After bariatric surgery, bus drive loses weight and gains confidence

Tampa Bay, FL

Jackie Chandler, 51, of Thonotosassa is a longtime bus driver with the Hillsborough County School District. She decided last year to have gastric bypass surgery and has lost at least 65 pounds since. She weighed 300 pounds before the surgery.

Chandler is pictured before her surgery, above, and after it, below. Since the surgery, there are things she can't eat, like pasta and ice cream. But her sleep apnea problems have subsided, and her diabetes medications have been cut.Chandler is pictured before her surgery, above, and after it, below. Since the surgery, there are things she can't eat, like pasta and ice cream. But her sleep apnea problems have subsided, and her diabetes medications have been cut.
Chandler is pictured before her surgery, above, and after it, below. Since the surgery, there are things she can’t eat, like pasta and ice cream. But her sleep apnea problems have subsided, and her diabetes medications have been cut.

Every year, about 250,000 people in the United States undergo surgery to lose weight, paying — or having their insurance companies pay — tens of thousands of dollars for procedures that essentially restrict how much food they can take in.

But are the surgeries safe? Do they work? And can they help treat diabetes, hypertension and other conditions caused or made worse by obesity?

Increasingly, the answer in the medical community is yes, yes and yes.

Doctors and others are bolstered by studies like one this month that showed improved outcomes and lower complication rates among Type 2 diabetes.

And they're encouraged by the endorsements of groups like the American Society for Nutrition and the Obesity Society, which called bariatric surgery "the most effective weight-loss therapy for obesity." Or the American Diabetes Association, which last year for the first time recommended bariatric surgery as a treatment option.

"We would not have imagined that day 10 years ago," Tampa bariatric surgeon Michel Murr said of the Diabetes Association's endorsement. "We've seen quite a shift of attitude."

Such acceptance likely will lead to a continued increase in surgeries, but also place greater pressure on public and private insurers to cover more of them.

Still, Murr and others caution that bariatric surgery is a major medical procedure and isn't for everyone, such as children and adolescents, or adults who are overweight but not considered obese. They also don't consider surgery a magic bullet for curing the country's obesity epidemic.

"We only operate on about 250,000 patients a year from a population of 30 million in the U.S. who are obese," Murr said. "In that regard, what are we going to do with the other 29,750,000?"

• • •

Most patients choose either a gastric bypass, which involves cutting and stapling the stomach, or gastric banding, which places an adjustable silicone ring around the top portion of the stomach. In both cases, a smaller pouch is created — the idea being that with less food filling a smaller stomach, patients lose weight.

Acceptance among the medical community has come slowly. Though the first procedures were performed in the 1960s, it was relatively uncommon even through the early 1990s.

"It was a very narrow field," said Murr, who started the bariatric surgery program at Tampa General Hospital in 1998. Primary care doctors weren't referring their obese patients for surgery. And most insurance wasn't covering it.

Murr said a number of factors helped shift the landscape. For one, more Americans were becoming obese. And second, the surgeries became safer and less invasive with the introduction of the laproscopic approach in the 1990s, which used several smaller abdominal incisions instead of a large one. Another major advance was the introduction of adjustable gastric bands in the past decade.

Then came the studies that showed the procedures were safer, had better outcomes and helped reduce or even eliminate chronic conditions associated with obesity. The most recent study appeared this month in Archives of Surgery, which showed lower complication rates and shorter hospital stays for Medicare beneficiaries who had the procedure after Medicare implemented certain criteria for prospective patients.

Medicare covers the procedures for people who are severely obese (body mass index of 35 or higher) and have a condition associated with obesity such as diabetes.

How much has the landscape changed?

"About half of the patients sent to my practice are directed by physicians," says Dr. John Baker, president of the American Society for Metabolic & Bariatric Surgery, who performs about 240 procedures a year at his Little Rock, Ark., practice.

• • •

But what about losing weight through diet and exercise?

Other studies have shown it is possible. The Louisiana Obese Subjects Study released this past month showed successes when placing participants in a structured medically supervised program.

And then there are the morbidly obese contestants on the popular TV show The Biggest Loser, who season after season lose large amounts of weight through improved diet and an intense exercise regimen.

Baker says those successes tend to be few and far between. Plus, "not all of us have a trainer that's going to push us to the limit every day."

• • •

Murr says people like Jackie Chandler are becoming a more typical obesity success story. The 51-year-old Hillsborough County school bus driver struggled with diabetes and sleep apnea and carried 300 pounds on her 5-foot-8 frame before deciding last year to have a gastric bypass surgery. Her BMI was 44.

Her insurance company, Humana, covered the procedure, which Murr said typically costs about $27,000 (gastric band procedures cost about $17,000).

Since Murr performed the surgery last September, Chandler has lost 65 pounds, no longer has trouble sleeping and is taking one medication for diabetes, instead of five.

Though the results so far have been positive, Chandler knows the surgery was just a tool to help her lose weight. The rest, she says, is up to her.

"I can't eat as much as I'd like to," she says. "Can't eat spaghetti anymore. Can't eat ice cream or chocolate." Patients have some dietary restrictions after surgery, and some experience nausea with certain foods.

And it's early. Studies suggest that bariatric patients can regain a significant amount of their lost weight. One 2004 study in the New England Journal of Medicine found that the percentage of weight lost for gastric bypass patients decreased from 38 percent after one year to 25 percent after 10 years.

But, the study notes, the improvement in their chronic conditions such as diabetes mitigated the fact they regained some weight.

Studies have also found that gastric bypass patients can suffer from vitamin and mineral deficiencies if they don't carefully manage their diets.

• • •

Surgeons say there's still a long way to go toward addressing the nation's obesity problem.

The percentage of obese people having bariatric surgery is small. And though surgery is covered for Medicare beneficiaries who meet certain criteria, insurance coverage for the general population is limited.

Humana, for example, doesn't offer it as a standard benefit; rather, it's offered as a buy-up option for employer groups with more than 3,000 members, said Dr. Jill Sumfest, the company's market medical officer for Central Florida. Currently, five groups in Central Florida offer it.

Members need to meet certain age and BMI requirements, and must have participated in a physician-directed weight management program for at least six months in the last two years.

Murr feels that's too restrictive. After all, he says, you don't tell someone that they have to have breast cancer or heart disease for a minimum period before you cover them.

He says Medicare has led the way for coverage; now it's up to private insurance companies and employers to recognize the benefits.

"There are enough studies now that the operation will pay for itself in two to three years . . . with the reduction of costs associated with other illnesses like hypertension, sleep apnea and diabetes," Murr said.

Both Murr and Baker say the real solution lies in comprehensive obesity management programs that include surgery as a choice. They say programs should include ways to curb the rising obesity rates among children and adolescents, such as better nutrition in schools and increased physical activity.

So, is the goal to get people to manage their weight so they don't get to the point where they need surgery?

"That's too ideal," Murr said.

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Gastric bypass was route to a new life for Sheriff

Milwaukee, WI

A little more than a year has passed since I grazed with John Schroeder at a Christmas party buffet table.

At 375 pounds, John knew this territory well - sandwiches, chips, rich dips, shrimp, desserts. But all that was about to change.

John, a friend of some friends of mine, told me he was having his stomach stapled a few days later. You know, bariatric surgery. The ol' gastric bypass.

His stomach would be reduced from about the size of a football, overinflated in his case, to the size of an egg. I wondered how a guy who clearly lived to eat would possibly manage portions to fit a space that small.

Well, I ran into John at the same party this Christmas and hardly recognized him. He had shed enough pounds, about 130, to build an average-size teenager.

"I'm still heading down," said the 41-year-old Wauwatosan. The married father of two is a Milwaukee County sheriff's deputy assigned to the jail.

His goal is to drop 20 more pounds and settle at 225. After falling off at two to three pounds a week, the weight lately has resisted disappearing a bit more.

You hear so much about how fat America has become, and it has. John Schroeder doesn't want to play that role anymore. This might be your New Year's resolution, too. Again.

A couple years ago, he tried out for TV's "The Biggest Loser," which has turned weight loss into a spectator sport. He got a callback but ultimately was passed over.

He seemed to have the right stuff for the show. John of buffet tables past was always hungry.

"I fit the old mode, I guess, the doughnut shop and that type of thing," he said.

Two hours before dinner, he'd stop at a fast-food drive-through for two big burgers. When the wind was right, he could smell the nearby pizza restaurant and bakery from his backyard spa.

"That would basically put me into a trance. I'd walk out of the hot tub and down the street in my swim shorts and unfortunately end up in the store buying pizza," he said.

Ice cream seemed to call out his name. His daily calorie intake? He had stopped counting. Never a small guy, he watched his weight go north of 300 and stay there.

He once was refused entry to a Disney World ride with his kids because he was too heavy. Airplane seats were brutal. His knees and feet hurt from holding him up. He was reinforcing his buttons with fishing line. The final straw was when he re-injured an old ankle injury from his football-playing days while chasing down a criminal.

John found his way to Craig Siverhus, a general/bariatric surgeon at Columbia St Mary's. In December of 2008, after extensive consultations and even psychological testing, Siverhus performed what's known as Roux-en-Y surgery on John, a common form of gastric bypass first done in the 1960s in the United States.

A small part of the stomach is cut away and stapled to form a pouch to accept food. The rest of the stomach and duodenum are bypassed to limit absorption, and the small intestine is surgically attached to the pouch, Siverhus explained.

The procedure usually results in the loss of 70% to 80% of a person's excess body weight, most of it in the first six months. There are risks. A tiny percentage of patients die. Ulcers and gallstones can appear. Eating sugary foods, pasta, bread or simply too much can make you sick. But Siverhus said the surgery often greatly reduces a patient's risk from high blood pressure and cholesterol, diabetes and sleep apnea.

The surgery can run $25,000 to $30,000. Insurance doesn't always cover it. Luckily for John, his did.

"John was a great candidate. He was very well informed, he was very well motivated to proceed with this, and he was willing to make lifestyle changes that would allow him to succeed with it," the doctor said.

John's wife, Kate, said people sometimes call this weight loss route a quick fix, but she has seen how radically John has changed his habits. Under stress, he might still hit the fridge, but now it's for yogurt rather than a hot dog with all the fixins.

John said Kate occasionally has to remind him to eat. His eyes are still sometimes bigger than his stomach, which isn't saying much. He'll fill a bowl with chili but eat only a small amount. He learned a painful lesson from a Reuben sandwich he chanced on St. Patrick's Day.

Kate said her husband has lost his desire to eat out, but some restaurants will charge him for a child's meal when he flashes his bariatric surgery membership card.

She'd love to lose 30 pounds herself, using traditional dieting, Kate said. People are always telling John how fabulous he looks now. The family bought bikes and plans more trips to the gym this year. Fewer frozen pizzas are on the horizon.

John has spent lots of money on new clothes and work uniforms as the pounds fell off. It's a nice problem to have. His waistline is down to nearly 36 after peaking at 52.

In December, for the first time, all four Schroeders appeared in the family Christmas card. John, who used to hate cameras and mirrors, finally wanted to be included. Recently, John noticed his clavicle peeking out from what had been excess fat, and he had to look online to see what it was.

For John, eating now means a few ounces at a sitting, about a third of a kid's meal or part of a Lean Cuisine dinner. He eats small pieces of fruit, nuts and veggies, and everything has to be chewed to death. It's crucial to drink enough water, but just sips at a time. He has so much more energy, despite eating so little.

What about beer?

"You're not supposed to," he said. "But I'm from Milwaukee so, yes, I'll sneak one in periodically."

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After gastric bypass surgery, couple loses 249 pounds in a year

Chicago, IL

Their daily Starbucks drink of choice was once a Venti Java Chip Frappuccino -- a whopping 600 calories in a cup.

These days, Lorie and Todd Richmond splurge on coffees with Splenda and a dash of half-and-half. But they are more likely to be riding their bikes, shooting hoops with their three kids or shopping for new clothes.

The Chicago Sun-Times featured the Richmonds in a Dec. 22, 2008, story after the couple from northwest Indiana had weight-loss surgery at the University of Chicago Medical Center on the same day.

Before the surgery, Lorie weighed 402 pounds, Todd 305.

A year later, Todd is at his goal weight of 207 pounds. He's off cholesterol and blood-pressure medications. Lorie weighs 251 pounds and is confident she can lose another 60 pounds or more to reach her goal.

Together, the two have lost 249 pounds in one year.

"It makes you feel so good that people notice," Lorie said. "For the first time in my life, I don't mind telling people my weight."

The Richmonds' say their quality of life also skyrocketed as their weight decreased.

They vacationed in the Smoky Mountains, hiking and riding roller coasters -- things they couldn't do before.

They bought bikes, and Todd consistently rode about 10 miles every other day throughout the summer. When she started, Lorie could only ride a block before having to stop; by the end of the summer, she took an eight-mile ride.

And when she ran to pick up an errant basketball while shooting baskets with her 7-year-old son, he said words she had never heard before: "I just saw my mom run."

"I almost cried," she said. "I was so happy I could do that with him. It gives me even more drive to keep going."

Dr. Vivek Prachand, an assistant professor of surgery at the University of Chicago Medical Center, performed Lorie's duodenal switch and Todd's gastric bypass.

A duodenal switch involves removing part of the stomach and bypassing much of the small intestine to limit how many calories are absorbed. A gastric bypass shrinks the stomach.

But the surgery alone wouldn't help the Richmonds lose and keep off the weight. They altered their diet and exercise habits -- something they had tried repeatedly in the past but without success.

"You have to recognize the surgery is a tool, it's not a cure," Prachand said. "I only take half the credit for it. You accomplish the other half."

The Richmonds said they were stung by hostile online anonymous critics who said the surgery was "cheating'' and accused the couple of laziness.

Prachand said he has heard all the criticism before, but said they are unfair. He said the surgery is highly effective and corrects multiple medical issues with one procedure.

"What we're dealing with when we're talking about surgery for severe obesity, we're talking about people who are 10 to 15 times heavier than the 10 to 15 pounds all of us have struggled with at one point or another," Prachand said. "Sometimes it's hard to project the added difficulty of that much more."

Beyond the surgery and added exercise, the Richmonds dramatically changed what they ate.

Todd said a year ago, he could "put a buffet out of business."

Now, the couple eat off saucers to help control portions.

They eat small meals consistently throughout the day, including daily breakfast.

