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The Role of Weight Loss Surgery

Posted Aug 24 2008 1:49pm

ANNOUNCER: Obesity is one of the biggest health crises today, with nearly two-thirds of the American population now classified as overweight or obese. Obesity is recognized as a leading health problem and a major cause of death in the United States.

DR. FELIX SPIEGEL: Obesity is a major medical problem because it causes life-threatening illnesses such as diabetes, high blood pressure, heart attacks, and it shortens people's lives by up to 20 years.

ANNOUNCER: Additionally, obesity can impact a person both psychologically and socially, with depression being the most common symptom. But, obesity can also take an economic toll.

DR. JAIME PONCE: There's studies that have shown that these people spend almost twice as much as a person that is not obese. Why is that? Because they have to pay the copay of their medicines, the visits to the doctors. And just simplistically, the clothing, the difficulty of doing some of the traveling arrangements, many other things will increase their spending.

ANNOUNCER: Although there are non-surgical weight loss methods such as diet and exercise programs, as well as medical treatments, they typically result in minor weight loss and are highly unsuccessful at maintaining any weight loss long term.

DR. JAIME PONCE: On average, you can lose about five to ten percent of your excess weight. The majority of the patients in studies show they can lose about 20 pounds. The problem with those programs is that they have a high failure rate in the long term. What happens is, 95% of the patients, if you follow them for three and four years, will regain that weight that they lost, and they gain a little bit more.

ANNOUNCER: By contrast, surgical weight loss has a much higher success rate both in terms of amount of weight lost and long-term durability.

DR. FELIX SPIEGEL: Weight loss surgery is done for permanent weight loss, and good weight loss surgery has at least ten year success rates of losing more than 50%, more than 60% of a person's excess weight and maintaining it.

DR. GEORGE WOODMAN: The fact is, for 98% of individuals out there who are morbidly obese, they will never lose any significant weight and never keep that weight off without surgery. And that's a fact that's been proven over and over.

ANNOUNCER: Although weight loss surgery is not for everyone, it can play a vital role in losing weight and preventing many of the medical problems associated with obesity.

DR. GEORGE WOODMAN: The best way to treat obesity and the complications that come along with it is to prevent them from occurring. Patients that we see in the office suffer from every type of medical problem that you can imagine. What we need to be doing is trying to get to these patients and target these individuals before those problems occur. It only increases the risk of complications to wait for them to get sicker and sicker.

DR. FELIX SPIEGEL: Weight loss surgery will either alleviate or completely cure a person's comorbidities, such as diabetes, high blood pressure, sleep apnea, asthma and joint disease. We have a long term follow-up showing that this is true, and these people actually become very, very healthy.

DR. JAIME PONCE: There's excellent studies on the gastric bypass and the LAP BAND® surgery in which patients that have type 2 diabetes and lose about 50 to 60% of their excess weight, the resolution of diabetes is more than 80%. That's huge. There's other studies that can show that high blood pressure can resolve in more than 50 to 60% of the times.

In most of the patients that don't get complete resolution, they improve. They decrease their number of medications. There's also a very good study coming from Australia on sleep apnea. Patients that go to sleep, stop breathing, they have to use a special mask to allow them to breathe, in more than 80% of the times, they stopped using the mask and they improved their sleep apnea.

The second biggest thing is the death rate. There's a very good study in which they compare these patients that have weight loss surgery with people that are overweight but didn't have weight loss surgery, and the mortality of these people that didn't have surgery was about 87% higher than the people that had weight loss surgery, meaning that by losing weight with weight loss surgery, we were able to reduce that mortality 87%. So it's very significant.

ANNOUNCER: There are also vast improvements in a person's quality of life following weight loss surgery.

DR. FELIX SPIEGEL: They can be more active. They can do things with their family. They can do things socially. They're sick much less often. They don't need to take medications and spend time going to pharmacies, spend time going to their doctor every other week to have their blood sugar checked, have their blood pressure under control. They become much more independent. They become much more social and they're able to pursue other things in life with less emphasis on their health maintenance.

ANNOUNCER: Surgical options for weight loss have become much more prevalent in recent years as attitudes toward weight loss surgery have changed.

DR. FELIX SPIEGEL: That's largely because of the failure of non-surgical methods of weight loss. As more and more people realize that they've been on 20 weight loss programs and diets, and they're much heavier than they used to be when they started, and they research more about surgery, they realize that surgery is really a good choice for them.

DR. JAIME PONCE: Medically, we needed a surgery that could be performed safely, that could be performed less invasive, and the new laparoscopic techniques that came in the early '90s allow the surgery to be done. More patient-friendly, less pain, less discomfort and less complications.

Socially, the biggest thing was the patient awareness, the public awareness of the surgery. You know, the more and more surgeries that were done, the more awareness was created. So that has created more buzz into the public in which now they're willing to look into the surgery and then realize that it can be done safely. So that changes the whole perspective.

DR. GEORGE WOODMAN: This is not the surgery that was done fifteen years ago or twenty years ago which had a significant failure rate and a significant risk of morbidity and even mortality. Surgery still has some risks but the fact is, is the benefits of surgery far outweigh the risks.

ANNOUNCER: Still weight loss surgery is not a "quick fix" and there is a lot that a patient must do after surgery to help ensure success. However, weight loss surgery can greatly increase an obese person's chances of losing the weight and keeping it off. The first step for anyone interested in weight-loss surgery is to talk to a weight loss surgeon about whether surgery is right for you.

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