Nutrition Frenzy

Risks of gastric-bypass surgery are often underplayed, some experts say

Doing everything right after bariatric surgery is no guarantee of success.

That fact may come as a surprise: With glowing media reports of its health benefits and a roster of celebrity success stories, weight loss surgery is beginning to feel like the miracle cure of the moment. Last year, doctors performed 205,000 bariatric surgeries, marking an 800 percent increase from a decade ago. As of 2004, 82 percent of patients are women, according to the U.S. Agency for Healthcare Research and Quality (AHRQ) in Rockville, Maryland. Weight loss surgeries are poised to become even more popular in the wake of findings that gastric bypass and banding can send type 2 diabetes into remission in many people. A 2007 report from the University of Utah School of Medicine in Salt Lake City found that obese patients who had bypass surgery had a 40 percent reduced risk of dying in the seven years after the procedure, compared with obese people who didn’t have the surgery. Bariatric surgeons are using results like those to make the case for surgery as a preventive measure against cancer, heart disease and diabetes in patients who are severely obese.

But despite the growing popularity of obesity surgery — and the general perception that it’s a shortcut to thinness and good health — it’s no easy path. The American Society for Metabolic & Bariatric Surgery (ASMBS) in Gainesville, Florida, puts gastric-bypass surgery’s death rate at between 1 in 1,000 and 1 in 200. In one AHRQ study, 4 in 10 patients developed complications within the first six months, including vomiting, diarrhea, infections, hernias and respiratory failure. Up to 40 percent of gastric-bypass patients can suffer nutritional deficiency, potentially resulting in anemia and osteoporosis; seizures and paralysis have been reported in extreme cases.

Even if patients avoid the major pitfalls, they could be in for a world of intestinal discomfort. Not to mention how difficult it is to retrain yourself to subsist on 3-ounce meals and vitamin pills after surgery. “If you’re here for the quick fix, then this surgery is not for you,” affirms Kelvin Higa, M.D., immediate past president of ASMBS. “This is a serious lifelong commitment.” It’s an adjustment so profound that patients are screened to make sure they’re psychologically up to the task — a test that, according to a recent study in the Journal of Clinical Psychiatry, one-fifth of would-be patients fail.

Check out Always Auditioning.