The type of surgery also made a difference.Procedures that permanently reduced the size of the stomach or bypassed it — sleeve gastrectomy, gastric bypass or duodenal switch — were more likely to result in the healthier BMI compared with adjustable gastric banding, a reversible procedure, Varban said. Less than 9 percent of patients with a BMI above 50 achieved the below-30 BMI goal, he said.
The report appeared online in July in the journal JAMA Surgery.Dr. Mitchell Roslin is chief of obesity surgery at Lenox Hill Hospital in New York City. He agreed that earlier surgery often pays bigger dividends in terms of weight loss and related medical problems. But Roslin cautioned that having surgery doesn’t mean you will achieve a normal weight. Also, patients have to consider the benefits and risks of each procedure, he said. The more aggressive the procedure, the greater the weight loss — but there’s also a higher risk for side effects, Roslin said. “The more we change the stomach and intestine, the more the weight loss and the lower the odds of regaining weight,” he said. “But the odds are higher of frequent bowel movements and the need to take micronutrient supplements.”
Another specialist stressed that losing weight at any level of obesity is beneficial.“Weight loss at whatever point you start is good,” said Dr. Bruce Wolfe, a professor in the division of bariatric surgery at Oregon Health and Science University. Everybody who has a BMI of 50 or 60 at one point had a BMI of 40, said Wolfe, co-author of an accompanying journal editorial. Getting bariatric surgery earlier might prevent patients from reaching a BMI of 50 or more, but even those who are severely obese can benefit from weight-loss surgery, Wolfe said.
Copyright © 2017, Chicago Tribune
Choosing an appropriate surgery is a difficult choice. There is no right answer. The surgery that you choose is a personal decision based on your habits, risk aversion, and lifestyle.
You may be a candidate for weight loss surgery if: You’re an obese adult, especially if you have a weight-related condition, such as type 2 diabetes. You know the risks and benefits. You’re ready to adjust how you eat after the surgery. You’re committed to making lifestyle changes to keep the weight off.