Dangers of Weight Loss Surgery

What No One Tells You About Weight Loss Surgery

 

This Surgery is Only for the very Obese!

"We sometimes get inquiries from people who might be just 50 pounds overweight, or even 20 or 30,” says Daniel Herron, M.D., chief of bariatric surgery at Mount Sinai Hospital in New York City. Although some unscrupulous doctors may operate on such people,  the American Society for Bariatric Surgery guidelines say patients should have a body mass index (BMI) above 40 (which is about 100 pounds overweight), or a BMI above 35 plus serious obesity-related medical problems like type 2 diabetes.

It won’t necessarily make you thin.

Bypass patients typically drop 50 to 75 percent of their excess pounds within a year of surgery. After that, weight loss levels off and some patients, while no longer morbidly obese, are still overweight. Take someone who’s 200 pounds overweight, after losing 75 percent of that, or 150 pounds, she would still need to lose 50 extra pounds to get to a healthy BMI. What’s more, some patients gain back 10 to 20 percent of the lost weight within three to five years. While weight loss surgery has helped some patients, doctors agree cutting your stomach in half isn’t an ideal solution. Some severely obese people simply can’t lose enough weight through diet and exercise alone, but the goal is to lose weight without surgery. And it is possible for anyone!

Complications are the Norm

One in 200 patients die after gastric bypass surgery, the most common weight loss operation, in which a surgeon seals off most of a person’s stomach, drastically reducing the amount of food she can eat. Although those considering surgery are counseled about such risks, complications may be more common than many women believe. A new study found that about 40 percent of patients had problems ranging from diarrhea after eating fatty foods to hernias and intestinal leaks. And because gastric bypass shrinks the areas of the digestive tract that absorb nutrients, patients can develop deficiencies that  must be supplemented for Life.

Surgical Complications

There are two common types of weight loss surgery. Gastric bypass surgery involves stapling off the lower part of the stomach and connecting the upper part to the small intestine. This procedure has more risks because it requires larger cuts and re-connections with stitches. The other type, gastric banding, is usually done laparascopically, involving just a few cuts in the skin. During the procedure a band or balloon is placed snugly around an area of the stomach like a belt. This method also results in a small pouch with a capacity of just a few ounces. Risks for any surgery include heart attack or stroke during the operation, infection in the incision or in the lungs and excessive blood loss. Dangers specific to gastric surgery are injury to the stomach or intestines during the procedure. These are more likely with gastric bypass surgery than with laparoscopic banding. 

Post-Surgical Complications 

After gastric bypass surgery there is the risk of leaking through the staples in the stomach, which may require emergency repair. After gastric band placement, there can be erosion of the band into the stomach, esophageal spasm and inflammation of the esophagus or stomach. With either method rapid weight loss leads to gallstones and gall bladder attacks at a higher rate than in the normal population.

 Mechanical Complications 

Over time, a patient who underwent weight loss surgery could experience a narrowing of the passage from the stomach to the intestine or breakdown of the pouch, both of which may require surgical repair. Vomiting and/or dumping syndrome are side effects that can happen from the change in the digestive anatomy. After a gastric band or balloon is inserted some patients have nausea or vomiting from eating too much at one time, blockage of the stomach outlet and constipation.

Malabsorption and Malnutrition 

Anemia from iron or vitamin B12 deficiency is a risk, because the healthy stomach is normally involved in the absorption of these nutrients. After any gastric weight loss procedure the drastic decrease in food consumed brings danger of inadequate nutritional intake. After months of eating so little, patients sometimes experience symptoms of malnutrition. All patients are prescribed multivitamins and some are prescribed protein supplements as well. Protein malnutrition can lead to a weakened immune system, hair loss and fatigue. The American Society of Bariatric Surgery lists symptoms to watch for that may indicate nutritional deficiencies, such as poor wound healing, easy bruising, numbness and tingling in the hands and feet or bone pain.

