Summer 2003
Extremely Overweight? Surgical Weight-Loss Program
Losing 80% of your excess weight has a healthy effect on your life!

Are you 100 pounds or 100% heavier than your ideal body weight? Have you tried faithfully to lose weight with diets and exercise, but been unable to keep the pounds off? You're not alone. Nearly 15 million men and women in the United States are extremely obese. And if you're that much overweight, you probably don't feel as good as you'd like to.

"Being extremely overweight can lead to significant medical conditions that have serious effects on your health, well-being, and life span," says Daniel Tran, MD, medical director of the Weight Management Center at Bridgeport Hospital. These conditions include—

Cardiovascular disease, such as coronary
artery disease, heart attack, heart failure,
stroke, and high blood pressure
The adult form of diabetes

Abnormal lung function, including sleep
apnea (brief periods in which the sleeper does not breathe), shortness of breath,and inability to get enough oxygen into the blood

A higher-than-normal risk of blood clots traveling to the lungs, which can cause sudden death
Severe arthritis, low back pain, joint deterioration, and chronic joint pain
Liver and gallbladder disease
Chronic venous insufficiency (in which blood in the leg veins becomes stagnant or even flows backwards, away from the heart), which may lead to varicose veins and leg ulcers
Increased risk of complications after any surgery
Significantly shortened life expectancy

Most, if not all, of these health risk factors will improve with significant weight loss. But for many people, faithfully following diets and exercise programs has not enabled them to lose weight. For these people, gastric bypass surgery may be the answer.

What is Gastric Bypass?

Gastric bypass surgery limits the ability of the stomach to store foods. This procedure has been shown to be safe and effective for weight loss. In 1991, the National Institutes of Health officially endorsed gastric bypass surgery as an accepted treatment for selected patients.

"The surgery is normally reserved for patients who are morbidly obese," Dr. Tran adds. "However, patient at lower weights with serious obesity-related medical conditions may be considered for the surgery."

In a gastric bypass, the stomach is completely divided to create a small working section called the "pouch" and a larger, non-working section. The pouch is so small it can hold only one ounce of food or less. The pouch is connected to the small intestine so the food travels from the pouch directly into the intestine, bypassing most of the stomach and the first part of the small intestine. The opening between the pouch and the intestine is deliberately made very small in order to slow the time it takes for food to transit, or pass through it. With the small pouch and slow transit time, a small amount of food makes you feel full for a long time, says Dr. Tran.

In the Weight Management Center at Bridgeport Hospital, gastric restrictive procedures are usually performed by laparoscopic (or "keyhole") surgery. This means the surgery is performed using miniature instruments and small incisions (each less than ½ an inch) in the abdomen. Compared with the usual long abdominal incision, these smaller incisions are less painful and faster to heal.

Diet Still Plays an Important Part

"Having gastric bypass surgery does not mean you will no longer have to diet," warns Laurie Jordan, RD, (Registered Dietitian) the Weight Management Center's dietitian. "This operation is meant to help you limit your food intake by reducing your hungry feelings. Weight loss is still your responsibility. You must consume fewer calories than you burn in order to lose weight after surgery. In fact," says Ms. Jordan, "the dietary restrictions after surgery are stricter than any dietary program you've ever tried before. But the results are well worth it!"

The Results
You can reasonably expect to lose about 60 to 80% of your excess weight within 18-24 months after surgery, according to Dr. Tran. You probably won't reach your so-called "ideal" body weight. Because most obese people have medium-to-large body frames (bone and muscle), reaching your fashionable "ideal" is unrealistic, and may even be dangerous. But you'll look and feel terrific at a 60% loss of excess weight, and more importantly, you'll be much healthier. Most obesity-related medical conditions, such as diabetes and high blood pressure, will be improved or even cured after weight loss.

For gastric bypass surgery to work, you have to be prepared to make major, permanent changes in your diet, behavior, and social habits. If you are not totally committed, your chances of failure are high, cautions Dr. Tran. But if you are willing to make the effort, the rewards are also high: better health, and a longer life in which to enjoy it!

For more information about surgery in the Weight Management Center at Bridgeport Hospital, please call 203-384-3890.