And while they haven't abandoned Starbucks completely, they cut out the oversize sweet drinks and other treats -- even though they say they are constantly celebrating.

"This year has been awesome for us," Lorie Richmond said. "There's so much, I want to shout at the rooftops. Life is opening up for us."

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Better gastric bypass surgery outcomes linke to preoperative weight loss

Trenton, NJ

Preoperative weight loss is associated with fewer complications after gastric bypass surgery, according to the results of a record review reported in the December issue of Archives of Surgery.

"Despite the improved ability to accurately predict an increase in surgical risk, the optimal preoperative preparation of such high-risk bariatric surgery candidates remains controversial," write Peter N. Benotti, MD, from Saint Francis Medical Center in Trenton, New Jersey, and colleagues.

"Proposed risk-reducing strategies supported by varying degrees of evidence include staged surgical procedures, preoperative gastric balloon placement for weight loss, and preoperative medical weight reduction....Because the major determinant of postoperative length of stay is operative morbidity, we hypothesized that preoperative weight loss will reduce the frequency of surgical complications in patients who undergo bariatric surgery."

At a comprehensive, multidisciplinary obesity treatment center at a tertiary referral center serving central Pennsylvania, the investigators reviewed records of 881 patients undergoing open or laparoscopic gastric bypass surgery from May 31, 2002, through February 24, 2006. Before surgery, all patients underwent a 6-month multidisciplinary program with the goal of achieving a 10% preoperative weight loss. The primary endpoints of the study were loss of excess body weight and rates of total and major complications.

Loss of 5% or more excess body weight was achieved by 592 (67.2%) of the 881 patients and loss of more than 10% excess body weight by 423 patients (48.0%). Compared with patients undergoing laparoscopic gastric bypass surgery (n = 415), those referred for open gastric bypass (n = 466) were generally older (P < .001), had a higher body mass index (P < .001), and were more often men (P < .001). In addition, they had higher total complication rates (P < .001) and major complication rates (P = .03) vs patients undergoing laparoscopic gastric bypass surgery. Increased preoperative weight loss was associated with decreased rates of total complications (P = .004) and, most likely, decreased rates of major complications (P = .06), based on univariate analysis. In a multiple logistic regression model controlling for age, sex, baseline body mass index, and type of surgery, increased preoperative weight loss predicted reduced rates of total complications (P = .004) and major complications (P = .03). "Preoperative weight loss is associated with fewer complications after gastric bypass surgery," the study authors write. "We hope that these findings will be confirmed by prospective, controlled trials and that bariatric surgeons will consider this modality for preoperative risk reduction in selected patients who are deemed high risk for complications after surgery." Limitations of this study include retrospective design, lack of a control group, referral bias, and possible unmeasured confounding variables. In an accompanying invited critique, Patricia L. Turner, MD, from the University of Maryland Medical Center in Baltimore, recommends emphasizing an aggressive preoperative weight loss regimen. "Overall, this article presents the largest study thus far, to our knowledge, which may demonstrate a significant advantage to preoperative weight loss," Dr. Turner writes. "Moreover, the authors did not experience the attrition feared by some surgeons should they require preoperative weight loss of their patients. These findings suggest that consideration be given to incorporating either a suggestion of or the requirement for modest weight loss prior to bariatric surgery as a means of decreasing postoperative complications."

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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.

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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.

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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!' "

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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."

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Single-incision gastric sleeve, gastric bypass surgery alternative

Houston, TX

There's a new weight loss surgery option available in Houston that doctors say is less invasive and allows patients a faster recovery. It could offer patients as much weight loss as the "gold standard" weight loss procedure, gastric bypass.

Denise Abrego-Carter is about to undergo a new procedure to help her lose weight. It's called the single-incision gastric sleeve.

She said, "He guarantees me about 70-80 pounds."

The "sleeve" procedure is similar to the more radical gastric bypass. But unlike gastric bypass, the "sleeve" requires only one incision and is a less complicated surgery.

Dr. Sherman Yu, a Memorial Hermann bariatric surgeon, explained, "With this newer procedure people are actually losing just as much weight as a gastric bypass, but the risks are about half the gastric bypass because we're not rerouting any of the intestines."

Surgeons go through the belly button to do the surgery which allows for less pain, faster recovery and better cosmetic results. It was an attractive idea for patients like Rebecca Hammonds. She had the surgery in May.

"I've seen absolutely fantastic results. I'm so thrilled," she said. "I did not like the idea of having an implantable device inside of me so that's why I didn't go with the band."

Hammonds has already lost 70 pounds in about four months and is thrilled. But what really surprised her were the other health benefits she gained from getting the gastric sleeve procedure.

"The increased energy, how much better I feel," Hammonds said. "Before surgery I had a lot of hip pain and I'd come home from work and I could hardly walk, I was hurting so bad. And now I get home and I can deal with my children and play with them."

For the doctors, that's what makes it all worthwhile.

"People are losing, again, 60, 70, 80 percent of their excess body weight," said Dr. Yu. "But more importantly, really what we focus on is that their medical problems get better."

"I haven't been ill. I haven't been really sick," Hammonds said. "I'm losing weight and feeling great."

Dr. Yu and Dr. Terry Scarborough of Memorial Hermann are the only doctors in Houston performing the single incision gastric sleeve procedure. They are currently training other surgeons around the country how to do it.

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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.

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Patient bleeds to death after gastric band surgery

A mother told to lose weight to avoid serious health problems died hours after surgery to fit her with a gastric band.

Susan Alderson had three litres of blood in her abdomen and had bled to death, a post mortem found.

Experts had advised the 49-year-old to have the band fitted, a procedure which reduces the size of the stomach.

Susan Alderson received gastric band surgery at the former Derby City General Hospital in January. She later bled to death

But after the operation, which was also to repair a hernia, Mrs Alderson suffered internal bleeding, which claimed her life, an inquest was told.

Mrs Alderson, a diabetic who weighed more than 16 stone, was told by dieticians she would need the surgery to help prevent other potentially life-threatening illnesses.

She was admitted to the former Derby City General Hospital in January.

The hearing, attended by Mrs Alderson's husband and son, was told the operation went ahead without complications and Mrs Alderson appeared to be recovering well.

Derby Coroner's Court heard she started bleeding internally hours later, leading to a cardiac arrest and her death the next morning.

Paul Leeder, who carried out the operation, said: 'I had never experienced any problems with patients having severe complications. I had not had a death either before that operation or since.'

He said Mrs Alderson's body mass index (BMI), which determines whether a patient has a healthy body weight by measuring their height and weight, was 44, classing her as morbidly obese.

A patient who weighs too much in comparison to their height is in danger of developing problems such as strokes, heart problems, arthritis and an increased risk of cancer.

Mr Leeder said: 'Mrs Alderson had been on a low-calorie diet but had only lost four kilogrammes (nine pounds).

'The three options were for her to carry on as she was, without surgery, to have a gastric bypass or to have the gastric band.

'The risk of bleeding, risk of death and failure rate of the procedure were explained. But the long-term benefits of sustained weight loss would have far outweighed the risks involved with the surgery.'

After surgery, Mrs Alderson, of Sinfin, Derby, was moved into a recovery area, where her blood pressure started to drop.

Doctors gave her injections to help boost her blood pressure but, later that evening, it started to drop again. She was moved to a higher dependency ward and appeared to be recovering.

Mrs Alderson was later transferred to a 'step-down' ward, where she suffered a heart attack and later died.

Her post mortem examination found between two-and-a-half to three litres of blood collected in her abdominal wall, close to the repaired hernia.

Dr Andrew Hitchcock, consultant pathologist at Royal Derby Hospital, said it was not clear where the bleeding had originated.

Dr Hitchcock said Mrs Alderson's medical cause of death was internal bleeding, related to the hernia repair and gastric band operation.

Recording a narrative verdict, deputy coroner Louise Pinder gave the cause of death as intra-abdominal haemorrhage and incisional repair and gastric band application.

Miss Pinder said: 'She had no particular interest in losing weight for interests of vanity, this was very much a medically-based decision.'

A spokesman for Derby Hospitals, said: 'Our thoughts are with Mrs Alderson's family.

'Any surgery carries a risk and in Mrs Alderson's case the risks were higher due to her high BMI, severe diabetes, liver problems and a hernia repair.

'These factors meant that when Mrs Alderson developed complications, her blood did not clot in the normal way.

'The coroner said that the clinical team could not have foreseen the tragic outcome in Mrs Alderson's case.'

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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."

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Obese student seeks charitable donations for gastric bypass surgery

Seattle, WA

A Seattle college student doesn't want to be the "biggest" man on campus and has started a Web site asking for donations to help him get gastric bypass surgery.

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Gastric bypass surgery malpractice: Fatal malpractice at NY hpspital unreported

Coney Island, NY

On July 17, 2006, Robert Asta had gastric bypass surgery at Coney Island Hospital. Six days later, the 54-year-old cook was dead.

Internal hospital records reveal a "foreign object" was left inside his body postsurgery, but for the year 2006, Coney Island Hospital reported zero cases in which a foreign object was mistakenly left in a patient after surgery.

Robert's son, Michael, was devastated. It was a surgery Michael didn't want him to have, but Asta desperately wanted to lose weight. The 6-foot, 375-pounder had tried all kinds of diets with little success.

"My life has never been the same. We were supposed to go into business together," Michael Asta said. "My family is heartbroken."

Asta never told his family what he was planning.

"None of us would have let him go," Michael Asta said.

The son said his father told him about the surgery a day after the operation — and said he was in a great deal of pain.

Robert called the hospital, but was told that pain after such an operation is a normal part of the recovery process.

Then on July 20, Asta received a call from the hospital asking him to come in for some further testing after lab tests came back with abnormal results.

The hospital found a piece of surgical tubing in material removed from Asta's body — an indication something had been left inside Asta postsurgery.

A CT scan was taken and the results were inconclusive. On July 23, Michael Asta received a call from his father's long-time girlfriend.

"She told me to come over because, she said, 'He feels very cold and I think he's dead,'" Asta said. When Asta arrived, his father was dead.

In response to the News' questions, the city Health & Hospitals Corp. insisted it didn't need to report this incident as "foreign object left in body" – a specific reporting category. Instead it was reported merely as "unexpected death."

HHC said surgical tubing was not left inside Asta, but an internal Coney Island Hospital document dated Aug. 22, 2006, that the family obtained in its lawsuit states, "Foreign Object left in body during surgical operation."

The autopsy report lists the cause of the death as a postoperative infection in the abdominal cavity that involved "retention of surgical tubing" in a surgical specimen.

Manner of death is listed as "therapeutic complication." Though the hospital didn't admit wrongdoing, the family's malpractice claim was settled for $675,000.

Asta left behind three adult children and two grandchildren.

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New study finds gastric bypass surgery not more risky for senior citizens than young

Dallas, TX

About 26% of seniors 65 and older in U.S. are obese, nearly 40% are overweight, putting them at a higher risk for Type 2 diabetes, high blood pressure and heart disease

Morbidly obese seniors, age 65 and over, who had laparoscopic gastric bypass surgery lost nearly 76 percent of their excess weight after two years and had low complication rates and short hospital stays comparable to younger surgical patients, according to a new study presented today at the 26th Annual Meeting of the American Society for Metabolic & Bariatric Surgery (ASMBS).

“Bariatric surgery in the older population is underutilized because of a misperception that old age alone puts patients at higher risk for complications and mortality,” said Joseph Kuhn, MD, co-author and director of General Surgical Research at Baylor University Medical Center in Dallas, TX.

“We found seniors can benefit just as much as younger people from bariatric surgery without taking on additional risk.”

In one of the largest series of laparoscopic gastric bypass surgeries performed on elderly patients, researchers from Baylor University Medical Center analyzed a prospective database of 100 patients over age 65 and compared safety and outcomes to a younger population.

All patients had laparoscopic gastric bypass surgery between January 2005 and July 2008.

Prior to surgery, older patients demonstrated higher operative risk profiles compared to their younger counterparts in relation to -
● sleep apnea (45% vs. 34%),
● Type 2 diabetes (65% vs. 33%) and
● hypertension (81% vs. 57%).

Older patients ranged in age from 65 to 77 with an average BMI of 45, and younger patients ranged in age from 18 to 64 with an average BMI of 47.

Post-operative excess body weight loss (EWL) and complication rates were comparable in both groups.

At 12 and 24 months, both lost nearly the same amount of weight -- patients over age 65 showed 75.9 percent EWL after one year and 75.5 percent after two years; patients under 65 showed 77.8 percent EWL after one year and 79.2 percent after two years.

Neither group reported any deaths in the two-year follow-up period.

Post-operative complications were -
● low: bleeding (>65 1% v. < 65 1.3%),
● pulmonary infections (>65 3% v. <65 1.3%),
● cardiac (>65 2% vs. <65 0.36%) and
● wound infections (>65 1% v. <65 1.7%).

Due to the age and overall health status of the older group, researchers noted it was particularly interesting to also find length of hospital stays (1.9 vs.1.3 days) and 30 day readmissions rates (6% vs. 7.4%) to be so comparable.

About 26 percent of people 65 and older in the U.S. are obese and another nearly 40 percent are overweight, putting them at a higher risk for Type 2 diabetes, high blood pressure and heart disease. Since 1990, the prevalence of obesity has increased more than 50 percent in the elderly.

“The population is getting older and unfortunately more obese, so we will see a corresponding increase in the number of patients over 65 who are eligible for bariatric surgery and surgery needs to be an option for them,” said Christopher Willkomm, MD, study co-investigator from Baylor University Medical Center.

People who are morbidly obese are generally 100 or more pounds overweight, have a BMI of 40 or more, or a BMI of 35 or more with an obesity-related disease, such as Type 2 diabetes, heart disease or sleep apnea.

According to the ASMBS, more than 15 million Americans are considered morbidly obese and in 2008 an estimated 220,000 people had some form of bariatric surgery. The most common methods of bariatric surgery are laparoscopic gastric bypass and laparoscopic adjustable gastric banding (LAGB).

The ASMBS is the largest organization for bariatric surgeons in the world. It is a non-profit organization that works to advance the art and science of bariatric surgery and is committed to educating medical professionals and the lay public about bariatric surgery as an option for the treatment of morbid obesity, as well as the associated risks and benefits.

It encourages its members to investigate and discover new advances in bariatric surgery, while maintaining a steady exchange of experiences and ideas that may lead to improved surgical outcomes for morbidly obese patients. For more information about the ASMBS, visit www.asmbs.org.

