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Spring 2005

Surgery for Obesity Helps Sustain Weight Loss

More than 23 million people in the United States are considered morbidly obese—100 or more pounds above their ideal body weight and with a body mass index (BMI) of 35 or more— putting them at substantially increased risk for conditions that include hypertension, diabetes, heart disease, stroke, sleep apnea, arthritis and cancer.

This year, more than 140,000 of them will undergo bariatric surgery, endorsed by the National Institutes of Health as the most effective way of obtaining and sustaining long-term weight reduction for extremely obese patients who have been unable to sustain weight loss in a medically supervised weight-loss program.

Bariatric surgery helps to facilitate dieting efforts by contributing to a sense of fullness after smaller and healthier amounts of food consumption. The Roux-en-Y procedure, considered the gold standard in bariatric surgery, reconfigures the stomach and small intestines to create a gastric pouch that can hold two to three bites of food, thereby providing the sensation of fullness when eating less. The LapBand procedure places an inflatable silicon band at the stomach’s opening to provide a feeling of fullness. Both operations are performed through small incisions using a laproscope.

Long-term studies have found that five years after bariatric surgery at least half of the patients maintain a weight loss of more than 50 percent of their excess body weight. However, it is important to recognize that it is only a tool and not a panacea, notes Carlos Gracia, M.D., chief of Minimally Invasive and Bariatric Surgery at UCLA. “The surgery doesn’t make patients exercise or choose healthy options on menus,” notes Dr. Gracia. “Patients need to understand in advance that they must take care of themselves and change their eating habits and lifestyles after the surgery.”

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