Sunday, September 27, 2009

Myths about Weight Loss Surgery

I frequent a site called Obesity Help. They often have some great articles on there. I really liked the one they recently posted on myths surrounding weight loss surgery. So I am posting it here.


1. Weight loss surgery requires an inpatient hospital stay.
Not true! In fact, most weight loss surgeries can now be performed as an outpatient. The laparoscopic adjustable gastric band is the most popular outpatient weight loss procedure. The laparoscopic sleeve gastrectomy can often be performed as an outpatient. Laparoscopic Roux-en-Y gastric bypass can also be performed with an overnight stay or a short one to two-night hospital stay.
I was released from the hospital the day after my surgery.

2. Weight loss surgery has high risks.
While weight loss surgery used to be considered a high-risk operation in the 1970s and 80s, this was due to many factors including the large open incision required, the severe medical problems of the patient candidate, and the relative inexperience of the surgeons and staff. All of these factors have changed markedly. Today, weight loss surgery is performed very safely with low risks in the hands of experienced surgeons and centers. And while any treatment or surgery or intervention has risks, for most people considering weight loss surgery, the risks of not undergoing surgery usually far exceed the risks of undergoing the procedure.

3. Surgery is the “easy way out.”
Successfully losing weight and keeping it off with weight loss surgery requires lots of hard work. It requires undergoing a rigorous evaluation and then attending educational classes and support groups and working on lifelong healthy habits and behaviors. It requires a great commitment and desire to achieve a valuable lifelong goal of reaching and maintaining a healthy weight.
Don't get me started on this one. Major pet peeve of mine.

4. You have to weigh over 300 pounds to qualify for weight loss surgery.
Many studies and many societies including the American Heart Association, the National Institutes of Health and the Medicare Reimbursement Process consider people candidates based on health conditions plus a calculation of the height and weight called the Body Mass Index or BMI (go to www.sasseguide.com to calculate your BMI). Numerous studies in recent years have shown marked health advantages to even moderately obese individuals who undergo weight loss surgery. Many people qualify who are as little as 50 pounds overweight.
My insurance requirements were a BMI of 40 or above OR BMI of 35
with 2 co-morbidities. I started out at a BMI of almost 48 and I
had 2 serious co-morbidities - high blood pressure and severe sleep
apnea.


5. People who undergo weight loss surgery need to have advanced, serious health conditions such as advanced diabetes and heart disease to qualify.
Each individual is assessed based on his or her specific health conditions and the Body Mass Index calculation. It is widely agreed that anyone with a Body Mass Index over 40 qualifies for weight loss surgery, even in the absence of health problems. It is also widely agreed that people with a Body Mass Index over 35 qualify for weight loss surgery when one or more obesity-related health conditions is present (including high blood pressure, diabetes, high cholesterol and obstructive sleep apnea).

6. You have to be in perfect health to qualify for weight loss surgery.
In fact, many people undergoing weight loss surgery do have health problems related to obesity. Some of these individuals have mild forms of the conditions and other people have more severe forms of the conditions. Each person should be assessed by an experienced bariatric surgeon to determine candidacy.
If you were in perfect health - why would you need surgery? Let's
own up to it - if you're heavy enough to qualify for surgery you are not in
perfect health.


7. There is a long recovery time after weight loss surgery.
Most people recover from weight loss surgery within one to two weeks. Some people go back to work and activities within a few days, especially after adjustable gastric banding surgery.
I timed my surgery between Christmas and New Year's. I took 4
days off of work - I was back to work a week after surgery. It was one of
the easiest surgeries to recover from - and I've had my share of
surgery.


8. After weight loss surgery, you won’t be able to eat anything that’s good.
Most people can eat a wide variety of all kinds of foods after weight loss surgery. Some people who have had Roux-en-Y gastric bypass surgery experience an unpleasant sensation when eating concentrated sweets such as desserts. However, most people can eat just about anything after weight loss surgery in small quantities.
Let's face it - I have redefined what "good" means to me. It does
take a while to get back to being able to eat "normally", but with the exception
of foods high in sugar - you should be able to eat other foods in
moderation.


9. You have to be a certain age to have weight loss surgery.
While it’s true that most centers describe age criteria, the range is usually very wide such as from 18 to 65. In addition, there are many studies citing the benefits of weight-loss surgery in patients over 65 and under 18.

10. You can’t have surgery if you have diabetes.
In fact, weight loss surgery is fast becoming a primary treatment for diabetes, particularly type II diabetes because of the high rate of cure of the disease after weight-loss surgery.

11. You’ll have a large incision and a big scar from weight-loss surgery.
Many centers perform over 95% of the weight loss surgical cases with minimally-invasive surgery or laparoscopy. This normally requires five or six small incisions on the abdomen.
I can't even see the small incisions from my surgery any more. I
have much larger scars from other surgeries.


12. Weight loss surgery is irreversible.
While most weight-loss surgeons and centers believe that it is best to think of the surgery as permanent, the truth is that surgery can be reversible. Laparoscopic adjustable gastric banding, in particular, is reversible fairly easily. Laparoscopic Roux-en-Y gastric bypass is reversible but requires a more significant operation in order to undo the bypass procedure.
It is helpful to think of it as irreversible, though.

13. Weight loss surgery has no real benefits except for looking better.
The truth is that weight loss surgery is primarily an intervention for improved health. While there are side benefits of improved self-esteem and cosmetic appearance, many of the health complications caused by being overweight can be dramatically improved or, in some cases, completely resolved by surgical weight loss procedures.
Two immediate benefits that I had from surgery was resolution of my
blood pressure and my sleep apnea. I was quickly headed to being a
diabetic and that resolved as well. And while I won't lie in that I feel I
do look better - there are parts of me that are SCARY from the extra
skin.


Kent Sasse, MD, MPH, FACS, is founder and medical director of both the
iMetabolic International Metabolic Institute and Western Bariatric Institute. He
is the author of Outpatient Weight-Loss Surgery: Safe and Successful Weight Loss
with Modern Bariatric Surgery. www.sasseguide.com.

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