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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."

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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.

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Gastric bypass: One man's journey

Baltimore, MD

Obesity is a condition that can cause all sorts of serious health and social problems, and they're all too familiar for an 11 News photographer who decided to have gastric bypass surgery.

Obesity can affect many things in life, including fitting into a movie seat, traveling on an airplane or going to a baseball game. They were problems long-time photographer Howard Melnick has been familiar with his entire life. 11 News decided to follow him on his journey through gastric bypass surgery.

Howard Melnick's Interview
Dr. Thomas Magnuson interview

Melnick has struggled with his weight all his life. He said it's tough carrying around heavy equipment, especially when he weighs more than 400 pounds.

"I was the fat kid who was about 10 minutes behind everybody else on the track. I was the fat kid who couldn't do chin-ups," he said.
Howard Melnick
Photographer Howard Melnick chose to get gastric bypass surgery.

His obesity has led to hypertension, sleep apnea and serious knee problems.

"My knees are shot -- just shot, and I need my knees (for work)," he said.

Finally, Melnick and his wife, Debbie, decided he would have bariatric surgery, or gastric bypass.

"It's the curse of my life. With Debbie, we love our lives today ... except for the weight," Melnick said.

Melnick's wife said she was fully supportive of his decision, but still worried because it was a big surgery.

"I'm very nervous, probably more than he is," she said.

Dr. Thomas Magnuson, the chief of general surgery at Johns Hopkins Bayview Hospital, said the surgery would take about three hours to complete and told Melnick the procedure has come a long way since it was first developed.
"Twenty years ago, people would lose weight then gain it back in two years (after gastric bypass). Now, they're more durable," said Dr. Thomas Magnuson

"They're a lot safer and they work better and last long-term. Twenty years ago, people would lose weight then gain it back in two years. Now, they're more durable -- a lifetime," Magnuson said.

Melnick could eventually lose many of the medical conditions caused by his obesity, Magnuson said.

After extensive counseling on nutrition, lifestyle and exercise, Melnick had his surgery.

"It hurts when I sit up and lay back down, but when I'm walking, not so much. They had me up last night," Melnick told 11 News the day after his surgery.

One week later, doctors said the surgery went well, and Melnick said he had already lost about eight pounds and was feeling great.

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Family demand answers after gastric bypass death

Macclesfield, UK

The family of a woman who died following a gastric bypass are demanding answers into her death.

Suzanne Wrighton, aged 59, died on May 30, 2008, less than 36 hours after having three operations at The Regency Hospital in Macclesfield.

Mrs Wrighton, who lived in Moreton Road, Crewe, decided to go in for the surgery paid for by the NHS at the private hospital because she was overweight and suffered from back pain.

Her husband Brian, aged 64, yesterday told an inquest into her death at Macclesfield Town Hall that he and his wife had been to two consultations prior to the operation and had been told there was a one per cent chance of fatality.

He said: "Suzanne had suffered from back pain for a long time. It started after she had a car crash in 1987. She had two operations on her spine but she still suffered from pain and she put on weight because she couldn't exercise.

"She decided on a bypass rather than a band. We know there is a risk with any operation but the risks we were told about weren't enough to worry her."

The inquest heard that after the first operation on May 28 Mrs Wrighton was in severe pain.

The following day consultant surgeon William Brough decided to perform a second operation to find out what the problem was but it wasn't until May 30 after the third operation that he found Mrs Wrighton had suffered a bleed.

Mr Brough said: "This was a rare complication that could not have been seen beforehand.

"It is the first time I have heard of a bleed from the staple line."

Mr Brough said that since Mrs Wrighton's death the hospital has altered protocol to ensure that all patients no matter how ill they are will have blood tests the day after the operation.

Mrs Wrighton died from adult respiratory distress syndrome (ARDS), which is when the lungs become filled with fluid and can't function properly.

Deputy coroner for Cheshire Janet Napier recorded a verdict of death due to complications following an operation for weight loss.

After the inquest Mr Wrighton, said: "We will be speaking to our solicitor and launching a complaint against the hospital. We are not happy with how Suzanne was treated. She was screaming out in pain most of the time she was in the hospital."

Suzanne's daughter-in-law Tammy Buxton, from Burslem, said: "The inquest hasn't really answered our questions.

"We still don't know why they failed to find the bleed until after the third operation.

"We have got to the bottom of the reason why she died. We don't want other families to go through the same pain and trauma we've been through."

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Married couple has bariatric surgery together

Poughkeepsie, NY

Married couples do lots of things together.

Sometimes, that involves activities designed to get healthier, such as exercising and eating better.

Trish and Jeff Tryon decided to take that one step further: They had gastric bypass operations on the same day.

In Part Three of The Early Showseries "HeartScore" on Wednesday, correspondent Debbye Turner Bell introduced viewers to the couple from Poughkeepsie, in upstate New York, determined to lose large amounts of weight to improve their health and up their odds of living long lives.

It used to Jeff, a take volunteer firefighter, four minutes to get into his gear. Now, he can do in half that time.

Trish, an EMT instructor, also struggled. "I would walk down the hallway and I'd have to sit," she told Turner.

They were both morbidly obese, medically defined as more than 100 pounds overweight. Jeff was 440 pounds. Trish weighed in at 399.

For her, it was a life threatening situation. She suffered from high blood pressure, high cholesterol, and heart problems.

After several failed diets, they explored weight loss surgery and decided to have gastric bypass procedures together.

"Without this operation," says Dr. Laura Choi, a surgeon at Danbury Hospital, in Connecticut, "it was very difficult for them to change their lifestyle."

An emotional Jeff recalled that Choi said, "You have a choice. Sign a contract to have the surgery and add 25 years to your life. Or sign a contract with a funeral home."

The Tryons had their operations in November. A small pouch was created in their stomachs, and their small intestines re-routed to the new, smaller stomachs. It's "worked out beautifully" for them, Choi says, because they have instant support with each other, and they both they recovered very quickly. "You can see it in their faces," she adds. "You can see how excited they are about shedding the pounds, being able to do those everyday things they love to do."

Since the surgery, they eat very small portions. No more sweets or fried foods.

In just three months, Trish has a hundred pounds and Jeff, 81.

His legs don't hurt anymore and now, when he drives the firehouse ambulance, he no longer worries about his belly getting in the way. And she can walk much better.

They've lost weight and gained a whole new life. "It made our love bond very close," Jeff says.

"I know now that I am going to be around to see my son get married and have kids," Trish said, beginning to cry, "and I didn't think I was going to do that before."

Before the surgery, she was taking 14 pills every day for the long list of health issues her weight was causing. She's now off all her medications.

"Contrary to what a lot of people believe about gastric bypass surgery and other types of surgery, it's not the easy way out," Choi observes. "The long-term success essentially depends on how well a person is able to change their lifestyle, and their outlook and relationship with food."

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Bariatrics surgery increases fertility of women and men

Pittsburgh, PA

Melody and Phillip McIntyre, both morbidly obese, tried unsuccessfully for three years after their 2003 marriage to have a child before Mrs. McIntyre decided to try a gastric bypass in hopes of increasing her fertility. Some obstetric nurse friends had told her they had seen "many success stories after the surgery."

And so Mrs. McIntyre, a nurse at UPMC-Horizon in Greenville who lives in West Middlesex, Mercer County, headed to Allegheny General Hospital for an appointment with surgeon Dr. Joseph Colella, director of the hospital's bariatric center.

"That was the first question I asked. I said, 'I want to have a baby. Can you help me?' " Mrs. McIntyre recalled.

The doctor answered "of course," talked to her and her husband about how obesity affects fertility, then suggested the same operation for Mr. McIntyre, a residential adviser for mental health patients. It was advice he followed after a cardiologist got his heart function working well enough to undergo surgery in April 2007, when he was 35 years old.

Mrs. McIntyre had her laparoscopic procedure in late October 2006 and then settled back to follow medical advice that female bariatrics patients wait a year to a year and a half -- or maybe even two years -- before trying to get pregnant in order to ensure there are no complications.

But it was Mr. McIntyre who had a complication during his 2007 procedure, hemorrhaging because his spleen had been traumatized. In going back in to find and stop the bleeding, doctors found a cancerous kidney tumor that they watched for a year before removing it all last April.

By that time, Mrs. McIntyre, now 34, was pregnant with little Trent, who was born Dec. 6. He was conceived just five months after she went off birth control.

Leslie Gore's story is even more amazing. The 24-year-old Penn Hills woman was told when she was 16 that she probably never would get pregnant because she had polycystic ovarian syndrome, a problem in which a woman's hormones are out of balance. Treated with hormones to induce periods, she steadily packed on the weight until she reached 285 pounds on a 5-foot-3 frame for a body mass index in the high 40s to low 50s.

Mrs. Gore, who is a pregnancy caseworker for Unison Health Plan, went to Dr. Dan Gagne (pronounced ga-NYAY), director of West Penn Hospital's Bariatric Surgery Center, for two reasons: in hopes of having a child and of getting healthy enough to live to raise him.

The surgery on Jan. 8, 2008 worked beyond her and husband Tyrone's wildest dreams: She got pregnant in October while still taking birth control pills. The baby is due July 4.

"We were both floored. We were completely caught off-guard," Mrs. Gore said.

She called Dr. Gagne to pass on the news and, she remembered, got this response: "I'm not surprised. Congratulations."

No wonder.

Since West Penn's bariatrics center opened in July 1999, Dr. Gagne said, "we've had at least 39 women get pregnant after bariatric surgery." Those are women who delivered full-term babies, he said, adding that at least five in the practice are pregnant now.

"Some of them had had previous pregnancies; a lot did not. A lot had diagnoses of polycystic ovary disease ... We had several who had had problems getting pregnant that did get pregnant."

Dr. Colella has had similar experience at Allegheny General and so has Dr. Anita Courcoulas at UPMC, where she is director of minimally invasive bariatric and general surgery.

"It's over 30 and that would be in six years," Dr. Colella said, "and those are the ones I know about who had infertility problems who moved on to successful conception and delivery."

One couple was so grateful that they named their son Joseph.

Dr. Courcoulas said the number of women who have become pregnant after weight loss surgery at UPMC's center in Magee-Womens Hospital is "definitely in the hundreds" but noted that the big number is due in large part to the size of the UPMC practice. "Just at Magee we do 1,100 weight-loss operations a year."

Though one recent medical bulletin from the Practice Committee of the American Society for Reproductive Medicine declared that "most obese women are not infertile," it also goes on to say, "Conversely, ovulatory function and pregnancy rates frequently improve significantly after weight loss in obese anovulatory women."

Certainly, the experiences of the Pittsburgh bariatrics doctors are that many presurgical patients are at least less fertile than normal.

"The take-home message is that fertility is certainly improved." said Dr. Ronald Thomas, director of maternal fetal medicine at AGH, whose department collaborated with Dr. Colella's on two published studies about pregnancy outcomes after the laparoscopic gastric bypass known as Roux-en-Y.

"In one article we talked about the fact that the typical advice is wait two years and stabilize before getting pregnant and the problem is many get pregnant after six, seven or eight months. ...

"[What happens is] patients begin to ovulate and get pregnant without trying to. The fertility comes back roaring into place. These patients don't realize their fertility markedly improves."

Hormones involved

Why does this happen? Doctors interviewed all cited changes in hormonal activity post-weight loss.

"A lot of times it seems to be the interplay of female hormones and fat," Dr. Gagne said. "Just as we see improvement in other health problems, this too happens in weight loss."

"I agree with that," Dr. Courcoulas said, "but we don't know exactly how."

"There's a dramatic change in the way hormones in the body are regulated after they lose all the fat cells," Dr. Colella said. "It's called the hypothalamic-pituitary axis, and its interaction with the ovaries gets reset to normal function so women begin to experience the normal circulation of hormones that trigger ovulation that occurs each month. ...

"The way we understand it in our world is the fat cells are an estrogen-producing engine and it overwhelms the axis and stops it from producing two hormones, follicle stimulating hormone and luteinizing hormone, and those two hormones are the ones responsible for triggering ovulation. So if they're not made in the appropriate amount in the appropriate time you don't get a normal ovulation event.

"And there also may be some changes in the lining of the uterus that make it less likely to allow implantation if an egg gets fertilized, but most commonly it's that they don't ovulate."

Dr. Scott Kauma, reproductive endocrinologist and director of the Jones Institute for Reproductive Medicine at the West Penn Allegheny Health System, theorized that resumed ovulation "might have to do with decreasing insulin resistance. It may be decreased circulating testosterone levels as they're losing weight or some unknown metabolic changes that stimulate the body to ovulate better. None of this is certain."

He said there's a similar uncertainty about why heavier women respond differently to other treatments, such as in vitro fertilization: "... the amount of medicine you need to use to get women to respond appropriately is much higher and pregnancy rates are lower. When I see the the pregnancy rates [of IVF] ... you're not guaranteed a pregnancy, but if you're obese the likelihood of getting pregnant compared to normal weight women is less."

Obese men are much less likely to undergo bariatric surgery because of fertility issues, but only because they are less likely to have the surgery at all. "There's an 8-2 ratio, women to men," Dr. Colella said, "but that's not because obesity is contained to women but because men are reluctant to seek help in specialty practices. The prevalance of obesity is roughly the same between men and women."

Helping men

And, Dr. Kauma said, men's fertility also is affected by their overweight.

"The heavier you are, the more of a problem you have with a lower sperm count," he said. "It may be that men who are heavy may have more estrogen floating around their bodies. The fat will convert testosterone to estrogen, and the estrogen tends to decrease the signals to the testes, which increase the sperm."

The other problem is that fat enveloping the scrotum elevates the temperature, affecting manufacturing of sperm. "The testes are in the scrotum because it's cooler there, which works better for sperm production," Dr. Kauma explained.

Though he was most interested in getting healthy and living long enough to raise a child, Phillip McIntyre said he had been told by two doctors that his fertility would be improved "and it was in the back of my mind that it would help."

Dr. Courcoulas also said she has "a couple [male patients] in the works right now [with improved fertility] as one of the reasons they're pursuing surgery."

Weight loss achieved through diet or a preferred combination of diet and exercise also would improve fertility, but, Dr. Kauma said, "90 percent of people who diet have trouble keeping it off. ...

