The Truth About Obesity Surgery

It's estimated that 5 percent to 10 percent of the United States population is morbidly obese and 60 percent is overweight.

As the country's weight problem gets more attention, people who are overweight are going to more extreme measures to take off the pounds. In this segment of the "Overweight in America" series, The Early Show took a look at the increasingly popular weight-loss surgeries.

According to the American Society for Bariatric Surgery, nearly 170,000 weight-loss surgical procedures were performed last year. About 110,000 of them were gastric bypass operations and about thirty percent were laparoscopic adjustable gastric band operations, which is commonly referred to as lap-band surgery.

Dr. Mitchell Roslin, chief of bariatric surgery at Lenox Hill hospital, said he expects the number of gastric bypass surgeries to stay the same and the lap-band to increase from about 30,000 to 60,000 a year. He said that at this point many people are still choosing gastric bypass because weight loss tends to be more dramatic.

"On average, people will lose about 70 percent of the amount they are overweight in one year, so the weight loss is really very fast," Dr. Roslin told The Early Show co-anchor Julie Chen. "The failure rate from that operation is very, very low, meaning people who don't lose weight."

Lap-band surgery is a popular option because it is easier to reverse. Dr. Roslin said the operation to reverse gastric bypass is actually more complicated than the initial operation. He said at his hospital, about 50 percent of patients are going with the lap-band surgery. In the past, 80 percent to 90 percent chose gastric bypass. He also said that people who are overweight but not morbidly obese are choosing the lap-band option.

As more people are looking to solve their weight problems with surgery, Dr. Roslin said insurance companies are making the procedures easier to pay for.

"Insurance companies are covering more and more bariatric surgeries, especially after last year's decision by the Center of Medicare Services, which has decided to cover obscenity surgery especially in centers that have good performance records and private insurers have followed suit by looking at bariatric programs."

But the long-term effectiveness of these surgeries is questioned by some experts. According a Metropolitan Life Insurance table, which measures ideal body weight, only 15 percent to 20 percent of bariatric patients reach the ideal body weight.

After gastric bypass surgery, many patients will regain 10 percent to 30 percent of the weight they initially lost. Although this does not mean that surgery isn't worthwhile, it shows that it is not a cure-all. Instead of seeing it as a quick fix, people should consider surgery to be valuable tools that can help severely obese individuals change their lives.

Dr. Roslin, who wrote a book called "Understanding Obesity Surgery" said the gastric bypass takes 80 to 120 minutes and costs about $25,000 to $30,000. The lap-band takes about 50 and costs about $18,000 to $22,000. Roslin said they both should last for life.

Here are some types of bariatric surgery:

  • Vertical Banded Gastroplasty: This was the first kind of weigh-loss surgery to become popular and is commonly known as stomach stapling. Basically, the surgeon creates a smaller tubular stomach with a special stapler, and its outlet, which is tightened, with a non-adjustable band. The smaller stomach makes people feel fuller after eating less food than normal.

  • Lap-Band: With lap-band surgery, there is no cutting or stapling of the stomach. There is something like a belt that goes around the outside of the stomach and makes the area where food goes smaller so people eat less. It can also be removed if needed.

  • Gastric Bypass: In this procedure, the surgeon creates a smaller stomach called the pouch, which is the size of a golf ball. The surgeon divides the intestine and brings the far end up and attaches to the pouch so a portion of the stomach is empty and no food will pass through it. Since the pouch is so small, people eat less.

  • Sequential Surgery and Sleeve Gastrectomy: This process is two-pronged. In the first operation, a portion of the stomach is removed and the patient is left with a small, tubular pouch. When discharged, patients receive nutritional guidance and weigh-loss tips. When the patient's weight levels off, gastric bypass portion is performed.

    For more information visit the American Society of Bariatric Surgery Website and the Lenox Hill Hospital site, nomoreobesity.com.
    • Caitlin Johnson

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