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When Weight Loss Surgery is Warranted - Bariatric Surgery Pros and Cons

Susanna Sisson's picture
Weight Loss Surgery

Weight loss surgery isn’t for everyone; and it’s not a panacea, but there are cases in which surgery to improve health might be warranted. Losing weight is not easy. It takes vigilance and work. The list of diets most people have tried before they resort to more drastic measure is long.


For instance, my older sister went on her first diet at about age 6. She was what people called chubby or roly poly. The truth is she and the rest of the siblings were fat. My older sister was 27 and 270 pounds when she decided to have her stomach stapled, a surgery that is not always lasting because over-eating can cause the staples to pop out, or the remaining pouch can stretch, and the weight is regained. She did lose about 100 pounds, got married and started having children. After her first child it was difficult to lose the post-baby weight. In between the second and third child, she had a revision of her surgery during an emergency gall bladder surgery and afterward had minimal weight loss. The side effects of the initial surgery were extensive, including vomiting and tooth enamel erosion, adhesions, osteoporosis, and bone degeneration. The surgery was performed in the late 70’s and of course surgical procedures have improved, but she has about a 10 inch midline abdominal scar. She has now shrunk in height about a hand’s breadth because of the osteoporosis.

My brother was always big. He played football in high school, but wasn’t a muscled up kind of guy; he definitely had a spare tire around his middle. Over the next 30 years went on and off Weight Watcher’s, losing and regaining over 100 pounds. At 49, he passed away due to his size and complications of orthopedic surgery.

My younger sister was chubby as a kid, slimmed up in her late teens, then, began to put on weight until at her largest she was at least a size 4X. At 5 feet 4 inches tall everything she did at that weight was more difficult. In her late 40’s she decided to start a walking program, stopped eating after 7pm, and ate a low-fat diet. Over the next year, she lost enough weight that I was shocked when I saw her, but she never lost all the pounds and is still considered morbidly obese.

I began putting on weight when I was in third grade and by the time I was in 8th grade weighed almost 200 pounds. I decided to go on a diet and that summer lost about 35 pounds. At 18 I learned about high protein, low carb and got down to a size 11. I started lifting weights and running and eventually and although I gained weight with my two children, I was able to resume my activities and lose the weight. I ran 40-50 miles a week until an injury late 40’s but rehabbed and started running again. Most of my life I was much thinner than the rest of my family, but I had to work very hard to keep my weight in check. I also learned a lot about nutrition and supplements over the years. But all the knowledge, dieting and exercise in the world won’t help if one’s hormones are out of balance. It was almost impossible to find a physician that didn’t want to put me on anti-depressants or diet pills rather than treat the underlying issue which was my thyroid. In desperation I began doing research and found out how to correct the nutritional deficiencies and hormones, in order to begin losing weight again, but in one’s 50’s it is not easy.

I have known many people who thought bariatric weight loss surgery would be a not only a piece of cake, but a panacea. It’s neither as you can see from reading my sister’s story. I know many people who have had one type or another weight loss surgery and some are success stories and others are not. Most had a modicum of success with losing weight and almost all required plastic surgery to remove the excess skin.

On the other end of the spectrum, my friend Shirley who is a nurse was very obese when we were working together. She decided to have a gastric bypass a few years ago, and is the smallest she’s ever been in her life. She just turned 60 years old, is running marathons and looks amazing.

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What are the types of bariatric procedures?

• Gastric bypass - Minimally invasive laparoscopic procedure involving multiple areas of the abdomen - changes normal process of digestion – RAPID weight loss over 3-6 months then final weight loss at 18-24 months – Risk of dumping syndrome – Full recovery within 2-4 weeks - Not reversible

• Gastric banding - Minimally invasive laparoscopic procedure, no stomach stapling, cutting or intestinal re-routing – Slow and steady weight loss setting at final weight around five years after surgery - Implanted medical hardware can cause damage to stomach – No dumping syndrome - Band is adjustable – Full recovery within 2-3 weeks - Reversible procedure

• Sleeve Gastrectomy - Minimally invasive laparoscopic procedure requires stapling - About 50% of desired weight loss within two years; about 80% of desired weight loss at about three years – No dumping syndrome – Full recovery within 2-4 weeks – Not reversible

With all the surgeries, nutrition and supplementation is important to get the right nutrients. Bariatric clinics employ nutritionists who teach the importance of eating nutrient dense foods. Losing weight may alleviate the health issues associated with obesity such as high blood pressure, high cholesterol, and Type 2 diabetes.

No matter what road one takes to lose weight, it is a difficult journey and whether one loses weight through lifestyle changes such as diet and exercise, or those lifestyle changes combined with surgery, the right nutrition is still vitally important. For those considering surgery, while it does help, it is a tool to lose weight and not a license to eat badly. Clearly no one make the decision to have surgery to lose weight lightly, and hopefully if they go through that much risk, will make the most of the surgery and do what it takes to lose the weight and keep it off.