As more people abandon New Year’s resolutions to lose weight and turn to obesity surgery, doctors are debating which type is safest and best.
And researchers are uncovering some surprising trends.
The most common method in the U.S. – gastric bypass, or stomach-stapling surgery – may be riskier than once thought. Yet surgeons still favor it for people who need to lose weight fast because of heart damage or other serious problems.
A gentler approach favored in Europe and Australia – an adjustable stomach band – can give long-term results that are almost as good and with far fewer risks. It may be the best option for children or women contemplating pregnancy, and it is reversible if problems develop.
A radical operation – cutting away part of the stomach and rerouting the intestines – is increasingly being recommended for severely obese people. It gives maximum weight loss but also is the riskiest solution.
A large U.S. government study just got underway to compare all three options.
But regardless of which method is used, studies show an inescapable reality: No surgery gives lasting results unless people also change eating and exercising habits.
“The body just has many ways of compensating, even after something as drastic as surgery,” said Dr. Louis Aronne, director of the weight-loss program at Weill-Cornell Medical College and president of the Obesity Society. The group’s recent annual conference in Vancouver, British Columbia, featured many studies on surgery’s long-term effects.
Obesity is a problem worldwide. About 31 percent of American adults – 61 million people – are considered obese, with a body-mass index of 30 or more. That’s based on height and weight. Someone 5-foot-4 is obese at 175 pounds; 222 does it for a 6-footer.
Federal guidelines say surgery shouldn’t be considered unless someone has tried conventional ways to shed pounds and is at least 100 pounds over ideal weight, or has a BMI over 40, or a BMI over 35 plus a weight-related medical problem such as diabetes or high blood pressure.
More people are meeting those conditions. A decade ago, fewer than 10,000 such surgeries were done in the United States. That ballooned to 70,000 in 2002 and more than 170,000 in 2005.
