WLS less risk than obesity

http://my.webmd.com/content/article/52/49941.htm


Weight Loss Surgery May Add Years to Life

Risk of Obesity Greater Than Risk of Surgery

By Laird Harrison
WebMD Medical News Archive Reviewed By Michael Smith, MD
on Friday, October 11, 2002


October 10, 2002 - There's no doubt that stomach-stapling surgery
leads to dramatic weight loss. But new research shows that the
procedure might also add years to life.


As the number of obese people in the U.S. has soared, so has the
popularity of the surgery. In fact, East Carolina University
researchers estimated that the number of people undergoing weight-loss
surgery increased from 40,000 in 2001 to 86,000 this year and will
reach 140,000 next year.


Past research has shown that gastric bypass improves diabetes, high
blood pressure, and other diseases related to excess fat. But the
effect on a person's lifespan has been unknown, until now


To answer that question, researchers at New Hampshire's
Dartmouth-Hitchcock Medical Center first looked at data from previous
research that showed how much a weight an average person loses after
having the surgery. Then they looked at the average life expectancies
of people at various heights and weights. In this way, they could
estimate how much the change in weight caused by surgery would affect
patients' life span.


The results suggest that most people eligible for the surgery would
benefit, says lead researcher G. Darby Pope, MD, surgery resident at
Dartmouth-Hitchcock. "By undergoing the surgery, they will gain life
years," he said. Pope presented the study this week at a meeting of
the American College of Surgeons in San Francisco.


People with a BMI -- a measure of obesity that takes both height and
weight into account -- over 25 are considered overweight. But
according to U.S. government guidelines, patients should have a BMI of
at least 40, or a BMI of 35 with a related serious disease, to be
eligible for gastric bypass surgery. Most such patients are more than
100 pounds overweight.


The results varied according to the patients' age, gender, and body
mass index (BMI). According to the researchers, a woman with a BMI of
45 at age 40 would gain three years of life. A man of similar age and
size could expect to gain 3.9 years.


These results are better than those obtained by heart disease surgery,
Pope said. But he cautioned that no one should interpret these
findings literally. The actual effects of the gastric bypass surgery
will vary a lot from one individual to another.


Questions about the benefits of gastric bypass surgery will be
answered with more certainty by studies now under way on large groups
of patients, Pope says.


The surgery is getting more popular not only because more people are
obese, but also because surgeons have improved their techniques. In
earlier weight-loss surgery, doctors routed the digestive track past
much of the intestines, resulting in malnutrition.


In the kind of surgery in the Dartmouth-Hitchcock study, most of the
stomach is stapled shut so that food can only enter a small pouch at
the top. A branch of the intestines is connected to this pouch. (The
unused part of the stomach is connected to this branch downstream in
order to drain its fluids.)


Patients vomit if they overeat, but feel full with much less food.
Typically, they lose about three-quarters of their excess weight in
the first year, then gradually gain some back. After ten years or
more, most carry about half the excess weight they had before the
surgery, says Pope.


Patients must take nutritional supplements for the rest of their
lives, and there is a chance of dying from complications of the
surgery. But Pope and his colleagues took this risk of complications
into account in their study and the results suggest that the risk of
death from the procedure are much less than the risk of death from
obesity.

"Daedalus" wrote in message
...

http://my.webmd.com/content/article/52/49941.htm


Weight Loss Surgery May Add Years to Life

Risk of Obesity Greater Than Risk of Surgery

By Laird Harrison
WebMD Medical News Archive Reviewed By Michael Smith, MD
on Friday, October 11, 2002


October 10, 2002 - There's no doubt that stomach-stapling surgery
leads to dramatic weight loss. But new research shows that the
procedure might also add years to life.


As the number of obese people in the U.S. has soared, so has the
popularity of the surgery. In fact, East Carolina University
researchers estimated that the number of people undergoing weight-loss
surgery increased from 40,000 in 2001 to 86,000 this year and will
reach 140,000 next year.


