“That thing that made you fat in the first place? They don’t cut that out during surgery.” Darlene Cates, mom in What’s Eating Gilbert Grape.
Every year hundreds of thousands of people seek out gastric bypass to lose weight and improve health. The short term effects of the surgery are substantial with many patients losing a large amount of weight within the first 12 to 18 months after surgery, but after that time frame, life changes are required to keep the weight off. According to Dr. James Ostroff, physician at UC San Francisco Medical Center, gastric bypass or weight loss surgery is just a “jump start” to weight loss. The doctor explains that “hormonal changes following surgery may result in loss of appetite…[but] the appetite soon returns.”
In a study published in 2006 by the Annals of Surgery, patients followed long term after gastric bypass tend to regain weight, especially those falling into the morbidly obese and super obese categories. Morbid obesity is defined as a body mass index of 40 to 44.9 and super obesity is defined as a body mass index of 45 and above. If gastric bypass is supposed to help people achieve a lower weight to improve help, why are the patients in the direst categories of body mass index regaining weight? Doctors suggest weight regain is associated with habitual eating, lack of portion control and lack of exercise; all life changes that could have helped patients lose weight before undergoing gastric bypass.
The hormone effect that reduces appetite only lasts about 12 months, according to Dr. James Ostroff, so after that 12 month weight loss period, patients have to rely on good, healthy habits to maintain weight loss. Some former gastric bypass patients suggest keeping off weight loss after surgery is just as hard as losing weight without the surgery.
Where Does Gastric Bypass Fail?
The same study that reported weight regain after gastric bypass revealed a commonly overlooked problem associated with weight gain. People who eat as a means of self medication for emotional distress and depression are not healed by gastric bypass. During the follow-up phase of the study, two patients committed suicide about nine years out from the gastric bypass surgery. The study included 272 patients of which 228 were contacted for long term follow-up. Two suicides account for about 1% of the study population. Of the 220,000 patients having gastric bypass in 2008, according to the 1% risk, about 2,200 are at risk of suicide.
Gastric bypass patients need to follow dieting guidelines established by weight loss surgeons for life. Changes in hormones will help control appetite for only a short while, after the initial 12 months, patients will need to maintain a diet of 1,000 to 1,200 calories per day from a diet that is low carbohydrate and very low sugar. Patients can learn to eat around the procedure, but that will only cause weight regain and subsequent potential health problems.
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