"The most successful way to lose weight and keep it off for good is gastric bypass or banding."

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Woman has gastric bypass surgery, changes lifestyle and loses 125 pounds

Mt. Vernon, IL

A couple of years ago, Brittny Knight decided once and for all that she wanted to lose weight. Now that she has lost 125 pounds, Knight said she continues to work toward her goal in order to live life to the fullest.

Knight said that when she was younger a childhood disease caused her to gain weight. Although she received leg surgeries, Knight continued to play sports in middle school and high school. About 10 years ago Knight said she lost a substantial amount of weight, but later in her career, it was harder to remain active with her traveling job.

“With the job I wasn’t really able to exercise and I grabbed fast food a lot so I put the weight back on pretty rapidly,” Knight said. “I was tired of being unhappy, depressed and not as outgoing as I once was. I just wanted to get this weight off and be more active in live again – live life again.”

At this point, Knight decided to have gastric bypass surgery at St. Alexius Hospital in St. Louis. Although she said this surgery is not a “cure-all,” it did serve as “a little boost to get me in the right direction.”

“I kind of thought, ‘If I have this surgery it’s going to end it all,’ but that’s not necessarily true,” Knight said. “There are stipulations you have to go by. Exercise, eating right and changing my whole mental outlook on making myself healthy is what got me where I am.

“It’s a complete mental overhaul with yourself and you have to make it work. If you’re not in the right state of mind, you’re not going to be successful.”

To help reach her goal, Knight joined Curves and said she continues to work out four to five times each week. Knight also exercises by walking on weekends and throughout the summer.

Knight also eats healthier now and keeps a mental note of what she eats each week. If she’s having a craving for something like chocolate, Knight said she buys a Reese's candy bar but will only eat half. Knight noted she has also incorporated more protein into her diet, and is careful about dishes covered in cheese or sauces, and salad toppings such as croutons and dressing.

Sometimes when she goes to restaurants, Knight laughingly said she is reminded of Meg Ryan in “When Harry Met Sally” when she is ordering food and takes awhile because she’s very particular about what she wants.

“Everybody says that keeping a journal of what you eat and how much you exercise during the week is a good way to keep track and it helps you in losing weight,” Knight said. “I’ve tried keeping journals and diaries but I get kind of busy and lose track. I do keep a mental thought in my head as to what I’ve eaten and where my calories are for the day.”

Knight said that observing what she eats and how often she exercises each week also helps her when she is having a hard time losing weight. If she skipped a workout or ate something not as healthy, Knight knows how to change the next week in order to stay closer to her plan.

Throughout her journey, Knight has found it’s important to put yourself first at times in order to maintain a healthy lifestyle.

“Losing weight is something that someone must be really serious about,” Knight said. “Sometimes you have to let certain things go and say “no” once in a while to take care of yourself. If you’re not healthy, you’re not going to be able to take care of people around you.”

Eventually Knight would like to participate in a 5K or 10K walk, and she is also aiming to lose 50 more pounds. Along with support from her family, friends and coworkers, Knight said watching TV shows including “The Biggest Loser” has motivated her to reach her goals.

“It’s been an inspiration to see that they were where I was and had some of the same emotions I had about myself,” Knight said. “Watching them get to their goal weight and succeed makes me want to do even more for myself, too. Even though I’m not going to win $250,000, it’s just all about the self-esteem and the energy. I already feel like I’ve won some type of lottery anyway because I feel so much better about myself, and doing this has made me much stronger.”

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Three Illinois sisters lose over 300 pounds after gastric bypss surgery

Joliet, IL

One sister bikes, one walks the trails and one works out on the treadmill.

All of them now living healthier and happier lives after undergoing bariatric weight loss surgery at Silver Cross Hospital last 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,” Sandra Schmidt said. “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 held at Silver Cross.

“This was a great way to learn about the entire process,” Andrea said. “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.”
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Their surgeon Dr. Christopher Joyce and his partner, Dr. Brian Lahmann, have performed over 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 Hospital's program has a 0 percent operative mortality (death) rate and an extremely low complication rate. And patients lose an average of 86 percent of their excess body weight within 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," Pamela said.

"Obesity is a medical condition, just like heart disease or diabetes,” Dr. Joyce stresses. “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,” Pamela said.

“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 40s being overweight,” Sandra said. “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,” Dr. Joyce. said. “Their new passion for life truly shows when you talk with them.”

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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."

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Man says he dodged death by losing 430 lbs., going from 640 to 210

New York, NY

Today is the first day of a year that Ernesto Suncar and his doctors feared he might never see.

Weighing 640 pounds, wearing 10X shirts and with a 70-inch waist, the 33-year-old New Yorker was told by doctors he would likely be dead within 12 months.

Realizing it was a choice between losing weight and dying, the proud father of three, who had tried every diet imaginable, underwent gastric bypass surgery - and has shed more than two-thirds of his former self.

"I want people to feel inspired when they look at me," says the Hell's Kitchen resident, who's down to 210 pounds. "Hopefully, if they have a weight issue, they will finally do something about it, starting right now.

"Losing this weight saved my life. Without the operation, I doubt I would be here to celebrate New Year's.

"It's scary to think what might have happened."

The business management student says his body ballooned after he came to the U.S. from his native Dominican Republic at the age 7.

"I was a normal, active kid who used to run and play outdoors in the tropical climate," he recalls. "When we moved into a small apartment where it was cold, I stayed inside and didn't get any exercise.

"The only games I played were video games."

His love of chow didn't help. He would gorge himself on Spanish-style fried pork chops, rice and plantains, McDonald's, pizza and pasta.

"My mom would tell the guys at the corner deli not to serve me, so I'd just walk to another block," Suncar admits.

He once lost 64 pounds on a 1,800-calorie-a-day diet, but then gained 120 pounds. At his heaviest, the 6-foot-2 food junkie tipped the scales at 640 pounds.

"My little son had to tie my shoelaces," he says. "I poked fun at myself, but inside I was hurting."

The turning point came when chronic breathing difficulties and the immense strain on his heart threatened to kill him.

"The doctor said, if I carried on as I was, I would be dead in a year," Suncar says.

Dr. Elliot Goodman, chief of bariatric surgery at Beth Israel Medical Center, performed the gastric bypass.

There were minor complications, but this winter, after following a nutritious eating plan and increasing his fitness at the gym, Suncar has reached - and maintained - a healthy weight.

His waistline has shrunk to 34 inches and, instead of having to buy expensive outsize clothes on the Internet, he shops for stylish gear at The Gap.

"I feel reborn," he says. "These days I can cycle along the Hudson River, play with my kids and this summer, I'm planning on taking a flight. Before, I couldn't have fit in an airline seat.

"I keep some of my old things in my closet to remind me of how I used to look. But there's no going back."

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Gastric bypass surgery resolves diabetes in teens

Los Angelos, CA

Teenagers who undergo gastric bypass surgery are often immediately relieved of Type 2 diabetes, according to research published today in the journal Pediatrics.

Studies on adults with Type 2 diabetes show that gastric bypass can result in disease remission or better disease control. However, this study is the first to explore the effects of the surgery in children. The study examined adolescents with Type 2 diabetes, which is usually related to obesity and is being diagnosed with alarming frequency in American children and teenagers.

Dr. Thomas Inge, director of the Cincinnati Children's Surgical Weight Loss Program for Teens, studied 11 extremely obese teens with Type 2 diabetes who had gastric bypass surgery and 67 obese teens who were receiving medical management for Type 2 diabetes. Among the 11 teens who underwent surgery, all but one had a remission in diabetes. The response was so rapid, the patients often discontinued medication for diabetes control before leaving the hospital after surgery. These teens lost an average of 34% of their body weight one year after surgery. In contrast, the teens who were medically managed did not have any weight change after one year and were all still taking medication for diabetes. The adolescents who had surgery also had improvements in blood pressure, cholesterol and triglyceride levels.

"The results have been quite dramatic and to our knowledge, there are no other anti-diabetic therapies that result in more effective and long-term control than that seen with bariatric surgery," Inge said in a news release.

Inge and his co-authors noted that future studies will be needed to track the long-term health of teenagers who participated in the study. Cincinnati Children's Hospital is home to a study funded by the National Institutes of Health that will collect and report outcomes on 200 teens undergoing weight-loss surgery nationwide.

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New Weight-Loss Surgery Helps Keep It Off

Miami, FL

New Surgical Tools Allow Surgeons To Reduce The Size Of The Pouch And Stomach Through The Patient's Mouth Without Making Cuts

Each year 200,000 people have gastric bypass surgery, and while about 15 percent of them will regain the weight, there's a new procedure helping those patients get back on track.

Suyin Marti is 42 years old, and had gastric bypass surgery 12 years ago. Her weight has been a lifelong battle.

"I gained weight and I lost it so many times over. A hundred pounds I gained and lost three times. Each time I would gain all that weight back and more," admitted Marti.

The weight is back again, and Marti blames family tragedy and the medication she's taking for depression contributing to her gain.

"Everybody always has the license to tell you how heavy you are but they don't know what it is to have this disease," Marti tearfully proclaimed.

Dr. Nestor de la Cruz Munoz is helping patients like Marti take back control of their lives by introducing them to the Rose procedure.

"It's a new procedure that we're going through the mouth rather than having to go through the abdomen with a camera and a transport system that allows us to put stitches in from the inside instead of from the outside," explained Dr. de la Cruz Munoz.

The Rose procedure restores the patient's pouch and stomach to match original post surgery sizes. That's important because scar tissue in the abdomen could complicate surgery for these patients.

Patients will spend one night in the hospital and wake up with a sore throat but no abdominal pain. They can return to normal activities in a day or two. Still, the doctor said patients still need to exercise and attend support groups for the entire process to work.

"We know that none of the surgeries cure obesity. They're just tools that you have to use. So if you don't use the tools correctly they're not going to work for you long term," warned Dr. de la Cruz Munoz.

Marti is prepared to do what it takes to lose the weight and regain her health. "I'm hoping they can go ahead and do the revision and take out the band and fix the problem that I had originally and it will help me lose the weight," said Marti.

The procedure is not currently covered by insurance, and can cost up to $12,000.

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Stanford study: Gastric bypass may boost smarts

San Francisco, CA

In the United States, with most Americans overweight or obese, the demand for gastric bypass surgery is booming. The procedure often results in dramatic weight-loss, but a study now suggests it could also lead to increased brain power.

Stanford researchers found that gastric bypass surgery improved a patient's ability to remember, think through problems, and pay attention to details. The findings were reported Tuesday at the American College of Surgeons annual meeting held this year in San Francisco.

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Study: Gastric bypass not effective diabetics

San Francisco, CA

Gastric bypass has helped thousands of people effectively lose weight, but a new study finds diabetics who undergo the surgery are less likely to see good results.

Researchers at the University of California San Francisco studied over 300 gastric bypass patients a year after their procedure.

They found patients with diabetes were unable to lose more than 40-percent of their excess body weight.

Researchers believe the medications diabetics take like insulin actually stimulate the body's production of fat and cholesterol.

They say changes in the use of these medications could give diabetics a better chance to achieve better weight loss results after gastric bypass.

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Could gastric bypass surgery cure diabetes?

Raleigh, NC

Gastric bypass and other surgeries have become a popular way for the obese to lose weight. The procedure has also proven effective at curing diabetes.

Mary Stanford weighed 300 pounds four years ago and was a Type 2 diabetic. Gastric bypass surgery helped her lose 140 pounds, and her diabetes disappeared almost immediately.

“(It was) definitely a relief. Your sugars are normal, you don't have to worry about testing every day (and) you don't have to worry about remembering to take your medication,” she said.

Some doctors are considering gastric bypass for a larger number of diabetics.

“We now have sufficient evidence that gastric bypass can improve diabetes dramatically,” said Dr. Francesco Rubino with the Weill Cornell Medical Center in New York.

There is an obesity threshold. Someone who is 5 feet 8 inches tall has to be at least 230 pounds to get the surgery. Rubino said he planned to begin a new study, performing the surgery on patients about 30 pounds lighter.

“We're going to compare surgery [with] conventional medical treatment to understand whether surgery might be preferable in this subset of patients,” he said.

Researchers say it's not just the weight loss that rids the body of diabetes. The surgery might also spark hormonal changes in the body.

“A large number of people with diabetes will see their diabetes drop off within days to a few weeks after the bypass, long before they've lost much weight,” said Dr. David Crumpler, an endocrinologist.

Experts say they believe it's possible that the surgery could even help diabetics who are just overweight and not obese.

“We have to be very cautious and do more studies before we offer surgery to everybody,” Rubino said.

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Gastrc byass surgery last resort after pills, diets

Lumberton, NC

Bernice Wilson sits in a hospital bed, listing the names of the diets and pills she’s tried in attempts to lose weight over the years.

The words trip off her tongue as though she’s naming her children: Slimfast; Weight Watchers; Atkins; South Beach; D-12; Adipex; Phen-Phen; Xenacal.

She’s sure there are more, but she can’t remember them all.

Now she’s trying something else — the laparoscopic adjustable gastric banding procedure, or lap-band — in which a band is wrapped around the upper part of her stomach to control the amount of food she can eat.

Wilson, who is 54, was the first person to undergo the procedure at Southeastern Regional Medical Center on Aug. 15.

Dr. Barry Williamson, who performed the laparoscopic surgery, said 30 patients are already lined up to receive it. He expects to do about three surgeries a week, or more than 150 a year.

The surgery is not cheap. At Southeastern Regional, lap-band costs between $15,000 and $20,000, depending on the length of hospital stay and other factors. It also doesn’t include the surgeon’s fees, said Faith Ferguson, bariatric program coordinator at the hospital.

Weight-loss surgeries, such as gastric bypass and gastropexy, can cost $30,000 or more in the United States. In some cases, insurance will pay for a portion. Medicare will pay when a hospital has been approved as a Bariatric Center of Excellence, Ferguson said.

Being obese can be even more costly.

Williamson estimated that it costs about $18,000 a year, per person, in doctor and hospital visits, diet plans and dining out, as well as the side effects from diabetes such as long-term dialysis resulting from kidney failure.

Fresh start

For Wilson, health concerns were only part of the reason she decided to have the procedure.

Mostly, she just wants a fresh start — a chance to try for a better life.

Wilson has been overweight for more than 30 years, since she had her twins. As she’s gotten older, it has been harder to lose weight, she said.