Past research has shown that gastric bypass improves diabetes, high
blood pressure, and other diseases related to excess fat. But the
effect on a person's lifespan has been unknown, until now


To answer that question, researchers at New Hampshire's
Dartmouth-Hitchcock Medical Center first looked at data from previous
research that showed how much a weight an average person loses after
having the surgery. Then they looked at the average life expectancies
of people at various heights and weights. In this way, they could
estimate how much the change in weight caused by surgery would affect
patients' life span.


The results suggest that most people eligible for the surgery would
benefit, says lead researcher G. Darby Pope, MD, surgery resident at
Dartmouth-Hitchcock. "By undergoing the surgery, they will gain life
years," he said. Pope presented the study this week at a meeting of
the American College of Surgeons in San Francisco.


People with a BMI -- a measure of obesity that takes both height and
weight into account -- over 25 are considered overweight. But
according to U.S. government guidelines, patients should have a BMI of
at least 40, or a BMI of 35 with a related serious disease, to be
eligible for gastric bypass surgery. Most such patients are more than
100 pounds overweight.


The results varied according to the patients' age, gender, and body
mass index (BMI). According to the researchers, a woman with a BMI of
45 at age 40 would gain three years of life. A man of similar age and
size could expect to gain 3.9 years.


These results are better than those obtained by heart disease surgery,
Pope said. But he cautioned that no one should interpret these
findings literally. The actual effects of the gastric bypass surgery
will vary a lot from one individual to another.


Questions about the benefits of gastric bypass surgery will be
answered with more certainty by studies now under way on large groups
of patients, Pope says.


The surgery is getting more popular not only because more people are
obese, but also because surgeons have improved their techniques. In
earlier weight-loss surgery, doctors routed the digestive track past
much of the intestines, resulting in malnutrition.


In the kind of surgery in the Dartmouth-Hitchcock study, most of the
stomach is stapled shut so that food can only enter a small pouch at
the top. A branch of the intestines is connected to this pouch. (The
unused part of the stomach is connected to this branch downstream in
order to drain its fluids.)


Patients vomit if they overeat, but feel full with much less food.
Typically, they lose about three-quarters of their excess weight in
the first year, then gradually gain some back. After ten years or
more, most carry about half the excess weight they had before the
surgery, says Pope.


Patients must take nutritional supplements for the rest of their
lives, and there is a chance of dying from complications of the
surgery. But Pope and his colleagues took this risk of complications
into account in their study and the results suggest that the risk of
death from the procedure are much less than the risk of death from
obesity.



But as others on this group has said, you'll have to change your eating
habits and exercise after the surgery to keep the weight off. Why not cut
out the expense and pain and change your eating habits and exercise to lose
weight? I understand it'll take longer to lose weight, but how long did it
take us to put this weight on??

I'm still considering the surgery, but the more research I do and the people
I talk to, I think I'm better off doing this on my own through my WOL/WOE
changes. There's a woman in my church that has had the surgery, but said
that there often are days where she'd wished she never had the surgery.

Even at the surgery seminar I went to all the doctors & nutritionists kept
reiterating that the surgery is a tool not a miracle cure.


My 2c,

Matty
481/440/250

On Tue, 22 Jun 2004 08:55:35 -0400, "Matty" ,
wrote:


"Daedalus" wrote in message
.. .

http://my.webmd.com/content/article/52/49941.htm


Weight Loss Surgery May Add Years to Life

Risk of Obesity Greater Than Risk of Surgery

By Laird Harrison
WebMD Medical News Archive Reviewed By Michael Smith, MD
on Friday, October 11, 2002


October 10, 2002 - There's no doubt that stomach-stapling surgery
leads to dramatic weight loss. But new research shows that the
procedure might also add years to life.


As the number of obese people in the U.S. has soared, so has the
popularity of the surgery. In fact, East Carolina University
researchers estimated that the number of people undergoing weight-loss
surgery increased from 40,000 in 2001 to 86,000 this year and will
reach 140,000 next year.


Past research has shown that gastric bypass improves diabetes, high
blood pressure, and other diseases related to excess fat. But the
effect on a person's lifespan has been unknown, until now


To answer that question, researchers at New Hampshire's
Dartmouth-Hitchcock Medical Center first looked at data from previous
research that showed how much a weight an average person loses after
having the surgery. Then they looked at the average life expectancies
of people at various heights and weights. In this way, they could
estimate how much the change in weight caused by surgery would affect
patients' life span.


