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Is Weight Loss Surgery Safe?
Howard LeWine, M.D.

HOME > HEALTH >
Ask the Harvard Experts: Is Weight Loss Surgery Safe?

 

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Q: I'm so frustrated with my weight. I'm heavier than ever. I've tried many different diets, programs and a couple of weight loss medications. My doctor has suggested that I consider weight loss surgery. I'm scared. How dangerous is it?

A: Weight-loss surgery (bariatric surgery) done by experts is getting safer, according to a study reported in the July 30 issue of the New England Journal of Medicine.

Bariatric surgery is very effective. Not only do people shed many pounds of fat, but they also decrease their risk of diabetes and heart disease. Their risk of death over time is about one-third lower than for very obese people who don't have surgery.

Your reluctance to have surgery is shared by many other patients. The three main reasons have been the risk of severe complications during and after surgery, long term health problems and cost.

The new study offers some reassurance about safety. Deaths and serious problems occurred during and shortly after surgery at rates similar to those of other major operations.

In addition, the study highlights which patients are most likely to get into serious trouble during and right after surgery. The patients at highest risk:

--Are extremely obese, with a body mass index of 55 or greater

--Have a history of blood clots in the legs and/or lungs

--Function poorly in everyday life. This group may be unable to walk even short distances or do daily activities without help.

Sleep apnea also increases the short-term risk of surgery. But obesity can cause sleep apnea. So this is a reason for obese people to consider the surgery.

In the past, some people had problems getting enough nutrition after the surgery. Some developed osteoporosis, or thin bones. These longer-term problems can now be prevented.

Cost is a complex issue. Surgery certainly is more costly than other weight loss techniques in the short run.

More procedures would greatly increase costs in our already unaffordable health system. But in the longer term, this may actually lead to major cost savings.

For carefully selected people, bariatric surgery can be considered if you have a body mass index (BMI) of 40 or greater or have certain medical conditions (such as high blood pressure, diabetes, heart disease or sleep apnea) and a BMI of 35 or greater.

They also must have made serious attempts at weight loss with non-surgical approaches, as you have done.

Howard LeWine, M.D. is a practicing internist and Chief Medical Editor of Internet Publishing at Harvard Health Publications, Harvard Medical School.)

 

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10 Salt Shockers That Could Make Hypertension Worse
Deborah Kotz

Does too much salt cause high blood pressure, or doesn't it? That debate has raged for decades, with a slew of studies finding "yes" and a slew of others finding "no." Two new studies published in the journal Hypertension tip the scales in favor of reducing sodium -- particularly for those 1 in 4 Americans who have high blood pressure. If you're unexpectedly getting too much sodium, here are some likely culprits ...

Could Cigarette Smoking Ever Get Safer
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Tobacco companies have begun "clinical trials" to assess whether a range of prototype "safer cigarettes" really do slash levels of toxic chemicals entering the body

Cholesterol - 10 Ways to Lower LDL and Raise HDL
January W. Payne

Your doctor tells you that your level of LDL -- the 'bad' type of cholesterol -- is too high, and, in a double whammy, he says that your level of HDL -- the 'good' cholesterol--is too low. Is there anything you can do to decrease the bad while increasing the good? There are steps you can take to accomplish this.

(C) 2009. PRESIDENT AND FELLOWS OF HARVARD COLLGE. ALL RIGHTS RESERVED DISTRIBUTED BY TRIBUNE MEDIA SERVICES, INC.

 

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