Obesity Discussion Forums

[Obesity Discussion]

The Truth About Obesity Surgery

NEW YORK, Nov. 30, 2006
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(CBS) It's estimated that 5 percent to 10 percent of the United States population is morbidly obese and 60 percent is overweight.

As the country's weight problem gets more attention, people who are overweight are going to more extreme measures to take off the pounds. In this segment of the "Overweight in America" series, The Early Show took a look at the increasingly popular weight-loss surgeries.

According to the American Society for Bariatric Surgery, nearly 170,000 weight-loss surgical procedures were performed last year. About 110,000 of them were gastric bypass operations and about thirty percent were laparoscopic adjustable gastric band operations, which is commonly referred to as lap-band surgery.

Dr. Mitchell Roslin, chief of bariatric surgery at Lenox Hill hospital, said he expects the number of gastric bypass surgeries to stay the same and the lap-band to increase from about 30,000 to 60,000 a year. He said that at this point many people are still choosing gastric bypass because weight loss tends to be more dramatic.

"On average, people will lose about 70 percent of the amount they are overweight in one year, so the weight loss is really very fast," Dr. Roslin told The Early Show co-anchor Julie Chen. "The failure rate from that operation is very, very low, meaning people who don't lose weight."

Lap-band surgery is a popular option because it is easier to reverse. Dr. Roslin said the operation to reverse gastric bypass is actually more complicated than the initial operation. He said at his hospital, about 50 percent of patients are going with the lap-band surgery. In the past, 80 percent to 90 percent chose gastric bypass. He also said that people who are overweight but not morbidly obese are choosing the lap-band option.

As more people are looking to solve their weight problems with surgery, Dr. Roslin said insurance companies are making the procedures easier to pay for.

"Insurance companies are covering more and more bariatric surgeries, especially after last year's decision by the Center of Medicare Services, which has decided to cover obscenity surgery especially in centers that have good performance records and private insurers have followed suit by looking at bariatric programs."

But the long-term effectiveness of these surgeries is questioned by some experts. According a Metropolitan Life Insurance table, which measures ideal body weight, only 15 percent to 20 percent of bariatric patients reach the ideal body weight.

After gastric bypass surgery, many patients will regain 10 percent to 30 percent of the weight they initially lost. Although this does not mean that surgery isn't worthwhile, it shows that it is not a cure-all. Instead of seeing it as a quick fix, people should consider surgery to be valuable tools that can help severely obese individuals change their lives.

Dr. Roslin, who wrote a book called "Understanding Obesity Surgery" said the gastric bypass takes 80 to 120 minutes and costs about $25,000 to $30,000. The lap-band takes about 50 and costs about $18,000 to $22,000. Roslin said they both should last for life.

Here are some types of bariatric surgery:


Vertical Banded Gastroplasty: This was the first kind of weigh-loss surgery to become popular and is commonly known as stomach stapling. Basically, the surgeon creates a smaller tubular stomach with a special stapler, and its outlet, which is tightened, with a non-adjustable band. The smaller stomach makes people feel fuller after eating less food than normal.


Lap-Band: With lap-band surgery, there is no cutting or stapling of the stomach. There is something like a belt that goes around the outside of the stomach and makes the area where food goes smaller so people eat less. It can also be removed if needed.


Gastric Bypass: In this procedure, the surgeon creates a smaller stomach called the pouch, which is the size of a golf ball. The surgeon divides the intestine and brings the far end up and attaches to the pouch so a portion of the stomach is empty and no food will pass through it. Since the pouch is so small, people eat less.


Sequential Surgery and Sleeve Gastrectomy: This process is two-pronged. In the first operation, a portion of the stomach is removed and the patient is left with a small, tubular pouch. When discharged, patients receive nutritional guidance and weigh-loss tips. When the patient's weight levels off, gastric bypass portion is performed.

Obesity Surgery facts

[freddebruyn]

Yes, there was a lot of positive information on the lap band on the internet when the procedure was approved. But many reports lately indicating an increase in complications and reduced weight loss over time. The internet seems not to reflect the "up to date" information anymore as so many old reports are still high ranked in the searches......

[Irving]

Originally Posted by freddebruyn

Yes, there was a lot of positive information on the lap band on the internet when the procedure was approved. But many reports lately indicating an increase in complications and reduced weight loss over time. The internet seems not to reflect the "up to date" information anymore as so many old reports are still high ranked in the searches......

i think the complications have always been there but with the news traveling better these days you hear more about it. also consider that there are more and more people getting this procedure done every year, so the more people that have it, the more people (as a total number) will have complications from it and the more you will hear about it. i also think that people gaining the weight back takes time, so while this procedure is increasing, it will take time for those final results to be made pulic. some are embarrassed to talk about it as well i am sure

[William Wallace]

I just learned quite a bit about obesity surgery. Good information everyone! I am just too scared to even try such a thing!

