Weighing the Risks
More than ever, obese patients are turning to gastric bypass surgery. The results can be striking, but it's not a slam-dunk
This summer, Sherrianne Swartz plans to do something that most people take for granted: ride a roller coaster with her teenage son. It's not fear that has kept Swartz, 36, on the ground for the better part of a decade--but fat. At over 400 pounds, she has been too big to fit into the seat. Until now, that is. Barely 16 months after gastric bypass surgery, which reduced her stomach to the size of a hard-boiled egg, Swartz has shed 185 pounds. And the other wild ride that she began at age 10 with her first diet is finally coming to an end. "I tried every diet and every diet pill there was," says Swartz, a customer service representative for an insurance firm who lives in Independence, Ky. "I'd go up and down and lose it and gain it; nothing was successful."
Swartz's story, which also included bouts with type 2 diabetes, high blood pressure, sleep apnea, and other potentially fatal complications from obesity, is becoming all too commonplace. It's no wonder. About two thirds of the American population is overweight, and roughly 30 percent of them are officially obese--defined as having a body mass index, or BMI, of 30 or more (5 foot 6; 186 pounds, for example). Some 9 million adults, in fact, carry an extra 100 pounds or more and are considered morbidly obese (a BMI of at least 40), the prime candidates for bariatric surgery.
In addition to medical problems, quality of life for many severely obese patients is virtually nonexistent. "I love to garden, but I had to stop," says Rhonda Waller, a Cincinnati office manager who has weighed as much as 300 pounds and recently had a knee replacement brought on by her extreme weight. "I can't get down on my knees, because I'll never get back up," says Waller, who is scheduled for gastric bypass surgery this month. Then there are the logistical issues--not being able to squeeze into a restaurant booth or buckle a seat belt--the chronic exhaustion, and the humiliation and public scorn.
Despite triumphant tales on reality shows of weight loss without drugs or surgery, most seriously overweight people stand a better chance of appearing on American Idol than they do of logging a triple-digit weight loss and keeping it off. "Diet, exercise, and behavior modification alone with people who are 100 pounds or more overweight has been a uniform failure," says Neil Hutcher, president of the American Society for Bariatric Surgery.
Last resort. With few options, doctors and patients are increasingly turning to gastric bypass surgery as a lifesaver and often as a last resort. In 1995, just 20,000 weight-loss operations were performed in the United States. Last year, there were 170,000, according to the ASBS. The most common procedure is the Roux-en-Y, which involves drastically shrinking the size of the stomach and rerouting the small intestine to reduce calorie absorption. The surgery has been thrust into the spotlight by celebrity patients, such as the Today show's Al Roker, Idol's Randy Jackson, and singer Carnie Wilson. The ability to perform the operation laparoscopically has also upped its popularity. With Medicare now expanding its coverage of the procedure, not to mention full-throttle marketing of the surgery, the number of bypass recipients is certain to grow.
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