New Surgery Puts Obesity Under Wrap

A bulfighter assistant adjusts his "capote" before the fourth bullfight of San Fermin festival in Pamplona, northern Spain, Friday, July 10, 2009.
AP Photo/Daniel Ochoa de Olza
This week, The Early Show's "Crossroads" series looks at new surgical procedure being used by medical professionals like Dr. Brian Quebbemann in the fight against obesity.

It is called bariatric surgery and it has received rave reviews from some past patients.

Ann Wilson of the rock group Heart has lost 50 pounds since January 2002, when an adjustable band was surgically implanted to restrict the size of her stomach.

The lap-band is basically an inflatable ring that encircles the stomach and squeezes it into an hourglass shape. It can be adjusted to permit food to pass through faster or slower. The upper compartment of the stomach is smaller so it will fill up quickly and eliminate feelings of hunger. You can have about two bites and then you have to slow down.

The upper compartment is one or two ounces - equal to one or two bites - and patient feel full when the compartment is full. If patients eat too fast, they will feel uncomfortable and get a cramping feeling. If they persist in eating anyway, they'll regurgitate the food. Most people only overdo it once or twice and then learn never to do it again because it's so uncomfortable. In general, people stop feeling hungry very quickly, and they lose weight because they don't have to eat constantly to fill the stomach to feel full.

Eight or 10 bites a meal and they're done — they feel satisfied. If they chew their food very slowly and eat slowly so that the upper compartment of the stomach can pass food to the lower part, they can eat more and refill the upper part. It's possible to eat a full meal over a period of two hours this way. Patients just have to wait until the upper compartment starts to empty into the lower one before eating more once the upper part is full.

The advantages of this type of surgery over gastric bypass, or stomach-stapling, is that recovery is quicker in bariatric surgery. Surgeons don't have to reroute the intestine or cut the stomach in half. There's no risk of leakage and less risk of infection. At the time of surgery, the risk of infection is higher with bypass. Lap-band can be done as outpatient procedure where you recover for about six hours and then go home.

CANIDATES FOR SURGERY

Most patients undergo the procedure because they realize that they are at a high risk of dying young, and they want to be there for their grandchildren. They realize obesity is the problem, and that they have a serious disease just by being obese. The typical patient candidate for the lap-band is obese because he or she eats larger than normal volumes of regular food. They don't have a craving or fixation for any food in particular; they're just big eaters.

They make ideal candidates because the lap-band simply slows down the rate that people can eat, so they eat much less. Patients able to eat three cheeseburgers in ten minutes are now able to eat a third of a cheeseburger in twenty minutes with the band.

Weight loss with the lap-band ranges from 10 pounds a month to 25 pounds a month, and most stay healthy during the weight loss. They lose weight by cutting out high-calorie foods. They keep protein and fruits in the diet to maintain nutrition. Patients usually start a meal with high-protein foods such as fish and chicken and move on to vegetables and starches. After that, if they want dessert, they can go ahead, but most of them are full by then.

Patients average 1,000 calories a day following the surgery. The goal is to change the patient into someone who values taste and flavor over volume. Patients are coached in a program that includes pre-operative education and post-operative support groups with patients in person and over the Internet.