Weight-Loss Surgery: Risks And Benefits
August 05, 2004
Surgery to produce weight loss is a serious undertaking. Anyone
thinking about surgery should understand what the operation involves.
Patients and physicians should carefully consider the following
benefits and risks:
Benefits
Right after surgery, most patients lose weight quickly and continue
to lose for 18 to 24 months after the procedure. Although most patients
regain 5 to 10 percent of the weight they lost, many maintain a
long-term weight loss of about 100 pounds.
Surgery improves most obesity-related conditions. For example,
in one study blood sugar levels of 83 percent of obese patients
with diabetes returned to normal after surgery. Nearly all patients
whose blood sugar levels did not return to normal were older or
had lived with diabetes for a long time.
Risks
Ten to 20 percent of patients who have weight-loss surgery require
follow-up operations to correct complications. Abdominal hernia
was the most common complication requiring follow-up surgery, but
laparoscopic techniques seem to have solved this problem. In laparoscopy,
the surgeon makes one or more small incisions through which slender
surgical instruments are passed. This technique eliminates the need
for a large incision and creates less tissue damage. Patients who
are superobese (>350 pounds) or have had previous abdominal surgery
may not be good candidates for laparoscopy, however. Less common
complications include breakdown of the staple line and stretched
stomach outlets.
Some obese patients who have weight-loss surgery develop gallstones.
Gallstones are clumps of cholesterol and other matter that form
in the gallbladder. During rapid or substantial weight loss, a person's
risk of developing gallstones increases. Taking supplemental bile
salts for the first 6 months after surgery can prevent gallstones.
Nearly 30 percent of patients who have weight-loss surgery develop
nutritional deficiencies such as anemia, osteoporosis, and metabolic
bone disease. These deficiencies usually can be avoided if vitamin
and mineral intakes are high enough.
Women of childbearing age should avoid pregnancy until their weight
becomes stable because rapid weight loss and nutritional deficiencies
can harm a developing fetus.
Source: National Institute of Diabetes and Digestive and Kidney
Diseases
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