[serenissima]

I attended a lecture last week by the surgeon who performs most of the bariatric surgeries in our area. He covered a lot of information; fortunately, he also had handouts! He requires would-be patients to meet many qualifications, not only physical but also psychological. As a result, he has had a high success rate in the 400+ operations he has done. But he made it very clear that the operation alone is not a magic wand: the patient needs to follow dietary instructions, take vitamin supplements, learn a new style and pattern of eating, exercise (ugh), follow up with the doctor regularly and participate in a support group. It was somewhat sobering--like most people, I'd prefer a magic wand--but it sounds like something I can do. I have an appointment for Oct. 3 with the surgeon. Wish me luck, please, new community!

[Obesity Discussion]

Originally Posted by serenissima

I attended a lecture last week by the surgeon who performs most of the bariatric surgeries in our area. He covered a lot of information; fortunately, he also had handouts! He requires would-be patients to meet many qualifications, not only physical but also psychological. As a result, he has had a high success rate in the 400+ operations he has done. But he made it very clear that the operation alone is not a magic wand: the patient needs to follow dietary instructions, take vitamin supplements, learn a new style and pattern of eating, exercise (ugh), follow up with the doctor regularly and participate in a support group. It was somewhat sobering--like most people, I'd prefer a magic wand--but it sounds like something I can do. I have an appointment for Oct. 3 with the surgeon. Wish me luck, please, new community!

That's awesome!! I really hope it works out for you. We have a few studies in here that cover things you can do to lower your risks of complications, some of which include losing some weight before hand, and scheduling your surgery at a certain time of the day.

[William Wallace]

Originally Posted by serenissima

I attended a lecture last week by the surgeon who performs most of the bariatric surgeries in our area. He covered a lot of information; fortunately, he also had handouts! He requires would-be patients to meet many qualifications, not only physical but also psychological. As a result, he has had a high success rate in the 400+ operations he has done. But he made it very clear that the operation alone is not a magic wand: the patient needs to follow dietary instructions, take vitamin supplements, learn a new style and pattern of eating, exercise (ugh), follow up with the doctor regularly and participate in a support group. It was somewhat sobering--like most people, I'd prefer a magic wand--but it sounds like something I can do. I have an appointment for Oct. 3 with the surgeon. Wish me luck, please, new community!

Absolutely have the best of luck! Getting approved is no easy task!

[MikeB]

Originally Posted by serenissima

I have an appointment for Oct. 3 with the surgeon. Wish me luck, please, new community!

I wish you luck on your weight loss quest however I am so con surgery it's not even funny. Every person I know who's had a surgery has lost and then regained weight. It's like wow I can still eat whatever I want but my stomach won't let me. The key is a TOTAL lifestyle change.

[inlove]

True. wishing you luck!!!

[Alex]

Originally Posted by MikeB

I wish you luck on your weight loss quest however I am so con surgery it's not even funny. Every person I know who's had a surgery has lost and then regained weight. It's like wow I can still eat whatever I want but my stomach won't let me. The key is a TOTAL lifestyle change.

I totally agree. I've seen some people say, after having lots of complications and issues, that they're offended when people claim it's "the easy way out". The thing is, it IS the easy way, in theory - while you still have to observe dietary limits, the surgery takes care of what I personally feel is THE biggest obstacle that people with weight problems need to overcome, and that's learning moderation. With this surgery, you don't have to do that - you still have to pay attention to the quality of your foods, but not the quantity, because there's physically only so much your stomach will hold.

When your stomach COULD hold a gallon but you only have a quart, that takes discipline. But, in my opinion, that's the only way you truly change your lifestyle. All due respect to people who have had the surgery and I'm sure they had their reasons, very good reasons, but it really does break my heart to see all the complications that seem to have arisen - it just strikes me as not the way to go. Hearing of people losing hair, teeth, bone density is an eye-opener, because there are usually two reasons people lose weight - for health and for looks. With all of those kinds of complications, it seems like both purposes are defeated with the aftereffects of these surgeries.

Majorly anti-surgery here. It sounds like an overly simplistic appraisal, but honestly - you've got to really WANT to change your lifestyle. Not just feel like you "should" or you "have to", but you've got to really want to.

[sass63]

Originally Posted by MikeB

I wish you luck on your weight loss quest however I am so con surgery it's not even funny. Every person I know who's had a surgery has lost and then regained weight. It's like wow I can still eat whatever I want but my stomach won't let me. The key is a TOTAL lifestyle change.

Your right the KEY is the lifestyle change. I have had the gastric by pass surgery I had it in 99 and lost a lot to start with and gained about 70 lbs back because I had the attitude I can still eat what I want when I want.

I am not as CON surgery as you are because I do believe that in some cases its have the surgery or die. But I believe more and more training should be done ahead of time and that surgery should only be done on the most extreme cases. An example of that is and I can use myself.

I was 427lbs my lungs where being crushed by the fat. I could not exersize I couldnt walk 5 ft without being so out of breath I had to stop and sit. I had high blood presure and my diabietes was totally out of control. I was on oxygen around the clock and a by pap machine to sleep at night. I was literally on knocking on deaths door. The surgery saved my life.

But I am con surgery for those that can still move and exersize and be trained and instilled into people that they have to make it is a lifestyle change and not a quick and permant fix. That is just not the case. I think that they should have people that have had the surgery talk to the ones that want to have it or are about to have the surgery. As well as professionals.

