Weight loss surgery has benefits and costs
While bariatric, or weight loss, surgery can yield substantial results for those battling the bulge, it is no magic bullet.
The procedure has risks, requires behavior modification and is intended only for those whose life is at risk due to being overweight.
The two most common surgeries, gastric banding and gastric bypass, are intended to treat obesity. Whatever cosmetic changes occur are side effects said Dr. Dexter Turnquest, medical director of the bariatric program at Houston Northwest Medical Center.
Treating obesity, which is considered a primary illness, also has the effect of treating secondary problems brought on by being overweight.
These conditions, collectively called comorbities, include high blood pressure, diabetes or sleep apnea, which is characterized by pauses in breathing during sleep.
Candidates for the surgery generally have to be morbidly obese, which is defined as a body mass index of 40 or higher. A six-foot tall person weighing 295 pounds meets the criteria. People with a BMI of 35 and who have two or more comorbidities are also considered morbidly obese.
Gastric bypass costs around $25,000, and gastric banding comes in at approximately $15,000. Both can be covered by insurance.
According to Turnquest the procedure is most common among adults in their 20s to 40s and is not recommended for those under 18 or over 65 years of age.
The surgeries both result in weight loss by limiting the amount of food that is consumed or absorbed by the body. The band divides the stomach, creating a smaller pouch. Gastric bypass surgically creates a smaller stomach, which is then connected to the small intestine.
Because of these changes to their digestive track, patients must be careful what, how and how fast they eat.
"The procedure itself has a bit of self-contained behavior modification," said Phillip L. Leggett, director of minimally invasive surgery at HNMC for University of Texas at Houston.
"The band will fail in people who are sweet eaters and high caloric liquid drinkers," he said.
Bypass recipients also have to be very conscious of their food behavior. If too much undigested food enters the small intestine a condition called "dumping" occurs. Symptoms can include vomiting, dizziness, cramping or diarrhea.
"The surgery requires behavior change," Turnquest said.
Resulting weight loss comes gradually, but within the first year or 18 months bypass patients can lose up to 75 percent of their excess weight.
Over the same period recipients of the band could lose up to 50 percent of undesired mass.
"It is the most gratifying procedure I do," Turnquest, who comes from an overweight family, said.
He added that people who are morbidly obese are often shut-ins but the results of the surgery gives them the confidence to go out.
"It's like a butterfly coming out of a cocoon," he said.
By JOSHUA MELVIN
jmelvin@hcnonline.com
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