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Summary
Weight loss surgery is a major decision, and there are several options available – which surgery is right for you?
Webcast Transcript
ANNOUNCER: Obesity is reaching epidemic proportions in the United States, with an estimated 9 million Americans falling into the category of morbid, or extreme obesity. Because many traditional methods of losing weight are highly unsuccessful, many are turning to weight loss surgery.
JAIME PONCE, MD: The purpose of weight loss surgery is to improve the health of morbidly obese patients. To improve the health, meaning that the medical problems that they have they can resolve or improve, or to prevent those medical problems.
ANNOUNCER: Body mass index, or BMI, is the index commonly used to determine if someone is overweight or obese. It is based on a person's weight relative to his or her height. A normal BMI is 18.5 to 24.9. A score equal to or above 25 is considered overweight. A score equal to or above 30 is considered obese. And a score equal to or above 40 is considered extremely obese.
JAIME PONCE, MD: An ideal candidate for surgery is somebody that has a BMI, a body mass index, of 40 or more, which is about 100 pounds or more above their ideal weight, or somebody that has a BMI in between 35 and 40 with associated medical problems. In addition to that, the person needs to be an adult. The person has to be overweight for at least five years, and has to have tried to lose weight before several times and failed.
ANNOUNCER: There are three main types of surgical procedures designed to promote weight loss in obese people.
GEORGE WOODMAN, MD: The first is malabsorptive procedures and those procedures are designed to help a person not absorb much of what they eat. Those procedures, by themselves, are really not done much any more. The two most commonly performed types of weight loss surgery are restrictive procedures and combined procedures. Restrictive procedures reduce how much the stomach can hold, that's what the gastric band does. And combined procedures restrict how much the stomach can hold, but they also reduce how much you absorb, but to a smaller extent from the malabsorptive procedures by themselves.
ANNOUNCER: The two most commonly performed weight loss surgeries are the gastric bypass, which combines restrictive and malabsorptime features in one procedure, and the LAP-BAND system, which is purely restrictive. Each has its advantages.
JAIME PONCE, MD: The advantages of the gastric bypass are that it has a proven track record—it's been used in the United States for about 30 years—and that it allows you to lose the weight faster than with the LAP-BAND. With the bypass, you lose the weight in about a year. You lose about 60 to 70 percent of your excess weight. With the LAP-BAND, it takes about 2 years to lose that weight. So the advantage of the bypass is that you lose the weight faster.
ANNOUNCER: The LAP-BAND system, however, has other advantages.
FELIX SPIEGEL, MD: The LAP-BAND's major advantages are extreme safety—return to work is extremely quick—and because there is no malabsorptive component, these patients don't need lifetime supplementation with specialized vitamins. The LAP-BAND is the only adjustable surgery that we have. By adjusting it, we can prevent the patient from gaining their weight back, and we have clinical data and trials ten or more years after LAP-BAND surgery showing that weight regain is minimal.
ANNOUNCER: Both the LAP-BAND system and the gastric bypass are very effective procedures and their long term weight loss profiles are the same. The average gastric bypass patient loses between 60 and 70 percent of their excess body weight in the first 12 months. The average gastric band patient loses approximately 50 percent of their excess body weight in 12 months.
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