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Surgery called best option for severe obesity By Amy Norton 684 words 10/12/2004 Reuters Health E-Line English © 2004 Reuters Limited. All rights reserved. Republication or redistribution of Reuters content, including by framing or similar means, is expressly prohibited without the prior written consent of Reuters. Reuters shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon. Reuters and the Reuters sphere logo are registered trademarks and trademarks of the Reuters group of companies around the world. NEW YORK (Reuters Health) - The various types of surgery used to battle severe obesity appear to spur substantial weight loss and improve weight-related ills in most patients, according to a research review released Tuesday. In fact, the study's lead author told Reuters Health, surgery may be the only good option for many of the 8 to 10 million Americans who are at least 100 pounds overweight -- those considered morbidly obese. "I think surgery is the only effective treatment we have for morbid obesity," said Dr. Henry Buchwald of the University of Minnesota in Minneapolis. That's because research has found that for people with severe weight problems, diet and lifestyle changes, even with the help of support organizations, often fail to bring lasting benefits. But in their review of 136 studies conducted since 1990, Buchwald and his colleagues found that patients who underwent various surgical procedures for obesity lost an average of 61 percent of their excess weight. And the large majority saw conditions such as high blood pressure, diabetes and high cholesterol improve or completely resolve. The findings are published in this week's issue of the Journal of the American Medical Association. Buchwald is a consultant to Ethicon Endo-Surgery Inc., a Cincinnati-based surgical-product maker that funded the study. Weight-loss surgery can be performed in several ways, but the common goal is to change the structure of the digestive tract to limit the amount of food a person can eat and process. A simpler variation is gastric banding, in which a band is placed around the upper portion of the stomach to form a small pouch that holds only a small amount of food at a time. But it's the more complicated types of obesity surgery that are most effective. In one form, Roux-en-Y gastric bypass, staples are used to create a small pouch in the stomach, and a portion of the small intestine is attached to the pouch so that food bypasses the rest of the stomach and part of the small intestine. Like any surgery, these procedures carry risks, Buchwald said. His team found that around one percent of patients died after undergoing more complicated procedures known as biliopancreatic diversion (BPD) and duodenal switch, in which portions of the stomach are removed. Mortality rates were lower for gastric bypass and gastric banding. In the long-term, nutritional deficiencies can become a concern with procedures like gastric bypass and BPD, because the digestive tract's absorption of nutrients is diminished. In addition, some patients suffer "dumping syndrome," in which food travels too quickly through the small intestine, causing nausea, weakness and diarrhea. Still, Buchwald said the rates of serious complications from obesity surgery are comparable to those of any major surgery. And the risks, according to the researcher, are generally outweighed by the "fantastic gains" of reversing the serious conditions that co-exist with morbid obesity. In their review, Buchwald and his colleagues found that in studies that looked at diabetes outcome, 77 percent of patients saw their diabetes go away, while 86 percent showed at least an improvement. High blood pressure resolved in nearly 62 percent, and fell in more than three-quarters, while about 70 percent of patients had improvements in their high cholesterol. Sleep apnea -- in which breathing stops and starts repeatedly during sleep -- resolved in nearly 86 percent of those with the condition. Weight loss was greatest with BPD and duodenal switch, with patients shedding 70 percent of their excess pounds, on average. Patients lost the least with gastric banding-about 47 percent of their extra weight. Even successful surgery is not the end of the obesity battle, however. According to Buchwald, patients need to be ready to "change their outlook on lifestyle" afterward, including turning their attention to eating healthy foods and getting the nutrients they need to avoid deficiencies. SOURCE: Journal of the American Medical Association, October 13, 2004. Last Updated: 2004-10-12 16:00:13 -0400 (Reuters Health)

Hey Tammy!!!!! Thanks for posting this artical.... Hopefully people will read it in the paper and realize that this is a good thing and maybe become more educated about it. Hope all is going well for everyone... I am doing well... trying to lose my 10 pounds!! UGH! Have a great day! Beckie

Hey Beckie! Mornin' sunshine! I feel for ya! I have to keep my off now. THAT's a challenge too. Still waiting for my call from Dr. Aranow's office. They are so backlogged.....

What a great article, and from a great source. I hope people pay attention and begin to understand this disease!

Good to see an article that cites research studies, not just opinion. Thanks for sharing!