WLS Info and data

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With more than 30 percent of Americans considered obese, a procedure

once reserved for few dangerously obese adults has ballooned in

popularity. But how safe is it?

Surgical weight-loss procedures were performed on nearly 200,000

Americans in 2005. Historically, gastric bypass surgery has been the

method of choice in the United States, but many physicians now claim

the " band " procedure is safer and just as effective, according to a

recent report in the New York Times.

Here's the rub: With the band, pounds drop off much more slowly and

Americans are impatient. The weight loss that can be achieved in one

year with gastric bypass takes five years with a band.

To partake of any weight-loss procedure, patients must have a body

mass index (BMI) over 40 or a BMI over 35 coupled with a weight-

related medical condition such as diabetes or high blood pressure.*

And while each these procedures may reduce the stomach to the size

of a coffee cup, they won't be effective if you re-fill the cup

hundreds of times a day!

What are your options for the surgical slim-down?

The Band: In this procedure, a " band " is placed over the top of the

stomach and inflated with saline to restrict the amount of food that

can enter and pass through the stomach. It's the preferred method in

Europe, but accounts for only 17 percent of weight loss procedures

in the United States. Weight loss is slower with the band, but the

procedure is fully reversible and has the lowest mortality rate (0.1

percent). The drawback: bands can erode over time and may need

adjustments to remain effective.

Gastric Bypass: The most common method in the United States, gastric

bypass (think stomach stapling) consists of stapling off a small

pouch from the rest of the stomach and connecting it to the small

intestine. The result: People can't eat as much because the pouch

holds less food and they absorb less of what they do take in because

part of the intestine is bypassed. Complications range from gas,

pain and diarrhea to malnutrition, osteoporosis and death (at a rate

of 2 percent).

Biliopancreatic Diversion/Duodenal Switch: With a 2.5 to 5 percent

mortality rate, this procedure is the riskiest in terms of death and

malnutrition. The switch preserves a valve that controls release of

food into the intestines from the stomach. And results are

astounding with 60 to 80 percent of excess pounds lost within a year.

-- Amy Paturel, M.S., M.P.H.

* To calculate your BMI, divide your weight in pounds by your height

in inches squared. Then multiply the result by 703.

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* Does not include all diets or weight-loss programs