“When you hit your 40s and 50s, man, this stuff is like glue,” she said.

The excess weight has caused health problems such as high blood pressure. Wilson said she worries about developing diabetes like her grandmother, who eventually went blind after her kidneys failed.

“I want to get off the blood pressure pills,” Wilson said. “Stuff really hides in this fat — diseases, illnesses.”

But she also wants to lose weight and experience the little things about life that she quit enjoying years ago.

“I want to walk up steps and not be out of breath,” she said. “I just hope I keep losing forever and ever. As long as I’m maintaining that healthy weight, I’ll be satisfied.”
Staff writer Jennifer Calhoun can be reached at calhounj@fayobserver.com or 486-3595.

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Student will be first adolescent to have gastric bypass as part of UM Health System program

Ann Arbor, MI

She wants to shop for a prom dress, buy clothing at a regular mall store and walk easily across the stage on graduation day.

"I don't want to wheeze when I grab my diploma," said Sarah White, 16, of Vandercook Lake. "I don't want to graduate in a really large gown."

With more than 410 pounds on her 5-foot, 4-inch frame, the Vandercook Lake High School junior is desperate to lose the weight that for years has restricted her activities, drawn sneers from some classmates and compromised her health.
About gastric bypass surgery

The surgery changes the anatomy of a patient's digestive system to limit the amount of food that can be eaten and digested. It redirects food to bypass most of the stomach and flow directly into the middle of the small intestine, which limits calorie absorption. The surgeon uses staples to create a walnut-sized pouch at the top of the stomach that holds about an ounce of food and sews part of the small intestine directly onto the pouch. Risks include death, blood clots in the legs, leaking at the staple lines in the stomach and dumping syndrome, caused by stomach contents moving too quickly through the small intestine. The syndrome causes diarrhea, abdominal cramps, vomiting, sweating and dizziness.

— Source: Mayo Foundation for Medical Education and Research

She is scheduled to undergo gastric bypass surgery Tuesday at C.S. Mott Children's Hospital at the University of Michigan in Ann Arbor. White will be the first adolescent to have the weight-loss surgery as part of the UM Health System's new Pediatric Comprehensive Weight Management Center program.

"Her health is so significantly affected that surgery is warranted," said Dr. Susan Woolford, a university pediatrician and the center's medical director.

The university set up the family-focused program a year ago to combat the growing problem of childhood obesity. White entered in February 2007 when she was at her peak weight of 423 pounds, said her mother, Patricia White.

Sarah White revamped her diet and started exercising more, but did not lose much weight due to underlying health conditions, including a thyroid problem, Woolford said.

The surgery, which restructures the digestive tract and shrinks the stomach to limit the intake of food, is becoming increasingly common among teens as more struggle with obesity. But it still is not performed often, doctors said.

Some children's hospitals do not offer the surgery, and Woolford said she doesn't know of gastric bypass ever having been performed on an adolescent at UM.

According to medical literature, there are concerns about the long-term effects and the ability of pediatric patients to give informed consent to an invasive procedure that involves a lifetime of follow-up care and dietary restrictions.

"I had no other option," said White, who with support from her mother made the decision to go ahead with the procedure despite some early reservations.

"I was scared about all my intestines looking like a modern-day Picasso," she said Friday at the high school. She plays clarinet in the band, belongs to Students Against Destructive Decisions and said she has a 3.79 grade point average.

She had some qualms about the permanency of the surgery, "But it's either face up to eternity or die at 20," she said.

Fighting the weight

For years, White's weight-loss attempts have failed.

"I remember in elementary school, she bought salads and white milk or water when she bought lunch every day; that didn't work. She walked three miles a day and that didn't work," said her friend, Kelsey Weathers, 16, a diminutive girl who has been friends with White since kindergarten.

White once joined Weight Watchers with her grandmother, but said it seemed weird to be with a group of older women. She didn't lose weight, became frustrated and quit.

She weighed 6 pounds, 13 ounces at birth but quickly gained weight, developing faster than average children, her mother said.

Sometimes it is just easier and cheaper to eat at McDonald's than buy healthier foods, said Sarah White, who listed her weaknesses as Mexican food and pizza. At times, she struggled with emotional eating, but wasn't the type who raided the refrigerator at night, her mother said.

"Her body just doesn't metabolize the food," Patricia White said of her daughter, who was diagnosed at an early age with a type of hypothyroidism, meaning her thyroid gland doesn't produce enough of certain hormones, which impact metabolism.
By Dave Weatherwax | Jackson Citizen PatriotSarah White collapses her head on her mother's shoulder, Patricia White, after finishing her workout Friday afternoon at Planet Fitness of Jackson.

Both sides of her family have overweight members, said Patricia White, whose brother had gastric bypass surgery about two years ago. "She is genetically screwed."

Her daughter was obese by age 8, said White, a single, working mother who is both fiercely protective and proud of her daughter.

The two are clearly close and tease each other continually.

Friday, Patricia White razzed her daughter about her weight-induced spinal curvature, calling her Quasimodo.

"Well, he got the girl in the end, so there is hope for me," Sarah White countered, smiling.

Struggling with pain

The surgery is expected fix some of her problems, such as the curvature and the weight-related pain she feels in her back and knees.

At 8, Sarah White was diagnosed with type 2 diabetes and metabolic syndrome, a cluster of conditions that occur together and increase risk of heart disease, stroke and diabetes.

The excess weight has affected her self-esteem, her friends said. She regularly endures strangers' stares. It also makes school occasionally difficult.

Though White is witty, reads regularly and impresses friends with her vocabulary, her classmates haven't always been accepting, she said. "Especially in middle school, when everyone is discovering the opposite sex."

She cried often then.

Before she got involved with the program at UM Health System, which taught her to change some of the behaviors that contributed to her weight issues, she said she felt like a panda.

"All I did was sit around and eat and look cute," said White, who likes pandas and has many stuffed versions of them in her oriental-themed bedroom.

By the time she got to high school, things got better as the focus turned to academics.
More info

For more information about the University of Michigan's Pediatric Comprehensive Weight Management Center, visit www.med.umich.edu/MPOWER

"I've always been the smart fat kid, which is better than just being the fat kid," said White, who speaks openly and often comically about her situation.

"What I can't do physically, I make up mentally."

Her band director, Chip Williams, called her a "very good student."

"She is one of my top players," he said after class Friday.

However, White said she cannot both play her clarinet and march because it requires too much air and energy.

Her size keeps her from sitting at classroom desks. Instead, she sits at a table outside the rows other students fill.

For school dances, she has worn a purple pin-stripe suit. "It is hard to be girly in this body," she said.

A new chapter

She is looking forward to shopping for a prom dress after her surgery, which could help her lose 100 pounds by her birthday in January.

Her goal is to lose at least 200 pounds.

The surgery is about 90-percent successful in spurring and maintaining weight loss, said Dr. Henry Buchwald, professor of surgery at the University of Minnesota in Minneapolis, who has specialized in metabolic or bariatric surgery for decades.

The mortality rate in surgery is about 0.5 percent, he said.

Long-term effects of the operation on teens have not entirely been explored because the surgeries have been performed for about 20 years. But the procedures have held up over five-, 10- and 20-year periods, Buchwald said.

"What we hope we are doing for these adolescents is giving them time. Obesity is a fatal disease," Buchwald said.

The Tuesday surgery likely will keep White in the hospital for a week and a half, she said.

Her diet will be seriously limited in the weeks after surgery, as it has been in the weeks leading up to surgery.

For lunch Friday, she ate applesauce, a protein shake and yogurt, in compliance with a liquid diet she has been required to follow since Aug. 26.

To avoid temptation, all solid food has been removed from the house, Patricia White said.

After surgery, patients have to stay on course and maintain healthy life style habits to be successful, Woolford said. "Weight-loss surgery is not a magic bullet."

White has made the necessary changes, including incorporating physical activity into her weekly schedule, Woolford said, and has a strong family support structure.

She is rarely, if ever, negative, her friend Weathers said.

Some of the dietary restrictions have been difficult, Sarah and Patricia White said, but the payoff will be worth it.

"It's a small sacrifice to live longer," Patricia White said.

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Teens turning to gastric banding weight-loss surgery

Wilmington, DE

Gastric banding isn't just for adults anymore -- many young obese patients at Alfred I. duPont Hospital for Children have found the procedure a success.

For most of her young life, forgetting to eat was not something Nicole Herman ever worried about. She often woke up with hunger pangs so intense they made her nauseous.

But these days, Herman has to remind herself to grab breakfast. Otherwise, it may be the afternoon until she gets those familiar stabs in her stomach to signal her body needs food. That feeling of always being hungry is gone.

So is 77 pounds -- and counting -- from her 5-foot-3 frame. After spending most of her teen years trying to lose weight, Herman has finally found success by exercising, watching what she eats -- and by having a silicone band inserted around her stomach to restrict the amount of food she can eat.

The 19-year-old college sophomore is one of 11 teenage patients who have undergone gastric banding surgery at the Alfred I. duPont Hospital for Children in the last year. The hospital is one of four nationwide participating in a five-year study by the Food and Drug Administration to evaluate the safety and effectiveness of gastric banding, also known as LAP-BAND, in teens.

"I wanted to have it done because I've been overweight ever since I was little," said Herman, who lives in Middletown when she's not attending the University of South Carolina in Columbia. "I had it done in hopes of trying to lose weight and keep it off."

Of the patients who have had the gastric banding procedure at A.I. duPont -- including Herman -- all have had similar levels of success with weight loss, said Dr. Kurt Reichard, a pediatric surgeon who performs the minimally invasive procedure at the hospital. About 50 more children ages 14 to 17 are in some stage of preparation for the surgery.

Although the LAP-BAND can radically change the life of a morbidly obese teen, it's not for everyone, Reichard reminds prospective patients and their families. The actual surgery is only one aspect of a multidisciplinary weight-loss effort that also includes psychological counseling, fitness assessments and training with an exercise physiologist, and extensive education in food nutrition with a registered dietitian before and after the operation.

"It's about what the kids can do for themselves," said registered dietitian Michell Fullmer, who works with teens in the weight management program. "The LAP-BAND, it's not a magic bullet. It's a tool. I hope we give them what they need to use this tool well."

For Herman, it was the right tool at the right time. After years of yo-yo dieting and feeling frustrated by her lack of success, she was ready for the challenge. "I realized it would be a big life change, but I was ready," she said. "I realized I have enough self-discipline to make this work."
A national problem

Nationwide, more than 1 million teens -- about one in six -- are obese. The effects of carrying that extra weight are more than just bigger waistbands. Many obese children also have other health problems such as diabetes, high blood pressure, sleep apnea and even worn-out joints.

The majority of obese teens can lose the extra weight through a combination of diet and exercise. But when an obese person becomes more than 100 pounds overweight, they are considered morbidly obese, and for them, it's much harder to lose the weight through traditional means.

Fortunately for Herman, she never suffered from high blood pressure, diabetes or other associated health problems. She ate well and got regular exercise as a dancer. "I was a healthy fat person," she said.

But she also has Ehlers-Danlos syndrome, a connective-tissue disorder that affects the joints and makes them more prone to dislocation. She has undergone 12 surgeries to address tissue and joint problems. Her most recent was this summer on her right ankle.

While the Ehlers-Danlos isn't directly affected by her weight, the excess pounds put pressure on her joints. For that reason, any weight loss would help her.

Still, losing weight proved to be a challenge over the years. By the time Herman was 9, she was considered obese. The last time she and a friend could wear matching clothes was the fifth grade. Among her family, she was the only one with a weight problem.

As a teenager, Herman tried Weight Watchers, Jenny Craig and NutriSystem. Such diets worked in the beginning, but soon she got bored and hungry. "It was like a roller coaster," she said. "I think probably I got frustrated with not succeeding."
'Off-label' use in teens

Gastric banding was approved by the FDA in 2001 for use in adults. In teenagers, it's considered an "off-label" use, meaning the operation wasn't intended for that purpose. The FDA trial, in which duPont Hospital is participating, aims to discover if gastric banding can be an effective tool in helping morbidly obese teens shed the weight that threatens to shorten their lives.

In the cases where gastric banding may be an option for teens, their youth may actually be a benefit. "Although there's a perception that teenagers are noncompliant and uncooperative, I don't find that to be the case," Reichard said. "Kids are more open to lifestyle changes."

Health professionals don't know what kind of long-term effects await obese teenagers as they age, particularly if they have other health problems, Reichard said. That's why it's important for them to try to lose any amount of weight they can.

Earlier this summer, Morgan Stanley Children's Hospital of New York-Presbyterian released preliminary data showing that teens who underwent gastric banding had improvements in their obesity-related medical complications just six months after the operation. The six boys and eight girls in the study lost an average of 20 pounds and saw significant reductions in abdominal fat, triglyceride and blood-sugar levels. Their liver function also improved.

Some of the teens who saw improvements in their blood-sugar and cholesterol levels didn't have excessively high numbers to begin with, said Dr. Ilene Fennoy, a pediatric endocrinologist with New York-Presbyterian, which is also part of the FDA study. That their health data were already within a normal range and still improved reaffirms that weight loss has beneficial effects beyond dropping a few clothing sizes, she said.

More data are needed to fully understand the benefits of gastric banding in teens and what potential long-term effects may result, but so far the results are mirroring the success found in adults, said Fennoy, lead author of the study and clinical professor of pediatrics at the Columbia University College of Physicians and Surgeons.

"This is early on but it's reassuring," said Fennoy, who presented the results in June to an annual meeting of the Endocrine Society in San Francisco. "It's showing we're already seeing changes in [symptoms of other ailments], even with not a huge amount of weight loss."
Making it work

In April 2007, after not finding success with any other weight-loss plans, Herman and her parents attended an informational meeting on gastric banding at A.I. duPont. She wasn't immediately sold. She was hesitant about having an operation to help her eat less, but the healthy eating and exercise components convinced her it could work if she believed in what she was doing. Her parents and friends pledged their support no matter the outcome.

"It helped that everyone was behind me on this," she said. "My family, especially my mom, has been so supportive of me."

Although her daughter has an outgoing personality, Sue Herman knew there were occasions where she felt singled out because of her size. She also she worried that her daughter's weight would impede her success in college and beyond.

"To watch her struggle was hard," she said.

When Nicole said she wanted to consider LAP-BAND, her mom went online and looked up information about the procedure. After extended discussions with the family's insurance company, which eventually agreed to cover the cost of the operation, they decided to pursue it.

