Ernest Nagel
is old
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The miracle weight loss that isnt
Risks of gastric-bypass surgery are often underplayed, some experts say
Despite the growing popularity of obesity surgery, its no easy path. Four in 10 patients developed complications within the first six months, according to one study.
By Sabrina Rubin Erdely
updated 8:33 a.m. CT, Mon., Aug. 18, 2008
Eileen Wells was smiling as she was wheeled into surgery. She was too excited to feel nervous. At 38, she was about to get a new lease on life, she says, echoing jargon in weight loss surgery ads. She had seen the before and after pictures in celebrity tabloids, watched the TV infomercials, listened to the patient testimonials and researched online. She was ready to begin her own transformation. At 5 foot 3 and 290 pounds, she was sick of being fat. Her joints ached. Her feet hurt. A stroll through the mall near her home in Greenwood Lake, New York, was enough to leave her sweat-slick and gasping for air. She was anxious to say good-bye to sleep apnea and dieting, ready to take control. And so in March 2005, Wells underwent a laparoscopic gastric bypass. She was grinning right up until the anesthesia knocked her out.
From the menu of weight loss (bariatric) operations, Wells had chosen the Roux-en-Y bypass, the most popular option in the United States. The surgery sectioned off her stomach to a thumb-sized sac sharply limiting the amount of food Wells could eat then connected it to a deeper portion of her small intestine, to limit absorption of the calories she did consume. (An increasingly popular alternative, gastric banding, cinches in the stomach to restrict its capacity.) The rearrangement required Wells to radically overhaul her eating habits. She learned to eat tiny, frequent meals, cutting her food into pencil erasersized bites. On her doctors orders, to replace nutrients no longer absorbed by her digestive tract, she faithfully swallowed a multivitamin, calcium and B12 supplements and two protein shakes daily. Soon she resembled the women in those weight loss infomercials: Fifteen months post-op, Wells had lost an amazing 160 pounds more than half her body weight bringing her down to a trim 130.
But although Wells looked like a satisfied customer, she didnt feel like one. Seven months after surgery she had developed an agonizing ulcer on the new inner seam between her stomach and intestine, which required a second operation. Not long afterward, Wells recalls eating a bite of tuna steak her husband, Ron, had prepared and doubling over in pain; an ambulance rushed her into surgery yet again, this time for an intestinal hernia her bowel had snagged on a slit in her abdominal wall. A fourth procedure followed to ease the pain of the abdominal scarring from her previous surgeries. Meanwhile, Wellss gastrointestinal pain had become so severe that she could barely eat. One day while shoe shopping, she realized she couldnt flex her right foot. Within weeks her limbs began to tingle, her energy evaporated and her weight plummeted. She stopped menstruating. By late 2006, Wells had shrunk to 105 pounds.
Story continues below ↓advertisement
I feel like Im dying, she told Ron. Months of doctors visits revealed that Wells had beriberi, a disorder caused by extreme thiamine deficiency. Rarely seen outside 19th-century Asia, its present enough among those in the weight losssurgery world that doctors call it bariatric beriberi.
A so-called shortcut
I was a model patient! I did everything right! Wells says today, still in disbelief that after all the hype and hope, her surgery turned out so disastrously. But as she learned the hard way, 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 didnt 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 its a shortcut to thinness and good health its no easy path. The American Society for Metabolic & Bariatric Surgery (ASMBS) in Gainesville, Florida, puts gastric-bypass surgerys 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. Some of these malnourished patients experience bizarre neurological problems, as Wells did.
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 youre 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. Its an adjustment so profound that patients are screened to make sure theyre 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.
All this for a surgery that the experts admit is poorly understood. Few randomized, controlled studies (the gold standard of research) have been performed comparing gastric bypass with nonsurgical weight loss therapy. Although initial weight loss can be dramatic gastric-bypass patients typically shed around 70 percent of excess weight patients gradually regain 20 to 25 percent of what they lose. For people with extreme obesity, defined as having a body-mass index of 40 or greater, gastric bypass often merely shifts them into the obese category. Obese patients can drop to overweight status (a BMI of 25 to 29.9). Yet fewer than 10 percent of patients achieve a normal BMI of 18.5 to 24.9, reports Lee Kaplan, M.D., director of the Massachusetts General Hospital Weight Center in Boston. Altogether, weight loss surgery remains an uncertain proposition, and although potential patients must meet certain criteria (as the women interviewed for this article did), experts caution that the surgery is definitely not meant for the mainstream. Because its risky, its only appropriate for a tiny fraction of people with obesity the sickest 1 to 2 percent, Dr. Kaplan says. The idea that all obese people should get surgery is insane. Yet thats the way weight loss surgery is being peddled to the public.
