Some doctors worry about overuse of weight-loss surgery: Others excited about gastric bypass surgery for moderately obese

Kalamazoo, MI

As gastric bypass and other bariatric surgeries are becoming more popular for weight loss and as minimally invasive surgical techniques are developed, some health professionals worry that the procedures may be overused.

“I think it’s wrong to do it on people who are minimally overweight,” said Dr. Jerome Cooper.

Cooper is the medical director of the Medical Weight Loss Clinic, a Southfield-based business that has 34 locations in Michigan and northern Ohio, including one in the Kalamazoo area.

“Bariatric surgery is a last resort, as I see it,” said Cooper, who was trained as a bariatric physician but has not done bariatric surgery.

He was raising his concerns in response to a recent Los Angeles Times report saying that new, incisionless techniques that are now in human trials at major hospitals may end up broadening the use of bariatric surgery to people who are only moderately overweight or on the lower end of the obesity scale.

“I think 100 pounds overweight or more with co-morbidity (another health condition such as diabetes) is a good rule to follow,” Cooper said.

The clinics that Cooper oversees are devoted to medically supervised weight loss through diet, exercise and medication. “We do some referrals for bariatric surgery” when it’s appropriate, he said.

“Bariatric surgery does offer the best results of any weight-loss treatment available today,” Cooper said, “but it’s not without the possible recurrence of weight gain, and there are post-surgical issues” such as the risks of leakage, bowel obstruction and dumping syndrome, which is involuntary vomiting or defecation.

“The risks of bariatric surgery must be weighed against the risks of being morbidly obese (overweight by 100 pounds or more or with a body mass index of 40 or greater), diabetes, arthritic problems, heart problems, certain cancers,” Cooper said. “It’s appropriate for the right people.”

Divided opinions

Health professionals at major medical centers who were quoted in the L.A. Times report — and in a similar Chicago Tribune story — were about evenly divided on using bariatric surgery in those who are not extremely obese.

Some said the surgery is underused as a way to deal with Type 2 diabetes and other obesity-related health problems, while others said the surgery carries the risk of long-term complications and that diet changes, exercise and medication should be recommended instead for the overweight or moderately obese.

The L.A. Times noted that statistics from the American Society for Metabolic & Bariatric Surgery show bariatric surgery rates have doubled in the United States in the past six years, with 220,000 of the procedures done in 2008.

Diabetes, though, is on the rise, too, and studies show bariatric surgery is achieving good results in controlling that disease in patients with BMIs between 30 and 35, said Dr. Stuart Verseman, who has been medical director of bariatric surgery at Borgess Medical Center since October 2005 and does bariatric surgery at both Borgess and Bronson Methodist Hospital.

“They’re finding a marked improvement in their diabetes after bariatric surgery and a decreased usage of medication,” Verseman said.

An example of someone with a BMI of 30 would be a person who is 5-foot-9 inches tall and weighs 203 pounds. That person would be 35 pounds above the normal weight range for that height, according to the U.S. Centers for Disease Control and Prevention.

While that example might not strike some people as a case of obesity, Verseman said that “even people with BMIs of 30 are considered clinically obese.”

Verseman, following National Institutes of Health guidelines, does bariatric surgery only on those with a body mass index of 35 or more and certain related medical conditions or 40 or more without those conditions.

But he said he finds it “very exciting to think about offering that to a larger population, especially with the number of diabetics increasing astronomically every year.”

Verseman is the only surgeon in Kalamazoo currently doing bariatric operations. Dr. Alan Saber, who had been the main physician doing bariatric surgery at Bronson, left in November and now works at Case Western Reserve University Hospitals, in Cleveland.

Verseman, like Cooper, said bariatric surgery should never be the first choice for weight loss. But he is much more open to the potential of its use in the moderately obese who have diabetes, high blood pressure or other weight-related conditions.

Krista Hampton, a registered dietitian who is Bronson’s bariatric coordinator, sees the value of bariatric surgery for the extremely obese, but she expressed reservations about using it in people who are overweight or moderately obese.

“Coming from my background, I would want someone to exhaust all other weight-management options first,” she said.

Surgery and support

Bariatric surgery is on the rise at Borgess and Bronson, as it is nationwide. In the fiscal year ending June 30, 2004, there were 14 bariatric surgeries at Borgess. From July 2008 through June 2009, there were 187 at Borgess, and in the last six months of 2009 there were 110, according to Rebecca Blades, a registered nurse who leads the Borgess bariatric program.

Bronson, which started its bariatric program in 2007, did 47 surgeries that year, 99 in 2008 and 112 in 2009, said public-relations specialist Erin Smith.

Verseman said his bariatric surgeries have had a major-complications rate of 2 percent, while the national average is 3.5 percent.

Representatives of both hospitals emphasized that they carefully screen those interested in bariatric surgery and offer continued support to those who get the surgery, trying to help them avoid overeating and stay active.

Borgess, for example, offers support groups, both in person and online, and offers classes in active living, Blades said.

“None of these operations are cures,” Verseman said. “They’re tools to help patients. And it’s a team approach we take, involving a dietitian, a psychotherapist, the primary-care physician. Patients need to follow guidelines afterward to improve their medical conditions.”

“If you start grazing, over time you can get a lot of calories in even after surgery,” Verseman said.

But if people getting bariatric surgery have to learn to make dietary and behavioral changes and stick with those changes to lose weight, why not instead work closely with people to support new eating habits and more exercise without doing bariatric surgery?

“I wouldn’t have somebody undergo bariatric surgery who has never attempted anything else before,” Verseman said. “Almost every patient (who undergoes bariatric surgery) has completed numerous diets” but has not succeeded in losing enough weight to improve their medical condition, he said.

“You don’t just wake up one morning and say, ‘I want to have gastric bypass surgery.’”

The surgery helps people feel full and therefore have less of an urge to eat, Verseman said. One type of surgery he does — a sleeve gastrectomy — takes out 75 percent of the stomach and gets rid of the hormone that causes hunger, he said.

Even without bariatric surgery, though, people can learn to ease feelings of intense hunger, Hampton said, by increasing the protein and fiber in their diets and decreasing the kinds of high-carbohydrate foods that cause blood sugar to spike and then drop.

She said some people who enter a weight-management program at Bronson with the idea of getting bariatric surgery decide not to have it once they learn to cook and eat differently, get more exercise and overcome some behavioral issues.

“We need to get back to the basics of how to cook and how to meal plan,” she said. “Convenience food is way too easy to get our hands on.”

Verseman expressed a similar sentiment but said he is glad he can help improve people’s lives through bariatric surgery.

“To see people get over medical conditions and get their lives back ... is really gratifying,” he said.

Gastric Bypass Surgery Malpractice Lawyers

 Subscribe to Gastric Bypass Surgery News

Gastric band surgery can help extend lives of obese people, says study

New York, NY

A new study backs up the belief that bariatric surgery is beneficial for losing weight and extending the lives of obese men and women.

But the precise pluses of the procedure vary by individual and are influenced by many variables, including a patient’s age, weight and gender, according to the Guardian.

The research was carried out at the University of Cincinnati Academic Health Center.

In one type of bariatric surgery, a physician wraps a band around the patient’s stomach, reducing its size. Because they feel full faster, people eat less.

Over time, they shed weight, which helps to prevent heart attacks, strokes and type 2 diabetes, according to The Guardian.

Bariatric surgery is typically given to people whose body mass index (BMI) is over 40.

But because any type of surgery comes with risk, including infection, other complications and even death, the study looked at potential positive outcomes versus the inherent danger of undergoing the knife.

Age was a significant variable, since younger patients undergoing surgery are less apt to die from surgery or develop complications.

Researchers found that for a 42-year-old woman with a body mass index of 45, weight-loss surgery could extend her life by up to 3 years.

A 44-year-old man with a BMI of 45, reaped slightly less dramatic results. He could expect to increase his life by 2.6 years after surgery.

Gastric Bypass Surgery Malpractice Lawsuit Attorney

 Subscribe to Gastric Bypass Surgery News

Study: Weight loss 6 months after gastric byass no different for patients who had mood and eating disorders pre-op

Storrs, CT

Researchers detail in 'Effect of mood and eating disorders on the short-term outcome of laparoscopic Roux-en-Y gastric bypass,' new data in eating disorders. "We examined whether patients with a history of mood and eating disorders (MED) had less weight loss and poorer treatment compliance after laparoscopic Roux-en-Y gastric bypass (LRYGBP) than patients with a history of either mood (MD)or eating disorders (ED), or no history of mood or eating disorders (ND). Consecutive LRYGBP patients (n=196; 43.6 ±10.9 years; BMI 47.2 ±7.4 kg/m2; 83.2% female, 91.8% Caucasian) underwent a preoperative psychological evaluation," investigators in the United States report (see also Eating Disorders Therapy).

"At 6 months post-surgery, body mass index (BMI), % excess weight loss (%EWL), hospital readmissions, and adherence to behavioral recommendations were assessed. Of the patients, 10.2% had MED, 36.7% had ED only, 24.0% had MD only, and 29.1% of patients had ND. MED patients fared worse than all other groups in dietary violations (p=0.03), exercise habits (p=0.05), and readmission rates (p=0.06) but there were no group differences in either BMI change or %EWL," wrote A.A. Gorin and colleagues, University of Connecticut, Center for Health.

The researchers concluded: "MED patients are at-risk for poor treatment compliance following LRYGBP; however, they achieve similar weight losses 6 months postoperatively."

Gorin and colleagues published their study in Obesity Surgery (Effect of mood and eating disorders on the short-term outcome of laparoscopic Roux-en-Y gastric bypass. Obesity Surgery, 2009;19(12):1685-90).

For additional information, contact A.A. Gorin, University of Connecticut, Dept. of Psychology, Center for Health, Intervention and Prevention, Storrs, CT

Gastric Bypass Malpractice Attorney - Medical Malpractice Trial Lawyer

 Subscribe to Gastric Bypass Surgery News

Britain’s "most obese teen" is slim after gastric bypass surgery, says would rather be dead

Selby, North Yorks, England

At 19 years of age, Malissa Jones of Selby, North Yorks, England, sees herself as the unhappiest woman alive, whose future is extremely bleak unless she somehow comes up with £20,000 required to undergo cosmetic surgery. At 16, Malissa, Britain’s fattest teen, underwent gastric bypass after doctors told her she only had months to live, and thus became the first person in the world to undergo the surgery. She is now telling Closer magazine she’d rather be dead than live her life as she is now.

Malissa knows that the surgery saved her life, especially since she had her first suspected heart attack at the tender age of 15. Doctors told her at the time that, although risky and not usually done on under-18s, the procedure was the only hope she had to live longer than a few more months. At the time, Jones was diagnosed with angina, had her internal organs compressed, could not move and breathed at night with the help of an oxygen tank. She weighed 34 stone (215 kg) and ate 15,000 calories a day (with the daily recommended intake being of 2,000).

Now, two years later, Malissa has lost 20 stone (127 kg) and her life expectancy is increased. Still, she is depressed and is on medication because she is constantly so ill she can hardly get out of the bed. She says she’s been left with so much excess skin from her weight loss that she truly wishes she had never had the surgery at all – anything, even death, is better than looking like this. She doesn’t have the money to undergo surgery to remove the saggy skin and the NHS will not pay for it.

“I know it sounds ungrateful, but I preferred my body when I was fat. At least it was firm and curvy, not droopy and saggy. I had nice firm arms – now the skin just hangs and I have to cover them up because they look so awful. The NHS won’t remove the skin and I’ll never manage to save £20,000 to have it done privately. The surgery might have saved my life, but I wish I’d never had it done,” Jones says for Closer.

There is tinge of regret though at not having tried to lose the weight the healthy way, with diet and exercise, and especially at having let her problems become so serious. “Although my heart’s healthier and life expectancy is normal, some days I’m too ill to get out of bed. […] I hope people read this and realize gastric surgery isn’t a miracle cure. I wish I’d lost the weight through exercise and healthy eating. I know this operation was life-saving, but the complications I’m suffering now might still kill me. The truth is I feel I’m no better off than I was before,” she says for the same magazine.

Gastric Bypass Malpractice Lawyers

 Subscribe to Gastric Bypass Surgery News

Urologist's opinion: Gastric band placement for obesity is not associated with increased urinary risk of urolithiasis compared to gastric bypass surgery

Berkley, CA

As morbid obesity is becoming increasingly prevalent in our western society, the surgical options for management of this disorder are being more widely utilized. These procedures include Roux-en-Y gastric bypass and gastric band surgery. It has been estimated that the number of bariatric surgeries performed has increased ten-fold in the past decade. It has been observed that in some patients undergoing bariatric surgery for obesity, new onset nephrolithiasis can develop.

These two studies very nicely show that patients at greatest risk are those with Roux-en-Y gastric bypass in which the normal gut flow and absorption is interrupted. These patients typically have an elevation in their urinary oxalate and a significant reduction in their urinary volume. Interestingly, patients with gastric banding appear to have a more significant reduction in their urinary volumes compared to the Roux-en-Y group of patients. However, the Roux-en-Y gastric bypass procedure results in a more significant hyperoxaluria and hypocitraturia.

Both of these studies note that due to the small numbers and the limited time of their study, they were unable to demonstrate that the increased urinary risk factors translated into an actual increased risk for renal stone development. However, it would seem prudent to counsel these patients even before they come to their surgical procedure with regards to dietary modifications to reduce their risk factors for renal stone development. These dietary modifications include maintaining an adequate fluid intake to potentiate a 2-liter urine output per day, 1,200 to 1,500 mg calcium citrate with Vitamin D and 500 mcg Vitamin B-12 and B-complex supplementation. Additional citrate supplementation may be important particularly in those patients with a prior history of stone disease.

Further clinical studies are still required to illustrate the effect of nutrition and pharmacologic therapy on the risk of stone development in patients undergoing bariatric surgery.

Gastric Bypass Malpractice Lawsuit Attorneys

 Subscribe to Gastric Bypass Surgery News

A prospective study of risk factors for nephrolithiasis after Roux-en-Y gastric bypass surgery (Abstract)

Roux-en-Y gastric bypass surgery has become an increasingly common form of weight management. Early retrospective reviews have suggested that new onset nephrolithiasis develops in some patients after undergoing Roux-en-Y gastric bypass. We present a prospective longitudinal study to assess risk factors for nephrolithiasis after Roux-en-Y gastric bypass.

