Fw: [WLS-LGBT] Popularity of Obesity Surgery Makes Gains

November 30, 2003

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Popularity of Obesity Surgery Makes Gains

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" I had this thought: If I die on the operating table, having the

surgery to try to better my life, I thought it was a better thing to do than

to live the way I was living, which, in my opinion, I was kind of waiting to

die anyway, " he said.

By the tens of thousands, morbidly obese people who have failed

at diets, support groups and exercise programs are turning to surgery to

lose weight.

In 1998, there were 25,800 obesity-related operations, most of

them gastric-bypass procedures commonly known as stomach stapling. This

year, the American Society for Bariatric Surgery estimates 103,200

operations.

Questions about the risks and growing use of the procedures

surfaced in recent weeks after two patients in New England died during

stomach-stapling surgeries. However, obesity specialists say the procedure

is safer than it has ever been — and that is contributing to the growing

popularity.

And for most patients, the risk of not having the surgery is

greater.

" It's an operation that helps cure people of this disease which

is life-threatening. People see it as some type of cosmetic surgery, when

it's not. More patients die waiting for surgery than die after surgery, "

said Dr. Janey Pratt, a surgeon at the Massachusetts General Hospital Weight

Center in Boston, which does about 300 gastric bypasses a year.

The operation involves using staples or stitches to close off

part of the stomach to form a small pouch about the size of an egg, which

limits how much food the person can eat. A part of the small intestine also

is bypassed to reduce nutrient absorption.

Risks include wound infections, stomach leaks and occasionally

life-threatening blood clots.

The International Bariatric Surgery Registry estimates one in

1,000 patients will die within four weeks of the surgery, and three in 1,000

will die within three months. Some surgeons in the field put the fatality

rate as high as one in 100 who have the surgery.

Powers, 42, of Worcester, was lucky. Even carrying more than 400

pounds on his 5-foot-11 frame, he had not developed many of the common

ailments associated with obesity. Still, sleep was fitful, and walking,

particularly upstairs, was exhausting. And he lived in a fourth-floor

apartment.

Powers underwent laparoscopic gastric bypass surgery in May 2001

and now weighs 280 pounds. He believes the surgery likely staved off the

onset of diabetes, and he has had no complications.

Surgery is not used to treat minor obesity. Candidates must be

100 pounds above their ideal body weight and have failed at other attempts

at weight loss.

Still, an estimated 15 million people would qualify for the

surgery, said Dr. Shikora, head of bariatric surgery at Tufts-New

England Medical Center in Boston. Tufts, which has the city's largest

obesity surgery program, closed to new patients for nearly six months

earlier this year to catch up with its backlog of patients. At one point,

there was a waiting list of 500 patients, Shikora said.

" It's no longer considered snake oil or some out there treatment

that doesn't work, " Shikora said.

Many insurance carriers have started to cover the procedures,

finding it cheaper to pay for the surgery than treating obesity-related

health problems such as diabetes and high blood pressure. Companies continue

to feel pressure to cover more obesity surgeries, but are cautious because

of the risks, said Pisano, spokeswoman for the combined American

Association of Health Plans, Health Insurance Association of America.

" When we do read about people who do have complications, I think

that only serves to reinforce the caution, " she said.

Powers agrees. He worries that the growing popularity and the

success of celebrities such as NBC " Today " weatherman Al Roker and singer

Carnie may make it look like a simple, convenient option, especially

for young people. " I don't think you see all the pain involved. You see the

finished product, " he said. " Carnie looks great and Al Roker looks

like a million bucks, but you don't see the post-op stuff. You eat half an

English muffin and you throw up. There's certain foods it takes you a year

to eat again. It's not a diet. You have to be ready to abandon the way that

you've lived with food for the rest of your life. "

___

On the Net:

American Society for Bariatric Surgery: www.asbs.org

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