CONTINUED: The selling of a surgery
The selling of a surgery
Before Ellen Marraffino underwent gastric-bypass surgery in December 2003, she attended an information session at a hospital in Orlando, Florida, and was surprised to find a revival-like atmosphere. They herded us like cattle into this large conference room. There were at least 100 people, all terribly desperate to lose weight, recalls Marraffino, a 49-year-old former teacher. They paraded the successful patients, giving them the microphone: I never thought I could wear a size medium in my life, and now Im so happy and things are wonderful! And everyones clapping. People were getting all whipped up, and the doctors were selling the surgery, she adds.
Free seminars have proliferated around the country, as doctors, hospitals and bariatric surgical centers find new ways to promote their services. Add to this the proliferation of billboards, TV ads and websites covered in flashing before and after photos and exclamation-studded enticements, looking more like ads for personal-injury lawyers than for a risky surgery. Is gastric-bypass surgery right for you? Click here to see if we can help you qualify! beckons one Houston practice. Another site announces a competitive packaged price for gastric banding patients opting to pay out-of-pocket a route that allows doctors to avoid dealing with insurance and ensures theyll get paid in full, as insurance companies have strict rules about which candidates qualify and sometimes dont cover the entire cost. Although self-payers are a small segment of patients, their numbers shot up 62 percent in a two-year span, according to a study by HealthGrades, an organization in Golden, Colorado, that rates the quality of health care providers. Thats a remarkable growth for an elective surgery averaging $25,000.
Meanwhile, the manufacturers of two competing brands of gastric bands Allergan, which makes the Lap-Band, and Johnson & Johnson, maker of the Realize Band have taken the unusual step of marketing a major surgery directly to consumers. In November 2006, Allergan introduced a TV campaign for the Lap-Band, and both companies have websites allowing would-be patients to watch or read testimonials from happy customers, link to loan providers before surgery and track their progress afterward. At the Johnson & Johnson site RealizeMySuccess.com, a banding patient can create a 3-D model of herself and see what she might look like after a dramatic weight loss. It works much like the cosmetic surgery industry: Its heavily advertised, to patients, especially to women. And theres lip service being paid to health, but for patients the great motivator is to improve appearance, asserts Paul Ernsberger, Ph.D., nutrition professor at Case Western Reserve University School of Medicine in Cleveland.
When the fat makes its way back
Some bariatric-surgery patients may rationalize any suffering they experience as the cost of losing weight. But even so, they may not keep the pounds off and the svelte ideal theyre aiming for may be a pipe dream in the first place.
Lisa Tannehill of Grants Pass, Oregon, had high expectations when she had a duodenal switch at age 38. Im a big believer in the surgery, she avers and remains so despite having to fight through a post-op nightmare of a hernia and a reaction to pain meds. In the first 18 months, she dropped 100 pounds from her 325-pound frame. From there, however, Tannehills weight plateaued and then, to her horror, the pounds began creeping back on. I didnt do anything differently! she says. I still ate tiny meals! Nevertheless, six years post-op, Tannehill has leveled off at 240 pounds, a net loss of 85 pounds.
The greatest period of weight loss is the 12 to 18 months after bariatric surgery, after which you start to see weight regain, according to Meena Shah, Ph.D., an obesity researcher at the University of Texas Southwestern Medical Center at Dallas. Her 2006 review of the controlled studies done on the issue revealed that the disease-fighting properties of both bypass and banding surgery go down as patients weight goes back up.
Story continues below ↓advertisement
Why isnt weight loss more lasting? More evidence is needed, but one possible explanation is physical: If you keep overfilling the stomach, it can stretch from its tiny postsurgical size to perhaps double its size. In the case of gastric bypass, hormones may also play a role: Researchers have found that the surgery alters the balance of hormones such as ghrelin that regulate hunger and fullness. For the first four or six months, we actually have to remind patients to eat, says Sandra Arioli, a registered nurse who runs a gastric-bypass support group at the Renfrew Center eating disorders clinic in Coconut Creek, Florida. Six months later, hormonal balance shifts again and the appetite returns, sometimes with a vengeance, Arioli says. Thats when they have to start listening to their body because it becomes harder to change their eating behaviors. Patients need to get into the exercise habit a task easier said than done and come to terms with life after food. Post-op, these people grieve for the loss of food, Arioli says. Food is their comfort. And if you dont figure out how to find comfort in other ways, youre going to go with what you know. These are some serious eaters.