A total of 45 morbidly obese patients scheduled to undergo Roux-en-Y gastric bypass surgery were enrolled in this prospective study between November 2006 and November 2007. Exclusion criteria included history of nephrolithiasis or inflammatory bowel disease. Serum uric acid, parathyroid hormone, calcium, albumin, and creatinine and 24-hour urine collections were obtained within 6 months before Roux-en-Y gastric bypass, and at 6 to 12 months postoperatively. A Wilcoxon signed-rank test was used to compare preoperative and postoperative serum laboratory values and 24-hour urine values. McNemar's test was used to determine if the percent of abnormal values underwent a statistically significant change after Roux-en-Y gastric bypass. For both statistical methods a p value was calculated for the change in each variable with p <0.05 considered statistically significant. Statistically significant changes included increased urinary oxalate and calcium oxalate supersaturation, and decreased urinary citrate and total urinary volume postoperatively. A statistically significant percentage of patients exhibited decreased urinary calcium, while a statistically significant percentage of patients experienced increased urinary oxalate and calcium oxalate supersaturation. Our prospective study demonstrated multiple factors that increase the relative risk of nephrolithiasis after Roux-en-Y gastric bypass. These changes may make stone formation after Roux-en-Y gastric bypass increasingly likely and pose an ongoing challenge in the realm of urology. Gastric Bypass Malpractice Lawsuit Attorneys

 Subscribe to Gastric Bypass Surgery News

Gastric bypass surgery: Couple sticks together through thick and thin

Lehi, UT

A couple in Utah County went under the knife together on a weight loss journey in hopes of losing hundreds of pounds.

The couple is Mike and Lorena Downey. The two took their vows 26 years ago promising to love each other in good times or bad, for better or for worse, in sickness and in health and to see each other through thick and thin.

When they married, in 1983, Mike and Lorena had a combined total weight of just under 300 pounds, but this year they tipped the scales at almost 600 pounds.

“I look in the mirror, I’m not happy with who I see. When I got to 270 pounds it blew my mind. I couldn’t believe it. I was so close to 300 pounds,” said Lorena.

Although the Downeys were happily married with children, their weight slowly started to come between them.

“How could you look at your wife and say you’re not the woman I married, when you’re looking at yourself and saying you’re not the man she married,” said Mike.

The two knew something had to be done and began researching options. In a desperate effort to shed the weight they turned to gastric bypass surgery. After deciding that the surgery’s pros outweighed the cons they chose to do the surgery together.

They went to St. Mark’s hospital where Lorena had her surgery on October 7th and Mike had his one week later.

Gastric bypass surgery is growing more popular every day as America’s obesity epidemic tips the scales. The surgery has been known to save lives but there can also be life changing drawbacks.

Their journey consisted of three trips to the ER during the week of Mike’s surgery and complications for Lorena resulting in two additional surgeries.

Both are fine and after just five weeks the couple has lost nearly 100 pounds. They have been walking everyday and both say they’re feeling better and have more energy.

Gastric Bypass Surgery Malpractice Attorney

 Subscribe to Gastric Bypass Surgery News

3 Years after gastric bypas surgery, man loses 259 pounds and competes in triathalons

St. Petersburg, FL

Three years ago, Chad Soileau was sitting in a roller coaster seat at Six Flags amusement park near Washington, D.C., when he was overcome with panic. He had waited in line for more than an hour for the four-minute ride on the Wild One, but when it came time to buckle up, the seat belt wouldn't fit.

"The attendant walked up and told me I was too big for the ride," recalled Soileau. "She yelled back to her co-workers, 'Bring the tool, we've got a large rider.' "

Five minutes seemed like an eternity as the crew struggled to extend the roller coaster's seat belt.

"Hundreds of people were watching," Soileau said. "It was the most humbling, humiliating experience of my life."

Afterward, Soileau stumbled off the ride and ran to the nearest restroom. "My stomach was in knots," he said. "I vomited for 10 minutes."

On Nov. 14, a very different Soileau will again face an audience — but this one will be cheering his remarkable achievements.

The Louisiana man will be among the 1,500 or so elite athletes who will gather on Clearwater Beach to swim 1.2 miles, bike 56 miles and run 13.1 miles in the Ironman World Championship 70.3. (The name comes from the combined distance of the three events, which is half the distance of the world famous Ironman World Championship held each October in Kona, Hawaii.)

"It has been a long road to get here," said Soileau, 37. "And I still have a long way to go."

Team 464

Despite the trauma of the roller coaster incident, it wasn't until a few months later that Soileau realized the full extent of his obesity.

"I was on the scale at the doctor's office when he asked if I knew how much I weighed," he said. "I figured about 350. He said no, 464."

Soileau couldn't believe he was off by 114 pounds. He made up his mind, then and there, that he would do something about his weight.

On March 22, 2006, he underwent gastric bypass surgery. "I call it my re-birthday," he said.

The surgery came with complications. He developed several blood clots and had to undergo three additional surgeries, including one to have his gallbladder removed and another to repair a twisted bowel and an internal hernia. But Soileau persevered.

Soileau was 34 when he started his weight-loss journey. Overcoming his longtime addiction to food was his first obstacle.

"I used to order double of everything . . . two appetizers, two entrees, two desserts," he said. "When I would go to the drive-through I would pretend there was somebody else in the car because I was ordering so much food."

Weight-loss surgery is no sure bet; plenty of people regain weight after the procedure. But after his surgery, Soileau found it easier to control his urges. (See related story, Page 12.)

"Physically I couldn't eat as much," he said.

The physical changes soon were followed by emotional ones. "After a while I stopped wanting the food,'' he said.

The victories piled up. One day, he discovered he could bend over to tie his shoes. "It was a huge accomplishment for me when I could get in my truck without my stomach hitting the steering wheel," he said.

Soileau set weight goals, which he published on his Web site, www.Team464.com:

"Weigh less than 400 pounds — DONE!''

"Weigh less than 350 pounds — DONE!''

He also kept track of his progress by his pants size: He went from a size 64 to a size 34.

ONE STEP AT A TIME

As he recovered from the surgery and started to drop pounds, he began to exercise.

He started off small, walking back and forth to the stop sign a block from his house. Gradually, his walks got longer and longer. Eventually, he started running, then swimming, then biking.

"I came up with a list of goals for myself," he said. "One of them was to complete a triathlon."

To help him reach his goals, he kept a training log.

"At first it was just a mile, then 2 miles, then 3 miles," he said. "The whole time I dreamed about completing a marathon."

Soileau, who has a girlfriend, works as a Web site designer in New Orleans. He struggles to find time for the one to two hours of daily training a triathlon requires. As for his diet, he focuses on fruits, vegetables, whole grains and lean protein to help power his new physique.

The discipline paid off. In February 2008, Soileau finished the Mardis Gras Marathon in New Orleans with a time of 5 hours and 36 minutes.

IRONMAN

Soileau has completed dozens of road races and triathlons. He was invited by the World Triathlon Corporation to be its guest at this year's event in Clearwater. Officials hope Soileau's story will inspire others to try the sport.

"It is an honor to be here," he said. "What other sport lets you share the course with the pros?"

But despite his success, Soileau doesn't feel as if he has won his battle against obesity. He won't feel victorious, he said, until he completes a full-distance Ironman.

"I will know I won when I step over the finish line and I hear the announcer yell, 'Chad Soileau, you are an IRONMAN!' "

 Subscribe to Gastric Bypass Surgery News

Is gastric bypass surgery a diabetes fix?

Los Angeles, CA

Within days of various weight-loss surgeries, blood sugar levels become easier to manage -- or are normal.

The discovery came about by accident more than a decade ago: Weight-loss surgery often led to dramatic improvements in the control of Type 2 diabetes, often before patients had even left the hospital.

Today, evidence of the connection is so solid that some doctors say surgery should be considered as a treatment for diabetes, regardless of a person's weight or desire to lose weight.

"We thought diabetes was an incurable, progressive disease," says Dr. Walter J. Pories, a professor of surgery at East Carolina University and a leading researcher on weight-loss surgery. "It . . . is a major cause of amputations, renal failure and blindness. This operation takes about an hour, and two days in the hospital, and these people go off their diabetes medication. It's unbelievable."

As many as 86% of obese people with Type 2 diabetes find their diabetes is gone or much easier to control within days of having weight-loss surgery, according to a meta-analysis of 19 studies published earlier this year in the American Journal of Medicine (78% of patients with a remission of diabetes and 86.6% with remission or improvement). But experts still aren't sure why obesity surgery helps resolve Type 2 diabetes or how long the effect might last. And they disagree on how big a role surgery should take in treating the illness.

"We are going from seeing the results to understanding why it happens," said Dr. Santiago Horgan, director of the Center for the Treatment of Obesity at UC San Diego.

This much is clear: Patients who have weight-loss surgery begin to lose weight rapidly, which by itself improves Type 2 diabetes, allowing diabetics to more easily control their blood glucose levels. But something else appears to be occurring as well.

There is strong evidence that surgery -- especially gastric bypass surgery, which makes the stomach smaller and allows food to bypass part of the small intestine -- causes chemical changes in the intestine, says Dr. Jonathan Q. Purnell, director of the Bionutrition Unit at Oregon Health & Science University. The small intestine has been thought of simply as the place where digestion occurs.

But researchers now suspect it has other functions related to metabolism. Surgery somehow alters the secretion of hormones in the gut that play a role in appetite and help process sugar normally.

Multiple studies in humans and animals indicate that surgery triggers reductions in ghrelin, the hormone that stimulates hunger, and elevates levels of peptide YY and glucagon-like peptide-1, both of which act as appetite suppressants. Another theory is that surgery might alter the expression of genes that regulate glucose and fatty-acid metabolism.

"There are these known components that improve glucose metabolism," Purnell says. "But there are very likely other things happening as well."

Which procedure?

The effect on diabetes can depend on the type of weight-loss surgery that is performed, says Pories, past president of the American Society for Metabolic and Bariatric Surgery. The highest rates of diabetes remission are seen in people who have gastric bypass -- about 83%.

But diabetes also tends to resolve or improve in 50% to 80% of people who have lap-band surgery, in which a band is placed around the top of the stomach to make it smaller, he says. And there is some evidence that the effect occurs a newer type of weight-loss surgery called gastric sleeve, in which a portion of the stomach is removed so that it takes the shape of a tube or sleeve.

Evidence suggests the effect on diabetes can last for an extended period or even indefinitely, particularly if people don't regain a lot of weight.

"There is durability, but we also know that some people do get the disease back again," Purnell says. "Weight rebound is probably one factor. We also know that diabetes is a progressive disease. It may depend on how long you've been diagnosed with diabetes. If it's early on, I think the durability may be better."

It's not clear yet why people have different responses.

"There is some evidence that African Americans don't respond as well as Caucasians, and men don't respond as well as women," Pories says.

Despite the unknowns, the evidence that a majority of people experience long-term improvement in blood glucose control suggests the surgery could eventually play a greater role in the treatment of obese people with Type 2 diabetes. The majority of American adults with Type 2 diabetes are overweight.

Traditional medical guidelines, which insurers follow, state that weight-loss surgery should be restricted to patients with a body mass index of 35 or greater who have related health problems. But some diabetes and nutrition experts think those recommendations don't go far enough. Several studies are underway, or will soon begin, to examine the benefits of surgery in people with Type 2 diabetes and a BMI of less than 35.

"We may have a cure for diabetes," Santiago says. "So we need to ask how medical therapies and surgery can help each other in the treatment of diabetes."

Studies from several other countries show that surgery also results in remission of diabetes for people who are not morbidly obese. There is even discussion, particularly in other countries, of performing weight-loss surgery for people with Type 2 diabetes who are not overweight.

Not without risks

In the United States, weight-loss surgery is still largely viewed as a cosmetic procedure and obesity as a lifestyle issue, not a chronic disease. Moreover, weight-loss surgery carries risks. The death rate is about one per 200 operations and severe complications can occur, including blood clots, infections related to surgery, and the need for corrective surgery due to leaks at the staple lines.

Other complications include vitamin and mineral deficiencies, dehydration, gallstones, kidney stones, hernia and low blood sugar.

However, a risk-benefit analysis published in April in the Journal of the American Medical Assn. by Purnell and a colleague suggests that if the number of gastric bypass operations performed on diabetic patients increased to 1 million per year, as many as 14,310 diabetes-related deaths might be prevented over five years.

Surgery also leads to other health benefits besides weight loss and better control of diabetes. Patients often see improvements in blood pressure, cholesterol, gastroesophageal reflux disease and sleep apnea.

"Doctors say, 'If I can lower glucose by medications, why send patients to surgery?' " Purnell says. "Surgery, however, allows people to have meaningful and sustained weight loss and their diabetes is better. There are risks involved with surgery, obviously, but it makes sense, to me, to do surgery."

The discovery of the gut hormones that play a role in appetite and insulin regulation may also lead to new medications for Type 2 diabetes, Pories says.

"You can't operate on 31 million Americans," he says. "But if we understood this mechanism and what are the molecules secreted by the intestines that cause diabetes, then we can cure it with a pill. I would not be surprised if, in the next five years, we have new medications."

 Subscribe to Gastric Bypass Surgery News

Laparoscopic gastric bypass surgery helps man shed obesity

St. Louis, MO

Two years ago, Herb Simmons tipped the scales at 497 pounds.

"As the years snuck up on me I noticed it was getting harder to get around," he says. "I couldn't leave home in the morning without soaking my knees in Ben Gay."

He was suffering from sleep apnea, atrial fibrillation and hypertension. Getting from his car to his house was an exhausting, stop-and-go process because he'd rest every few feet to catch his breath. He needed an extra seat belt on airplanes and a chair without arms in restaurants.

Simmons says he didn't eat big meals, but admits to snacking on chips and slurping sugary colas every day. He says he's been on every diet known to man.


"I once lost 100 pounds on OPTIFAST and regained 200," he says. "I was a yo-yo dieter."

In 2007, he attended a bariatric seminar to learn more about Lap-Band surgery, a laparoscopic procedure to place a silicone band around the top of the stomach. The band reduces the amount of food the stomach can hold so patients eat less. Simmons made an appointment with one of the surgeons, Dr. Van L. Wagner, of Heart of America Bariatrics in Lemay. He was surprised when Wagner recommended gastric bypass instead.

Gastric bypass uses staples to make the stomach smaller, then reroutes food past part of the small intestine. Patients feel full sooner, and absorb fewer calories and nutrients.

