Surgeons to obese Americans: Cut it out!

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In 2009, nearly a quarter of a million Americans underwent gastric bypass surgery, demonstrating the growing popularity of the procedure, especially in the wake of our nation s expanding waistlines. And though some experts argue that the operation does not sustain long-term weight loss, a recent analysis published in the Annals of Surgery found that people who opted for the surgery were actually able to keep their weight off for two years or more.

Gastric bypass is a type of surgery that literally shrinks the size of the stomach so that people feel fuller more quickly. In addition, a detour is created around part of the small intestine, and thus fewer calories and nutrients are absorbed, resulting in weight loss. In order to qualify for the procedure, patients must have a BMI (body mass index) of at least 40, or between 35 and 40 if they have at least one other obesity-related comorbidity, such as hypertension or diabetes.

For the study, researchers from the Penn Metabolic and Bariatric Surgery Program at the University of Pennsylvania reviewed 22 previous trials that tracked over 4,200 gastric bypass patients. They found that the study subjects lost, on average, about two-thirds of their excess weight; after a two-year follow-up period, almost three-quarters of the group had managed to keep it off over that time.

According to ACSH s Dr. Ruth Kava, Bariatric surgery has been shown in numerous studies to be a viable option for severely obese patients who have been unable to normalize their weight through other means.

ACSH advisor Dr. Judy Stern, professor of clinical nutrition and internal medicine at the University of California-Davis, agrees. She notes that there is excellent evidence to support the use of gastric bypass for long-term weight loss and/or the prevention of weight gain, since diet and exercise don t work for many in the long run. The next question that we should be addressing, she says, is how young can a patient be to undergo the procedure?