The results suggest that most people eligible for the surgery would
benefit, says lead researcher G. Darby Pope, MD, surgery resident at
Dartmouth-Hitchcock. "By undergoing the surgery, they will gain life
years," he said. Pope presented the study this week at a meeting of
the American College of Surgeons in San Francisco.


People with a BMI -- a measure of obesity that takes both height and
weight into account -- over 25 are considered overweight. But
according to U.S. government guidelines, patients should have a BMI of
at least 40, or a BMI of 35 with a related serious disease, to be
eligible for gastric bypass surgery. Most such patients are more than
100 pounds overweight.


The results varied according to the patients' age, gender, and body
mass index (BMI). According to the researchers, a woman with a BMI of
45 at age 40 would gain three years of life. A man of similar age and
size could expect to gain 3.9 years.


These results are better than those obtained by heart disease surgery,
Pope said. But he cautioned that no one should interpret these
findings literally. The actual effects of the gastric bypass surgery
will vary a lot from one individual to another.


Questions about the benefits of gastric bypass surgery will be
answered with more certainty by studies now under way on large groups
of patients, Pope says.


The surgery is getting more popular not only because more people are
obese, but also because surgeons have improved their techniques. In
earlier weight-loss surgery, doctors routed the digestive track past
much of the intestines, resulting in malnutrition.


In the kind of surgery in the Dartmouth-Hitchcock study, most of the
stomach is stapled shut so that food can only enter a small pouch at
the top. A branch of the intestines is connected to this pouch. (The
unused part of the stomach is connected to this branch downstream in
order to drain its fluids.)


Patients vomit if they overeat, but feel full with much less food.
Typically, they lose about three-quarters of their excess weight in
the first year, then gradually gain some back. After ten years or
more, most carry about half the excess weight they had before the
surgery, says Pope.


Patients must take nutritional supplements for the rest of their
lives, and there is a chance of dying from complications of the
surgery. But Pope and his colleagues took this risk of complications
into account in their study and the results suggest that the risk of
death from the procedure are much less than the risk of death from
obesity.



But as others on this group has said, you'll have to change your eating
habits and exercise after the surgery to keep the weight off.

I absolutely agree.

Why not cut
out the expense and pain and change your eating habits and exercise to lose
weight? I understand it'll take longer to lose weight, but how long did it
take us to put this weight on??

This surgery should never be made available to people who want to lose
20 pounds on a whim.

But people who are facing real health risks could be in for a lot more
pain and expense if they don't take these drastic measures. Many may
not have the time left to lose the weight required.


I'm still considering the surgery, but the more research I do and the people
I talk to, I think I'm better off doing this on my own through my WOL/WOE
changes.

I know nothing about your situation, so I won't comment on it. I know
three people personally who've had it done. Two of them had it done a
couple of years ago and the recovery was not easy. You have to deal
with a lot trying to relearn how to eat. But now both are fine and
keeping the weight off is not a problem.

I know a third person who did have some complications and may need a
second surgery, they aren't sure yet.

There's a woman in my church that has had the surgery, but said
that there often are days where she'd wished she never had the surgery.

Thats true of a lot of surgeries though. And all procedures get better
the more surgeons do them and figure out how to improve the process.


Even at the surgery seminar I went to all the doctors & nutritionists kept
reiterating that the surgery is a tool not a miracle cure.


Completely agree with you here as well. My only point was that there
are serious risks from being morbidly obese. Lots of critics of WLS
act like it's the new fad nosejob, which simply isn't the case.

People who get it are in real danger from being fat, otherwise it
would not be available to them.

Jade

Daedalus wrote in message . ..
Why not cut
out the expense and pain and change your eating habits and exercise to lose
weight? I understand it'll take longer to lose weight, but how long did it
take us to put this weight on??

This surgery should never be made available to people who want to lose
20 pounds on a whim.