With a Lap-Band, patients lose only between 50 and 70 pounds in the first year then often taper off on weight loss, Wagner says. With gastric bypass they almost always lose between 200 and 250 pounds in two years.

"Bypass is usually a better option for patients who are sicker, older and have higher weights," Wagner says. "And Herb was extreme on several of those things so banding would not have provided the weight loss he needed."

Wagner performed laparoscopic gastric bypass surgery on Simmons Sept. 19, 2007, at St. Alexius Hospital.

Gastric bypass comes with risks, including developing gallstones and nutritional deficiencies.

Simmons takes calcium and vitamin pills and drinks protein shakes to prevent malnutrition. Two weeks after surgery, he began walking, first up and down the sidewalk in front of his house, then on a quarter-mile track. At first he couldn't walk a lap without stopping to rest several times. Within a few months, he was walking two miles. Now, he walks three to five miles every afternoon and bicycles three to five miles every evening.

He also eats a lot less, especially high-fat, sugary foods.

"It can cause dumping syndrome, which makes you want to lock yourself in a room for hours," Simmons says. WebMD describes the syndrome as a shock-like state that lasts for 30 to 60 minutes after small, easily absorbed food particles are rapidly dumped into the digestive system. Symptoms include a clammy sweat, butterflies in the stomach, a pounding pulse, cramps and diarrhea.

Simmons says his triglyceride and cholesterol levels have plummeted, his sleep apnea has dissipated and his blood pressure medications are one-fourth the dose they were before surgery. His legs no longer swell and his knees feel fine.

He credits ongoing counseling by Wagner and St. Alexius' NewStart program for his success. Both offer emotional support, nutritional guidance and ongoing education.

Last month, Simmons celebrated the second anniversary of his surgery by walking 3.7 miles as part of the Walk From Obesity event in Creve Coeur.

"After my wedding anniversary, my surgery date is the second-most important anniversary for me," Simmons says.

Gastric Bypass Malpractice Lawsuit Attorney

 Subscribe to Gastric Bypass Surgery News

California woman seriously ill after gastric bypass surgery finds hope

Modesto, CA

Tests have shown that Sandi Krueger's golf-ball-sized pouch no longer breaks down the food she eats, but dumps it directly into her small intestine. Before the feeding tube, her attempts to eat caused nausea and she often had dumping syndrome, a reaction when certain foods pass too quickly into the intestine, resulting in sweating, rapid heart beat and weakness.

Her journey began in 2002 with a gastric bypass at Doctors Hospital of Manteca, which later closed its bariatric program. She had constant dumping and severe weight loss, had a falling out with her surgeon and went to the University of California at San Francisco for corrective surgery in 2004.

Her condition improved for several months and then her condition gradually deteriorated. She stopped working as a nursing assistant last year and then UCSF rejected her request for a reversal surgery.

Repairs are complex

She's made the 165-mile trip to Delano because Keshishian accepted her Medi-Cal coverage and he specializes in revising or reversing gastric bypasses. A reversal has some of the same risks as gastric bypass; in addition, the surgeon must deal with scar tissue that grows between the left side of the liver and upper part of the stomach.

"You have to peel the stomach away from the liver," Husted said. "It's tricky and can take a long time."

Many patients who aren't absorbing enough nutrients can improve with counseling and treatment, experts say.

Until her surgery is scheduled, Krueger will stay with the tube- feeding routine — 44 ounces of water mixed with a formula of protein, vitamins and other stuff costing the family $549 a month. With her husband drawing unemployment, it strains the family budget, but at least she feels healthy.

"It is nice to be a mom again," she said. "It feels like I have missed six years of my life."

Gastric Bypass Malpractice Lawsuit Attorneys

 Subscribe to Gastric Bypass Surgery News

Gastric bypass surgery death rates drop, study reveals

Seattle, WA

Obese, but worried that surgery for it might kill you? The risk of that has dropped dramatically, and now is no greater than for having a gall bladder out, a hip replaced or most other major operations, new research shows.

The study looked at safety results for gastric bands and stomach stapling at 10 U.S. hospitals specializing in these procedures from 2005 through 2007. For every 1,000 patients, three died during or within a month of their surgery, and 43 had a major complication.

That is much better than the 20 or so deaths per 1,000 patients that studies found just a few years earlier. And it's surely lower than the longer term risk of dying of heart disease, diabetes and other consequences of lugging around more pounds than an obese person's organs can handle, experts say.

Many studies have compared those odds, and "all show a higher risk of dying if you do not have surgical treatment than if you do," said Dr. Eric DeMaria, weight loss surgery chief at Duke University Medical Center.

He had no role in the new study, which was led by Dr. David Flum at the University of Washington in Seattle. Results appear in Thursday's New England Journal of Medicine.

About one-third of American adults are obese, with a body mass index of 30 or more. The index is based on height and weight. Someone who is 5-feet-4 is obese at 175 pounds; a 6-foot person is obese at 222 pounds.

Federal guidelines say obesity surgery shouldn't be considered unless someone has tried conventional ways to shed pounds and has a BMI over 40, or a BMI over 35 plus a weight-related medical problem like diabetes or high blood pressure.

Last year, at least 220,000 obesity surgeries were done in the United States, says the American Society for Metabolic & Bariatric Surgery. The most popular method is a gastric bypass in which a small pouch is stapled off from the rest of the stomach and connected to the small intestine. People eat less because the pouch holds little food, and they absorb fewer calories because much of the intestine is bypassed. This can be done with traditional surgery or laparoscopically, through small keyhole incisions.

Another solution is a gastric band. A ring is placed over the top of the stomach and inflated with saline to tighten it and restrict how much food can enter and pass through the stomach.

The new study looked at the safety of these methods in 3,412 gastric bypass patients and 1,198 given stomach bands.

Death, serious complications or the need for another procedure occurred in 1 percent of people receiving bands, nearly 5 percent having laparoscopic gastric bypass, and nearly 8 percent of those given a traditional surgical bypass. Maybe

DeMaria cautioned against comparing the numbers, because healthier people may have been steered toward laparoscopic procedures that may not have been an option for others with more health risks.

Complication rates were greater in people with a history of clot problems, sleep apnea and certain other medical issues, the study found.

The federal government paid for the study. Many of the researchers have ties to companies that make obesity treatments, and several have testified in surgery lawsuits.

The results put the spotlight on cost issues, Dr. Malcolm K. Robinson, a surgeon at Harvard Medical School, wrote in an editorial accompanying the study.

"In the past, now outdated bariatric procedures carried unacceptably high risks. The weight loss associated with the procedures was questionable, and the long-term health benefits were unproven," he wrote.

Now, the evidence shows that "surgery is safe, effective, and affordable," because it can lower doctor visits, medication use and other medical expenses, Robinson wrote. However, "the expense of operating on the millions of potentially eligible obese adults could overwhelm an already financially stressed health care system."
On the Net:

* New England Journal: http://www.nejm.org
* National Institutes of Health surgery explanation: http://win.niddk.nih.gov/publications/gastric.htm

Gastric Bypass Malpractice Wrongful Death Trial Lawyers

 Subscribe to Gastric Bypass Surgery News

More than 50% Increase in gastric bypass surgeries over past 12 months in UK

York City, UK

Operations to combat weight gain have increased by more than a half in the past 12 months.

The news follows the tragic death of York mum Kerry Greaves, who underwent gastric bypass surgery to try to slim down so her daughter, Melissa, would not be teased at school. Sadly, complications led to Kerry’s death at the age of only 30.

Figures released by the NHS show that in the 12 months leading up to April this year, 4,324 people nationally underwent operations to have gastric bypasses or gastric bands fitted to help them lose weight. That is a 52 per cent increase over the 2007-2008 figures, when 2,838 opted for surgery.

Operations of this type can cost about £10,000 and most of those who opt to go “under the knife” are women – about three-quarters of the total who opt for surgery.

The treatment is predominantly available for patients whose body mass index (BMI) exceeds 50 – the average BMI is between 18 and 25.

People with a BMI of more than 40 are considered to be morbidly obese while a measurement of more than 30 is classed as obese.

According to the NHS figures, only 38 per cent of people are a healthy weight. The rise in the number of people wanting gastric bypass surgery has been borne out by York GP Dr David Fair, who said he had seen a marked increase in the number of people wanting the procedure.

But surgery should always be seen as the last option when dieting and exercise has failed.

Although low risk, Dr Fair said that potential problems could arise with any type of operations.

That is what happened to Kerry. After having the operation her stomach failed to heal properly, and she underwent a further 14 operations before dying of organ failure.

Gastric Bypass Surgery Malpractice Lawyers

 Subscribe to Gastric Bypass Surgery News

New study claims gastric bypass and gastric banding weight-loss surgery safe

St. Louis, MO

Obese patients who undergo weight-loss surgery have a low risk of dying or developing complications that require a second surgery or longer hospital stay, a study found.

About 4.1 percent of 4,610 people in the study who had either gastric bypass surgery or gastric banding developed at least one major complication in the 30 days after surgery, according to research published today in the New England Journal of Medicine. Those who underwent gastric banding had fewer complications.

Weight-loss surgery has soared in popularity in the U.S. The number of such operations rose more than tenfold to about 171,000 in 2005 from about 16,200 in 1994, according to an editorial in the journal. The data shows that, at least in the short term, these procedures are relatively safe and future research may help identify which surgery is best for a particular patient, said study author Bruce Wolfe, a professor of surgery at Oregon Health and Science University in Portland, in a telephone interview. Based on the findings, he said, "the surgery is basically safe."

Gastric Bypass / Gastric Banding Malpractice Lawsuit Attorneys

 Subscribe to Gastric Bypass Surgery News

Gastric bypass surgery using robots reduce pain and speed recovery

Phoenix, AZ

Gastric bypass surgery has gone robotic at one Arizona hospital.

Using robots, doctors at Banner Gateway Medical Center can perform the surgery from inside the person's body, KPHO-TV reported.

"The robot allows you to perform the surgery (not only) in high definition, but also in three dimensions," said chief of surgery Dr. Rob Schuster.

Schuster said the procedure is less invasive and painful and it cuts the risk of infection.

Doctors use state-of-the-art technology with a three-dimensional image of the surgical area. The display controls the surgical instruments, working with the doctors' hands, wrists and eyes in real time.

"It really allows us to perform a more precise and perfect operation," Schuster said.

Schuster said the new procedure will result in shorter hospital stays and shorter recovery times, so patients are able to return more quickly to their normal routines.

Banner Gateway Medical Center is one of only a handful of hospitals in the country that use this technology.

KPHO's report did not address any additional costs or risks from the assisted surgery.

Gastric Bypass Surgery Malpractice Lawsuits

 Subscribe to Gastric Bypass Surgery News

ASMBS: Laparoscopic adjustable gastric banding less effective than gastric bypass and sleeve gastrectomy

Dallas, TX

Patients who underwent laparoscopic adjustable gastric banding achieved less weight loss and less improvement in comorbid conditions than those who had gastric bypass or sleeve gastrectomy.

Slightly more than half of gastric banding patients lost more than 50% of excess weight after five years compared with more than 90% of patients who underwent laparoscopic Roux-en-Y gastric bypass, Diego Awruch, MD, reported at the American Society of Metabolic and Bariatric Surgery.

Surgical failure, defined as less than 50% excess weight loss, was almost six times more common with gastric banding.

"Laparoscopic adjustable gastric banding was associated with fewer complications, but the percent weight loss at one and five years was inferior to laparoscopic Roux-en-Y gastric bypass," said Dr. Awruch, of Pontificia Universidad Catolica in Santiago, Chile.

"Surgical failure occurred in more than 40% of patients who underwent gastric banding, and 16% of the patients required surgical revision of the initial procedure," he said.

Similar disparities in weight loss occurred in the comparison of gastric banding and sleeve gastrectomy.

Across the entire range of body mass index (BMI), laparoscopic sleeve gastrectomy led to greater weight loss, said David Schumacher, MD, of Wright State University in Kettering, Ohio.

Dr. Awruch reported outcomes for 91 patients treated with laparoscopic Roux-en-Y surgery and 62 who underwent gastric banding from 2001 to 2003.

Five-year follow-up was available for 73.6% of the gastric bypass patients and 91.5% of the gastric banding patients.

Comparison of baseline characteristics showed that bypass patients weighed significantly more (106.4 versus 97.6 kg, P<0.001) and had a significantly higher BMI (39 versus 35, P<0.001).

Gastric bypass was associated with a higher rate of early complications (14.2% versus 1.6%, P=0.009). In addition, nine bypass patients required reoperation or endoscopic dilatation compared with one patient in the banding group.

Late complications occurred in 37.3% of bypass patients compared with 27.4% of gastric banding patients, but the difference did not reach statistical significance. A higher proportion of gastric banding patients required reintervention (23 of 62 versus 20 of 91).

Percent weight loss at five years averaged 92.9% with gastric bypass compared with 59.1% with gastric banding (P<0.001).

Dyslipidemia, insulin resistance, hypertension, and type 2 diabetes improved or resolved in 80% to 100% of bypass patients compared with 20% to 40% of the gastric banding group.

At five years, 94% of bypass patients and 54.4% of gastric banding patients had maintained >50% excess weight loss.

Dr. Schumacher reported outcome data for 104 patients who underwent laparoscopic sleeve gastrectomy and 227 who had gastric banding from January 2006 through August 2008. Follow-up data were 99% as of January 2009.

Among patients followed for at least 18 months (about half of the total), weight loss averaged 133.82 lb in the sleeve group versus 58.93 lb in the banding group.

For the same time interval, excess weight loss averaged 55.54% with sleeve gastrectomy versus 38.65% with banding.

Stratification of patients by baseline BMI showed that sleeve patients had a greater excess weight loss in patients with BMI more than 50 (50% versus 33%), 40 to 49 (68% versus 40%), and less than 40 (90% versus 43%).

Readmission rates were 6% of sleeve gastrectomy patients and 1.3% with gastric banding. One patient (0.96%) in the sleeve group required reoperation compared with 19 (8.4%) gastric banding patients.

"Laparoscopic sleeve gastrectomy appears to allow greater weight loss in all BMI classifications over time with fewer reoperations," said Dr. Schumacher. "The most efficient weight loss occurred in the lowest BMI classification.

"Laparoscopic sleeve gastrectomy can be used effectively as a primary operation in any weight classification, achieving a greater than 50% excess weight loss in all BMI subsets."

 Subscribe to Gastric Bypass Surgery News

Gastric Bypass surgery: Pros and Cons

Tulsa, OK

Gastric bypass surgery is growing more popular every year as America's obesity epidemic tips the scales. Even the elderly, and people with health problems are turning to this surgical solution to obesity.