Gastric banding works by making the stomach smaller. Unlike gastric bypass surgery, the stomach is not cut. Instead, a silicone band -- about the size of a shower curtain ring -- is inserted laparascopically around the top of the stomach. The band creates a small, egg-sized pouch for food consumption. It can be tightened or loosened by adding or removing saline solution into the band.

Compared with other weight-loss operations, gastric banding is less invasive. It also can be reversed, unlike gastric bypass surgery, which cannot. Still, like any operation, gastric banding carries some risks, including infection at the site of the incision. Gallstones also can occur in patients who undergo the surgery. Once the band is inserted, there is a small risk that it can slip out of place and cause pain and discomfort.

After the band is on, patients usually can eat only about 4 ounces of food at a time, far less than what they had been eating. Most of their meals are high in protein to prevent the loss of muscle mass. One of the first signs of not eating enough protein is hair loss, but later on, lost muscle mass from protein deficiency can effectively halt calorie loss.

Fullmer, the dietitian, holds monthly information meetings for prospective patients considering gastric banding. She said the first question asked is usually about the post-surgery diet.

"When I pull out a plate of what their diet is going to look like after surgery, I routinely get a gasp from the whole audience," she said. "It's sort of disbelief."

The first week after surgery, Herman was on an all-liquid diet while her swollen stomach adjusted to the band. She was still eating only liquids when she moved into her dorm. For the first months, she ate most of her meals in her room. She shared details of her surgery with only a few close friends.

Nowadays, a typical breakfast for Herman is a container of yogurt mixed with protein powder. Lunch may be a salad with half a piece of chicken. Dinner is a small portion of chicken or fish and vegetables. Post-surgery, she discovered she can no longer eat red meat, bread or rice because it upsets her digestion. She takes vitamin and calcium supplements to get enough nutrients and omega-3 fatty acids.

In addition to changing her diet, Herman has made exercise a priority. At school, the pre-med major fits in a workout no matter how crammed her schedule is, penciling it in as she would a class. The importance of working out was hammered in by exercise physiologist Lauren Falini, who tells patients exercise will not only help them lose weight but tone their bodies.

"Exercise is the other half of the equation," said Falini, who has patients keep track of their workouts with an exercise log. "It's about energy in and energy out."

The weight started disappearing rapidly within a month of Herman's surgery. By the time she stepped off the plane to visit her family in October, she was 40 pounds lighter. And she had already reached her first goal -- to fit in a size 18 pair of American Eagle jeans, something she had never done.

For Sue Herman, who hadn't seen her daughter since she left for college, the sight of her trimmer daughter was more than she expected.

"Beforehand I thought, 'What am I going to say if she's the same size? How am I going to inspire her to keep going?' " she said. "When I saw her, I couldn't stop looking at her."
A new person -- on the outside

Reichard attributes the early success of the gastric banding program to the extensive preparation the teens undergo before the procedure. Teens participating in the study spend about six months learning how to eat better, move their bodies more and understand the underlying emotional issues that may affect their success at keeping the weight off long term.

"We spend a huge amount of time getting to know them and their environments," he said. "It's the most important part of the program."

As part of the preparation, teens are expected to lose or maintain their weight before they have the gastric banding done. When the time comes for surgery, they must write a letter to the team requesting the procedure and laying out the reasons why they're a good candidate.

Working with the therapists in the weight management program, teens begin to realize the impact of the lifestyle changes they're incorporating, said Meredith Lutz Stehl, a clinical psychologist who works in the program. They begin to feel they have control over their weight, provided they follow the steps outlined by the weight management staff.

"It's such a crucial time to be able to get some hope, to believe they can feel like they can make some changes," Lutz Stehl said. "It's such a pivotal time for that, as opposed to people who have perhaps waited until their 20s or 30s to consider this."

In her letter, Herman spelled out some of the challenges in her path -- her Ehlers-Danlos, heading to college and adjusting to dorm life. But it's clear those are just small hurdles she intended to overcome.

"When I first heard about the LAP-BAND, I was a little skeptical and I wondered if it would really work and how hard it would be," she wrote. "You all changed that for me and made me believe that if I really want this as bad as I do, that I can work hard and get to where I want to be."

A year later, there's no denying Herman has changed from the 291-pound young woman who used to succumb to aching hunger pains. Now down eight pant sizes, she shops with friends at Old Navy and American Eagle, stores she bypassed on the way to plus-size clothier Lane Bryant. At her latest doctor's appointment this month, she weighed 214 pounds, down another 25 pounds from when she left school in May. She hopes to lose enough to wear a size 12 or 14 pants, about two sizes away.

Her megawatt smile is the same as it was before, but there's a new confidence that radiates from her, a self-assuredness strengthened by her weight-loss success. She feels healthy, strong, energized.

"Being overweight wasn't a big thing in my life. I've never wanted to be a size 2," she said. "I've always felt pretty good in my own skin."

But even she's surprised sometimes by the changes she sees.

"You catch a glimpse of yourself in the mirror, and you can't believe it's really you," she said.

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Risks of gastric-bypass surgery are often underplayed, some experts say

Greenwood Lake, NY

Despite the growing popularity of obesity surgery, it’s no easy path. Four in 10 patients developed complications within the first six months, according to one study.

Eileen Wells was smiling as she was wheeled into surgery. She was too excited to feel nervous. At 38, she was about to get “a new lease on life,” she says, echoing jargon in weight loss surgery ads. She had seen the before and after pictures in celebrity tabloids, watched the TV infomercials, listened to the patient testimonials and researched online. She was ready to begin her own transformation. At 5 foot 3 and 290 pounds, she was sick of being fat. Her joints ached. Her feet hurt. A stroll through the mall near her home in Greenwood Lake, New York, was enough to leave her sweat-slick and gasping for air. She was anxious to say good-bye to sleep apnea and dieting, ready to take control. And so in March 2005, Wells underwent a laparoscopic gastric bypass. She was grinning right up until the anesthesia knocked her out.

From the menu of weight loss (bariatric) operations, Wells had chosen the Roux-en-Y bypass, the most popular option in the United States. The surgery sectioned off her stomach to a thumb-sized sac — sharply limiting the amount of food Wells could eat — then connected it to a deeper portion of her small intestine, to limit absorption of the calories she did consume. (An increasingly popular alternative, gastric banding, cinches in the stomach to restrict its capacity.) The rearrangement required Wells to radically overhaul her eating habits. She learned to eat tiny, frequent meals, cutting her food into pencil eraser–sized bites. On her doctor’s orders, to replace nutrients no longer absorbed by her digestive tract, she faithfully swallowed a multivitamin, calcium and B12 supplements and two protein shakes daily. Soon she resembled the women in those weight loss infomercials: Fifteen months post-op, Wells had lost an amazing 160 pounds — more than half her body weight — bringing her down to a trim 130.

But although Wells looked like a satisfied customer, she didn’t feel like one. Seven months after surgery she had developed an agonizing ulcer on the new inner seam between her stomach and intestine, which required a second operation. Not long afterward, Wells recalls eating a bite of tuna steak her husband, Ron, had prepared and doubling over in pain; an ambulance rushed her into surgery yet again, this time for an intestinal hernia — her bowel had snagged on a slit in her abdominal wall. A fourth procedure followed to ease the pain of the abdominal scarring from her previous surgeries. Meanwhile, Wells’s gastrointestinal pain had become so severe that she could barely eat. One day while shoe shopping, she realized she couldn’t flex her right foot. Within weeks her limbs began to tingle, her energy evaporated and her weight plummeted. She stopped menstruating. By late 2006, Wells had shrunk to 105 pounds.

Read more, "Risks of gastric-bypass surgery are often underplayed, some experts say"

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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.

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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.

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Can gastric bypass cure diabetes?

San Francisco, CA

A new study is trying to learn whether a surgery meant to cure obesity, could also cure the symptoms of diabetes, even if the patient isn't overweight. It's a strategy that's not without controversy.

Pat Prescott is fighting to control her type 2 diabetes. She carries her blood glucose meter, a cooler for her insulin and gets regular exercise through ballroom dancing.

Still she says her symptoms have been getting worse.

"It just doesn't work anymore," said Prescott.

So when she learned that a surgery used to treat obesity has the side effect of improving diabetes, she approached her doctors, but was told she wasn't overweight enough to qualify.

Now, she's hoping to join a new clinical study, headed by surgeon Francesco Rubino. He is testing whether that same surgery, similar to gastric bypass, can improve diabetes in people who aren't obese.

"We're shifting towards a new concept, which is using surgery to intentionally treat diabetes," said Dr. Francesco Rubino from Weill-Cornell Medical School.

As he documented in the Journal Diabetes Care, when obese patients have surgery that bypasses part of their small intestine, their symptoms often disappear within days, long before they begin to lose weight.

"With some operations like gastric bypass or similar procedures, the remission of diabetes symptoms is very quick after surgery, which even precedes the weight loss," said Dr. Rubino.

In fact, researchers have known about those effects for several years. But offering gastric bypass to non-obese diabetics is controversial.

"I think it has no place outside of obesity surgery," said UCSF professor of endocrinology Dr. Robert Lustig.

Dr. Lustig says diabetes can be caused by combination of factors, including the health of beta cells, the agents in the pancreas that produce insulin.

"Diabetes is a complex disease. If you have a problem with your beta cells, then doing a bariatric surgery isn't going to rescue you," said Dr. Lustig.

Still, patients like Pat Prescott may have a part in testing the theory. Recruitment for the study begins this fall.

"I want to live long enough to enjoy my grandchildren. I want to keep dancing, I like to dance," said Prescott.

It's significant to note that the type of gastric bypass being tested in the study is performed on the small intestine, which has a complex role in how the body processes food.

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48 year-old father dies 5 weeks after gastric bypass surgery

Manchester, UK

An obese father of two died after suffering complications from surgery to help reduce his weight, a coroner has ruled.

Gary Cooper, 48, of Ashton-under-Lyme, Manchester, died five weeks after having gastric bypass surgery last October.

The "gentle giant", who was believed to have weighed around 26 stone, had the NHS-funded operation at the private Alexandra Hospital, Cheadle, on October 14 last year.

Mr Cooper was released from hospital four days later despite being breathless and in agony, the inquest at Stockport Magistrates' Court heard.

The following day, he was rushed to Tameside General Hospital after his condition deteriorated and, the next day, he had an emergency operation to repair two leaks in his stomach.

Nine days later, he had a second operation to repair a third leak and, after a brief spell in intensive care, appeared to be recovering well.

However, on November 22, the day before he was due to be released and the date of his wife Sonia's birthday, he collapsed and died.

Coroner John Pollard said he had doubts about the way the risks of surgery were explained to Mr Cooper by his surgeon, Bart Decadt.

He said: "I am satisfied that these risks were discussed, but I am left with a remaining doubt as to whether they were perhaps addressed by Mr Decadt in a rather light-hearted way and the real risk may not have had as firm an impression in the mind of Gary Cooper as ought to have been the case to enable him to make a fully considered and informed decision."

Mr Pollard said he intended to ask the Alexandra Hospital to review its patient discharge policy and to report back to him.

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Post-gastric byass body lift surgery, only way to lose excess skin

New York, NY

Tipping the scale at 330 pounds, 47-year-old Cindy Schreiner decided to get gastric bypass surgery in 2002.

“I was downtown on 9-11,” Schreiner recounted. “And I couldn’t run … I had a colleague pulling me down the street saying come on, you can run, you can run and I just thought, I can’t move anymore and I was so huge.”

It was turning point for Schreiner, who has lost 185 pounds to date.

But working out daily and changing her eating habits has not helped Schreiner obtain the body she has always wanted.

“I would grab the skin and go I want this gone,” she told FOXNews.com. “Because I had worked so hard to lose the weight and I didn’t see all the benefits because the skin was hanging.”

Click here to watch Schreiner tell her story.

Dr. Lyle Leipziger, chief of plastic surgery at Long Island Jewish Medical Center and North Shore University Hospital, said weight loss surgery is only half the battle for patients like Schreiner.

The majority of patients have excess skin, which could weigh five to 10 additional pounds. As a result, psychological and physical issues often plague patients after weight loss surgery.

“We've had patients that have excess abdominal skin almost hanging down to their knees,” said Leipziger, adding that the skin sometimes makes it difficult for patients to walk or move. “Patients can come in and sometimes they can get infections in the area underneath that abdominal extra skin.”

Body lift surgery was the answer to Schreiner’s problems. Sort of like a tummy tuck for your whole body, Leipziger said, a body life is the only way for these patients to get rid of the extra, baggy skin.

“You feel self-conscious about it,” she said. “You feel like you have, you’re flattening it, pushing it down … to hide it.”

But even with surgery, results do not happen overnight.

“The patient should have most importantly realistic expectations, understand that we can do a lot, we can’t turn people into supermodels, but we can certainly improve their appearance and quality of life.”

Schreiner has undergone five body lift procedures to contour her tummy, breasts, outer thighs, buttock and back. With one more surgery left to go, Schreiner is excited to finally have her "dream body". “I feel like I’ve been given a new life,” admitted Schreiner. “I’ve always dreamt of looking like this. I really did. And it’s like, I’m here.”

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Soprano Deborah Voigt lost 120 pounds after gastric bypass surgery

New York, NY

Deborah Voigt chuckles when I ask her about the brouhaha over the skimpy frock she couldn't fit into that delighted the often dull world of grand opera.

In 2003 Voigt was obese, as she herself admits, and was dropped from a revival of Richard Strauss's ``Ariadne auf Naxos'' at the Royal Opera House in London. ``Inappropriate casting in this particular production,'' said the house, and paid off her contract.

In Christof Loy's staging, the character of Ariadne wears a silky and close-fitting outfit, and is required to roll on the floor. In fairness to the Royal Opera, Voigt had been booked to sing before the staging had been designed.

``In terms of the production, it was the right decision to drop me from the role,'' says the American soprano with a shrug. ``I still think it could have been worked through however. We could have come to a mutually satisfying result.''

When Voigt went public, the media had a field day about the rights and wrongs of realism in opera. The uproar became known as ``the affair of the little black dress.''

