Health Take-Away: Weight-loss surgery offers a lasting solution for chronic obesity

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For the roughly one-third of Americans who suffer from chronic obesity, following through on well-intentioned plans to eat better and lose weight can be a lonely, uphill battle. They find themselves caught in a seemingly endless up-and-down cycle, trying diet after diet, experiencing occasional success, but ultimately ending up where they started or heavier than ever.

The good news is that there's a proven medical solution for those with chronic obesity, a way to halt the cycle, literally change your metabolism and dramatically improve your health. Bariatric or metabolic surgery, known more simply as weight-loss surgery, is a tool unlike any other to help you gain control of your weight, eliminate chronic health conditions and vastly improve your quality of life. Weight-loss surgery is recognized by the National Institutes of Health as the only weight-loss method that works for people suffering from chronic obesity. The American Diabetes Association now considers bariatric surgery a standard treatment option for treating Type 2 diabetes.

Obesity is at the root of many life-threatening health conditions, but also is a preventable cause of death. Weight-loss surgery often can significantly alleviate, even eliminate the presence and risks of serious medical conditions, including Type 2 diabetes, heart disease, high blood pressure, stroke, hypertension, high cholesterol, joint pain, chronic depression and sleep apnea.

You may be a candidate for weight loss surgery if you are:

- Over the age of 18;

- Obese with a Body Mass Index (BMI) of 35 or above;

- Struggling with diabetes, high blood pressure and/or cholesterol, heart disease or sleep apnea, arthritis and joint pain, and other obesity-related conditions;

- Have tried or are currently trying to lose weight through other means, such as diet and exercise;

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- Psychologically ready for weight loss surgery and willing to commit to a whole new lifestyle;

- Not drug- or alcohol-dependent.

There are two main types of weight loss surgery:

- Gastric bypass — This uses several mechanisms to help patients lose weight. Using minimally invasive surgery, the stomach is divided to create a small gastric pouch. The small intestine is connected to the pouch in a Y configuration, diverting digestive enzymes downstream. You will feel full quickly, eat less and not feel hungry. At the same time, changes in your metabolism help you lose weight and improve problems like obesity. Patients generally lose 60 to 80 percent of their extra weight in the first year.

- Sleeve gastrectomy — A narrow sleeve of stomach is created with surgical staples and the rest of the stomach is removed. The sleeve is about the size of a banana. This procedure limits the amount of food you can eat and helps you feel full sooner. Food passes through the digestive tract in the usual order, allowing it to be fully absorbed in the body. Generally, patients lose around 60 percent of their excess weight.

The surgery itself is only half the equation; you're the other half. The surgery is a tool to help you gain control of your weight and improve your health. Like any tool, it only works if used correctly. That's why it's essential that any weight-loss surgery is accompanied by a comprehensive patient education program designed to teach you how to use that tool successfully. Before and after surgery, you need to make a strong personal commitment to changing your life.

If any of what you've read here resonates, talk to your primary care physician about whether weight-loss surgery would be right for you. It's not just about shedding weight and looking better, it's about changing your body's metabolism. It's a transformation. It's the ultimate resolution to strengthen your health and lengthen your lifetime.

Andrew Lederman, MD, FACS, FASMBS, is a bariatric surgeon and medical director of the Berkshire Center for Weight Loss Surgery at Berkshire Medical Center.


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