It is a surgery that saves lives. But some also warn there can be life-changing drawbacks.

"These were 26 - and I wear a size 8 now," said Leslie Blunt as she proudly showed off the pants she will never wear again thanks to gastric bypass surgery. She has lost 140 pounds. "It works. It does. You live a healthier life," she added.

Micah Anderson chose gastric bypass surgery when his weight ballooned to 500 pounds. "Lost little over 200 pounds - easy," he told 2News anchor Karen Larsen. "I'm happy with myself. More confidence."

While gastric bypass is known for bringing on drastic weight loss, what many do not realize are specific changes it may cause for an individual, along with health benefits.

"A lot of this junk food they were eating before - their taste has disappeared they don't want it anymore," according to Dr. Luis Gorospe, gastric bypass surgeon at Bailey Medical Center in Owasso. Both Anderson and Blunt went to Dr. Gorospe for surgery. His patients come from surrounding states, drawn by his surgery success rate, the promise of dramatic weight loss and the immediate health benefits of gastric bypass.

"If they have diabetes - 70 percent of these patients wake up with normal blood sugar and will not require medications - forever," Dr. Gorospe said.

Studies show gastric bypass may improve or even eliminate such health problems as:

Leslie Blunt says she is living proof, "I don't have high blood pressure. I don't have diabetes. I am pill free."

However, Micah Anderson tells a different story. "I'll vomit maybe not every week - but if something doesn't agree it does come right back up."

When surgeons create a tiny new stomach for patients, vomiting is a common problem when patients eat too much, too fast - until they get used to their new, smaller stomach. Micah says he expected that - but then he started fainting - once behind the wheel of his car.

Anderson's wife Katie said, "The passing out has happened four times. Spells where he could potentially pass out... weekly!"

Frightened by the potential danger such episodes represented, the Andersons began researching online and discovered other gastric bypass patients having such problems.

"Describing the same kind of drunk-like symptoms, incoherent, can't talk, slurring the speech. and people were experiencing the same things," Katie added.

The Andersons say they went to numerous doctors and nutritionists, trying to find a physician who was experienced with gastric surgery side effects. After trial and error, they say they have finally found the right doctor to care for Micah. As a result, Micah now follows a diet carefully crafted to meet his personal needs. He eats every two hours, consumes plenty of protein and takes vitamins.

"For me its lack of eating. I forget to eat and that's what causes my issues. It's partially my fault as much as it is the surgery," Micah said. "If I don't follow the rules like they tell you - you do have issues."

Doctor Gorospe agreed. He said healthy eating - the same issue obese patients struggle with before gastric bypass - is more important than ever after surgery. "If you follow the rules, this surgery will be successful," Dr. Gorospe said.

Because some patients do encounter issues following surgery, and with their new lifestyle, Doctor Gorospe offers monthly support groups. "I make it a point of being there," he said. "I want to be available to my patients." The meetings offer patients an opportunity to share their stories and talk with Dr. Gorospe.

Micah did attend the monthly meetings. However, some of his problems did not occur until several years following the procedure. As a result of his struggle, the Anderson's suggest to those considering gastric bypass surgery: do plenty of research, know the rules they will have to live by, and read up on potential side effects.

"There is a list and, by golly, one of those things on the list will affect you," Katie Anderson said. "They just need to tell you flat out - you are trading one set of issues for another set of issues."

However, when asked if he would have the surgery again, Micah's answer is, "Unfortunately, yes." He went on to say he is pleased with his more than 200 pound weight loss. His joints ache less when he gets out of bed in the morning, and it is easier to be active.

Leslie Blunt agrees. Now, this svelte hair stylist says work is easy. No more suffering from carrying too much weight while being on her feet each day. Plus, she loves buying clothes with her new look and the fact that she is setting a good example for her young children by living a healthier lifestyle.

In fact, Leslie says gastric bypass surgery is the best thing she ever did for herself. "Yes! I would do it over and over and over again! I never want to be that way again."

Gastric Bypass Malpractice Lawyers

 Subscribe to Gastric Bypass Surgery News

Help now available after failed gastric bypass surgery

San Diego, CA

A new procedure, called a ROSE procedure, is now available for patients who have had gastric bypass, lost weight and then slowly put weight back on again as their stomach pouch stretched. One of the problems with surgeries that reduce the size of the stomach for weight loss is that the pouch size may not be permanent. Over time, the pouch can enlarge to the point where meals of significant size can be eaten.

Rose, or Restorative Obesity Surgery, Endolumenal, is an outpatient procedure where the surgeon inserts a tiny camera and special tools into the stomach by introducing them into the mouth and down through the esophagus. Remarkably, no incisions are made to reduce the size of the stomach opening and the actual stomach. The surgeon essentially makes folds in the tissue of the stomach from the inside, similar to creating pleats, then uses stitches to hold the folds in place.

The procedure is currently available at the Center For The Treatment of Obesity at UC San Diego Medical Center.

 Subscribe to Gastric Bypass Surgery News

Woman's decision to undergo gastric bypass changes her life

Harrisburg, PA

Corinna Van Hine's moments of reckoning with her weight were mounting. At 30, she was out of breath when she walked with her husband, often avoiding hills. Shopping for women's clothes was a thing of the past, and she was buying from the racks in men's departments instead. She could barely squeeze into seats at movie theaters or amusement parks.

The worst setback was when her 320-pound frame kept her from horseback riding, a passion since she was 5 years old. "It really limited me because you have to have a big enough horse to handle your weight," Van Hine said. "My weight had gotten to a point where it wasn't safe for the horse for me to be riding it."

That's when the Steelton woman decided enough was enough. After years of shedding pounds through dieting and exercise only to regain the weight and sometimes more, she hit the books and Internet for any information on weight-loss surgeries.

It eventually led Van Hine to Penn State Milton S. Hershey Medical Center's Surgical Weight Loss Program, where patients go through an extensive evaluation before undergoing six months of medically supervised weight loss prior to approved surgery. In March 2006, she attended an informational session with surgeons who explained the types of surgery offered -- Roux-en-Y gastric bypass surgery and laparoscopic adjustable gastric banding -- the risks involved and what to expect afterward. Van Hine left the meeting feeling more confident than she had in a long time.
Vince CassaroSince gastric bypass surgery, Van Hine has lost 115 pounds. She also eats better and exercises, often for a 2-mile walk with Callie, her dog, in and around her Swatara Township home.

Although she had lost 60 to 70 pounds on her own in 2001, she was sidelined by a broken collarbone, and the weight became increasingly difficult to keep off. "I said to myself, 'This is probably my only answer out of it,'" Van Hine said. "I thought, at 30 years old, I can't be doing this my whole life -- losing it and gaining it back. It hurts too much to be yo-yoing back and forth again and again."

Ann M. Rogers, a physician and the director of Hershey's weight loss program, said Van Hine is one of hundreds who have turned to its surgeries to lead healthier lives. About 80 percent of the patients are women, all of whom are severely obese -- 100 pounds over their ideal weight or a body mass index greater than 40 -- with health issues linked to their weight, Rogers said.

Like Van Hine, most candidates also are well informed about the surgeries before they walk in the hospital's doors. "I'd say 99.9 percent of them are ready to go with surgery by the time they come to our informational sessions," Rogers said. "Most of them have already spent years trying to lose weight. No matter how much they are able to lose, they invariably gain it back and then some. They simply can't keep it off."

In December 2006, after months of preparation and restricted dieting, Van Hine was wheeled in for a laparoscopic Roux-en-Y gastric bypass, in which doctors create a small pouch and bypass a portion of a patient's intestines through several small incisions.

Weight loss occurs rapidly in the first six months following surgery and slowly tapers off 18 to 24 months afterward. Patients can expect to lose an average of 77 percent of their excess body weight within a year after surgery, according to experts. As with any surgery, however, the procedure carried its risks, and they weighed on Van Hine's mind.

Death can occur in about 1 percent of gastric bypass surgeries, and less severe complications can arise in 10 percent of cases. Surgical risks include intestinal leakage and internal bleeding, while all surgeries carry the risk of pneumonia, heart attack and blood clots.

Fortunately, Van Hine said, she escaped any serious complications and, to her surprise, didn't feel much pain when she awoke from her surgery." I was shocked that I didn't feel bad. It didn't hurt, but it felt like I had done some sit-ups," she said. "I didn't use any pain medication by the second day."

There were challenges ahead, Van Hine said, and she was mentally prepared for it. For weeks, she would have to live on a liquid-only, protein diet. Small amounts of foods would come in several months. "I've gotten sick a few times," Van Hine said, usually because she didn't chew her food long enough. "That's the tool of the surgery. It's your body saying, 'No, you can't eat that.'"

As of October, Van Hine has dropped nearly 115 pounds, taking her from a size 32 to 14 or 16 --in the women's departments. The real payoff though: She is finally feeling more like herself.

"Mentally, I never felt like a fat person. Finally, the person I was in my head and the person I am on the outside are ... becoming closer together. It feels like being let out of jail."

Before surgery, Corinna ate more than the average person -- when she wasn't dieting over the years, that is. It wasn't uncommon for her to go through fast-food drive-throughs for loaded hamburgers and greasy fries. She also didn't know "when to say when" during dinners. Today, her appetite is very satisfied with smaller amounts of food, and she can still enjoy her favorite prime rib -- she just has to chew it to death before swallowing.

She's not concerned about losing more weight because she's happy at her current level. If she loses more, great. If she doesn't, that's fine, too. She is well aware that she has to exercise and keep a healthy diet to maintain the surgery's results.
Vince CassaroJason Van Hine, Corinna's husband, has lost 40 pounds with his wife. He didn't undergo surgery; he's just exercising and eating better.

Van Hine's husband, Jason, didn't realize how overweight his wife was until he recently stumbled upon some old photographs. "She kind of looked miserable," he said. "I didn't see that when I took those pictures then."

The couple now exercises together at a local gym, enjoys walks and is working to restore their old home.

"A lot of people think this a quick and easy fix, and it's not at all," she said. "It's a massive lifestyle change. You need to be committed to it. You can build a house with a hammer, but the hammer is not going to do the work by itself. You've got to choose to use the tool."

Surgical treatments

There are three ways that bariatric surgery may promote weight loss in obese patients:

• Decreasing food intake (restriction).
• Causing some food to be poorly digested or absorbed (malabsorption).
• Combination of restriction and malabsorption.

The Roux-Y Gastric Bypass is the surgical procedure offered at Penn State Hershey Medical Center. It provides gastric restriction combined with some malabsorption. Both the open and laparoscopic surgical procedures are available.

Open gastric bypass surgery can now be performed through a 6- to 8-inch midline incision. This operation is restrictive in nature but also creates a "dumping physiology." A 30- to 60-cc gastric pouch is created using several staple lines. The gastric pouch is drained into a segment of jejunum (small intestine) and "bypasses" the distal stomach and duodenum.

The small gastric pouch is "restrictive" and consumption of excessive carbohydrate rich liquids causes "dumping" or abdominal discomfort. The result is sustained weight loss of 50 percent excess body weight in more than 80 percent of patients. Gastric bypass is associated with iron and vitamin B12 deficiency, therefore patients must take supplemental vitamins after surgery.

You're not eligible: If your body mass index is below 35, you are not eligible for this surgical procedure. To find your body mass index, type the term into any Internet search engine to come up with a calculator.

 Subscribe to Gastric Bypass Surgery News

Gastric bypass surgery’s complications can be devastating for some patients

Modesto, CA

Sandi Krueger of Turlock, Calif., dropped 120 pounds with weight-loss surgery, but she is hardly a success story.

The 2002 surgery led to chronic malnutrition and anemia. As the pounds melted away, so did her life.

With a sunken face and protruding collar bones, she is too weak to work and spends most afternoons on the couch wrapped in a blanket.

She has thoughts of giving up, but wants to be there for 12-year-old daughter Megan and 19-year-old son Dustin.

“It’s not acceptable leaving me like this,” said the 103-pound Krueger, who at 38 looks closer to 50. “I’ve gone to doctor after doctor and basically they don’t help me.”

According to studies on bariatric surgery, patients with long-term complications are in the minority and disastrous outcomes such as Krueger’s are rare. But with 200,000 weight-loss surgeries being performed each year, she and other patients believe the long-term complications deserve more attention.

Looking for hope

Krueger’s options appear to be running out. Her anemic blood hasn’t been responding to iron shots and she was told last month that she can’t have the gastric bypass reversed.

“This isn’t a life,” said Robert De Kasha, her brother. “If she doesn’t find an answer, she is just going to fade away.”

Spurred by a national epidemic of obesity, bariatric surgery has become a standard of care for people with weight-related health issues. It has improved the lives of people who suffered from diabetes, high blood pressure, sleep apnea and other issues, experts say. No one is sure why some bariatric patients fare better than others.

The stomach-shrinking surgery has risks, such as leaks that can cause life-threatening infections, hernias and bowel obstructions. After the surgery, patients are expected to follow nutritional and lifestyle guidelines to achieve weight loss and avoid trouble with their altered digestive tracts.

Most patients will have “dumping syndrome” at some point, when food passes too quickly from the tiny stomach pouch into the small intestine. Because the stomach hasn’t broken down the food, the person gets a rush of blood sugar, rapid heartbeat, sweating and nausea.

Other patients may have iron and vitamin B-12 deficiencies years after surgery. All bariatric patients need to take vitamin supplements for life.

A nationwide study released in 2006 concluded that bariatric surgery complications are common. By examining insurance claims for 2,522 surgeries, researchers with the federal Agency for Healthcare Research and Quality found that 40 percent of patients had complications in the six months after surgery, about double the rate in previous studies.

The complications ranged from the minor to the severe, including dumping syndrome, problems with the bariatric connections, hernias, infections and pneumonia. Post-surgery problems sent 18 percent of patients back to the hospital, some for costly readmissions or corrective surgery.

The agency contends that surgical advances recently have lowered the complication rate to 30 percent, still high for an elective procedure, said William Encinosa, lead author of the study.

“Anytime you can cut into the intestine, you have a risk of complications,” he said. “Clearly there are benefits for people who are morbidly obese, but these patients need to know what they are getting into.”

Live longer

Less is known about complications years after the surgery, although a 10-year Swedish study found many patients kept the weight off and had increased longevity.

