WLS is a lifetime committment

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From the Ft. Worth Star-Telegram:

Posted on Fri, Jan. 30, 2009

LIFETIME COMMITTMENT

By ROBERTA MALLARD

Melinda is planning her wedding for late summer next year. At 80

pounds overweight, she wants to slim down and fit into her four-sizes-

too-small wedding dress. She will use her dream gown as motivation in

what will be her first attempt at weight loss.

Chad just got back from the doctor. His blood pressure was

dangerously high, he was diagnosed as a Type II diabetic, and the

scale showed a shocking 420 pounds. He must lose 210 pounds.

With today's over-abundant sources of advice, ads and articles on

regaining normal weight and health, folks like Melinda and Chad have

multiple choices.

After consulting with a physician, they might choose to restrict

calories and increase aerobic and weight-bearing exercise, or work

with a nutritionist or perhaps submit to a bariatric procedure.

Bariatric surgeries include Gastric Bypass, (dividing the stomach

into a small upper pouch and a larger, lower pouch and rearranging

the small intestine to allow both sections to connect) and Gastric

Banding or Lap Band surgery (a gastric band, an inflatable, silicone

prosthetic device, is placed around the top portion of the stomach to

create a small pouch, usually by laparoscopic surgery).

O'Brien is director of the Center for Obesity Research and

Education at Monash University in Melbourne, Australia with

associations with The Institute of American Gastric Banding (True

Results) with offices in and Hurs, TX.

According to O'Brien, a patient like Melinda might be a candidate for

bariatric surgery because she is obese, but because she has not tried

nonsurgical, caloric restriction and exercise for three to five years

as a weight-loss method she is not eligible.

On the other hand, a man like Chad who is morbidly obese and has life

threatening conditions such as diabetes and high blood pressure is a

viable candidate even though he has been attempting weight loss for

only a year.

If Chad chooses gastric bypass, he should lose about 66 percent of

his extra weight in two years. He must learn to chew his one-half-cup

meals slowly and take special supplements as this operation

interferes with absorption of nutrients. If he chooses banding, he

will have the small meals and the weight loss will be slightly less

with fewer possible complications.

In both options, according to Dr. Augustus Lyon a surgeon with

Arlington Memorial Hospital, conditions like Chad's diabetes and high

blood pressure should abate by 90 percent.

Both surgeons agree that follow-up and commitment to the bariatric

lifestyle is critical. Post-operation patients are required to engage

in exercise and weight training to build health and muscle mass.

Since both bypass and lap band are permanent for lifetime, precluding

complications, yearly check-ups are required. These evaluations

determine general health and check for complications such as

nutritional deficiencies, adhesions, bowel blockages and lung or vein

problems.

Because weight loss is rapid, particularly with bypass, those who

have less elasticity in their skin may need plastic surgery to

correct the folds of skin which create huge upper-arm flaps and

stomach flaps which can hang down to the knees.

Chen, a plastic surgeon with Methodist Hospital, Fort

Worth, said that more patients are coming to see him as a result of

weigh-loss surgery.

Several factors contribute skin becoming loose, Chen said. " Age is a

factor as are genetics and how quickly the patient gained and lost

weight. Loose skin can lead to infection, bleeding and skin

breakdown, " he said.

Chen said that plastic surgery options may include breast

augmentation, face, buttock and thigh lifts, tummy tucks and upper-

arm skin-fold removal.

Lyons said that the benefits of bariatric surgery outweigh the risk

and said he chose the field because of the rate of success. He sees

folks, like Chad, who lose weight and become healthy again.

" My patients seem happy and excited, " said Lyons. " One of my patients

told me she was so excited to buy clothes at the Banana Republic for

the first time. "