The least risky and least invasive option, laproscopic band, or lap-band, surgery made headlines when New Jersey Gov. Chris Christie had the procedure in February. The surgery, which can be reversed, involves wrapping an adjustable silicone band around the top of the stomach, Garber says. Another option is a procedure known as a sleeve gastrectomy, which removes 70 percent of the stomach, folding it into a long tube or sleeve. Finally, gastric bypass is the most involved and riskiest of the surgeries, as it entails stapling and dividing the stomach and reconnecting the intestines, he says.
In every case, the choice is "never cosmetic," Garber says. "It's always for medical reasons. We do it to give them healthier, longer lives."
According to the American Society of Metabolic & Bariatric Surgery, patients lose up to 60 percent of their former weight six months after surgery and 77 percent of their weight a year later. The society states that the surgeries also help to "prevent, improve or resolve more than 40 obesity-related disesase or conditions including Type 2 diabetes, heart disease and certain cancers."
For Stewart's part, his asthma, sleep apnea and blood pressure problems have all disappeared. "All of my health issues have completely reversed, every single one of them," he says. Meanwhile, he also feels a lot more confident. As a coworker told him recently, he carries himself differently, with his head up and his posture straight.
However, experts emphasize that the surgery is just the first step toward recovery, and success hinges on a dedicated effort involving nutrition, fitness and necessary support.
"You can't just do the surgery alone and expect to have good long-term outcomes," says Stacy Brethauer, the Cleveland Clinic surgeon who treated Stewart. As Brethauer explains, only once patients have the surgery can they then get healthy through diet and exercise. "Once people reach a certain point in terms of their weight and comorbidities," or related disorders, "diet and exercise alone is ineffective," he says.
As Garber puts it, surgery "is not the easy way out. It's the only way out."