Irrelevant point, because it's not. However, it *is* allowed and paid
for by insurance for people who want to lose ~70lbs or so, which
really isn't that different from 20lbs in the scheme of things.

But people who are facing real health risks could be in for a lot more
pain and expense if they don't take these drastic measures. Many may
not have the time left to lose the weight required.

Other than the ~3ft of bypassed small intestine, WLS isn't going to
fix anything that simple commitment won't either.

I'm still considering the surgery, but the more research I do and the people
I talk to, I think I'm better off doing this on my own through my WOL/WOE
changes.

I know nothing about your situation, so I won't comment on it. I know
three people personally who've had it done. Two of them had it done a
couple of years ago and the recovery was not easy. You have to deal
with a lot trying to relearn how to eat. But now both are fine and
keeping the weight off is not a problem.

One of my friends at work (5'11", ~275lb) nearly died from
complications. Even after a full recovery, he now has to eat like a
squirrel. What a poor decision he made. I can understand why he did
it, since before starting my weight loss regimen I though dieting was
horrible and ultimately fruitless, but 4+ months in losing 1-2lbs/week
is painless and not that big a deal at all.

There's a woman in my church that has had the surgery, but said
that there often are days where she'd wished she never had the surgery.

Thats true of a lot of surgeries though. And all procedures get better
the more surgeons do them and figure out how to improve the process.

yeay. Sign me up to be guinea pig #4,403.

Even at the surgery seminar I went to all the doctors & nutritionists kept
reiterating that the surgery is a tool not a miracle cure.


Completely agree with you here as well. My only point was that there
are serious risks from being morbidly obese. Lots of critics of WLS
act like it's the new fad nosejob, which simply isn't the case.

People who get it are in real danger from being fat, otherwise it
would not be available to them.

Wrong. People at 35BMI, which for my height is 265lbs, can qualify for
this surgery if they have issues like sleep apnea or knee cartilage
damage.

Most people at 300 can *easily* be down to 200 in about a year, WLS or
no.

1000kcal/day deficit is all it takes, and I've found a 1000 kcal daily
deficit to be really easy to maintain, though I don't have kids, a
family, demanding work, etc.

Heywood

232/196/182

On 22 Jun 2004 12:00:20 -0700, (Heywood Mogroot),
wrote:

Daedalus wrote in message . ..
Why not cut
out the expense and pain and change your eating habits and exercise to lose
weight? I understand it'll take longer to lose weight, but how long did it
take us to put this weight on??

This surgery should never be made available to people who want to lose
20 pounds on a whim.

Irrelevant point, because it's not. However, it *is* allowed and paid
for by insurance for people who want to lose ~70lbs or so, which
really isn't that different from 20lbs in the scheme of things.

Actually, everything I've read quotes 100lbs or more overweight as the
requirement to qualify for the surgery. That may have changed
recently.

Of course these people could lose it conventionally. I think the
immediate health risks of the person should be a consideration.

However, I'd much rather my tax dollars and insurance payments went to
the surgery than to treating their diabetes and kidney dialysis when
they don't lose it later in life.

I think it's also naieve to say 50 lbs is not much difference in the
grand scheme. it totally depends on your state of health.


But people who are facing real health risks could be in for a lot more
pain and expense if they don't take these drastic measures. Many may
not have the time left to lose the weight required.

Other than the ~3ft of bypassed small intestine, WLS isn't going to
fix anything that simple commitment won't either.

Simple commitment seems to be an impossible task for many obese people
(consider the existence of fat acceptance)

But lacking the willpower and dedicaiton required to successfully diet
(I agree everyone should have it) It does indeed physically prevent
you from overeating, which is a fix for those without the willpower.


I'm still considering the surgery, but the more research I do and the people
I talk to, I think I'm better off doing this on my own through my WOL/WOE
changes.

I know nothing about your situation, so I won't comment on it. I know
three people personally who've had it done. Two of them had it done a
couple of years ago and the recovery was not easy. You have to deal
with a lot trying to relearn how to eat. But now both are fine and
keeping the weight off is not a problem.

One of my friends at work (5'11", ~275lb) nearly died from
complications. Even after a full recovery, he now has to eat like a
squirrel. What a poor decision he made.

