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Surgery is no cure-all for obesity, doctors say

Posted - Jul. 26, 2004 at 1:20 p.m.



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Jul. 26--Since 1999 when musician Carnie Wilson lost 150 pounds after undergoing gastric bypass surgery, obese adults -- an estimated 140,000 this year -- have been lining up at bariatric clinics across the country.

But some are now raising concerns about the surgeries made famous by Wilson and, more recently, broadcaster Al Roker and American Idol's Randy Jackson. In Web chat rooms, those who have had weight loss surgery lament their struggle to keep the pounds off. Some say they've regained much of the weight and question whether the surgery is the cure-all they'd hoped for.

Doctors say it never was.

Although physicians counsel patients about the importance of diet and exercise, some people don't follow the guidelines and put weight on as a result.

"There is not a single perfect operation for obesity," said Dr. Todd McCarty, medical director for the Baylor Weight Loss Surgery Program in Dallas. "Weight loss surgery is only a tool to facilitate weight loss."

Those tools -- the most common being the gastric bypass and Lap-Band surgery -- reduce the stomach's ability to hold food. In the gastric bypass, which has been performed in the United States for 17 years, the stomach is stapled to create a pouch, and part of the small intestine is bypassed. In the Lap-Band surgery, which the FDA approved in 2001, an inflatable belt is used to shrink the stomach.

With the stomach only able to hold 1 to 3 ounces of food, compared with the 50 ounces it once did, the weight comes off. Typically, adults lose most of their weight during the first 18 months after surgery.

But after they've lost the weight, some people push the envelope, said Dr. Adam Smith, a surgeon with the Bariatric Program Team at the surgery clinic of the University of North Texas Health Science Center. They figure out how much they can eat before they get sick, then stop just short of that.

"Rarely, if ever, do they regain all of the weight they've lost," he said "But human beings are smart creatures, and they will find ways to undo anything we do to try and help them."

Cornelia Whatley, 54, who lost 110 pounds with the help of Lap-Band surgery, said the procedure helped her learned how to eat less and focus on healthy foods so she has not regained much weight.

"If I want something, I eat it; I just don't eat the whole thing," she said. "I'll allow myself chocolate, but I only eat a few Reese's Pieces."

For most people, support groups help. Weight loss surgery is a drastic change, and people benefit from support, said Dr. James Hall, a psychologist on the Bariatric Program Team at the UNT center.

"They have to look at eating as something they have control of, rather than food controlling them," he said.

When they hit a plateau, it can be especially painful, because most obese people have a lifetime of diet failures.

"They think this has failed, too," he said.

Laurie Taylor, who lost 100 pounds after gastric bypass surgery four years ago, said that she recently gained about 10 pounds. But unlike in the past -- when 10 pounds would have turned into 30, then 70 -- she got back in control quickly, she said.

"Your little pouch works if you work it," said Taylor, of Dallas, who now leads a support group through Baylor. "It's a tool, it's no guarantee that you'll keep the weight off."

It's a tool that can, most importantly, reduce the risk of diabetes, heart disease and other obesity-related conditions.

"Even if Carnie Wilson puts 10 pounds on, the weight loss she's had still dramatically affects her health," Smith said. "She'll live probably 12 years longer because of it."

Whatley said that since the weight-loss surgery she has been healthier and able to do things she couldn't do before. "I feel like my life has been given back to me," she said.

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(c) 2004, Fort Worth Star-Telegram, Texas. Distributed by Knight Ridder/Tribune Business News. For information on republishing this content, contact us at (800) 661-2511 (U.S.), (213) 237-4914 (worldwide), fax (213) 237-6515, or e-mail reprintskrtinfo.com.

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