Bailey's success story is a common one. In 75% of cases, bariatric surgery succeeds where other methods fail. Dramatic weight loss begins immediately after the procedure and levels off in 18 to 24 months. The average patient loses between 50% and 75% of his/her excess weight and keeps it off -- a feat no diet or drug has yet to match.
It's clear that nonoperative treatment doesn't work for the severely obese, Brolin says. "In this group, the failure rate of dieting approaches 100%."
Other weight-loss experts concur. Compare bariatric surgery to dieting and it's no contest, says John Foreyt, a psychologist at Baylor College of Medicine in Houston, who works extensively with bariatric surgery patients. The average dieter loses 10% of his body weight. For someone who is severely obese, that can be a mere 30 or 35 pounds, says Foreyt.
Using behavior modification, such as diet and exercise, the most weight a person can hope to shed is one to two pounds per week, says Randall Flanery, a psychologist at the St. Louis Behavioral Medicine Institute in St. Louis. At that rate, a person who needs to drop 150 to 200 pounds may die of an obesity-related illness before getting the weight off, he says.
Surgery Isn't a Cure
Still, Flanery and Foreyt agree that every other weight loss option should be exhausted before considering something as drastic as surgery. "Bariatric surgery is not a first, second, or even third alternative," Flanery says. "Surgery is not a magic bullet for obesity."
"The biggest misconception about bariatric surgery is that it's going to solve the problem," Foreyt says. "It's part of the answer, but it's not the whole answer. It's critical that people eat well and exercise after surgery."
Indeed, up to 25% of bariatric surgeries fail. These patients either never reach their target weight or regain pounds by slowly and deliberately ingesting high-calorie foods and, over time, stretching the pouch far beyond its original size. "There's a patient out there who can beat any operation designed," Brolin says.