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[Guest guest]

Our health: Gastric bypass surgery is no sure-fire antidote for

obesity

Barbara Ilardi

Guest essayist

(November 28, 2005) — I thought it would by the answer to my

prayers. When my osteoarthritis was so severe that a mobility

scooter was my only way to get around, my orthopedic surgeon said he

would not attempt hip replacement surgery with my weight at over 300

pounds. That surgery on both hips was the only way I could regain

the ability to walk. So when my endocrinologist suggested I consider

gastric bypass surgery, I believed it was indeed the answer to my

prayers.

The path I had taken to reach that weight was typical of many. I was

obese as a child, an adolescent and an adult. I had lost and gained

hundreds of pounds through diet, exercise, protein drinks and drugs.

Each time I regained more weight and more quickly than the time

before.

My weight loss attempts and health problems qualified me for the

surgery, and I passed the required psychiatric evaluation to examine

my motives and likelihood of complying with the post-surgery

regimen. The doctor who was to perform the surgery outlined the

plan; his physician's assistant, who herself had undergone the

surgery more than 10 years before, was my primary information

source.

The limitations were severe. For six months after surgery, I could

consume only liquids. Then solids were introduced slowly. The

surgery also results in bypassing the gallbladder, so medication is

required for life to replace that organ's function, as well as a

daily multivitamin to replace what is lost as a result of the food

restrictions.

The surgery was successful, although the aftermath was painful and

the limitations difficult. There was no way I could eat more than

one-third cup of anything at a time. Any deviation, any carbonated

beverages, any sweets would result in severe pain, sweating,

diarrhea and eventual vomiting. But the weight came off very fast —

100 pounds in four or five months — and I was able to have both hips

replaced and regain some mobility.

However, within two years, I began to gain back weight — 70 pounds

over four years. I was stunned to realize this could happen and

raced for an appointment with the surgeon. I had not herniated —

broken the staples that create the stomach pouch — but I was one of

the patients who figure out a way to beat the surgery by eating more

often than recommended. They told me I had to exercise, watch my

diet and consider counseling. Where had I heard that before?

I also began to have lots of cavities all at once. Apparently the

vomiting after surgery can result in cavities just as it does for

persons who have bulimia.

I am stunned at the surge in popularity of this surgery. It is also

being marketed as a solution for obese adolescents. Do they and

their parents know about long-term effects of this surgery?

Was it worth it? Not to me. Surgery is billed as the last resort for

morbid obesity. When you fail at it, the self-loathing is even worse

than failing at dieting.

For some, this surgery results in long-term weight loss. However,

regaining the weight brings back all the pre-surgery health issues

on top of the surgery's side effects and lifelong regimen of

medications.

So before you take this step, talk to people who have done it. Find

out all about it, not just the successes. Get accurate statistics on

percentages of weight loss and weight gain, because you will live

with the operation's physical and emotional consequences forever.

It's not just another failed diet; it's an alteration to your body

and its functions with lifelong consequences.

And never, never believe it is the answer to your prayers.

Ilardi, of Pittsford, is a professor emeritus of sociology,

University of Rochester.