Weight Loss Surgery for Obesity

The first weight loss surgery Garrick Pedersen underwent nearly killed him.

Doctors placed an elastic band around Pedersen's stomach just below the esophagus to restrict how much food he could eat. Pedersen, who weighed close to 300 pounds, began to lose weight almost immediately after the surgery.

"I was overjoyed," says Pedersen, 52, a lawyer in the San Francisco Bay area. "I felt better. I looked better." What's more, very small portions of food left him feeling full.

Then came trouble. Pedersen felt sharp abdominal pains and was rushed into surgery. The band around his stomach had slipped, threatening to cut off circulation. Had he waited much longer, he could have died. The band was safely removed, but Pedersen began to regain weight quickly.

"I was devastated," he remembers. "It wasn't just a matter of wanting not to be fat, though that certainly mattered to me. There are serious health problems associated with being obese, which I was. And I already had many of them. I was being treated for diabetes. My hips and my knees were deteriorating. My blood pressure was too high. Being obese was almost certainly going to cut my life short. And when you have two young kids, that's a hard thing to think about."

So, less than a year later Pedersen was back in the hospital, undergoing another weight loss operation. This time, surgeons bypassed a large section of his stomach and eliminated a stretch of his intestines, an operation called gastric bypass. Three months after the second operation, Pedersen has lost more than 45 pounds, enough that people stop him on the street to say how great he looks.

Weight loss surgery: Drastic solutions to a drastic problem

Pedersen is hardly alone in resorting to drastic weight loss surgery to shed pounds. More and more severely overweight and obese people are turning to bariatric surgery, as these weight loss procedures are called. According to a 2005 report published in the Journal of the American Medical Association, the number of bariatric operations increased sevenfold in just five years-from 13,365 operations in 1998 to 102,177 in 2003. Survey results also show a steep climb in the number of men opting for weight loss surgery.

Since surgical approaches to treat obesity were first undertaken in the 1970s, they've been controversial. If the problem is that obese people eat too much, chopping away parts of their stomachs and intestines to get them to eat less seems an extreme solution.

"But the fact is, dieting and other lifestyle interventions simply don't work very well for most people," says Edward Livingston, MD, a surgeon at Southwestern Medical School in Dallas and head of bariatric surgery for the nation's Veterans Affairs system. "And for people who are obese, they almost always fail." To keep prescribing treatments that have been shown repeatedly to fail is simply bad medicine, he insists.

In truth, early attempts at weight loss surgery didn't work all that well either. They carried serious risks of infection and death. But now, surgeons have refined two basic approaches, experts say, gastric banding and gastric bypass surgery, which offer better results with far fewer complications than earlier procedures.