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Gastric Bypass 'is not a cosmetic surgery'

The skinny on weight-loss surgery, Part One

Published: Monday, February 6, 2012

Updated: Monday, August 27, 2012 16:08

Gastric bypass graphic stomach

Lisa Armstrong

Weight loss has become a multi-billion dollar industry in America. There are thousands of fitness centers and diet plans that all claim to work. Especially this time of year, many people strive to lose weight for their New Year's resolutions. It is never easy losing even a few pounds, and sometimes we need help from professional nutritionists and even surgeons.

One of the most drastic weight-control measures is a bariatric surgery known as gastric bypass. The surgery, according to the Mayo Clinic, entails a surgeon making a cut across the top of the patient's stomach, sealing it from the rest of the stomach and dramatically reducing the amount of food the person can consume in one sitting.

The human stomach can normally hold "about three pints of food," according to the Mayo Clinic website. With the bypass, the resulting stomach "pouch" can hold "only about an ounce of food."

Obesity is a serious and difficult issue because it can cause heart disease, stroke, Type 2 diabetes and certain types of cancers. Nevertheless gastric bypass is not a choice to make lightly, and doctors discourage turning to it as an "easy" alternative to dieting or exercise.

The process to undergo bariatric surgery can take up to six months. Numerous psychiatric and dietician sessions are required. The surgery costs from $18,000 to $35,000. Because of the cost, insurance companies are hesitant to pay for it unless the patient has tried other ways to lose weight.

Like other surgeries, it can result in numerous health complications. With gastric bypass there are short and long- term risks. Anesthesia complications, infections, and bowel obstructions can occur. After the surgery, patients may regain the weight or have psychological issues.

The gastric band—an adjustable system which performs the same function as the surgery, but can be removed—has fewer risks since there are no incisions, but there is a 1 percent chance that a blood clot will form in the legs during surgery.

"My thinking and eating is my problem," said Helen Bolar. She attends gastric bypass information sessions at Northwestern Memorial Hospital in Streeterville. Bolar wants to lose at least 75 pounds by undergoing surgery. She is afraid of gastric bypass surgery because of the risks and instead wants to have the gastric band inserted.

The ideal patient for either gastric bypass or the band must have a BMI of 40 or higher. This means that they must be more than 100 pounds overweight.

"Surgery is the easy part...the hard part is not gaining the weight back," said Dr. Alexander Nagle, a doctor at Northwestern who performs gastric bypasses, during an information session. "It is a life-changing commitment to diet and exercise... and will increase life expectancy."

Obesity is a complex issue, and despite numerous debates and studies, there is no consensus as to what "causes" it. Genetics play a huge role in how the body processes food, and certain types of medications such as steroids and antidepressants can also affect the body's metabolism.

Weight gain and obesity have risen over the past few decades because of how Americans consume food.

There are fast food restaurants on every corner. More restaurants offer foods that are higher in sugar and fat. Portion sizes in this country are larger than average as well.

There is also a socioeconomic element to consider. In poor neighborhoods and rural communities, where obesity is more often seen, a lack of affordable food options and grocery stores make it harder to access healthy food. Also, people in these communities don't always have the option to walk or bike to work or school.

Technology is also a contributing factor. Children and adults spend countless hours sitting in front of television or computer screens instead of being active.

A new study published in "Food Quality and Preference," a journal of the Sensometric Society, stated that, "non-food products that are produced to smell like food, such as chocolate or fruit-scented personal care products may increase food intake and lead to obesity."

Other problems are with the traditional "food pyramid" and the USDA guidelines, according Monica Eng, a health writer for the Chicago Tribune.

"Fat has been largely vindicated as a contributor to obesity and yet the USDA [United States Department of Agriculture] is still telling people to drink low fat milk and cut fat in other areas," Eng said. "Anyone who follows the USDA guidelines will probably remain obese until its guidelines catch up to the most recent science."

A dietician can help personalize a diet that does not necessarily follow the food pyramid. Nutrition Counseling Services offers individual diet plans. NCS is just one of many counseling and treatment centers that offer help to Chicagoans.

Students around the nation, including DePaul students are conscious of the risks of overeating and not getting enough exercise.

Victoria Prasil, a junior at DePaul, exercises regularly.

"There are so many people who have health problems and don't do anything proactive to change their health," Prasil said. "I'm fortunate to be healthy and I want to do all I can ensure to stay healthy inside and out."

Gastric bypass and other bariatric surgery may be the best option for a person's health and well-being, but it is a decision to be made with care. Unlike a diet, gastric bypass cannot be stopped or reversed if it does not work out.

"[Bariatric surgery] is not a cosmetic surgery," said Nagle. "It is a major surgery…that is used to prevent and treat medical problems."

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