Krueger, who once worked two jobs as a nursing assistant, sought treatment for an injured back in 2002. A specialist suggested that the 5-foot, 250-pound woman lose weight through bariatric surgery to deal with the back problem, she said.

She had what’s called a Roux-en-Y gastric bypass at Doctors Hospital of Manteca, Calif. To perform the common procedure, surgeons create a small pouch from the stomach and make a connection between the bottom of the pouch and a section of small intestine.

Most of the stomach and part of the intestine are bypassed, so the person feels full after a few bites of food and the intestine absorbs fewer nutrients.

Krueger, weighing 219 by the time of surgery, lost weight quickly as dumping syndrome made her sick for months. When she went to the doctor with complaints, he urged her to stick with the dietary instructions and take supplements, she said.

Bariatric surgeries were discontinued at Doctors Hospital of Manteca, so Krueger sought help from specialists at University of California at San Francisco Medical Center. In 2004, surgeons there corrected a problem from the initial surgery and, as her strength returned, she got up on water skis for the first time.

She gained 22 pounds, then her troubles returned and she bottomed out at 98 pounds.

With her body starved of nutrients, her blood sugar dropped so low she was admitted to Emanuel Medical Center for a week of monitoring, she said.

Tests have shown that her pouch no longer holds food but dumps it directly into the small intestine. Even if she eats five times a day, she doesn’t get the protein and other nutrients she needs.

She’s tried protein bars and countless other foods and even finds that fish is hard on her digestive tract. Daughter Megan brings her toast and crackers because she knows those are easy on her stomach.

Krueger said it’s heartbreaking for her daughter to see her tired and faint all the time. She has lost hair, her teeth are decaying, and she’s often out of breath.

To treat her anemia, she’s had a blood transfusion and three rounds of iron infusions. A reaction to the last infusion caused her blood pressure to plummet and nurses to come to her aid.

Second thoughts

Last year, she was considered for having the gastric bypass reversed at UCSF, but doctors told her in December that it was too dangerous. They were concerned that her remaining stomach would have inadequate blood flow and would rot, she said.

“That day was hard for me,” she said. “I don’t know what is ahead. I feel my life has been taken from me.”

Dr. Guilherme Campos, director of bariatric surgery at UCSF, said about 1 percent to 4 percent of the center’s patients suffer from nutritional deficiencies over the long term. The UCSF center has dieticians and other staff to work with patients with malnutrition. Reversal operations are major procedures and are done as a last resort, he said.

The surgeon contended that bariatric surgery is an effective way to treat morbid and superobesity, the main reason university hospitals have adopted the treatment in recent years.

“The benefits by far outweigh the risks that are associated with the procedure,” he said.

While many patients sing the praises of weight-loss surgery, including television personalities Al Roker and Star Jones, some patients say they’ve had a tough time.

Donna Sellers, 61, of Modesto, said four members of her family had weight-loss surgery with mixed results. Her husband and younger daughter lost weight with no complications. But Donna shed weight too fast and suffered from dumping, malnutrition and dehydration the first year after her 2004 surgery at Memorial Medical Center.

Attempts to eat made her feel sick and sweat profusely, even though she followed the guidelines to eat pureed food and take small bites, she said. She went from 246 pounds to 123 in six months and landed in the emergency room, where she was treated for dehydration for several hours, she said.

She finally discovered she could eat chicken and Swiss cheese, and force-fed herself. To deal with the hot flashes of dumping syndrome, she laid on the cold floor tiles of her kitchen to eat meals, she said.

Five years after the surgery, she still is forcing herself to eat and is relying on her nursing training to maintain her weight in the 130s.

“I eat three or four bites and then wait 10 minutes and eat some more,” she said. “I eat a scrambled egg for breakfast, and tomorrow a scrambled egg makes me sick.”

She said one of her daughters had the same post-surgery troubles, as well as a calcium deficiency resulting in dental problems.

A 2001 surgery in Southern California saved Alycsha Bostic of Merced, Calif., from sleep apnea and asthma attacks. But she developed hernias requiring two operations and iron deficiencies that cause headaches and dizziness.

Losing 160 pounds boosted her fertility and she got pregnant twice despite being on birth control, she said. Doctors put a port in her chest to feed iron into her blood during pregnancy. Her ferrous levels are a third of normal since her second child was born in 2007.

Bostic, 34, hopes doctors can figure how to get more iron into her system — and she needs another hernia operation.

“I am so tired of having surgery,” said Bostic, who talks with other bariatric patients with complications. “We’ve all had hair loss. I still get dumping syndrome. If I don’t chew my food 50 times, it collects at the bottom on my esophagus and I throw up.”

More than 3,000 weight-loss surgeries have been performed at Memorial Medical Center in Modesto since 2003.

Deana Chiarchianis, health center manager, said the post-surgery complications at the hospital are far lower than the numbers in the AHRQ report. The study considered data before widespread use of laparoscopic techniques, which have reduced problems such as surgical wound infections and hernias, she said.

The hospital tries to ensure good outcomes by evaluating and educating surgical candidates, including a psychological assessment of their ability to cope with the surgery. It also stresses post-surgery guidelines such as teaching patients to prevent dumping through the proper choice of foods.

“They need to understand that the surgery is a tool and the patient is responsible for complying with the recommendations for follow-up, nutrition, exercise and behavior change,” she said.

Dr. Kelvin Higa, a Fresno, Calif., surgeon and past president of the American Society for Metabolic and Bariatric Surgery, said it’s important for patients to have lifelong follow-up with their surgeons. Usually, there are surgical options for patients with severe complications such as Krueger’s.

“Any patient that has those problems should not be sitting there. They should seek help,” he said. “Almost invariably we can take these patients and adjust their anatomy to take care of their nutritional issues.”

Krueger said her poor health has taken a toll on family life. No longer does she take Megan to cheerleading and dance classes. She and her husband have postponed their dream of building a home.

Krueger worked as long as she could at Emanuel Medical Center last year to keep her health benefits, but ran out of strength. Her primary care doctor is trying to line her up with a nutritionist or hematologist who accepts Medi-Cal.

A feeding tube could be next if she loses more weight, which reminds her of a 32-year-old bariatric patient at a care facility where she worked.

“She had a feeding tube and it really bothered me,” Krueger said. “If I don’t get better, I know my organs will take a toll. If they would put me on the operating table to take me back to 250 pounds, I would do it.”

 Subscribe to Gastric Bypass Surgery News

3 sisters net triple-digit weight loss after gastric bypass surgery

Joliet, IL

One sister bikes, one walks on trails and one works out on a treadmill. All of them are now living healthier lives after undergoing bariatric weight-loss surgery at Silver Cross Hospital in July.

Together, the three sisters have already lost more than 300 pounds.

"One of the reasons we decided to have the surgery was because our mom was overweight and died at age 68 of congestive heart failure," said Sandra Schmidt. "Our dad was thrilled when we told him and is so proud of all of us that we have stayed committed to losing weight."

Inspired by a co-worker who had weight-loss surgery, Sandra told her sisters, Andrea Russell and Pamela Bricker, about it. They decided to attend a free informational seminar at Silver Cross.

"This was a great way to learn about the entire process," said Andrea. "Once I learned what my options were, my apprehensions were alleviated and I became more determined to live a healthier life. Plus, it has been a great support having my sisters to talk to during the entire process."

Their surgeon, Dr. Christopher Joyce, and his partner, Dr. Brian Lahmann, have performed more than 1,000 weight-loss procedures, including laparoscopic gastric bypass, Lap-Band and the new Realize gastric band system. A Bariatric Center of Excellence as well as a Blue Cross Blue Shield of Illinois Blue Distinction Center for bariatric surgery, the Silver Cross program has a 0 percent operative death rate and a low complication rate. And patients lose an average of 86 percent of their excess body weight four years after gastric bypass surgery.

"Our patients benefit from a multidisciplinary approach," Dr. Joyce said. "We screen them very carefully to ensure their success and safety."

Pamela says you have to be determined to stick to the program, but the support is there to help you succeed. "We couldn't have found a better program. Dr. Joyce, his staff and the nurses at Silver Cross were all so kind, supportive and down-to-earth. We wouldn't have been so successful in our weight loss if it were not for them," said Pamela.

"Obesity is a medical condition, just like heart disease or diabetes," Joyce said. "Unfortunately, there is a lot of prejudice against obese people, but this surgery can help them lose weight and, most importantly, keep it off."

"Prior to my surgery, I suffered from high blood pressure and cholesterol, diabetes and painful joints. Now I'm not taking any of those medications," said Pamela.

"I've lost weight that I never could lose," added her sister, Andrea.

"I should have done the surgery years ago because I wasted my forties being overweight," said Sandra. "My life has changed dramatically. I used to have foot problems and now I don't, and my stamina is so much stronger, enabling me to play with my 7-month-old grandson."

"The sisters are a wonderful example of how life-changing bariatric surgery can be," said Joyce. "Their new passion for life truly shows when you talk with them."

 Subscribe to Gastric Bypass Surgery News

Physicians debate best candidates for gastric bypass

Washington, D.C.

Recent studies showing that gastric bypass surgery extends the lives of obese patients is forcing surgeons to make tough decisions about who should go under the knife and who shouldn't.

Internists, cardiologists and endocrinologists, more than ever, are referring patients who traditionally haven't been candidates for the weight-loss surgery, also called bariatric surgery.

"I am being asked to operate on 78-year-olds with co-morbidities of heart disease and diabetes," said Dr. Edward H. Phillips, executive vice chairman of the Department of Surgery and a surgeon at the Center for Weight Loss at Cedars-Sinai Medical Center in Los Angeles. Phillips questions whether these patients will benefit, or if the damage has already been done.
ad_icon

"So, while it is obvious a 30-year-old will benefit, at what age is too old?" he asked.

The success of gastric bypass is also stoking debate about its use as a treatment for type 2 diabetes. Mounting evidence suggests this type of surgery may dramatically improve patients with the disease, freeing them from a lifetime of diabetes medications.

"There's more acceptance now of the concept that bariatric surgery is a truly life-saving type of therapy rather than just a way to shed pounds," said Dr. Francesco Rubino, chief of Gastrointestinal Metabolic Surgery at Weill Cornell Medical College in New York City.

Still, more long-term studies are needed, and clinicians and policymakers must reach a consensus on who should have access to this type of surgery, noted Rubino, who directed the 1st World Congress on Interventional Therapies for Type 2 Diabetes, held in New York City in September.

An estimated 205,000 bariatric surgeries were performed in the United States in 2007, according to the American Society for Metabolic & Bariatric Surgery (ASMBS). That's an increase of almost 20 percent from two years earlier.

If patients commit to making necessary changes in their diet and exercise regimens, gastric bypass surgery can provide long-term, consistent weight loss, according to the Mayo Clinic.

Not only does it help shed pounds, but a pair of studies published last year in the New England Journal of Medicine found that it can help obese people live longer.

One study, led by Ted Adams of the University of Utah School of Medicine, tracked almost 16,000 obese people, half of whom had weight-loss surgery. After an average of seven years, the death rate was 40 percent lower for people who had the surgery compared with those who didn't. Diabetes-related deaths were cut by a whopping 92 percent.

The other study, led by a Swedish team, involved more than 6,000 obese patients. After an average follow-up of more than a decade, those who had bariatric surgery were 29 percent less likely to die than those who did not undergo surgery.

 Subscribe to Gastric Bypass Surgery News

The trouble with gastric bypass surgery

Phoenix, AZ

Many extremely obese people these days, under the mistaken belief that it will be the answer to their health problems, are flocking to get gastric bypass surgery. Now this treatment option may be pushed on even more people. A study published in The American Journal of Managed Care reports that bariatric surgery can "pay for itself" by diminishing the number of insurance claims filed by people who are grossly overweight.

Gastric Bypass Surgery Is No Picnic

However, gastric bypass surgery has many associated risks. The risks, according to a Mayo Clinic article, include death, blood clots in the legs, leaking at the staple lines in the stomach, incision hernia, narrowing of the opening between the stomach and small intestine, dumping syndrome, iron deficiency anemia, vitamin B-12 deficiency, vitamin D deficiency, dehydration, gallstones, bleeding stomach ulcers, intolerance to certain foods, kidney stones, low blood sugar, body aches, fatigue (like when one has the flu), feeling cold, dry skin, hair thinning and hair loss, and mood changes. Of course, there are also the same risks that go along with any surgery, like bleeding, infections, and adverse reactions to the anesthesia. That doesn't exactly sound like a picnic, no pun intended.

Will Surgery Save Insurance Companies Money?

Unfortunately, there is even more reason to be concerned about gastric bypass surgery. Dr. Douglass warns in an article that the funding for the study that purports that this surgery will save insurance companies money came from a company known as Johnson & Johnson's Ethicon Endo-Surgery, Inc., which is a major manufacturer of bariatric surgical instruments. Additionally, Dr. Douglass points out that Dr. Scott Shikora, a co-author of the study, is the president of the American Society for Metabolic and Bariatric Surgery. It's easy to see that the members of this group would clearly benefit if insurance providers would decide that they could save money if more patients were approved for this course of treatment.

Up to Five Percent Die Within a Year of Surgery

The sad truth of the matter is that, according to Dr. Douglass, up to five percent of the patients who undergo this course of treatment are dead within a year. (That's certainly one way to trim down future medical costs.) While Dr. Douglass believes that surgery should always be a last resort, many other doctors believe that the current requirement by insurance companies that people first try to lose weight by a six-month doctor-supervised weight loss program is unreasonable. Says Douglass: "People like Shikora would prefer that patients go right from the dining room table to his operating table." While natural health advocates might not agree with Dr. Douglass on all of the issues, most certainly appreciate his acerbic wit. Hmmm... was the guy who said that "the way to a man's heart is through his stomach" a bariatric surgeon?

 Subscribe to Gastric Bypass Surgery News

Gastric bypass surgery can reverse metabolic syndrome

Rochester, MN

Metabolic syndrome, a cluster of conditions that increases the risk of heart disease, stroke and diabetes, in extremely obese patients can be cured by gastric bypass surgery, according to the findings from a new study.
ADVERTISEMENT

"Reversibility of metabolic syndrome depends more on the percentage of excess weight lost than on other clinical or demographic characteristics," the research team reports in the journal, Mayo Clinic Proceedings.

To determine the effect of major weight loss on the metabolic syndrome, Dr. Francisco Lopez-Jimenez and colleagues evaluated patients being considered for bypass surgery at the Mayo Clinic in Rochester, Minnesota, between 1990 and 2003.