But a new theory might provide some answers about post-op weight gain, and prove that willpower has little to do with it. Researchers are now theorizing that the reason patients lose a certain amount of weight in the first place is because gastric bypass, in part by toying with hormones, somehow lowers the bodys natural set point, the weight your system is most comfortable maintaining. A patients hunger returns, because the body has achieved that lower set point. The surgery changes our physiology, the way the body responds to food. It makes heavy people more like people who are naturally thin, enthuses Dr. Kaplan, who is conducting cutting-edge research on the topic. Understanding this as a set-point issue allows us to stop blaming the patient who doesnt do as well, because they were just built that way. What they lose is what they lose, and they cant expect to lose any more.
Figuring out the mysteries of bariatric surgery has become an urgent new frontier. Once experts understand how it works, they hope to be able to re-create its positive results in nonsurgical ways so the surgery can be phased out altogether. Surgery is the best thing we have right now, but it isnt the optimal cure, Dr. Higa says. We need to figure out why it works, so we can eliminate it. If we do this right, we wont be doing surgery for obesity in 50 years.
Giving up on a miracle
Months of surgeries and nutrition therapy failed to pull Eileen Wells out of her downward spiral. I was a skeleton, just wasting away, she remembers. My doctor told me that if I didnt gain weight, I might die. Which is why in June 2007, Wells found herself being wheeled into surgery yet again crying this time en route to having her gastric bypass reversed.
Some experts argue that, unfortunately, bariatric procedures are not truly reversible. If you have a two-story addition put on your house, and then you tell the guy take it down well, he might take it down, but your house might never be like it was, says Louis Flancbaum, M.D., a retired bariatric surgeon in Teaneck, New Jersey. Removing a gastric band is easier than reversing a bypass. But in all, bariatric reversals or take downs, as patients call them are imperfect procedures with one near-guaranteed result: Patients will regain much of the weight theyve lost. Moreover, people who have their bands removed may find future weight loss surgery more risky, according to the ASMBS.
Nevertheless, it seems inevitable that as the number of bariatric-surgery patients continues to rise, so, too, will the number of complications and reversals. And although experts assert reversal surgery is exceedingly rare less than 1 percent of cases a number of women interviewed for this article have undergone it.
The miracle weight loss that isnt
Risks of gastric-bypass surgery are often underplayed, some experts say
Despite the growing popularity of obesity surgery, its no easy path. Four in 10 patients developed complications within the first six months, according to one study.
By Sabrina Rubin Erdely
updated 8:33 a.m. CT, Mon., Aug. 18, 2008
Eileen Wells was smiling as she was wheeled into surgery. She was too excited to feel nervous. At 38, she was about to get a new lease on life, she says, echoing jargon in weight loss surgery ads. She had seen the before and after pictures in celebrity tabloids, watched the TV infomercials, listened to the patient testimonials and researched online. She was ready to begin her own transformation. At 5 foot 3 and 290 pounds, she was sick of being fat. Her joints ached. Her feet hurt. A stroll through the mall near her home in Greenwood Lake, New York, was enough to leave her sweat-slick and gasping for air. She was anxious to say good-bye to sleep apnea and dieting, ready to take control. And so in March 2005, Wells underwent a laparoscopic gastric bypass. She was grinning right up until the anesthesia knocked her out.
From the menu of weight loss (bariatric) operations, Wells had chosen the Roux-en-Y bypass, the most popular option in the United States. The surgery sectioned off her stomach to a thumb-sized sac sharply limiting the amount of food Wells could eat then connected it to a deeper portion of her small intestine, to limit absorption of the calories she did consume. (An increasingly popular alternative, gastric banding, cinches in the stomach to restrict its capacity.) The rearrangement required Wells to radically overhaul her eating habits. She learned to eat tiny, frequent meals, cutting her food into pencil erasersized bites. On her doctors orders, to replace nutrients no longer absorbed by her digestive tract, she faithfully swallowed a multivitamin, calcium and B12 supplements and two protein shakes daily. Soon she resembled the women in those weight loss infomercials: Fifteen months post-op, Wells had lost an amazing 160 pounds more than half her body weight bringing her down to a trim 130.