Just my 2 cents for what its worth.

[dmax]

hi,
you havent mentioned gastric sleeve,,i had it done in india 5 days ago,im now back home in uk and feeling good,eating very little and it seems to be really working as can only down a half glass of milkshake then im full

[skinnycow13]

Did anyone watch The Biggest Loser this season?? There was a man on there who weighed over 400 lbs even after a stomach stapling surgery. He tried everything to lose weight including that surgery but nothing worked until The Biggest Loser. I love that show!!

[Obesity Discussion]

Originally Posted by dmax

hi,
you havent mentioned gastric sleeve,,i had it done in india 5 days ago,im now back home in uk and feeling good,eating very little and it seems to be really working as can only down a half glass of milkshake then im full

What made you decide to do it in India or was it just the cost? Just curious, what was the price difference between having it done at home versus doing it in India?

Originally Posted by skinnycow13

Did anyone watch The Biggest Loser this season?? There was a man on there who weighed over 400 lbs even after a stomach stapling surgery. He tried everything to lose weight including that surgery but nothing worked until The Biggest Loser. I love that show!!

I only caught a few glimpses, however this could be a good example of how important it is to make a lifestyle change and maintain it whether it be with or without weight loss surgery.

[Thaddeus]

Surgery unfortunately is self-mutilation, that I willingly signed for. So far I am glad I did.

[Jasmine130]

Originally Posted by Thaddeus

Surgery unfortunately is self-mutilation, that I willingly signed for. So far I am glad I did.

Me too!

[jtafaro]

I had the lap band surgery six years ago. At frst I had to learn what I could and couldn't eat. Then I had to figure out what I could eat and lose weight. I chose the weight watchers program. I didn't go to meetings although I have in the past. I just ate what they recommeded and didn't eat what they said to avoid. It worked. But it takes a lot of organization and eliminates eating out for the most part.

I think most people trying to lose weight need some kind of supervision even it its self supervision. I am a scientist by profession and believe in documenting what ever I do. I keep a little book of monthly calenders and write down my weight every morning--good or bad. That way I can see what I am doing. I have even graphed it and that shows what is really happening over time.

Anyone who has tried to lose weight knows you don't lose in a linear fashion. You stair step your way down. But you can gain linearly.
The trick is to not let plateaus and small weight gains discourage you. This is a marathon--not a sprint.

I am interested in what others think about this and what problems they are having. The purpose of these forums it to help each other and its good to know we as individuals aren't alone out there.

Joe T

[monique]

I have certainly found it a stair-stepping, slow process! Had you tried before getting your surgery? I would think the learning to eat would be required ahead of time, to see if the surgery was necessary after all. I am really impressed by your 151 pounds loss! Way to go!!!

Also, I too find it useful to keep charts and graphs of my progress, that little graph of the first 39 pounds always reminds me that I've made a lot of progress, even if sometimes it feels painfully slow!


~Monique

[Jasmine130]

Hey Joe T, you are right on re how tracking and documentation is so helpful...up, down, plateau...if I don't know where I'm at, I tend to get unmoored. And that leads to trouble for me.

During the first 2 months following my gastric bypass, I lost a steady 2 lbs. per day. Then, per usual, my weight loss rate slowed down and I had occasional plateaux. I think the longest plateau was five weeks long. Having learned from my surgeon and support groups that plateaux are the norm, I was not alarmed and not even frustrated. I just kept on plan and eventually started the downward trend. I have a graph of my weight loss and BMI changes, I will try to copy into a post here. Stair-stepping indeed.

I agree that weight gain tends to be linear. I don't have a chart to demonstrate that, and I rarely weighed myself because I didn't want to know how much weight I had gained. But I bet if I did track my weight, I would see a linear gain!

I also track my caloric intake and output using an online program. My eating plan is 1300-1400 cals/day with at least 70 grams of protein. No more than about 12 grams of sugar per meal or snack because (1) I'll "dump" and (2) high sugar foods are binge triggers for me. My gastric bypass helps keep me within these parameters.

I can eat out almost anywhere, except I don't do buffets or the brazilian steakhouse scene very often as I don't get my money's worth . I do a lot of eating off the appetizer menu, and tapas is a great option too.

It's really good to have you on this forum!

[Jasmine130]

Originally Posted by serenissima

I attended a lecture last week by the surgeon who performs most of the bariatric surgeries in our area. He covered a lot of information; fortunately, he also had handouts! He requires would-be patients to meet many qualifications, not only physical but also psychological. As a result, he has had a high success rate in the 400+ operations he has done. But he made it very clear that the operation alone is not a magic wand: the patient needs to follow dietary instructions, take vitamin supplements, learn a new style and pattern of eating, exercise (ugh), follow up with the doctor regularly and participate in a support group. It was somewhat sobering--like most people, I'd prefer a magic wand--but it sounds like something I can do. I have an appointment for Oct. 3 with the surgeon. Wish me luck, please, new community!

I wish you good luck Serenissima! Keep us posted on your plans, and feel free to ask questions here too. A few of us have had weight loss surgery and some are getting ready to have it, or are in the consideration stage.

Hugs,
Jasmine