All patients met at least three of the five criteria for the metabolic syndrome - high levels of triglycerides (a "bad" fat), low levels of high-density lipoprotein "good" cholesterol, increased blood pressure, high blood sugar levels and obesity.

The study group included 180 patients who underwent gastric bypass and 157 patients who did not undergo the procedure, either because they declined surgery, were denied coverage by insurance providers, or did not maintain lifestyle interventions during their evaluation. All patients received medical and dietetic care and extensive counseling about the importance of physical activity.

The mean body mass index (BMI) was 49 in the surgical group and 44 in the nonsurgical group. A normal BMI is considered to be between 18.5 and 24.9.

During an average follow-up of 3.4 years, the prevalence of metabolic syndrome decreased from 87 percent to 29 percent in the surgical group, and from 85 percent to 75 percent in the control group. The authors estimate that the number of patients needed to treat with bypass surgery to cure one patient of metabolic syndrome was 2.1.

Weight loss averaged 44 lbs in the surgical group and 0.2 lbs in the nonsurgical group. Additional analysis showed that the percentage of excess weight lost was the primary factor that determined the resolution of the metabolic syndrome.

"Our study provides robust data to practicing clinicians about the benefits of counseling weight reduction in metabolic syndrome patients," Lopez-Jimenez and his associates conclude.

They recommend "gastric bypass surgery should be considered as a treatment option in patients with metabolic syndrome that has not responded to conservative measures" in those eligible for surgery.

SOURCE: Mayo Clinic Proceedings, August 2008.

 Subscribe to Gastric Bypass Surgery News

Gastric bypass surgery patient story: The road to recovery continues

Columbia, TN

here are very few times when I am driven to tears.

However, sometimes there are instances that a person can’t control their emotions.

That happened to me this morning when my little brother Ben called to tell me that Wednesday was a special anniversary.

He reminded me that it has been exactly one year since he underwent gastric bypass surgery.

As I chronicled in a column last year, Ben has struggled with his weight for many years before finally reaching his breaking point.

Ben weighed in at a debilitating 452 pounds and was literally struggling with nearly every breath.

After trying and failing with several different weight loss methods, Ben made the difficult decision to undergo gastric bypass surgery.

The results have been nothing short of amazing.

Ben’s latest weigh-in had him coming in at a svelte 260 pounds. That means that he has lost 192 pounds since that momentous day last August and I couldn’t be more proud.

The before and after pictures of him are so startling that I was glad I was sitting when I first saw them.

There’s no way to accurately describe the difference in his appearance that has taken place in just a year.

In addition to his physical appearance, Ben’s mental health has also improved. He realizes that he has a new lease on life and expects to take full advantage of it. As Ben put it, he was once dying from obesity, depressed and feeling hopeless, but now he is full of joy with renewed hope.

That’s what this crazy world is all about, isn’t it?

People somehow finding the strength to battle through adversity to better themselves.

With the high stress, non-stop lives that most of us lead, sometimes it’s hard to keep things in the proper perspective.

Ben’s struggle has helped me to do just that.

He is an inspiration to me and a constant reminder to not take for granted those things which I cherish in my life like my beautiful wife and son.

In a world where sometimes we put an unhealthy emphasis on sports, it’s good to be reminded there are also other things to be concerned about.

Don’t get me wrong, I’m still sports-crazed.

Trust me — new perspective notwithstanding — I will be on the edge of my seat Sunday afternoon watching my Kentucky Wildcats battle loathsome Louisville.

But while my love of sports will never lessen, I’m going to try and not let it dominate who I am.

Sports are great and serve as a wonderful diversion from the struggles that so many people face.

However, sports are just that, a diversion.

I truly hope that is the lesson I can take from Ben’s journey that only has 60 pounds remaining.

I know 60 pounds seems like a lot, but it is nothing but a final bump on Ben’s remarkable road to recovery.

 Subscribe to Gastric Bypass Surgery News

Former 1,100 pound man loses more than half his weight after gastric bypass surgery, now ca driver car and ride bike

Omaha, NE

Times are tough for the Nebraska man who once weighed more than 1,000 pounds, but Patrick Deuel says he's trying to stay positive.

Deuel weighed almost 1,100 pounds in 2004, and he had to have his bedroom wall cut open so he could be hospitalized for lifesaving gastric bypass surgery.

By late 2006 he was down to 370 pounds, but when he stepped on a scale in May he was back up to 540.

His wife says none the less, Deuel is able to go out and do the things he wants to do. His surgeon says his health is generally good, noting he can drive a car and ride a bike.

The former restaurant manager is now looking for a new line of work, while he and his wife survive on a Social Security check of less than $600 a month.

 Subscribe to Gastric Bypass Surgery News

Are you a candidate for gastric byoass surgery?

The option of surgery to treat obesity has gained in popularity over the past several years. As the techniques and knowledge regarding the subject have improved, so too have the results. However, not everyone is a candidate for surgery when it comes to their weight. Moreover, one must be sound psychologically as well as physically to undergo either of the two most common procedures, Rous-En-Y gastric bypass and adjustable gastric banding.

Generally speaking, one must have a body mass index (BMI) greater than 40 to be considered for surgery, or have a BMI greater than 35 with one or more obesity related co-morbidities such as diabetes, obstructive sleep apnea, hypertension or the metabolic syndrome. In addition, it is rare that a physician or other healthcare provider will move right to the surgical option without first exhausting all the non-surgical options. Usually, both the surgeon who will perform the procedure and the individual's insurance company will want to see that the patient has truly "failed" diets, exercise, and group programs such as Weight Watchers, Nutrisystem and others, before agreeing to go ahead with surgery.

Both Rous-En-Y gastric bypass procedure and adjustable gastric banding are very effective at helping people lose weight. One study, which looked at any type of weight loss surgery, showed maximal weight loss at 1-2 years with a 32% drop for the gastric bypass procedure and 20% with the gastric banding procedure. The loss at 10 years post surgery was more modest but rather significant nonetheless with gastric bypass at 25% and gastric banding at 14%.

If you are an individual with the above mentioned criteria for severe obesity (a.k.a morbid obesity), and you have indeed failed many attempts at sustained weight loss over a period of a few years, weight loss surgery may certainly be an option, and you are encouraged to speak with your primary care provider about the subject. Be cautious though.

Firstly, by its mere nature, obesity, especially with co-morbid conditions such as diabetes, hypertension and high cholesterol, will put you in a higher surgical risk category with potential for more complications. Your surgeon and primary care provider will most likely want you to undergo a battery of tests to ascertain your overall health and suitability for the procedure as well as assess your perioperative risk for complications.

Also, often overlooked, is the psychological trauma for patients, many of whom have been heavy their entire lives and are not fully prepared for the change they will experience after surgery. For instance, some patients have battled depression and anxiety having come to identify themselves as obese, but now are no longer. They can have difficulty adjusting their psyche to a new body image. Moreover, the individual's relationship with food can change dramatically, especially after gastric bypass surgery, an added trauma. Often, one cannot eat as much post surgery and patients can find that an unusual issue to deal with having not anticipated this before the surgery. In all likelihood, one will most likely be required to undergo a psychological evaluation in addition to the physical one.

 Subscribe to Gastric Bypass Surgery News

The skinny on gastric bypass surgery

Downey, CA

(Lakewood Regional Medical Center)

The majority of adults in the United States are overweight or obese, and obesity is a leading cause of death. Published scientific reports show that non-operative methods have not been effective in achieving significant long-term weight loss in severely obese individuals.

In recent years, society has shown increased awareness of the need for the treatment and prevention of obesity. Advances in technology and modern medicine have given those people a chance to have a longer and healthier life.

Bariatric surgery has proven to be the only effective intervention for weight loss in the morbidly obese.

“While it’s always best to lose weight through a healthy diet and regular physical activity, weight loss (bariatric) surgery may be the only real long-term solution for those who have been struggling with chronic obesity for years,” says Shyam Dahiya, M.D., a surgeon at Lakewood Regional Medical Center’s Bariatric Surgery Program.

Dahiya, a board-certified general and laparoscopic surgeon with more than 26 years of experience, has perfected the most advanced method of bariatric surgery, the Dahiya Vertical Micropouch. Laparoscopic gastric bypass surgery makes four or five small, half-inch incisions while surgeons view the operation on a television monitor.

“This recent and minimally invasive approach to bariatric surgery will provide the patient with a more rapid recovery, which allows patients to return to their normal activity faster,” said Dahiya, a fellow of American College of Surgeons. “This laparoscopic technique for the bypass allows many patients, many of whom might not consider baratric surgery as a long-term solution for their condition, the opportunity to treat obesity permanently with fewer side effects.”

Psychologists will counsel patients prior to surgery to help prepare them for a lifetime commitment. A team of medical specialists is also available at Lakewood Regional to assist patients in the months after surgery, including nurses, internists, anesthesiologists, cardiologists, gastroenterologists, registered dieticians, plastic surgeons, and registered physical therapists.

As obesity rates creep skyward, so do the number of Americans turning to surgery as a weight loss tool. Although today’s bariatric surgery is safer and more effective than earlier versions, the procedure is not an instant cure. Reserved only for the severely obese (those who tip the scales at 100 pounds or more over their normal body weight), bariatric surgery is a drastic step and patients must make radical, lifelong dietary changes, and permanent weight loss is not guaranteed.

Still, a growing number of doctors are recommending bariatric surgery for severely obese patients who find themselves at wits’ end about weight loss. In its clinical guidelines for obesity treatment, the National Institute of Health supports the use of bariatric surgery in the severely obese, citing studies that show the procedure often alleviates or eliminates many obesity-related conditions.

 Subscribe to Gastric Bypass Surgery News

Laparoscopic gastric bypass provides better results

New York, NY

Performing gastric bypass surgery to reduce the weight of morbidly obese patients using a laparoscopic method, rather than the conventional more invasive "open" abdominal method, reduces postoperative complications, the need for a second operation, and shortens hospital stays, new research shows. Nevertheless, laparoscopic gastric bypass is more expensive.

Obesity surgery, also called bariatric surgery, is growing in popularity and more and more of these operations are being done using a laparoscope, note co-authors Dr. Wendy E. Weller, from the University at Albany in New York, and Dr. Carl Rosati, from Albany Medical Center.

This is done by placing one or more small incisions in the abdomen, through which a hollow tube is inserted. This allows very small instruments to be inserted to perform the gastric bypass. The entire procedure is visualized on a screen. In contrast, the more invasive "open" procedure involves making an incision to open the abdomen so the procedure can be performed.

The current study, reported in the Annals of Surgery, involved an analysis of data from 19,156 subjects who underwent gastric bypass surgery in 2005 and were logged in the Nationwide Inpatient Sample, the largest all-payer inpatient database in the U.S.

Slightly less than 75 percent of the patients underwent laparoscopic gastric bypass, the report indicates.

Laparoscopic gastric bypass was linked to a reduced risk of several complications. With open surgery, the risk of pulmonary complications was increased by 92 percent, for cardiovascular complications it was 54 percent, for sepsis, a serious system-wide infection, the risk was more than doubled and the risk of anastomotic leak, leakage from the operative site, 32 percent higher.

On average, performing laparoscopic rather than open gastric bypass reduced the hospital stay by about 1 day.

The average total charges were similar for the two procedures, but median total charges were significantly higher with laparoscopic gastric bypass: $30,033 vs. $28,107 respectively.

After accounting for various patient and hospital factors, laparoscopic surgical patients were less likely than their open-surgery counterparts to require reoperation, the investigators found.

While these findings suggest some advantages with the laparoscopic operation, "most reassuring for the bariatric surgery community is that the hospital outcomes were excellent overall in both the laparoscopic and open procedures," Dr. Michael G. Sarr, from the Mayo Clinic in Rochester, Minnesota, comments in a related editorial.

 Subscribe to Gastric Bypass Surgery News

Obesity epidemic leading to rise in gastric bypass surgery

Longview, TX

As advancements continue to change the field of medicine, patients continue to benefit. Average life expectancy is still rising, and new medicines are increasing the quality of life for patients with chronic conditions.

In spite of these medical advancements and a cultural shift emphasizing the importance of exercise, one particular area that remains unsettling is the growing number of overweight or obese Americans. Using measured heights and weights, the 2003-2004
National Health and Nutrition Examination Survey (NHANES) reported that 66 percent of American adults are either overweight or obese.

For many obese or overweight Americans, shedding weight has led them to lifestyle changes, such as a healthier diet and a new exercise regimen. Many others go the surgical route, as 177,000 Americans opted for weight loss surgery in 2006 alone. The vast majority of those surgeries were Roux-en-Y gastric bypass surgery. While gastric bypass can seem like a quick fix that enables patients to shed weight almost overnight, the surgery and its ramifications are in fact quite complicated, and should never be looked at as an easy way to drop weight.

What Is Gastric Bypass?

Roughly 80 percent of the weight loss surgeries performed in America this year will be gastric bypass procedures. This is a two-part procedure.

· Stomach pouch: The creation of a stomach pouch is the portion of the procedure many people refer to as “stomach stapling.” During this part of the surgery, the stomach is divided unequally, with one large pouch and one much smaller pouch. After this division, the smaller pouch is sewn or stapled. That pouch can only hold a very small amount of food (roughly one cup). Such a small holding capacity is designed to make people feel full faster, which in turn will make them eat less.

· Bypass: In the second stage the surgeon will employ the Roux-en-Y technique, in which the smaller pouch is disconnected from the first part of the small intestine (the duodenum). The surgeon will then reconnect the stomach to a lower portion of the intestine (the jejunum). Once that has occurred, any food consumed will pass directly from the stomach into this lower portion, where fewer calories and nutrients are absorbed.

What Happens After the Surgery?

While patients can expect to lose weight after gastric bypass surgery, there are negative consequences as well. Though not all patients will experience such consequences, and death is extremely rare (especially when surgery is performed by an experienced gastric bypass surgery), some of the following might occur after surgery.

· Wound infections

· Problems with digestion

· Bleeding

· Ulcers

Those are some of the more common complications after surgery. Some of the less common, though extremely serious and potentially life-threatening, complications include the following.

· Pulmonary embolism (blood clot)

· Serious infection and persistent bleeding

· Heart attack

· Leakage in the surgical connections in the intestines

Because of the nature of the surgery, in which food is re-routed into the jejunum where less nutrients are absorbed, certain health problems can arise as a result. For example, the human body needs a certain amount of iron and calcium to remain healthy. However, the jejunum does absorb these nutrients well, and therefore conditions such as anemia and osteoporosis can arise as a result. Iron and calcium supplements, as well as routine blood tests, can lower the risk of developing such conditions.