But although Wells looked like a satisfied customer, she didnt feel like one. Seven months after surgery she had developed an agonizing ulcer on the new inner seam between her stomach and intestine, which required a second operation. Not long afterward, Wells recalls eating a bite of tuna steak her husband, Ron, had prepared and doubling over in pain; an ambulance rushed her into surgery yet again, this time for an intestinal hernia her bowel had snagged on a slit in her abdominal wall. A fourth procedure followed to ease the pain of the abdominal scarring from her previous surgeries. Meanwhile, Wellss gastrointestinal pain had become so severe that she could barely eat. One day while shoe shopping, she realized she couldnt flex her right foot. Within weeks her limbs began to tingle, her energy evaporated and her weight plummeted. She stopped menstruating. By late 2006, Wells had shrunk to 105 pounds.
Story continues below ↓advertisement
I feel like Im dying, she told Ron. Months of doctors visits revealed that Wells had beriberi, a disorder caused by extreme thiamine deficiency. Rarely seen outside 19th-century Asia, its present enough among those in the weight losssurgery world that doctors call it bariatric beriberi.
A so-called shortcut
I was a model patient! I did everything right! Wells says today, still in disbelief that after all the hype and hope, her surgery turned out so disastrously. But as she learned the hard way, 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 didnt 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 its a shortcut to thinness and good health its no easy path. The American Society for Metabolic & Bariatric Surgery (ASMBS) in Gainesville, Florida, puts gastric-bypass surgerys 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. Some of these malnourished patients experience bizarre neurological problems, as Wells did.
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 youre 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. Its an adjustment so profound that patients are screened to make sure theyre 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.
All this for a surgery that the experts admit is poorly understood. Few randomized, controlled studies (the gold standard of research) have been performed comparing gastric bypass with nonsurgical weight loss therapy. Although initial weight loss can be dramatic gastric-bypass patients typically shed around 70 percent of excess weight patients gradually regain 20 to 25 percent of what they lose. For people with extreme obesity, defined as having a body-mass index of 40 or greater, gastric bypass often merely shifts them into the obese category. Obese patients can drop to overweight status (a BMI of 25 to 29.9). Yet fewer than 10 percent of patients achieve a normal BMI of 18.5 to 24.9, reports Lee Kaplan, M.D., director of the Massachusetts General Hospital Weight Center in Boston. Altogether, weight loss surgery remains an uncertain proposition, and although potential patients must meet certain criteria (as the women interviewed for this article did), experts caution that the surgery is definitely not meant for the mainstream. Because its risky, its only appropriate for a tiny fraction of people with obesity the sickest 1 to 2 percent, Dr. Kaplan says. The idea that all obese people should get surgery is insane. Yet thats the way weight loss surgery is being peddled to the public.
CONTINUED: The selling of a surgery
The selling of a surgery
Before Ellen Marraffino underwent gastric-bypass surgery in December 2003, she attended an information session at a hospital in Orlando, Florida, and was surprised to find a revival-like atmosphere. They herded us like cattle into this large conference room. There were at least 100 people, all terribly desperate to lose weight, recalls Marraffino, a 49-year-old former teacher. They paraded the successful patients, giving them the microphone: I never thought I could wear a size medium in my life, and now Im so happy and things are wonderful! And everyones clapping. People were getting all whipped up, and the doctors were selling the surgery, she adds.
Free seminars have proliferated around the country, as doctors, hospitals and bariatric surgical centers find new ways to promote their services. Add to this the proliferation of billboards, TV ads and websites covered in flashing before and after photos and exclamation-studded enticements, looking more like ads for personal-injury lawyers than for a risky surgery. Is gastric-bypass surgery right for you? Click here to see if we can help you qualify! beckons one Houston practice. Another site announces a competitive packaged price for gastric banding patients opting to pay out-of-pocket a route that allows doctors to avoid dealing with insurance and ensures theyll get paid in full, as insurance companies have strict rules about which candidates qualify and sometimes dont cover the entire cost. Although self-payers are a small segment of patients, their numbers shot up 62 percent in a two-year span, according to a study by HealthGrades, an organization in Golden, Colorado, that rates the quality of health care providers. Thats a remarkable growth for an elective surgery averaging $25,000.
Meanwhile, the manufacturers of two competing brands of gastric bands Allergan, which makes the Lap-Band, and Johnson & Johnson, maker of the Realize Band have taken the unusual step of marketing a major surgery directly to consumers. In November 2006, Allergan introduced a TV campaign for the Lap-Band, and both companies have websites allowing would-be patients to watch or read testimonials from happy customers, link to loan providers before surgery and track their progress afterward. At the Johnson & Johnson site RealizeMySuccess.com, a banding patient can create a 3-D model of herself and see what she might look like after a dramatic weight loss. It works much like the cosmetic surgery industry: Its heavily advertised, to patients, especially to women. And theres lip service being paid to health, but for patients the great motivator is to improve appearance, asserts Paul Ernsberger, Ph.D., nutrition professor at Case Western Reserve University School of Medicine in Cleveland.
