Throughout the world, people have been struggling with the onslaught of a disease, one that kills in months, years, or decades, with no real indication of a prognosis once the disease is discovered in a person. There are many different treatments for the disease, but no one seems to have found a cure that will work for everyone. Some respond to a change in dietary intake, some require surgery, and some just don’t seem to care. The disease is known as obesity, and the cure seems to be weight-loss surgery (WLS).
I have personally struggled with obesity for years now, over a decade. Recently, WLS was brought to my attention by a family member who had gone through it herself, a few years ago. She suggested that perhaps it would be an option for me. I have to say, though, that I have a hard time believing that there can be a quick “cure” for obesity. I have tried the liquid-diet, the tuna diet, the grapefruit diet, the water diet, and the fasting diet. I have tried Atkins, The Zone, Slim-Fast, Weight Watchers, Jenny Craig, and any other “miracle” that came my way, but all of them have failed. If I took the weight off at all, it came back with a vengeance later. My weight now hovers around 320 pounds, and no matter what I try, it doesn’t change. Oh, it may go up or down by a few pounds every so often, but for the most part, that is my average weight.
I decided, upon hearing that I should look into WLS, that I wanted to know more about it. Why is it becoming so popular? Why all the sudden attention on men and women who have had the surgery, and have these wonderful success stories? Is this really a “cure” for obesity, or just another fad? I wanted to know more, so I turned to the resource that has provided me any information I sought in the past-the internet.
When searching for information about the surgery, I started at the site that has always pointed me in the right direction before-Google. There is not much you cannot find on the Google search engine, and it is always an excellent source for any information you need. I started my search with “weight-loss surgery”, and was given another term within the first few links. Wikipedia is credited as being the “encyclopedia of everything” on the internet. When looking up WLS, it gave me the following terms:
Biliopancreatic diversion
Vertical Banded Gastroplasty and Adjustable Gastric Banding
Gastric Bypass Surgery
Sleeve gastrectomy with duodenal switch
I learned that each of these are different types of WLS, the most popular of which seems to be the third, Gastric Bypass (also known as “Roux-en-Y gastric bypass”), where the stomach is almost completely removed, leaving a pouch the size of an egg for food to be digested from. Essentially, it forces the body to take on the properties of a fasting diet, but with enough caloric intake to allow essential nutrients to pass through.
I wanted to compare a few different surgical procedures, so I also checked on some other sites available, which boast the offering of support for pre- and post-operative patients of WLS. There are so many of these available, it was difficult to choose which I wanted to use for my research. I decided to use the process of elimination to weed out those that would not offer me any useful information. I looked for the sites that had the largest member base, offering the most first-hand experiences, and those with the most realistic explanations of the surgeries. The first site I visited that seemed to have reputable information was the site for Pacific Laparoscopy, a site dedicated to the history and evolution of WLS, and where it seems to be headed. The website offered excellent resources for the scientific aspect, but I also wanted to know what real people had to say about it, not just the doctors that would surely make a truckload of money from performing one of these procedures.
One site in particular, ObesityHelp.com, offered all these things and more. Their research was astounding, and their members were sectioned off into message boards based on what state they were from (or country, if not in the USA), as well as which surgery they had or were going to have. This site seemed like a good place to start my research into what people really thought of the surgery, and which surgery they would recommend, overall.
My research took me all over the internet, looking for information from people who had actually been through WLS, and could tell me one way or the other if it was a scam, a fad, or really legitimate. What I found astounded me.
The process is a long one, in which a patient has to undergo dietary changes supervised by a medical professional through their insurance before they are even considered for WLS. A person would need to prove that it was not just poor eating habits that had put their weight at such a high level. Their Body-Mass Index (BMI) is calculated, and that determines the level of obesity. According to the National Center for Health Statistics,
BMI values less than 18.5 are considered underweight.
BMI values from 18.5 to 24.9 are healthy.
Overweight is defined as a body mass index of 25.0 to less than 30.0. A BMI of about 25 kg/m2 corresponds to about 10 percent over ideal body weight. People with a BMI in this range have an increased risk of heart and blood vessel disease.
Obesity is defined as a BMI of 30.0 or greater (based on NIH guidelines) – about 30 pounds or more overweight. People with a BMI of 30 or more are at higher risk of cardiovascular disease.
Extreme obesity is defined as a BMI of 40 or greater.