What WOULD he have died from ultimately otherwise, though? As the
article I originally posted states, statistically the surgery risk
appears to be less at this point than obesity related ailments.

Many many people have actually chosen death due to obesity over
finding the will to change their lives. I can't be judgmental enough
to say they deserve to die because of their own bad choices. Maybe
they do, but this at least is another choice for them.

I can understand why he did
it, since before starting my weight loss regimen I though dieting was
horrible and ultimately fruitless, but 4+ months in losing 1-2lbs/week
is painless and not that big a deal at all.

Again, I agree. I am totally behind the dieting idea before the
surgery. And I can't defend or even understand people like fat
acceptors who claim they can't physically lose weight and that dieting
is evil.



There's a woman in my church that has had the surgery, but said
that there often are days where she'd wished she never had the surgery.

Thats true of a lot of surgeries though. And all procedures get better
the more surgeons do them and figure out how to improve the process.

yeay. Sign me up to be guinea pig #4,403.

I'd take it over having to go to a dialysis clinic twice a month or
having my feet removed.


Even at the surgery seminar I went to all the doctors & nutritionists kept
reiterating that the surgery is a tool not a miracle cure.


Completely agree with you here as well. My only point was that there
are serious risks from being morbidly obese. Lots of critics of WLS
act like it's the new fad nosejob, which simply isn't the case.

People who get it are in real danger from being fat, otherwise it
would not be available to them.

Wrong. People at 35BMI, which for my height is 265lbs, can qualify for
this surgery if they have issues like sleep apnea or knee cartilage
damage.

Well, sleep apnea can kill you and knee cartilage damage is often
permanently debilitating, especially if you have to have orthoscopic
surgery. I'd call that real danger.


Most people at 300 can *easily* be down to 200 in about a year, WLS or
no.

1000kcal/day deficit is all it takes, and I've found a 1000 kcal daily
deficit to be really easy to maintain, though I don't have kids, a
family, demanding work, etc.

You'd probably lose weight faster if you did. Congratulations, by the
way, on your success. Keep it up!

Jade


Heywood

232/196/182

Daedalus wrote in message . ..
On 22 Jun 2004 12:00:20 -0700, (Heywood Mogroot),
wrote:

Daedalus wrote in message . ..
Why not cut
out the expense and pain and change your eating habits and exercise to lose
weight? I understand it'll take longer to lose weight, but how long did it
take us to put this weight on??

This surgery should never be made available to people who want to lose
20 pounds on a whim.

Irrelevant point, because it's not. However, it *is* allowed and paid
for by insurance for people who want to lose ~70lbs or so, which
really isn't that different from 20lbs in the scheme of things.

Actually, everything I've read quotes 100lbs or more overweight as the
requirement to qualify for the surgery. That may have changed
recently.

A BMI of 35 gets you qualified if you can convince your insurance
company that you have eg. sleep apnia and/or other obesity-related
health issues.

Of course these people could lose it conventionally. I think the
immediate health risks of the person should be a consideration.

WLS doesn't address these "immediate health risks", other than the
~3ft of bypassed small intestine.

However, I'd much rather my tax dollars and insurance payments went to
the surgery than to treating their diabetes and kidney dialysis when
they don't lose it later in life.

At the risk of being insensitive, I'd rather have insurance payments
go to surgically attaching a zipper to people's mouths. Less invasive,
and probably more cost effective.

I think it's also naieve to say 50 lbs is not much difference in the
grand scheme. it totally depends on your state of health.

It's 15-30 weeks of nice, easy dieting. Sorry, I don't see the
significant risk of those 50lbs as they are coming off, especially
since those same pounds will come off at a similar rate after WLS.

But people who are facing real health risks could be in for a lot more
pain and expense if they don't take these drastic measures. Many may
not have the time left to lose the weight required.

Other than the ~3ft of bypassed small intestine, WLS isn't going to
fix anything that simple commitment won't either.

Simple commitment seems to be an impossible task for many obese people
(consider the existence of fat acceptance)

Then maybe we should throw our public monies at that problem. One idea
I had was an adult fat farm, like say on the Big Island or other
resort area. 2-3 months of lifestyle change. Not sure it would work,
but slicing up one's stomach is just w-r-o-n-g for anyone not
seriously, seriously obese.

