What You Might Not Know About Weight Loss Surgery

From the WebMD Archives

Nov. 14, 2014 -- For Julie Murphy, being overweight was familiar. After all, her entire family was big. But she was determined to handle things differently.

“My mom never would go anywhere with us -- she was always so embarrassed because she was so overweight,” says 57-year-old Murphy, who's from eastern Tennessee. “I was determined that I wasn’t going to be like Mom. I was not going to shut myself out of my kids’ lives.”

And she didn’t. Even at 268 pounds, she got to their games, recitals, and their school functions. It wasn’t until she had grandchildren that things got harder.

“I had been diagnosed with diabetes, I had arthritis in both my knees, I got out of breath easily,” she says. “I had grandkids now, and I wanted to be able to do things with them.”

Murphy decided the best course of action for her was to undergo gastric bypass surgery. This shrinks the size of your stomach, so you can't eat as much as before. The surgeon also re-routes, or bypasses, part of your digestive system so you don't absorb as much food.

“I knew I had made the right choice, and I said I did this for myself, I didn’t do this for anybody else,” she says.

So in March of 2004, she went under the knife. And just 1 day later, the trouble began.

“I’m in the hospital, post-op, and the lady goes to help me in the bed," Murphy says. “She kind of throws me back and I pull every muscle in my stomach.”

Shortly after that, she got kidney stones, a known complication of weight loss surgery. Next up was low potassium levels, which kept her in the hospital for 8 days.

She also needed her pouch -- the small amount of stomach she had left -- stretched five different times, because she couldn’t stop vomiting when she ate.

“My last name is Murphy,” she says. “It’s kind of like Murphy’s Law – anything that can go wrong is going to go wrong.”

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Risks of Surgery

According to Edward Lin, DO, the surgical director of Emory University’s Bariatric Center, Murphy’s complications were some of the less severe type.

Of course, with any major surgery, he says, there is a risk of a heart attack or blood clots.

“The [other big] one would probably be leaks,” Lin says. “You’re taking two pieces of bowel and attaching them to each other, and they can leak. These patients can get very, very sick.”

While major complications of weight loss surgery can be deadly, they are rare.

According to the American Society for Metabolic and Bariatric Surgery, the chances of having a major complication are only about 4.3%. The risks of staying obese are far more dangerous.

Weight loss surgery “has become extremely safe and effective,” says John Morton, MD. He's the chief of bariatric surgery at Stanford University. “Safer than the removal of a gallbladder, in fact, and that has happened in just over a decade.”

But, he says, the risks are real, and they should be taken seriously.

"Any time you discuss surgery, you have to discuss risk and benefits, but clearly the balance of benefits far outweighs the risks,” he says.

Several studies released earlier this year confirm that.

According to the reports, people who underwent weight loss surgery took fewer medications than those who did not have surgery, lost significantly more weight than the non-surgical group, and lowered their risk of type 2 diabetes.

But Lin says that even minor complications, like those Murphy had, can have a major impact.

“The most important thing I do is to convey stories of complications I’ve seen,” he says. “What I tell [patients] to do is pretend you’ve had these bad complications. What is your plan after that? If you have young children, who is going to help you take care of them?”

Still, well-informed patients who weigh the risks carefully can have very successful outcomes, he says.

“People usually do this out of desperation because they have tried all kinds of things. They can’t get the job they want, people look at them differently,” Lin says. “When you’re diabetic, or when your cholesterol is through the roof, this gives you a chance at life.”

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'A Complete Lifestyle Change'

Murphy says despite all of the complications she faced, she would make the same decision all over again.

Her diabetes is gone, and she’s down about 45 pounds -- though she had lost over 100 pounds at one point. She’s regained some of the weight, she says, because she snacks too often, and has developed a thyroid problem unrelated to the surgery.

“I had to fight this whole journey afterwards, and I had every little setback over and over and over, but in the long run, it paid off,” Murphy says. 

She says she’s able to move around more easily, feels better overall, and has great blood pressure and cholesterol numbers.

Still, 10 years later, she says she can’t eat much at a time -- a few bites of very tender meat or a small burger at dinner -- or else she risks vomiting.

And she says she never could have imagined the psychological issues she’d face.

“It is a huge eye-opener, even when you go back and see the pictures of yourself, you’re kind of like, ‘I didn’t realize that I looked like that,’” Murphy says. “But you still have trouble. You’re never going to get over the fat person.”

Lin says the bottom line for people considering the surgery is that it can be life-saving, but don’t go into it without understanding the journey.

“You really need strong support for something like this, and it is far from being the easy way out,” he says. “It is a complete lifestyle change.”

WebMD Health News Reviewed by Brunilda Nazario, MD on November 14, 2014

Sources

SOURCES:

Julie Murphy, Gastric bypass patient, Tennessee.

Edward Lin, DO, MBA, professor of surgery, Division of General and GI Surgery, Emory University School of Medicine; surgical director, Emory Bariatric Center.

American Society for Metabolic and Bariatric Surgery: "Metabolic and Bariatric Surgery Fact Sheet."

Schauer, P. New England Journal of Medicine, May 2014.

American Society for Metabolic and Bariatric Surgery Obesity Week 2014 Conference, Boston, Nov. 2-7, 2014.

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