One Woman's Story, from Self Magazine
Patsi Parker felt fat and was eager to find a solution. She thought she'd found it when she decided to have her stomach surgically stapled, drastically reducing its size. But there is mounting evidence that some doctors are performing weight-loss surgery on patients who are not obese enough to require it. Parker soon discovered that she was one of them. Before the surgery, Parker stood 5 feet 6 inches tall and weighed 218 pounds. The attractive 45-year-old brunette had tried the standard weight-loss tactics, including diets and aerobics, but she couldn't stick to any of them. Then Parker ran into two colleagues who had undergone gastric bypass surgery. Once very overweight, both women were now remarkably slim. Parker immediately asked the name of their weight-loss surgeon, made the call and prepared for her own operation. In order to qualify for the procedure, she actually put on additional weight. Recently, however, Parker was featured in Self magazine's investigative report on the dangers of weight-loss surgery — especially for those who undergo it for cosmetic reasons. 

   Struggling with abdominal pain, vomiting and an inability to gain weight, she wishes she had stuck with her old body.  Patsi like so many believed the hype about surgical options for the obese from the media attention given to celebrities like pop singer Carnie Wilson who had it done and began trumpeting her success on television and in magazines. Wilson lost 150 pounds in the 18 months after weight-loss surgery (also called WLS). Prior to that, she weighted 300 pounds and suffered from sleep apnea, a potentially deadly breathing disorder, so she was an appropriate candidate for the procedure. despite the undesirable consequences.

   Parker, however, feels she was not. Within a week of her surgery, she felt awful and was vomiting constantly. "I started having complications almost immediately post-op," she says. "I've had two surgeries since to remove adhesion's, and unfortunately, they're back again." 

   After the operation, patients are supposed to slowly begin eating spoonfuls of solid food, but sometimes they cannot digest certain foods and may experience vomiting, explosive diarrhea, or cramping and faintness (known as "dumping"). Patients have to take vitamin and mineral supplements, because they are prone to deficiencies. Complications from the procedure include chronic malnutrition, osteoporosis, infections and intestinal leaks. According to the National Institutes of Health, a candidate for WLS should suffer from "clinically severe obesity," with a body mass index (BMI) of 40, or higher. BMI measures the weight to height ratio, and is used by doctors to calculate obesity. 

   Parker had a BMI of 37 when she got the operation.

"No Going Back"

Dr. Edward Livingston, director of the University of California at Los Angeles Bariatric Surgery Program, says the weight-loss surgery should be reserved for people who have problems that result from obesity. "You do this once and there is no going back," he told ABCNEWS' Good Morning America. "They have to be emotionally prepared to change their eating habits for good." The American Society of Bariatric Surgery says weight loss surgeries have increased from about 20,000 in 1995 to an estimated 45,000 in 2001. It estimates a 7 percent complication rate. But Livingston's own study of 800 patients found complication rates of 20 to 40 percent, with everything from intestinal leaks to nutritional deficiencies. Gastric bypass surgery entails shrinking the stomach from about the size of a small melon to the size of an egg. Doctors reroute the intestinal track so that patients eat less, absorb fewer calories and lose weight — fast. Obesity and Surgery Surgeons recommend the procedure for patients whose obesity is life-threatening and who can't lose weight any other way. For that group, the dangers are real: Every year about 280,000 obese people die from illnesses related to their excess weight, including diabetes, heart disease and sleep apnea.

 My Personal Take on Weight Loss Surgery 

Any one below 500 pounds can lose that weight without weight loss surgery! We have all seen it time and again on the Biggest Loser and show like it. And if you have spent any time on this looking through the posts on my blog, you know the answer. First you need to consume, and be able to absorb, the critical nutrients that your body is screaming for. Second, and the most important element behind every weight loss show, coaching. You have to be guided through this process by some one who knows, and cares enough to get you through it. And lastly you have to have a community of people who have been, or are going through the same journey as you are. You have to have fellowship, and you will accomplish your goals.

Thank you.

John Cardinal

Copyright Healthy Weight Loss for Life 2012