FARGO -- More than 177,000 people in the U.S. received weight-loss surgery in 2006, and that number continues to grow.
Most undergo the Roux-en-Y gastric bypass, in which most of the stomach is bypassed and a small stomach pouch is made. Dr. Dan Smith, who did most of the Neal family's surgeries at St. Joseph's Center for Weight Management in Park Rapids, Minn., said the procedure is done so often because it works.
"In the morbid obese population, the chances of anything nonsurgical producing substantial long-term weight loss is less than 1 percent," he said.
Smith has performed about 1,940 gastric bypasses - both open and laparoscopic - since 2000. On average, his patients keep off 70 percent of their excess weight after five years, he said.
While the Roux-en-Y has been around for 30 years, it is still major surgery. To qualify, patients must have a BMI of 40 or higher (usually at least 100 pounds overweight) as well as some of the following co-morbidities:
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- Heart disease or enlarged heart.
- High blood pressure.
- Diabetes.
- Sleep apnea.
- Acid reflux.
- Lower leg edema.
- Asthma.
- Joint problems.
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- Plantar Fascistic.
Smith said complications from Roux-en-Y are rare but do happen. The most serious - infections, blood clots or leaks in the surgical connections to the intestines - occur in the first month of surgery. Smith said there is a 2-in-1,000 mortality rate nationally, although some statistics are as low as 1 in 300. Other possible complications include bowel obstruction, hernia, ulcers, malnutrition or stricture (in which scar tissue forms, preventing the patient from keeping down food).
People who receive this surgery may experience temporary hair loss, temporary "dumping syndrome" (in which they vomit and/or develop diarrhea from high amounts of sugar or fats) and excess sagging skin. They also must make permanent lifestyle changes, such as:
- Learning to eat small, protein-rich meals without drinking liquids at the same time.
- Faithfully taking a host of supplements to avoid malnutrition.
- Committing to healthier eating and more exercise to ensure long-term success.
- Forgoing certain foods (everyone tolerates foods differently after surgery, but people have reported developing problems with everything from bread to milk).
The Forum of Fargo-Moorhead and the Herald are Forum Communications Co. newspapers.