When the fat makes its way back
Some bariatric-surgery patients may rationalize any suffering they experience as the cost of losing weight. But even so, they may not keep the pounds off and the svelte ideal theyre aiming for may be a pipe dream in the first place.
Lisa Tannehill of Grants Pass, Oregon, had high expectations when she had a duodenal switch at age 38. Im a big believer in the surgery, she avers and remains so despite having to fight through a post-op nightmare of a hernia and a reaction to pain meds. In the first 18 months, she dropped 100 pounds from her 325-pound frame. From there, however, Tannehills weight plateaued and then, to her horror, the pounds began creeping back on. I didnt do anything differently! she says. I still ate tiny meals! Nevertheless, six years post-op, Tannehill has leveled off at 240 pounds, a net loss of 85 pounds.
The greatest period of weight loss is the 12 to 18 months after bariatric surgery, after which you start to see weight regain, according to Meena Shah, Ph.D., an obesity researcher at the University of Texas Southwestern Medical Center at Dallas. Her 2006 review of the controlled studies done on the issue revealed that the disease-fighting properties of both bypass and banding surgery go down as patients weight goes back up.
Story continues below ↓advertisement
Why isnt weight loss more lasting? More evidence is needed, but one possible explanation is physical: If you keep overfilling the stomach, it can stretch from its tiny postsurgical size to perhaps double its size. In the case of gastric bypass, hormones may also play a role: Researchers have found that the surgery alters the balance of hormones such as ghrelin that regulate hunger and fullness. For the first four or six months, we actually have to remind patients to eat, says Sandra Arioli, a registered nurse who runs a gastric-bypass support group at the Renfrew Center eating disorders clinic in Coconut Creek, Florida. Six months later, hormonal balance shifts again and the appetite returns, sometimes with a vengeance, Arioli says. Thats when they have to start listening to their body because it becomes harder to change their eating behaviors. Patients need to get into the exercise habit a task easier said than done and come to terms with life after food. Post-op, these people grieve for the loss of food, Arioli says. Food is their comfort. And if you dont figure out how to find comfort in other ways, youre going to go with what you know. These are some serious eaters.
But a new theory might provide some answers about post-op weight gain, and prove that willpower has little to do with it. Researchers are now theorizing that the reason patients lose a certain amount of weight in the first place is because gastric bypass, in part by toying with hormones, somehow lowers the bodys natural set point, the weight your system is most comfortable maintaining. A patients hunger returns, because the body has achieved that lower set point. The surgery changes our physiology, the way the body responds to food. It makes heavy people more like people who are naturally thin, enthuses Dr. Kaplan, who is conducting cutting-edge research on the topic. Understanding this as a set-point issue allows us to stop blaming the patient who doesnt do as well, because they were just built that way. What they lose is what they lose, and they cant expect to lose any more.
Figuring out the mysteries of bariatric surgery has become an urgent new frontier. Once experts understand how it works, they hope to be able to re-create its positive results in nonsurgical ways so the surgery can be phased out altogether. Surgery is the best thing we have right now, but it isnt the optimal cure, Dr. Higa says. We need to figure out why it works, so we can eliminate it. If we do this right, we wont be doing surgery for obesity in 50 years.
Giving up on a miracle
Months of surgeries and nutrition therapy failed to pull Eileen Wells out of her downward spiral. I was a skeleton, just wasting away, she remembers. My doctor told me that if I didnt gain weight, I might die. Which is why in June 2007, Wells found herself being wheeled into surgery yet again crying this time en route to having her gastric bypass reversed.
Some experts argue that, unfortunately, bariatric procedures are not truly reversible. If you have a two-story addition put on your house, and then you tell the guy take it down well, he might take it down, but your house might never be like it was, says Louis Flancbaum, M.D., a retired bariatric surgeon in Teaneck, New Jersey. Removing a gastric band is easier than reversing a bypass. But in all, bariatric reversals or take downs, as patients call them are imperfect procedures with one near-guaranteed result: Patients will regain much of the weight theyve lost. Moreover, people who have their bands removed may find future weight loss surgery more risky, according to the ASMBS.
Nevertheless, it seems inevitable that as the number of bariatric-surgery patients continues to rise, so, too, will the number of complications and reversals. And although experts assert reversal surgery is exceedingly rare less than 1 percent of cases a number of women interviewed for this article have undergone it.