Although there can be complications, many gastric bypass patients experience positive results. Weight loss is often dramatic, especially for patients who were considerably overweight.

Another benefit of gastric bypass is that patients who have obesity-related health problems often see improvements in those conditions after surgery. Such conditions include diabetes, sleep apnea and high blood pressure.

While the benefits of gastric bypass surgery are numerous and have helped many a public figure, it’s important to recognize the surgery is not a one-size-fits-all solution, and each case needs to be examined on an individual basis.

 Subscribe to Gastric Bypass Surgery News

Gastric bypass surgery: Lifestyle change & lifetime commitment

McAllen, TX

I have been working at my hospital since 1986, and I was obese most of my life.

In 2004, my hospital began offering weight-loss surgery. I had health problems such as hypertension and metabolic syndrome. I was never able to lose enough weight to make a difference in my hypertension.

I made the decision to have a Roux-en-y Gastric Bypass.

Within 3 months postop, I was able to stop taking of my glucophage, as well as medication for my hypertension, which I had taken for 17 years.

I am now the Bariatric Program Manager as well as a Certified Bariatric Nurse and we have achieved ASMBS Center of Excellence for Bariatric Surgery.

I enjoy being a resource person for our patients undergoing weight loss surgery and for those considering weight loss surgery. I want everyone to be as successful and as happy as I am with this life changing procedure.

Weight-loss surgery is not without risks, but neither is being obese. I tell everyone this is a personal decision that only they can make. It is a lifestyle change and a lifetime commitment. Make sure you do your research and put yourself in the most experienced hands possible.

Medicare and some insurance companies are only reimbursing procedures done at facilities that have achieved ASMBS Center of Excellence by the Surgical Review Corporation or American College of Surgeons Level I Certification.

Weight-loss surgery is a treatment for obesity and is done for health reasons. It is not a cosmetic procedure.

To qualify for weight-loss surgery you should have a BMI of 40 or greater, or 35-39 with comorbid conditions such as diabetes, depression, hypertension, urinary stress incontinence or sleep apnea, just to name a few.

Remember, surgery is a tool that should not be taken for granted.

By Paula Kilgore, RN, CBN
McAllen, TX

 Subscribe to Gastric Bypass Surgery News

Woman sheds 800 pounds after gastric bypass surgery

Mount Vernon, OH

Flowers will bloom outside Mindy Sheriff's home this summer for the first time in 15 years.

"Life is sweet" now for Sheriff, 47, since gastric bypass surgery two years ago allowed her to lose more than 800 pounds.

It probably saved her life. At her heaviest, Sheriff, 47, weighed about 1,000 pounds. She is now at 191. "In 1993, I got really sick and had a lot of fluid retention," she said. "I was just raising my kids at the time, and so I was already staying at home and rarely going out."

That lifestyle would continue for another 13 years. "My legs started getting really bad, and I was having a lot of ulcers, which is common in obese people," Sheriff said. "I just couldn't get around good, so I started gaining weight."

In April 1998, Sheriff was admitted to MedCentral/Mansfield Hospital with breathing problems. "My doctor walked into my hospital room one day and said to me, 'Mindy, if you don't lose weight, I can't promise you another six months,' " she said. "It was devastating, and a rude awakening. When you gain weight, when you're heavy, you see yourself as you want other people to see you. You don't see yourself as you really are."

At the time, Sheriff's registered weight was 961. "I was bigger than that, but for a long period of time they couldn't weigh me," she said. "It's pretty embarrassing to be taken down to the laundry to get weighed, but even that scale didn't go any higher."

Along with health issues, Sheriff said being stubborn added to her problems. "Everyone kept trying to get me to seek help and my mother always told me, 'The Lord helps those who help themselves,' " she said. "But I wouldn't listen. I wasn't motivated. I didn't care about myself and I had very low self-esteem."

For a while, Sheriff said, she was in the care of a nursing facility. She lost 113 pounds there, but she regained most of it after she was dismissed. On Christmas Eve 2005, Sheriff was taken back to the hospital by ambulance. "I didn't even know I was going," she said. "My daughter and doctor decided I should go. I was mad at everyone for a while."

The next stop was The Medical University Center of Ohio in Toledo. "They asked if I was willing to talk to a bariatric surgeon up there," she said. "On Martin Luther King Day 2006, a doctor came in and told me what I needed, and within three weeks I was approved for the surgery."

On May 3, 2006, she had gastric bypass surgery. Her stomach was stapled, creating a much smaller food pouch and allowing food to bypass part of the small intestine. The net effect was feeling full more quickly and a reduction of food and caloric intake.

Sheriff's new life had begun. "The weight came off quickly," she said. "For a long time, I was losing 10 to 15 pounds a week. I am now down to 191 and am a hundred times more active. I used to have to use a cane, walker or wheelchair to get around, but now I don't use any of those.

"This past winter, I actually went outside and shoveled snow. I do my own housework and laundry now. I just planted vegetable and flower gardens for the first time in years. It's wonderful."

Sheriff said she exercises and goes to therapy three times a week. She and her ex-husband have gotten reacquainted and have been dating now after being apart for 25 years. "There are so many everyday things people take for granted that I am just now rediscovering," she said. "Life is sweet."

 Subscribe to Gastric Bypass Surgery News

Laproscopic gastric bypass surgery gives new life to Milwaukee hairdresser

Milwaukee, WI

At age 37, local hairdresser Ann Marie Heim learned that if she didn't do something to improve her health, she would die by age 40. Heim suffered from morbid obesity for nearly 15 years and after undergoing laparoscopic gastric bypass surgery in 2002 has lost a remarkable 225 pounds. Thanks to the surgery, last month Heim turned 40 and feels better than she ever imagined.

An adopted child, Heim believes her biological mother was obese but concedes that despite healthy offerings from her parents, she ate whatever she wanted and constantly craved sugar. In her adult life, Heim suffered from severe weight induced diabetes for nearly 10 years. She constantly felt sick with physical aches and pains and had difficulty carrying her nearly 418 pounds around every day.

"My doctor said, 'I have nothing vested in you, you have nothing vested in me, but you should know that you are going to die.' He was cut and dry. He said, 'You need to take hold of your weight,'" Heim admits.

It was this honesty that Heim needed to begin looking into the options to save her life. Dr. Manfred Chiang at the Bariatric Institute of Wisconsin required Heim to complete months of clinically monitored exercise and diet before undergoing the surgery. More >>

 Subscribe to Gastric Bypass Surgery News

Genes may determine success of gastric bypass surgery

Danville, PA

Researchers study genetic factors in success of gastric bypass surgery and other bariatric procedure.

Two obesity-related genetic variations may be associated with higher body mass index (BMI) among severely obese patients (BMI of 40 or higher) who have bariatric surgery to help them lose weight, say American researchers.

Bariatric surgery is a highly effective treatment for severely obese patients, according to background information in the study. However, some patients don't lose weight after bariatric surgery.

"Identification of variables that determine the success of bariatric surgery have shown little consistency, and long-term success may depend on not yet identified factors," noted the researchers at the Geisinger Clinic in Danville, Pa.

They studied 707 severely obese (average BMI 51.2) patients who had gastric bypass surgery. Blood samples from the patients were analyzed for two common single nucleotide polymorphisms (SNPs) previously found to be associated with obesity. SNPs are variations caused by alteration of single building block of DNA.

The researchers found that about 21 percent of the patients had two copies of one obesity-related SNP, 13 percent had two copies of the other SNP, and 3.4 percent had two copies of both SNPs.

There was no significant BMI difference between patients with two identical copies of either one of the SNPs and those without two identical copies. However, patients with either two copies of both SNPs, or two copies of one and one copy of the other SNP, had much higher BMIs than other patients. Less than 20 percent of the patients in the study had these genetic features.

The findings were published in the March issue of the journal Archives of Surgery. More >>

 Subscribe to Gastric Bypass Surgery News

Carnie Wilson's war: Weight gain after gastric bypass bariatric surgery

Gaining weight after bariatric procedures such as gastric bypass surgery can be discouraging as it is unhealthy.

For many veterans of crash diets, killer workouts and tailored meal plans, weight loss surgery is the nuclear option in a battle against the bulge.

But while such procedures can indeed lead to dramatic weight loss, for some the pounds return. Such appears to be the case with musical star Carnie Wilson, whose fluctuating figure dominated tabloid front pages this week in the latest chapter of her widely publicized fight against obesity since her gastric bypass surgery in 1999.

Wilson, 31 at the time, weighed more than 300 pounds before the procedure that reduced the size of her stomach to that of an egg.

By all accounts, Wilson's gastric bypass bariatric surgery was a success; she dropped 152 pounds.

Until recently she sported a trimmer figure. New photos released by the celebrity Web site TMZ.com Tuesday show the singing star significantly heavier than before.

 Subscribe to Gastric Bypass Surgery News

After years battling weight, Trib writer turns to bariatric surgery - gastric bypass

Waco, TX

Waco Tribune staff writer Terri Jo Ryan has battled weight problems most of her life. After a frightening diagnosis, she weighed pros and cons and opted for bariatric surgery. She shares her story with others who might be fighting obesity and studying their options.

In the final years of her life, my mother had three killers stalking her — chronic obstructive pulmonary disease, chronic heart disease and diabetes. On March 18, 2007, diabetes won.

So I was alarmed when my doctor told me that my mother’s killer had me in its sights, too. In June, I found out I had type 2 diabetes.

After the diagnosis, I was depressed and frightened. I am one of eight siblings, nearly all of us overweight, and I did not want to be the first one to die of obesity.

I spent a weekend re-evaluating my life and made a resolution: I would not continue to commit slow-motion suicide by eating whatever the heck I wanted. I rejoined the YMCA, where I do water aerobics three or four days a week. I gave up sugar, sodas, white potatoes, white bread and ice cream. I cut my portions in half.

Weight-loss surgery had been an option rolling around in my mind for more than a year. I’d been reading up on various procedures, side effects and mandatory lifestyle changes that come from having your innards rerouted for life.

A decade earlier, I would have sneered at the suggestion that I have surgery to correct the consequences of irresponsible consumption. But as someone who had tried numerous diets only to gain it all back and then some, I have come to appreciate the powerful tool that weight-loss surgery can offer in the perpetual battle against the bulge.

gastric bypass malpractice lawyers

 Subscribe to Gastric Bypass Surgery News

Bariatric patients find more options than just gastric bypass surgery

Wausau, WI

Local weight-loss surgery programs are facing competition for patients from an eastern Wisconsin program.

Midwest Bariatric Solutions and Theda Clark Medical Center in Neenah will hold a bariatric surgery information session Thursday. Dr. Raymond Georgen, a member of the practice, said it holds seminars outside the Fox Valley on a regular basis.

"Our practice is statewide," Georgen said, noting he has had several patients travel from Wausau, central Wisconsin and Michigan's Upper Peninsula for gastric bypass surgery and a procedure using an adjustable band to reduce the stomach's capacity. More >>

 Subscribe to Gastric Bypass Surgery News

Gastric bypass surgery malpractice causes need for multi-organ transplant

Trent, PA

Ruth Baer, 37, of Trent had weighed 298 pounds. She had a gastric bypass operation, but the procedure was done wrong and she didn’t know it.

In September 2004, her house burned down. She became ill, but doctors thought it was because of stress. At the time she was working for Woodmen of the World life insurance and was doing a medical study for the U.S. Department of Health. She is now on disability.

“On Sept. 15, I won’t forget it, I was throwing up every day,” she said. “I was on my way home from work and I passed out. I woke up in a cornfield. I told the doctor it was more than my nerves.”

An endoscopic examination showed that gastric bypass surgery done in 2000 had been done incorrectly. Because of the malpractice, food wasn’t bypassing her stomach; it was staying in a secondary pouch and decomposing. The only way to get the food out was to vomit, she said. It damaged her organs.

She had reconstructive surgery at Magee-Womens Hospital in Pittsburgh, then a similar procedure at UPMC Presbyterian hospital in Pittsburgh. She had feeding tubes for one year. When her condition deteriorated, she was referred to the transplant program at UPMC Presbyterian.

She became very ill. One day, a home health nurse came in and Baer told her she was dying. More >>

gastric bypass malpractice lawsuit attorneys

 Subscribe to Gastric Bypass Surgery News

Gastric bypass surgery may help cure diabetes

Alexandria, LA

A lot of people would consider surgery a drastic measure for treating diabetes.

But, a well-respected study, finds gastric lap-band or gastric bypass surgery may help cure the disease.

Even though 50 year old Ben Hunter was obese he didn’t get gastric bypass surgery to lose weight.

“I did it because I had diabetes that was out of control.” said the one time 313 pounder.

And it worked.

According to a new study of 60 diabetic patients, weight loss surgery controls and cures diabetes in 80 percent of the people who had it done.

That compares to about 10% who got treated with medication.

Dr. Alan Whittgrove a bariatric surgeon said, “Very few of them got control of their diabetes with medical treatment whereas with the weight loss from the adjustable band almost 80% lost their diabetes along with loosing their weight.”

It works like this, a lap-band is tightened around the stomach to make it smaller, so you eat less food and lose weight, which controls diabetes.

In gastric bypass surgery, the intestine is cut and re-attached to the stomach, so food is not absorbed in the usual way which also controls and sometimes cures diabetes. More>>

 Subscribe to Gastric Bypass Surgery News

Gastric bypass surgery may help cure diabetes

Alexandria, LA

A lot of people would consider surgery a drastic measure for treating diabetes.

But, a well-respected study, finds gastric lap-band or gastric bypass surgery may help cure the disease.

Even though 50 year old Ben Hunter was obese he didn’t get gastric bypass surgery to lose weight.

“I did it because I had diabetes that was out of control.” said the one time 313 pounder.

And it worked.

According to a new study of 60 diabetic patients, weight loss surgery controls and cures diabetes in 80 percent of the people who had it done.

That compares to about 10% who got treated with medication.

Dr. Alan Whittgrove a bariatric surgeon said, “Very few of them got control of their diabetes with medical treatment whereas with the weight loss from the adjustable band almost 80% lost their diabetes along with loosing their weight.”

It works like this, a lap-band is tightened around the stomach to make it smaller, so you eat less food and lose weight, which controls diabetes.

