& Joannie Dobbs Saturday
September 23, 2006
Weight-loss surgery comes with risks
If you watch the weight-loss infomercials on TV, you get the idea that many people are succeeding at losing weight. But, according to scientific studies, less than 5 percent of obese individuals are successful at maintaining that weight loss. As a consequence, surgical treatment of obesity, called bariatric surgery, is becoming increasingly common.
Since severe obesity is associated with many health risks, bariatric surgery is often considered to be a reasonable option when the risks of the obese condition are judged to exceed the risks of the surgery.
However, this can be a difficult judgment to make.
Question: What are the most common types of bariatric surgery?
Answer: The most common approach involves placing an adjustable band around the upper part of the stomach. This greatly restricts the amount of food that can be consumed. The band can be adjusted or surgically removed if necessary.
Other approaches to bariatric surgery are designed to restrict the amount of food that can be consumed and to reduce the ability of the intestine to absorb food components. This is done by rerouting a portion of the intestinal tract so that a part of it is bypassed -- usually the stomach and upper part of the small intestine.
With this treatment, only a small amount of food can be eaten at one meal, and the nutrients are poorly absorbed.
Q: What are the consequences of bariatric surgery?
A: Rapid weight loss is guaranteed but permanent weight loss is not.
Eventual regain of at least some weight usually occurs, and maintaining a reduced weight requires ongoing lifestyle and behavioral management.
The list of bariatric surgery side effects is extensive. A few of these include loss of muscle, food passing through the intestines too quickly, gallstones and additional surgery for gall bladder removal, and the effects of many nutrient deficiencies if the intake of food and supplements is not managed carefully.
Perhaps the most overlooked side effect is the loss of bone mass and increased risk of osteoporosis. Rapid weight loss by any means is known to be associated with bone loss, but the accelerated rate of loss caused by bariatric surgery greatly increases this problem. To compound this, the bypassed upper portion of the intestine is the part that absorbs calcium most efficiently.
Alan Titchenal, Ph.D., C.N.S. and Joannie Dobbs, Ph.D., C.N.S.
are nutritionists in the Department of Human Nutrition, Food and Animal Sciences,
College of Tropical Agriculture and Human Resources, UH-Manoa.
Dr. Dobbs also works with the University Health Service
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