Obesity expert Dr. Lou Aronne
"You definitely have a significant improvement in health, but people don't go down to their ideal body weight when they have surgery. These people went from having a body mass index, which is the way we measure overweight, from well over 40, down to 35. They were still in the category of what we call obesity, but it was much better than it was before."
Aronne stresses that, "You need to focus on your diet and on exercise. People will do much better if they have surgery if they diet and they follow an exercise program. People who don't follow a diet and exercise program can lose weight and then regain a significant amount of weight."
Those aren't the only post-surgery long-term concerns: "One of the problems we're seeing is people developing deficiencies of certain nutrients such as calcium, vitamin D, zinc and others. People who have surgery need to be on a lifelong program of nutritional supplementation. So, instead of taking diabetes medicine or blood pressure medicine, they're now taking vitamins. But if they do that, they can live a long and healthy life."
Education about proper diet and portion control is also important, Aronne says: "A lot of people are taught that. What happens is, when you have the surgery, there is a drive by the body to regain weight. Your body wants you to regain weight. It does things that sort of play with your mind to make you start eating sweet foods, starchy foods and that seems to rev up the appetite of people who've had surgery. It's a constant battle to stay away from that kind of food. It's tougher than it looks. Some people go into this and think they're cured. They're not. There's still a battle going on."
Aronne adds that obesity surgery carries significant risk and, "The risk seems to increase with age. Another paper just published shows that the older you are, the greater the risk of the surgery.
"It's still worth having surgery if you have the health problems we associate with being severely obese."