In gastric bypass surgery, the intestine is cut and re-attached to the stomach, so food is not absorbed in the usual way which also controls and sometimes cures diabetes. More>>

 Subscribe to Gastric Bypass Surgery News

Texas man has gastric bypass surgery, loses 500 pounds

Houston, Texas

A man who weighed 1,035 pounds a few months ago, has now lost almost half his weight! This all thanks to a doctor who has given him his life back.

In April of last year, 40-year-old Kenneth Brumley was bedridden. He had been confined to bed for four years.

He, literally, had to be cut out of his home in Spring, Texas.

Brumley was taken to Renaissance Hospital where he underwent a series of bariatric and skin reduction surgeries.

He has now lost 500 pounds and is able to get into a chair.

Brumley plans to get to the point where he can walk out of the hospital and he hopes it will be in no more than 6 months from now.

But he knows this will take some work from his part. His first goal is to be able to stand and take steps. Brumley does physical therapy on a daily basis.

He plans to get his life back on track by joining a church, getting involved in the community and even going back to school and work.

Brumley wants to be an inspiration to others and show them that you can overcome being morbidly obese.

gastric bypass surgery

 Subscribe to Gastric Bypass Surgery News

Teens having gastric bypass surgery and lap band procedure to lose weight

Chicago, IL

On yesterday’s ‘Oprah’ TV show we got to see teens that underwent either lapband or gastric bypass surgery in order to lose weight. Gastric Bypass and lapband procedure are similar in that they goal is to reduce the size of their stomachs to lose weight. The lapband procedure is more reversible in that they do not create a smaller stomach; they use a band to constrict the flow of food. Gastric bypass is a permanent procedure that the surgeons create a smaller stomach.

One teenager underwent lapband surgery in Tijuana Mexico at the age of 13. The mother said that she would have done it in the US, but nobody would do this procedure for someone this young. The daughter seemed to be happy with the results and has trimmed down. More >>

gastric bypass malpractice lawsuits

 Subscribe to Gastric Bypass Surgery News

Gastric bypass surgery, last resort for morbidly obese

North Andover, MA

Although most people can lose weight the old-fashioned way through disciplined eating and regular exercise, bariatric (the treatment of obesity) surgery is an option for very overweight people who have tried everything else.

"You don't just jump into this," says Dr. Frederick Buckley Jr., F.A.C.S., who practices general, vascular and bariatric surgery in Salem. "We're the last stop, and this solution is intended to be forever."

Weight-loss surgery is not for the slightly overweight, nor is it a quick fix for people who haven't tried other methods first. To be eligible, patients must be at least 100 pounds overweight, undergo psychological and cardiac screening and commit to a new eating pattern for the rest of their lives. Insurance companies may also require them to undergo six months of physician-monitored weight loss (usually by a primary-care provider) during the year prior to surgery or their own six-month phone-monitored system, which Buckley believes is less effective than proceeding directly to what he considers "life-saving" surgery.

Most of Buckley's patients have tried other programs without success. "Our patients have lost and regained hundreds of pounds," he said. "It is not a pure willpower thing and it's not for lack of trying that they come here." More >>

gastric bypass lawsuits - not a proper candidate

 Subscribe to Gastric Bypass Surgery News

Gastric bypass surgery, from 444 lbs. to marathon

Clarion, MS

Sheila McNair's journey began in 2003: the moment she looked at a family reunion photograph of her and her grandson.

"When I looked at that picture, I told myself 'I can't go on like this,' " said McNair, who had battled obesity since she was 12. "I had to do something. Obesity runs in both sides of my family and my mom died in 2001 due to diabetes. I didn't want to go that route. I was overweight to the point where basically all I could do was go to work and come home."

So McNair underwent gastric bypass surgery on May 3 of 2004. She weighed 444 pounds that day. Three years and 265 pounds later, she completed her first marathon.

It came just a year after she began in Marathon Makeovers, a support group that prepares runners for the 26.2-mile race. McNair finished the race. Her official time was 7 hours, 24 minutes and 43 seconds.


"If there is one word to describe her it is 'determined,' " said Simpson, director of Marathon Makeover. "She came in last January just able to walk a mile. But those race officials that wanted her to step off the course were not going to stop her." More >>

gastric bypass lawsuits

 Subscribe to Gastric Bypass Surgery News

Despite risks, gastric-bypass surgeries soar

Herald, FL

Monica Ramos lost about 200 pounds the hard way.

In 2004, a doctor stapled her stomach and rerouted her intestines.

A year later, Ramos collapsed in her home and was rushed to the hospital, where she needed another operation to stop internal bleeding.

Her weight-loss surgery represents the gamble that legions of morbidly obese Americans are taking every year. For many, it is worth the risk.

When Ramos had her initial operation, she was on 17 medications for diabetes and other ailments. Today, she needs no prescriptions. Her diabetes is gone; she feels great.

But the soft-spoken nursing student warns that surgery is not a cure for obesity.

"This is a lifelong commitment, and there are going to be days when you're sorry you've made this commitment," said Ramos, 26, who runs a support group in Orlando for weight-loss-surgery patients.

If current trends continue, she will be busy.

Weight-loss surgery -- commonly referred to as bariatric surgery -- has exploded in the United States from an estimated 16,200 procedures in 1992 to about 205,000 in 2007. More >>

gastric bypass malpractice lawsuits

 Subscribe to Gastric Bypass Surgery News

Before gastric bypass surgery, a commitment to change a lifestyle

Pittsburgh, PA

After the birth of her third child, Karen Elliott noticed her weight was steadily creeping up. By the time she hit 280 pounds, Elliott knew something needed to be done. She chose to have gastric bypass surgery at Excela Health Westmoreland Hospital.

"It has really saved my life," said Elliott, 47, of Greensburg.

Choosing surgery was easy, Elliott said -- even an invasive procedure that reduced the size of her stomach and left her unable to eat big meals.

The hard part was taking the steps required before doctors would consent to the procedure. More >>

gastric bypass malpractice attorneys

 Subscribe to Gastric Bypass Surgery News

Bariatric surgeon performs rare gastric bypass surgery in Cedar Falls

Waterloo, IA

Of the 11 cases of a rare laparoscopic surgery reported worldwide, one has been performed here in the Cedar Valley.

Dr. J. Matthew Glascock, medical director for the Midwest Institute of Advanced Laparoscopic Surgery located at Sartori Memorial Hospital, heads the team of medical professionals who recently performed a laparoscopic Roux-ex-Y gastric bypass with visceral malrotation.

Visceral malrotation is the twisting of the intestines, which occurs in the womb, Glascock said. While 75 percent of patients with malrotation are diagnosed by the age of 1, 25 percent aren't diagnosed until adulthood. These are usually discovered when the patient is undergoing another procedure or during an autopsy.

While Glascock routinely performs the Roux-ex-Y gastric bypass operation, it is rare to perform one with a patient with visceral malrotation. More >>

Gastric Bypass Surgery Malpractice Lawyers

 Subscribe to Gastric Bypass Surgery News

Teen Opts for Gastric Bypass Surgery

New York, NY

Girl, 17, discusses long battle with obesity and decision to gastric bypass surgery.

When she was in the third grade, Amanda Baron bent the scales at 200 pounds, and in the next eight years she did everything she could to lose weight – personal trainers, fat camps, diets. Finally, at the age of just 17 and with her weight pushing 250 pounds, she underwent bariatric surgery (gastric bypass surgery) to reduce the effective size of her stomach. more >>

teen gastric bypass malpractice attorneys

 Subscribe to Gastric Bypass Surgery News

Woman on death bed warns of gastric bypass surgery dangers

December 2, 2007

As she lay dying, Jan Malcolm made her husband promise.

"Tommy, we've got to tell people," she said. "If I live through this, we need to warn everyone so that no one else has to suffer like this. If I die, you must warn everyone so they will be aware of what to do to avoid this."

The last words T.F. "Tom" Malcolm heard from his wife of 47 years were, "You were right." more >>

gastric bypass lawsuit attorneys

 Subscribe to Gastric Bypass Surgery News

Carnie Wilson re-gains most of weight lost after gastric bypass surgery

November 29, 2007

Singer CARNIE WILSON is struggling with her weight again after piling on the pounds following the birth of her baby daughter. The Wilson Phillips star underwent gastric bypass surgery in 1999 when she weighed an estimated 300 pounds (136 kilograms) - but insists that wasn't the end of her weight worries. Wilson admits she's still fighting to get fit after weighing in at 240 pounds (108.8 kilograms) following the birth of baby Lola in April, 2005. She says, "I was back to 240 pounds after I had my baby. It's (weight) never going to be what I want it to be, always when I want it to be. I'm struggling with 30 (pounds) now."

gastric bypass surgery malpractice lawyers

 Subscribe to Gastric Bypass Surgery News

ORLive Presents: Minimally Invasive Roux-en-Y Gastric Bypass

November 7, 2007

Gastric Bypass Weight-loss surgery is the first surgery PinnacleHealth is scheduled to host on the Internet over the next year. Luciano DiMarco, DO, FACOS, medical director of bariatric surgery at PinnacleHealth, will perform Roux-en-Y Gastric Bypass on www.OR-Live.com. Since 1998, Luciano DiMarco, DO, FACOS, and his partners, have performed this surgery laparoscopically, reducing chance of infection, shortening hospital stay and improving recovery time.

Airing gastric bypass weight-loss surgery online gives prospective and current patients a behind-the-scenes look at what happens during surgery. It showcases the laparoscopic technique.

Roux-en-Y gastric bypass malpractice lawyers

 Subscribe to Gastric Bypass Surgery News

Singer Tammy Fletcher's Gastric Bypass Story

A different tune: Singer Tammy Fletcher: On her career, weight loss, her life

Tammy Fletcher is known for her big voice and commanding stage presence. But in the past two years, the Eden singer’s presence has physically shrunk. The 47-year-old diva lost 170 pounds off her 5-foot, 4 inch-tall frame.

The weight loss was spurred by the discovery that Fletcher had Type 2 diabetes and further fueled by her mother’s death last year. A stressful job and unhealthy lifestyle factored into her weight gain, which topped at 344 pounds.

“I was an apple — a very big apple. But I carried it well. I’m an entertainer, and I have a good self-esteem,” said Fletcher, speaking by phone from her home this week. “But it’s a very unhealthy lifestyle for me.”

Fletcher lost 70 pounds through diet and exercise before she decided to have gastric bypass surgery in November last year. She’s lost 100 pounds since.

Here the well-known jazz, blues and gospel singer talks about her life-altering weight loss, her career and the “second half” of her life:


On why she undertook such a huge lifestyle change:

“I’m going to be 50 years old soon, and I want the other half of my life to be one of physical fitness. To do anything I want to do — to ride on a roller coaster because I’ll fit, to wear a size 12, which I do now. I don’t want my frame to get in the way of that.”

“Everyday of my life I’ve dedicated to service. ... For once I want to take care of myself. Me first. Then I can do a better job at all the other stuff.”


On gastric bypass:

“I had gastric bypass. I need to tell people because they say I did it the easy way. In no way do I recommend this surgery to anyone. It was the most difficult thing I’ve ever been though. It was grueling, painful. It was a lifestyle change. It is a tool, not a miracle.”


On discrimination she faced for being overweight:

“I didn’t mind being a big girl. I loved being a big woman. ... It was just an outer shell. I didn’t like the way the world treated me. I didn’t like having to not to sit in an airplane without getting an extension, things like that bothered me. I liked myself. I tried to be a good role model for other large women. I try to carry the torch, to fight that fight. To not allow discrimination that is blatant.”

“I was booed at the Apollo not because I was white — because I was fat. Fat and white are a double death. Until I opened my mouth, and I won — until I sang, and I proved myself. I got tired of holding that torch.”


On her slimmer persona:

“I am who I am. I’m just a smaller version of that person. I command attention, no matter if I’m as big as I was or as medium as I am now. ... I’m half the girl I used to be, and I’m still a ton of fun, as I like to say. And I mean it. Now I can juggle more than one or two things.”

“I think it’s funny, people just stare at me. They don’t believe how I could possibly do this. Some people were angry; they missed this big girl who I was. That’s their problem.”


On her voice:

“People ask silly questions like ‘Is your voice the same?’ I can still sing, and I have more energy now to sing longer. Because I was so heavy it was an incredible workout to sing, it was very tiring. I was warm all the time, sometimes I’d get lightheaded and I never knew why. (Diabetes) was coming on. My body was starting to show signs.”


How her renewed health affected her career and propelled her back into the recording studio in December:

“I have a purpose. There’s meaning to my life, and I have a direction and I couldn’t do it being unhealthy. One of which is writing my own music and recording an album of my stuff with musicians who are the best. I couldn’t do it because I was physically unhealthy, depressed and just sick, physically sick.”


On continuing to lose weight and maintain her health:

“I have a sweet tooth, and it’s tough for me. My blood sugars are all normal because I’ve lost so much weight. I’ve been able to maintain it and keep a healthy attitude about it and realize it’s about portion control. A calorie is a calorie is a calorie.”

“I completely changed the amount of food I ate. I changed the quality of the food I ate. I don’t eat fast food. I try to pre-prepare ... I’m not perfect at this, I’m just learning. I work out on a daily basis in a small way. Anything I can do, whether its dancing in my house, running up and down the stairs. Every step counts. Don’t think it doesn’t because it all adds up.”

Her advice to people who are considering gastric bypass surgery:

“If you can do it conventionally, do it. (The surgery) saved my life, but by no means is it simple. I cannot stress support enough. You must surround yourself with people who support you on this. You cannot support yourself with naysayers. You will suffer.”

“I didn’t go into this lightly. This is a serious change of life and your family will change with you or they won’t. You’ll have to bear that. It’s not about your family it’s about you.”

 Subscribe to Gastric Bypass Surgery News

Roux-en-Y Gastric Bypass Surgery Live on ORLive, 11/7/2007

ORLive Presents: Minimally Invasive Roux-en-Y Gastric Bypass Weight-Loss Surgery Webcast: November 7, 2007 6:00 PM EST

Weight-loss surgery is the first surgery PinnacleHealth is scheduled to host on the Internet over the next year. On Wednesday, November 7 at 6 pm, Luciano DiMarco, DO, FACOS, medical director of bariatric surgery at PinnacleHealth, will perform the gold standard of weight-loss surgery, Roux-en-YGastric Bypass, at the PinnacleHealth Community Campus, on www.OR-Live.com.

Video-Link Available: http://www2.marketwire.com/mw/frame_mw?attachid=610003

gastric bypass malpractice

 Subscribe to Gastric Bypass Surgery News