Weight Loss Surgery for Obesity
Bariatric surgery as a quick fix for obesity in men
Weight loss surgery: Drastic solutions to a drastic problem continued...
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
Weight loss surgery: Band versus bypass
The simplest type of weight loss surgery, gastric banding, involves placing
a band around the upper part of the stomach, which creates a small pouch. The
operation restricts the amount of food that can be digested, making people feel
full with much smaller portions.
In the second and more complicated procedure, gastric bypass surgery, the
surgeon creates a small pouch out of the stomach and directly connects the
pouch to the large intestine. In most cases part of the large intestine is also
removed. Because a large stretch of the digestive tract that normally absorbs
food is bypassed, patients absorb fewer calories from the food they eat.
For men, weighing the risks and benefits of these two types of weight loss
surgery is especially thorny. "Men in general experience more complications
from bariatric surgery than women," Livingston explains, "probably in part
because they carry more abdominal fat than women, so the operation is more
difficult to perform. "But men also suffer more complications as a result of
obesity than women, so they stand to benefit more by losing weight."