Voigt, 47, is now 120 pounds lighter after gastric bypass surgery, and has been invited back to London to sing Ariadne in the same staging. The soprano says she hopes that certain ghosts now will be laid to rest. More >>

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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

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Gastric bypass surgery expands life for entire family

Yuma, AZ

Betty Lee used to weigh 245 pounds; her sister-in-law, Jean Ferguson, weighed 226 pounds. Both can recall painful memories that caused them to feel ashamed as children and adults.

"I've been heavy all my life ... I can remember in high school ---- when you choose teams for basketball or baseball ---- I was among the last because I was always heavy," Ferguson said.

For Lee, the most painful memories are of people ignoring her. "They ignore you because they are embarrassed for you. That is what I found more than anything. They think to themselves, 'Oh that person could lose weight if they really wanted to,' and they don't understand how difficult it is."

But after having gastric bypass surgeries, Lee weighs 120 pounds and Ferguson weighs 180.

Lee and Ferguson are among 10 members of an extended family who underwent the procedure. Ferguson says all 10 agree that it is one of the best things they could have done for themselves.

Ferguson's three daughters, one granddaughter, two nieces and one nephew all had the surgery.

Lee had her surgery in April 2006 at the Alvarado Hospital Medical Center in California. So did Ferguson, who went through her surgery in January.

Lee's bypass surgeon was Julie Ellner, a bariatric surgeon at Alvarado Hospital. Through an e-mail, Ellner described how the surgery is done.

"The stomach is divided into two sections, creating a 'top' piece that is the size of a golf ball that receives the food. The rest of the stomach remains in place but is no longer attached to the 'new' small stomach ---- it is traced down to the next part of the digestive tract, called the small intestine. The small intestine is then attached to the 'new' small stomach to catch food.

"A very small amount of food will completely fill the 'new' stomach, and the person feels full immediately. When the food passes into the small intestine, the hormonal craving for food decreases and the brain's desire for food shuts down."

Lee and Ferguson both say they went through the surgeries for health reasons.

Lee had the surgery "because I had become borderline diabetic and my blood pressure was going up. I was getting into a very unhealthy category."

"The reason I did it," said Ferguson, "is because I'm on high blood pressure medicine and was borderline diabetic ... I could feel myself slowing down as I aged, and I thought to increase my health and longevity for life, I needed the surgery."

Now two years after her surgery, Lee says she feels like a new person.

"I lost more than half of my body weight, so I can walk and exercise. I went back to work after being retired for 12 years. You have energy (and) you feel good."

Although the surgeries were a success for Lee and Ferguson, Lee wants people to know that bypass surgery is a tool and not a cure for obesity.

"Of course you have to eat properly," Lee said. "There are certain rules to the menu that you have to maintain, and vitamins that you have to take.

"You have to take vitamins and you have to drink water, and you have to exercise, and no snacking. If you follow those guidelines you will be successful," Lee said.

"The surgery is not a quick fix and the patients need to be motivated" before the surgery, Ellner said. "If not, then I don't operate on them."

Ellner performs around 200 surgeries a year, and the candidates have to be 90 pounds over their ideal weight. She also has "long conversations" with her patients to inform them about certain side effects that come with the surgery.

"Complications can be caused by not following instructions," Ellner said. A leak between the stomach and the intestine can develop, or a pulmonary embolism can be caused by a clot that forms and goes to the lungs. Because of these risks, Ellner gives two-hour seminars on obesity, how the surgery is performed, the risks and benefits of the surgery and who would be a good candidate for the surgery.

The best patients are willing to make the commitment by researching for themselves what the surgery involves, Ellner said.

Ferguson's husband, Phil, who was 67 when he went through the bypass surgery, used to weigh 265 pounds and now weighs 180.

"I'd do it again if I had to. My wife is the 10th person in the family to have it done," Phil said. "It's good for your health, and if you got certain problems, it will relieve them."

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Is gastric bypass surgery a cure for Type 2 diabetes?

Greensboro, NC

When Dr. Enrico Jones became so overweight he could no longer work in his yard, he underwent bariatric surgery.

He expected to lose weight, and he has — 70 pounds. But he also has gotten other benefits.

In particular, combined with a diet he began before surgery, the procedure has left his Type 2 diabetes in remission. He no longer needs to take medicine to control it.

That's important because Type 2 diabetes, the most common type, can lead to blindness, kidney disease, heart disease, nerve damage and other problems. In North Carolina, the incidence of diabetes more than doubled in the past decade; more than 9 percent of the state's population now has the disease.

Researchers are now looking at whether a particular type of bariatric surgery, the gastric bypass, can be used as a direct cure for Type 2 diabetes in people who are not overweight. That's because some patients who have undergone gastric bypass surgery have seen their Type 2 diabetes disappear almost overnight.

Cris Clark of Greensboro had the procedure in December 2006. At the time, she weighed 298 pounds and suffered from Type 2 diabetes and high cholesterol, itself a risk factor for heart disease. She was taking medications for both conditions.

Her weight gradually receded to its present 180 pounds. But she was able to stop taking her diabetes and cholesterol medicines immediately.

"The day right after the surgery, I wasn't on (them) anymore," she said.

Other bariatric patients who have undergone a different procedure, in which a silicone band is wrapped around the stomach to reduce hunger — "lap band" surgery — have found that their diabetes comes under control more gradually as they lose weight. That's what happened with Jones.

How does gastric bypass affect diabetes? Researchers suspect that the answer has to do with hormones. Research with rats in which their upper small intestines were bypassed — also bypassing the pancreas, which produces insulin — found that the procedure eliminated Type 2 diabetes almost immediately. When the procedure was reversed, the rats developed diabetes again.

It is not clear whether the procedure could be used as a direct cure for Type 2 diabetes in people. The United States currently does not allow bariatric surgery on people who are not overweight. But clinical trials in Brazil are beginning to see whether such surgery can eliminate Type 2 diabetes in people who are not overweight.

"This requires much more research, which all the (medical) societies are doing," said Dr. Kristen Earle, a Greensboro bariatric surgeon. "It's an interesting finding, but it's very early. … Whenever you put a first study out there, you have to say, 'OK, what's your five-year data? What's your 10-year data?'"

Lisa White is a believer. The Gibsonville woman had lap-band surgery in 2007.

Although she did not have diabetes, both her parents did, and before the surgery, her own blood-sugar levels were approaching diabetes level. Now, they're normal.

But weight loss and diabetes control weren't the only benefits, she found.

Before surgery, her blood pressure had been 140 over 90 even with medication. Now, she says, it is 120 over 75, within the normal range.

"I'd do it again tomorrow," she said about her surgery.

Jones still has to take medication, but now his blood pressure is under control. Before the surgery, it wasn't.

He also no longer experiences the joint problems that led to his needing a hip replacement when he was still in medical school.

The painful bone spurs he used to develop in his feet are a thing of the past.

The benefits of bariatric surgery go well beyond simple weight loss, medical researchers have found. And that's good because obesity has become so common and the risks associated with obesity are so great.

About 15 percent of adult Americans were obese in the late 1970s, the U.S. Centers for Disease Control and Prevention found, but that figure had more than doubled by 2004.

In addition to high blood pressure, Type 2 diabetes and high cholesterol, obesity can increase the risk of heart disease, stroke, gall-bladder disease, sleep apnea and some cancers.

Researchers also believe that if obese people lose a significant amount of weight, they are at reduced risk of cancers of the kidney, breast, colon, liver, pancreas, ovaries, esophagus and gall bladder.

Weight loss from bariatric surgery also can eliminate sleep apnea, a condition in which a person stops breathing in his sleep multiple times during the night.

Sleep apnea doesn't just cause poor sleep. It also puts people at increased risk for heart attacks, strokes, high blood pressure, obesity and diabetes.

Weight loss from bariatric surgery can even reduce the incidence of erectile dysfunction and other sexual problems in obese men, new research suggests.

The benefits of bariatric surgery are not widely spread so far because only about 1 percent of Americans who are eligible for bariatric surgery have had it, CBS' "60 Minutes" has reported. It can cost $25,000 or more, and insurance doesn't always cover it.

But Jones found his procedure worthwhile, in part because he's back working in his yard. He has always loved doing that, but in the summer of 2006 he realized he had grown so heavy he no longer had the energy.

Now, since losing those 70 pounds, "my feet don't hurt anymore, and I'm back to cutting my grass."

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Knoxville woman undergoes sleeve gastrectomy, very pleased with results

Knoxville, TN

Sara Trombley tried every kind of diet on the market. She did Weight Watchers, liquid diets, and pills. Nothing seemed to help her lose weight and keep it off. She began researching surgery options. She was originally a lap-band patient, but then learned about the gastric sleeve procedure. Sara also says she had to overcome her mental issues in regards to eating.

"I struggled with binge eating disorder for a few years and that's when my weight I almost doubled my weight," she says.

The new procedure is called a sleeve gastrectomy and it involves removing part of the stomach. Dr. Mark Colquitt is one of the first physicians in East Tennessee to perform this new procedure. "You cut the stomach and you remove the bottom half and what's leftover is a sleeve," he explains.

Sara had the surgery in February of 2008 and is very pleased with the results. "I've lost 45 pounds and I couldn't have done that with any diet," she says. "I have confidence that it is going to stay off I'm not constantly scared that if I look at a bag of chips the weight is going to come back on."

Dr. Colquitt says the surgery isn't as risky as gastric bypass but some patients can benefit more than others. "Anybody who meets certain criteria as far as weight generally, you are looking at someone who is 100 pounds overweight. We used a scaled called BMI weight and it has to be 35 or greater."

Sara is pleased with her results since the sleeve procedure but says success starts in the mind. "I think the most important thing is to address any mental emotional issues you have with food. You have to get those taken care of or our not going to be successful for me it's the most important thing."

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Doctor recommends gastric bypass as way to prevent diabetes

New York, NY

Research shows weight loss surgery may be able to completely reverse Type 2 diabetes, as close to 90 percent of those with the disease are overweight, but the numbers of people getting the surgery are still small. NY1 Health & Fitness reporter Kafi Drexel has more on why this may be and what doctors are hoping can be done about it.

Before undergoing gastric bypass surgery, Judy Grant, 58, was 306 pounds and suffered from Type 2 diabetes. Now a year later, she's more than 100 pounds lighter and all signs of Type 2 are gone.

"I wasn't insulin dependent yet, but that was coming," she said. "And I knew that I was quickly approaching that because I was just having so much trouble and it took so much to manage me and I was thinking, 'If I continue on, where will I be?'"

Obesity is a leading cause of Type 2 diabetes. Doctors say weight loss surgery, also known as bariatric surgery, works because it leads to long-term weight loss, which helps lower blood sugar levels. Some of the latest research shows that diabetes goes away in many patients who undergo gastric bypass even before they start losing significant amounts of weight.


"In more than 434 patients who underwent gastric bypass, 89 percent of those have completely eliminated diabetes," said Dr. Piotr Gorecki. "We still call it suppression, rather than a cure, because still certain factors may be important there. But for practical reasons, they do not take their medicine, their glucose levels are normal, and they do not have any other features of diabetes as a disease."

Gorecki points out even those patients who are not "cured" so-to-speak are seeing significant improvements.

Despite the successes, there are still relatively few people undergoing the procedure. Guidelines from the National Institutes of Health, written nearly two decades ago, say only the morbidly obese should be eligible, possibly putting up roadblocks for potentially millions of mildly obese patients who could benefit.

Doctors, like Gorecki, who see the benefits in patients say it is time those guidelines start to be re-evaluated.

"Since both of these diseases, obesity and diabetes, are so prevalent and are so epidemic on such a large scale, this will be a major issue for insurance companies, for all third-party payers, including the government, for medical and surgical societies to come up with new guidelines," he said.

But with no plans in the works to revise guidelines, doctors or patients will probably not see any change to guidelines overnight. They say the hope is that continued evidence pointing to improved health benefits will change the outlook.

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UC Irvine tests VBLOC implant

Irvine, CA

A weight-loss device placed under the skin is being tested at UC Irvine, KNBC's Dr. Bruce Hensel reported.

College student Jeff Collins, 24, has struggled with his weight his entire life despite trying everything from dieting to weight loss drugs.

"I've been fat, thin, fat, thin, all my life," Collins said.

When medication failed Collins, he considered gastric stapling or bypass until he heard the downsides.

"I went to an information session with 100 other people. They said there was a 1 percent mortality rate with the operation, and I looked around the room and realized one of us in this room would die. That scared me," Collins said.

What didn't scare Collins was a study at UC Irvine on a new weight loss device called VBLOC.

"The VBLOC's completely different. It doesn't alter the anatomy. It doesn't restrict the quantity of food you eat. Essentially, it actually inhibits the signal that runs between the stomach and the brain," said Dr. Ninh Nguyen of UC Irvine Healthcare.

According to VBLOC researchers, two tiny parts are placed under the skin. One turns the other on and it blocks signals to the nerve, which may control hunger signals to the brain.

Results have varied and the device's makers said, "The results of this study and this patient are not a claim for the potential effectiveness of VBLOC Therapy."

Although Collins had his procedure in January, both he and the researchers don't know if he's in the active group that had the device turned on or the inactive group

"I think it is on," Collins said. "I feel a change in my eating habits. I mean, before the surgery I could go to McDonald's and get a super-sized meal and eat all of it and still not feel full. Now, if I try to order it, I feel full before eating everything."

"Some preliminary data from outside the U.S., particularly Australia and Mexico, have shown that the excess weight loss at about six months is relatively good, (and) about 22 percent of excess weight loss at six months," Nguyen said.

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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."

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StomaphyX: Gastric bypass surgery without the incision

Miami, FL

Doctors have announced a ground-breaking procedure. It allows them to perform surgery without making an incision, anywhere. CBS4's Dr. Sean Kenniff explains how it works.

Darlene Dillard lost 100 pounds with gastric bypass. But like 1/4 of people who undergo obesity surgery, a few years later she started to gain weight back.

"I had gained about 30 pounds outside of my range of weight," said Dillard.

Instead of operating again, doctors did something drastically different. It's called Stomaphyx--a natural orifice surgery.

"It is going to be a totally different new era of surgery," said Dr. Michel Gagner from Miami's Mount Sinai Medical Center.

He says it really is a surgical revolution -- with no incisions surgical instruments are inserted through natural orifices. In this case: Darlene's mouth, to make her stomach pouch smaller.

CBS4's Dr. Sean Kenniff said natural orifice surgery isn't limited to obesity procedures. Doctors are now perfecting techniques to treat everything from appendicitis to cancer."