I haven't been that fat so I admit the great possibility that straight
dieting gets harder the heavier you are.

I'm still considering the surgery, but the more research I do and the people
I talk to, I think I'm better off doing this on my own through my WOL/WOE
changes.

I know nothing about your situation, so I won't comment on it. I know
three people personally who've had it done. Two of them had it done a
couple of years ago and the recovery was not easy. You have to deal
with a lot trying to relearn how to eat. But now both are fine and
keeping the weight off is not a problem.

One of my friends at work (5'11", ~275lb) nearly died from
complications. Even after a full recovery, he now has to eat like a
squirrel. What a poor decision he made.

What WOULD he have died from ultimately otherwise, though? As the
article I originally posted states, statistically the surgery risk
appears to be less at this point than obesity related ailments.

He was ~275. He'd given up, and took the easy out. I understand his
decision, since dieting can really really suck if you don't know what
you're doing (in fact, dieting the wrong way can do just as much
damage if not more than over-eating in the first place).

Liquid diets, SlimFast, and other crash programs are not the answer to
obesity -- running a ~1000kcal/day calorie deficit is IMV. This will
work down most obesity problems given a year or two of commitment, at
the same rate as WLS patients. Without the pain and suffering, or
altered lifestyle.

Many many people have actually chosen death due to obesity over
finding the will to change their lives. I can't be judgmental enough
to say they deserve to die because of their own bad choices. Maybe
they do, but this at least is another choice for them.

I don't judge people without being in their shoes, but all I'm saying
is that, other than the bypassed small intestine, WLS doesn't provide
any benefits that simple diet changes won't also.

I can understand why he did
it, since before starting my weight loss regimen I though dieting was
horrible and ultimately fruitless, but 4+ months in losing 1-2lbs/week
is painless and not that big a deal at all.

Again, I agree. I am totally behind the dieting idea before the
surgery. And I can't defend or even understand people like fat
acceptors who claim they can't physically lose weight and that dieting
is evil.

Dieting sucks if you do it wrong (eg. go no-fat, twigs and rabbit
food, 400 kcal/day crash diets, obsess over every calorie, etc).

There's a woman in my church that has had the surgery, but said
that there often are days where she'd wished she never had the surgery.

Thats true of a lot of surgeries though. And all procedures get better
the more surgeons do them and figure out how to improve the process.

yeay. Sign me up to be guinea pig #4,403.

I'd take it over having to go to a dialysis clinic twice a month or
having my feet removed.

Other than the ~3ft of bypassed small intestine, WLS doesn't offer any
benefits that eating less won't give you. People can and do abuse
their stomachs after WLS too.

Even at the surgery seminar I went to all the doctors & nutritionists kept
reiterating that the surgery is a tool not a miracle cure.


Completely agree with you here as well. My only point was that there
are serious risks from being morbidly obese. Lots of critics of WLS
act like it's the new fad nosejob, which simply isn't the case.

People who get it are in real danger from being fat, otherwise it
would not be available to them.

Wrong. People at 35BMI, which for my height is 265lbs, can qualify for
this surgery if they have issues like sleep apnea or knee cartilage
damage.

Well, sleep apnea can kill you and knee cartilage damage is often
permanently debilitating, especially if you have to have orthoscopic
surgery. I'd call that real danger.

So? WLS isn't a magic wand that takes the weight off instantly. A 1000
kcal/day deficit diet will take off weight for most people just as
effectively, with a lot less pain, hassle, and expense.

Most people at 300 can *easily* be down to 200 in about a year, WLS or
no.

1000kcal/day deficit is all it takes, and I've found a 1000 kcal daily
deficit to be really easy to maintain, though I don't have kids, a
family, demanding work, etc.

You'd probably lose weight faster if you did. Congratulations, by the
way, on your success. Keep it up!

Trying to... got a bit cocky today about being safely under 200 for
the first time in about 6 years and ate too much... Going to need to
really get back to my pre-vacation habits...