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Weight-loss surgery may expand to include more patients

Studies have shown that weight-loss surgery can resolve type 2 diabetes and other health conditions such as sleep apnea, high cholesterol, and hypertension. Research also shows that weight-loss surgery is the most effective method for lasting weight loss. Depending on the type of surgery, most patients lose 50% or more of their excess body weight, and keep the weight off for 10 years after surgery. Weight-loss medication, however, typically results in just a 5-22 pound weight loss over the course of one year.

Some physicians believe that making weight-loss surgery available to more patients could help reduce a future epidemic of health problems. "We're seeing increased disability due to obesity among a younger population," said Dr. John Baker, president of the American Society for Metabolic & Bariatric Surgery. "We can't afford to wait. As a tool to bring down costs and the burden of disease, bariatric surgeons have the most effective tool in medicine today."

Dr. Santiago Horgan, a surgeon with UC San Diego, agrees. "People 50 pounds overweight are the ones we should treat, before the problem gets worse," he said.

But not everyone is so sure that surgery is the answer. Some doctors believe bariatric surgery is too risky for patients who are only moderately overweight.

"The fact that bariatric surgery is the only efficient method of long-term weight loss is true," said Dr. Blandine Laférrere, a diabetes expert at Columbia University College of Physicians and Surgeons in New York. "But does that mean everyone who is overweight should have it? I don't think so, because none of these procedures is benign."

And although technological advancements in surgery can lead to shorter hospital stays and easier recovery periods for patients, long-term surgical complications remain. Paul Ernsberger, an associate professor of nutrition at Case Western Reserve University School of Medicine, worries that more accessible surgery would lead to people electing surgery for purely cosmetic reasons. The focus should be on health, Ernsberger states, and not simply on weight.

Since diet and exercise are a key component of losing weight after weight-loss surgery, some bariatric professionals believe patients should exhaust all other measures before considering surgery, and that procedures such as Lap-Band or gastric bypass should be used only as a last resort.

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