The patient would also need to show that their weight was causing what are known as “co-morbidity conditions”, where other health problems are cropping up because of the obesity. Diabetes, PCOS, and heart attacks are just a few of the co-morbidity conditions that “count” as being caused by the obesity. These are all factors that are taken into account when an insurance company processes a request for WLS. I found that, if a person can prove that they have one or more of the co-morbidity conditions and a BMI of over 50, they are often pre-approved for the surgery because their health risks are so high if surgery is postponed or denied.
Since the gastric-bypass surgery is the most popular, it is also the one more insurance policies will cover. The other surgical procedures are often met with more resistance when requested, because they are still seen as “experimental” procedures. However, just because it is authorized most often does not automatically make the gastric-bypass surgery the safest, healthiest, or the best choice. In my research, I found that the results for the gastric-bypass surgery are very similar to those of one of the others, the sleeve gastrectomy with duodenal switch procedure, often referred to as duodenal switch or DS.
The DS surgery consists of removing two things. The first is the large section of the stomach, to the outer right of the organ. This lessens the size of the stomach significantly, but still leaves it intact as a stomach (as opposed to the egg-sized pouch left for gastric-bypass patients). The doctor also detaches the small intestine from the stomach, and attaches the ileum directly to the stomach by the duodenum. By doing this, a large amount of the food digested is passed through the colon below before it reaches a point of absorption, making it easier for the patient to lose weight because their body is not absorbing the fats from the food they eat.
Both of these procedures have the potential for complications, including hemorrhaging, leakage from the sutures inside the patient, and even death. They are not recommended for all patients, and the mortality rate in both is over 1%, higher than other, less-invasive treatments like a dietary change. It was becoming a little clearer to me why this is called a last resort for weight-loss.
Upon talking to several of the men and women who have had either of the surgeries, I found that the personal experiences are just as varied as they can be. Some individuals had excellent recovery time, and were back to work within a week, with hardly any change to their lifestyle. Others were still on a leave-of-absence from their job after several months. One thing I did find they all had in common, though, was the rate at which they lost the weight. Most people said they had lost over 100 pounds within the first year (what they called the “century mark”), and then the loss slowed after that. A few even lost twice as much in the first year, with very few side effects. All of those I spoke with, however, attributed their loss not just to the surgery, but mostly to the changes they had made in their lives after the procedures. They spoke of the changes in their diet, the exercise they were now capable of doing, and the increasing satisfaction from these changes. Rather than dreading going to the gym, like myself, they were looking forward to the experience!
The results were staggering; I never imagined that WLS could produce such amazing results in most patients. I had assumed it was just like any other weight-loss “trick”, where it would work for a small handful of people, and everyone else would be sorely disappointed. I was very glad to see I was wrong about that. It would seem that WLS offers a stepping stone for those so far beyond healthy weight limits that they can’t get a handle on it. It is not a cure, as so many of the people on the websites repeated; it is a step in the right direction. WLS does not “solve” your weight problem, it cannot “cure” your obesity, but it does give the starting point that many people cannot manage by themselves.
I have not decided yet whether or not to pursue WLS for my own weight issues. In truth, I am wary of anything with a mortality rate of over 1%, even knowing that is not very high for surgery involving people whose bodies cannot support them any longer. At this point, though, I am thankful for the resources available to research the procedures, so that if I do decide to attempt it, I will not be going into it blindly, or with unreasonable expectations. With so many diet fads out on the market, it is often difficult to know when there is no other choice beyond surgery.
Works Cited
WikiPedia
Weight Loss Surgery Wiki
http://en.wikipedia.org/wiki/Weight_Loss_Surgery
Pacific Laparoscopy
Advanced Laparoscopic and Endocrine Surgery
http://www.pacificsurgery.com
ObesityHelp
Duodenal Switch
http://www.obesityhelp.com/forums/DS/
Beverly Hills Institute for Bariatric Surgery
Gastric Bypass (Roux-en-Y)
Dr. J. Nazarian, MD, F.A.C.S.
http://drnazarian.com/?id=procedures#roux-en-y_gastric_bypass
Sono Clinic
Predictors of Complication and SubOptimal Weight-Loss after Laparoscopic Roux-en-Y Gastric Bypass
http://tinyurl.com/f384n
Centers for Disease Control and Prevention
“BMI-Body Mass Index: BMI for Adults” 30 May, 2006
http://www.cdc.gov/nccdphp/dnpa/bmi/adult_BMI/about_adult_BMI.htm
