weight loss surgery alters the anatomy of the stomach to change the amount you can eat, how hungry you feel, and how your body absorbs calories. The two major procedures offered in the United States today are the sleeve gastrectomy and the roux-en-Y gastric bypass. In the sleeve, 80 percent of the stomach is removed, creating a small banana-shaped pouch. In the bypass, the stomach is reduced to the size of an egg and then attached to the middle of the small intestine, skipping a section of intestine and limiting the absorption of calories. Both are minimally invasive procedures and patients usually go home the day after surgery.
How effective is bariatric surgery?
You will lose anywhere from 60 to 80 percent of your excess weight within the first two years. It’s not uncommon for a 300-pound individual to lose 100 pounds in 6 months. On average, patients maintain 50 to 60 percent of their excess weight loss after five years, meaning the regain a small amount of their lost weight. Life-threatening illnesses such as type 2 diabetes, high blood pressure, sleep apnea, and high cholesterol are improved in over 80 percent and cured in over 60 percent of patients. The risks for colon, breast, and pancreatic cancer, are reduced by over 60 percent compared to individuals with obesity who do not undergo bariatric surgery.
How safe is bariatric surgery?
Thanks to decades of research and standardized techniques, bariatric surgery has complication and mortality rates of 4 and 0.1 percent, respectively. These are equal to or lower than most commonly performed surgeries in the United States including gallbladder removal, appendectomy, and knee replacement. Evidence shows that the risks of surgery are dramatically lower than the risk of life-long severe obesity.
Why does bariatric surgery remain uncommon?
Before the 2000's, most procedures were done with a large incision and had high complications rates. Many procedures, such as the adjustable gastric band (or LAP-BAND®) fell out of favor due to high rates of weight regain and complications. This has led to a stigma among some patients and physicians against bariatric surgery despite major medical and technological advancements.
What can we do?
Severe obesity affects over one-third of Americans and almost 40 percent of Louisiana residents. The costs in earnings, years, and loved ones lost are astronomical. While diet, medication, and exercise are helpful and effective, we need to use the best, safest tools to fight this epidemic. Bariatric surgery is that tool. When properly and safely performed, it is the best way for you to change the way you eat and live for the better. We need to have honest conversations about weight and bariatric surgery with each other and our doctors. Working together, as we do with all our patients at the Center for Surgical Weight Loss at West Jefferson Medical Center, we can change one of healthcare's greatest challenges.