What about weight loss surgery?
Weight loss surgery - also called bariatric surgery - has become more popular in recent years. More than 109,000 weight loss operations were performed in 2003.3, 28 Bariatric surgery is not a “quick fix”; it is major operation that has risks, as with any other type of surgery. Common complications include bleeding, infections, respiratory problems, and even death. It is important to understand the risks and benefits before deciding to have this procedure.
Who should consider weight loss surgery?
Though it is the most effective weight loss therapy for very obese men and women, weight loss surgery is not for everyone. Only people with extreme obesity (class III, a BMI over 35) or people with class II obesity and a severe obesity-related medical complication such as high blood pressure, diabetes, heart failure, or sleep apnea should consider having this surgery. But even then, this is a treatment of last resort after both lifestyle changes and drug therapy have failed.29
What is weight loss surgery?
There are 5 different types of weight loss surgery, each distinguished by the technique they use to physically shrinking the size of the stomach. The most popular type of weight loss surgery is gastric bypass surgery.
What happens during gastric bypass surgery?
In gastric bypass surgery, a small portion of the stomach is either stapled or strapped aside to create a pouch. The pouch is then attached to a middle portion of the small intestine so that the food bypasses much of the stomach and the intestines as it is being digested. The smaller stomach cavity means that you feel full more quickly and because the food travels though a smaller section of the intestines, fewer calories are absorbed. Generally, a 3- to 4-day hospital stay is required. After you go home, you'll need to follow a strict diet, take nutritional supplements, and exercise for the rest of your life.
What other factors should I consider before having surgery?
The procedure may or may not be covered by your insurance (bariatric surgery generally costs between $20,000 and $35,000).30 If you and your doctor do decide that this surgery is right for you, choose a surgeon who has done many of these procedures before. The risk of death and complications is lower for a surgeon with more experience.31 A study of more than 60,000 Californians who underwent gastric bypass surgery between 1995 and 2004 found that they were twice as likely to be hospitalized in the year after their surgery than in the year prior.32 Most of these hospital stays were for complications related to the gastric bypass operation.
How well does this surgery work?
People who have had weight loss surgery lose an average of 44 to 66 pounds. Along with shedding the extra pounds, people who underwent weight loss surgery found that some risk factors for heart disease, such as diabetes and high blood pressure, improved.33 A few studies show that people who have this procedure keep the weight off for many years. However, some people do gain the weight back. In one study, after 14 years, 10% of people who had gastric bypass gained back much of the weight they had lost.34
Will liposuction reduce my risk of heart disease?
Liposuction is a cosmetic procedure where a plastic surgeon uses a small vacuum to suction out areas of fat from under the skin. The jury is still out on whether or not liposuction can reduce your risk of heart disease. One small study of 15 women found that 3 months after the procedure, risk factors such as CRP, cholesterol, and blood pressure had not changed for these obese women.35 A second small study of 30 women found that 6 months after liposuction, formerly obese women had reduced some risk factors for heart disease.36-38 Other studies have also found that some, but not all, risk factors are reduced after liposuction, but the results are mixed and the studies have only been done on small groups of women.36-38
For more information on bariatric surgery:
Medline Plus: Weight Loss Surgery
NIDDK: Bariatric Surgery for Severe Obesity
For more information:
NHLBI: Overweight & Obesity
Healthier US.gov
Weight Control Information Network
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