"Removal of part of the liver, removal of adrenal, removal of part of the stomach, doing bowel connections," explained Dr. Gagner.

And many other procedures are being performed through the rectum, esophagus and vagina.

" It's just the beginning, it's going to explode in the next five years, you're going to be hearing a lot more about this," said Dr. Gagner.

With Darlene's weight loss, her medical problems disappeared.

"There was borderline diabetes, borderline hypertension," explained Darlene. "I had stress fractures of my feet."

And she hopes the new no-incision surgery will keep the pounds, and those problems away.

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What to do when gastric bypass surgery obesity fails

Los Angeles, CA

The number of people getting obesity surgery has more than doubled in the past eight years. But the highly popular and risky procedure doesn't always work for everyone. So can these patients be helped? One local doctor offers a high-tech solution.

When 47-year-old Patricia Weiss gets on a scale these days, she smiles.

"I've lost about 35 pounds since I had it. It's been a year almost a year," said Patricia.

It's been a year since her second time around with an obesity procedure. The first time was in 2002 -- Patricia underwent a gastric bypass and lost 150 pounds. But then the weight started to creep back on.
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"I put on about 30 to 40 pounds, and I said, 'No, no, going the wrong way.' I didn't do all this to have this come back," said Patricia.

In 2007, there were about 160,000 to 200,000 gastric bypasses performed -- that's at least double the number performed in 2000. Of those surgeries, doctors say about 15 percent fail.

Often patients regain because they start to over eat again and stretch out their reconstructed pouch. Patricia went to see Dr. Jeremy Korman. He says standard x-rays and endoscopes don't give doctors the whole picture and this makes it difficult to proceed. He says he may be the only surgeon in the U.S. to use the 64 slice CT scan technology on obesity surgery patients.

"Now once we understand accurately the size of the pouch, we can plan what kind of operation would be appropriate, what size of revision operation is appropriate," said Dr. Korman.

Dr. Korman says he can either redo the original surgery, implant a LAP-BAND to restrict the pouch growth, or perform a new minimally invasive endoscopic procedure in which he sews up and shrinks the pouch from the inside.

Patricia opted for the LAP-BAND. More >>

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Gastric bypass surgery shows promise for treatment of diabetes

Washington, D.C.

Rocco Turso was injecting himself with insulin three times a day, swallowing pills twice daily and restricting his diet. But his diabetes was still out of control, blurring his vision, making his feet numb and sapping his energy. So he decided to try an experimental operation. Within days, his blood sugar was normal and he was off all his medications.

"It's been truly amazing," said Turso, 62, a construction superintendent from Harrison, N.Y. "I use the word 'miracle.' The diabetes was killing me. It's given me back my life."

Turso is one of a handful of Americans who have undergone a novel procedure that proponents say appears to offer the most important advance since the discovery of insulin in treating one of the most common chronic diseases.

"It's extremely promising," said Madhu Rangraj, chief of laparoscopic surgery at the Sound Shore Medical Center in New Rochelle, N.Y., who performed the operation bypassing part of Turso's small intestine in March. "It's a surgical solution to diabetes."

While many surgeons share Rangraj's enthusiasm, and some diabetes experts agree that the operation and similar ones may lead to fundamental new insights into the disease, other experts remain cautious. Much more research is needed, they say, to validate the effectiveness of the procedures. They worry that the operations will start to proliferate before their long-term safety and effectiveness have been proven, as often occurs with novel surgeries.

"I'm skeptical," said R. Paul Robertson, president-elect of the American Diabetes Association. "It bothers me to see this message being put out there that we can now cure diabetes through surgery. They have to prove that to me."

Turso's operation is a variation of a procedure developed to treat severe obesity. Known as bariatric surgery or gastric bypass, the standard operations reduce the size of the stomach and bypass part of the intestine. That limits the amount of food a person can eat and the calories that can be absorbed. The procedures have soared in popularity as the obesity epidemic has spread and clinical trials have validated their safety and effectiveness. More >>

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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 >>

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Philadelphia woman found it took more than a gastric bypass procedure to maintain her weight loss

Philadelphia, PA

IN THE PAST few years, bariatric surgery, otherwise known as gastric bypass or gastric banding, has become all the rage.

With 65 percent of Americans either overweight or obese, according to the federal Centers for Disease Control, it's not surprising that many people are electing to have this procedure done.

After all, post-procedure weight losses range from 60 to 80 percent of excess body weight in patients with a body mass index of 35 to 60, over the first two years. That could roughly equal a loss of 80 to 150 pounds, depending on your original weight.

Undoubtedly, weight-loss surgery guarantees permanent weight loss, right?

Well, perhaps . . .

Melissa Blanco, 32, once carried a whopping 274 pounds on her 5-foot-4-inch frame. But the Philly native shed 130 pounds after having the gastric bypass procedure.

"I did Weight Watchers, Jenny Craig, and the weight-loss program at the University of Pennsylvania, and had some success to some degree, but could not maintain it. I started feeling tired and wobbly. I knew something had to change," Blanco said.

So, in the winter of 2005, after doing some research, she decided to have gastric bypass surgery that reduced her stomach to the size of an egg. More >>

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Virginia woman dies, contracted human variant of mad cow after gastric bypass surgery

Portsmouth, VA

A 22-year-old Virginia woman suspected of having the human variant of mad cow disease died at 5:30 p.m. Wednesday, The Virginian-Pilot reports.

Doctors suspect Aretha Vinson contracted Creutzfeldt-Jakob Disease shortly after she had gastric bypass surgery three months ago. The disease, which affects roughly one-in-a-million people, is a degenerative and fatal brain disorder linked to tainted medical instruments and certain medical procedures, as well as to contaminated beef.

Vinson’s health began to deteriorate just after she had the surgery. The Portsmouth, Va., resident's motor skills and memory had faded and she became unconscious and died at the Bon Secours Maryview Medical Center.

There is no treatment or cure for the disease.

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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.

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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.

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Would you get gastric bypass surgery, Lap-Band surgery?

From CNN - Paging Dr. Gupta

A few weeks ago, a good friend told me that she'd be getting a Lap-Band procedure done.

She told me about her upcoming weight-loss surgery over a sushi lunch and very excitedly explained all aspects of the procedure. It would be minor surgery -- minimally invasive, take about an hour, no major side effects, covered by insurance for a mere co-pay of $20.

She wouldn't need to stay overnight in the hospital, she told me, but her doctor liked to be safe. "I have the same doctor as Al Roker for when he had it done," she added.

To be honest, I was stunned, when I know I shouldn't have been. After all, we do weight-loss stories of all kinds as part of the Fit Nation series. Lap-Bands, which restrict the size of the stomach, really do work for a lot of people. In fact, in a January issue of the Journal of the American Medical Association, one small study found that 75 percent of people who got Lap-Band surgery experienced a remission of their type 2 diabetes -- possibly because of fewer calories being consumed. In the group that just tried diet and exercise, only about 14 percent experienced remission. More >>

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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 >>

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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.

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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 >>

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Gastric bypass surgery Part I: A big risk

Orlando, FL

Monica Ramos lost about 200 pounds the hard way. In 2004, a doctor stapled her stomach and rerouted her intestines.

She underwent gastric bypass surgery. 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 's worth the risk. More >>

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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 >>

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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 >>

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Montana Health Watch | gastric bypass surgery

Billings, MT

In the last few years, more than two hundred severely overweight Montanans have undergone gastric bypass surgery at St. Vincent Healthcare in Billings.

The surgery changes lives but it's not as easy as it looks.

Julie Lovell introduces us to two sisters from Miles City; who found it takes perseverance, family support and a sense of humor to succeed after gastric bypass surgery.

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Carnie Wilson on gastric bypass surgery & pregnancy

Carnie Wilson on what should come first, Gastric bypass surgery or pregnancy.

A lot of people struggle with weight, and Carnie Wilson is no stranger to that battle. She was very public about her decision to undergo gastric bypass surgery years ago. After a successful surgery and great results, she found herself pregnant and gaining weight again. Is it wise to undergo gastric bypass before having children? Carnie speaks out. More >>

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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 >>

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Despite risks, gastric-bypass surgeries soar

Orlando, FL

Gastric-bypass procedures can be effective -- but require a lifelong commitment.

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 Orlando 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 pa- tients.

If current trends continue, she will be busy. More >>

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Gastric Bypass Surgery on Again for 500 lb. Florida Man, New Insurance Covers Bariatric Surgery

Orlando, FL

Neal Pittard, the dangerously overweight Longwood man who came within 3 1/2 weeks of gastric-bypass surgery last summer, is still waiting for the procedure that he and his doctors think will save his life.

Pittard's plight was chronicled earlier this year after Florida Hospital's in-house insurance company refused to cover the procedure. Florida Hospital offers gastric-bypass surgery at its Celebration Health campus, touting the procedure as "the only proven consistently effective treatment for morbid obesity."

Pittard, who is 34 and weighs 500 pounds, was insured through his wife, then a nurse at Florida Hospital Orlando. His doctors strongly recommended gastric-bypass surgery for Pittard, but Florida Hospital's insurance policy does not cover it.
More >>

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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 >>

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Carnie Wilson: Life after Gastric Byass Surgery

New York, NY

Carnie Wilson sat with down with TODAY’s Hoda Kotb and Natalie Morales on Tuesday, cradling a cup of coffee — and thinking about all the things she could eat with it.

“It will always be a battle,” she said in reference to her lifetime war with her weight and an addictive personality that also led her on the road to alcoholism. “I’m a little up right now,” she went on, talking about her weight. “I go a little down, a little up.” more >>

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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 >>

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Gastric bypass surgery gives 38-year-old new opportunities

December 1, 2007

Four years ago, Wendy Juliano struggled with health problems and could barely walk up a flight of stairs or bend over to tie her shoes, all because of her weight.

The Gilbert 38-year-old wanted her life back. So in March 2004, she underwent gastric bypass surgery, which created a small stomach pouch to restrict her food intake.

At 5 foot, 4 1/2 inches tall, she went from 290 pounds to her lowest at 123 pounds.

She was able to stop taking her heart and asthma medicine, stopped her breathing treatments and has a renewed sense of energy and self-worth.

“I’m a full-time wife, full-time student, full-time employee, full-time mom and full-time grandma,” said Juliano, who is due in March with her third child. more >>

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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."

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LAP-BAND(R) System Weight-Loss Surgery Associated With More Than 70 Percent Reduced Risk of Death in People With Severe Obesity

November 21, 2007

About Obesity

In the United States, obesity is considered the second leading cause of preventable death (7). Further, research has shown that individuals with a BMI of 35 or more have a reduced life expectancy of nine to 13 years (8). A BMI of 35 or more translates to a weight of 200 pounds or more for a woman of average height (5' 4") when ideal weight at this height is considered to be 140 pounds, and to a weight of 250 pounds or more for man who is six feet tall when ideal weight for this height is considered to be 177 pounds.

About the LAP-BAND(R) System

The LAP-BAND(R) System was approved by the FDA in June 2001 for severely obese adults with a Body Mass Index (BMI) of 40 or more or for adults with a BMI of at least 35 plus at least one severe obesity-related health condition, such as Type 2 diabetes, hypertension and asthma. Used in more than 300,000 procedures worldwide, this simple reversible surgically implanted device has safely helped severely obese adults successfully achieve and maintain long- term weight loss.

The LAP-BAND(R) System was developed to facilitate long-term weight loss and reduce the health risks associated with severe and morbid obesity. Unlike gastric bypass, it does not involve stomach cutting, stapling or intestinal re-routing (9,10). Using laparoscopic surgical techniques, the device is placed around the top portion of the patient's stomach, creating a small pouch. By reducing stomach capacity, the LAP-BAND(R) System can help achieve long-term weight loss by creating an earlier feeling of satiety. The LAP-BAND(R) System is adjustable, which means that the inflatable band can be tightened or loosened to help the patient achieve a level of satiety while maintaining a healthy diet. It is also reversible and can be removed at any time.

Severely obese people who received the LAP-BAND(R) Adjustable Gastric Banding System to lose weight had a 72 percent reduction in their risk of dying compared to obese people who were not offered any specific weight-loss treatment, according to findings published in the December issue of the Annals of Surgery (1). The LAP-BAND(R) System was approved in June 2001 by the U.S. Food & Drug Administration for weight reduction in severely obese adults.

"This research is critical because it shows that people with severe obesity, who are known to be at a much higher risk than the general population for dying prematurely, may be able to significantly decrease their risk with laparoscopic adjustable gastric banding," explains Dr. Paul O'Brien, FRACS a study author from the Monash University Centre for Obesity Research and Education (CORE) in Melbourne, Australia, head of the Centre for Bariatric Surgery in Melbourne and the National Medical Director for the American Institute of Gastric Banding in Dallas, Texas. "What is also particularly compelling is that this study shows it is possible to gain a significant survival benefit without the risks associated with more invasive bariatric surgical procedures, such as gastric bypass." http://www.earthtimes.org/articles/show/news_press_release,228703.shtml

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Luqaimat Diet or Gastric Bypass Surgery

November 16, 2007

Thousands of obese people who had gastric bypass surgeries achieved long-term weight loss. In contrast, the majority of the millions who did dieting, exercise, and used weight-loss drugs failed to maintain their achieved new weights. The scientific reasoning for that observation was described in a medical article at New England Journal of Medicine, May 23rd, 2002.

British scientists found that hunger hormone (Ghrelin) blood levels were raised in those who perform dieting, while it was sharply low at those who had gastric bypass. The lead author David E. Cummings, MD, postulated that if we can block Ghrelin medically we will not feel hunger pains, hence will keep weight off for long. Gastric bypass surgery, works because of two reasons. First, it dramatically reduces the active gastric size to only 5% of the original pre-operative size; therefore, it reduces the food intake volume dramatically. Second, it suppresses the gastric mucosal cells secretion of Ghrelin, due to the contact of food with a very small gastric surface area. more >>

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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.

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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.”

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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

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Health Risks Remain After Gastric Bypass Surgery

Surgeons Urge More Post-Surgical Follow-Up of Patients

While gastric bypass surgery may help obese people improve their health by shedding weight, the procedure may have a darker flipside when it comes to patients' risk of death from suicide and a continued risk of heart disease.

According to a study published in the current issue of the journal Archives of Surgery, this increased risk may indicate that bariatric surgery patients may require more intense follow-up in the months and years after their procedures. More >>

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