Welcome to Weight Loss Diet - Information on Manhattan weight loss surgery

IT'S NO SECRET: AMERICANS have gotten fat. According to the U.S. surgeon general, 61 percent of adults and 14 percent of teenagers are overweight. Obesity rates have tripled among children and teens in the last 20 years.

As waistlines have expanded, so has the number of Americans turning to bariatric (weight-loss) surgery. The procedure has exploded in popularity. But is losing weight through radical surgery a smart choice, especially for teens?

PRO

Lawrence Capici has struggled with his weight his entire life. Already overweight in first grade, he was prescribed medication to curb his appetite. It didn't help.

By the time he reached high school, Lawrence stood 5 feet 4 inches tall and weighed 322 pounds. He was obese; an obese person weighs at least 20 percent more than his or her ideal body weight. Obesity is associated with serious health risks, including diabetes, heart disease, stroke, and some types of cancer. Obesity is also a risk factor for sleep apnea, a condition in which a person stops breathing for brief periods during sleep.

Lawrence hadn't developed those conditions but was feeling the physical strain of carrying so much extra weight. He had trouble walking. His energy was always low. Worse, he was picked on constantly at school and seriously depressed. "I was isolating myself from my family and friends, and I wasn't really living," he told Current Science.

Diets and exercise didn't help Lawrence. Studies have shown that most obese people who do lose weight by dieting can't keep it off. For that reason, supporters of bariatric surgery argue that it's the only surefire method for losing significant amounts of weight and maintaining the weight loss over time. Furthermore, a study published last fall in the Journal of the American Medical Association found that weight-loss surgery reversed diabetes, high blood pressure, high cholesterol, and sleep apnea in the majority of obese patients who had the operation.

At 17, Lawrence had gastric bypass surgery, the most common type of bariatric surgery in the United States. The operation shortens the intestines and reduces the stomach to the size of an egg. Afterward, the patient can't absorb as many calories and feels full after eating just a small amount of food. Patients typically lose more than 100 pounds in the year after surgery.

Lawrence's surgeon, Louis Flancbaum of St. Luke's-Roosevelt Hospital in New York City, agreed to perform the procedure only after he was certain that Lawrence had tried every other method of losing weight. "I had tried so many things that the surgery seemed to be the only option," Lawrence said.

A year and a half later, Lawrence is 130 pounds lighter. "I feel so much better about myself," he said. "So energized."

CON

Not everyone agrees that bariatric surgery is safe for teens. The operation can be risky for anyone; 1 to 2 percent of patients die during surgery or recovery. Serious complications include bleeding, hernias, bowel obstructions, and severe infections.

A bowel obstruction is a complete or partial blockage in the intestines. A hernia occurs when part of the intestine slips through a small opening in the abdominal wall. Ten to 20 percent of patients need follow-up surgery to repair such problems, according to the National Institutes of Health (NIH). Lawrence's surgery left him with an abdominal wound that didn't heal for months. He also developed a hernia.

After bariatric surgery, patients must dramatically change the way they eat. Overeating can cause violent vomiting and diarrhea, and many patients can no longer tolerate foods high in fat or sugar. People who have had the surgery have trouble absorbing enough nutrients and water. They must take vitamin supplements and sip water throughout the day to avoid malnutrition and dehydration. The NIH reports that nearly 30 percent of patients develop nutritional deficiencies.

Bariatric surgery is not reversible, and critics say many teens aren't mature enough to make a decision that will affect them for the rest of their lives. "Basically, you're altering a vital body system, the digestive system, in a way that can't be reversed," explained Joanne Ikeda, a pediatric obesity expert at the University of California at Berkeley.

Bariatric surgery has been performed on adolescents only in the last few years, adds Ikeda, so any teen undergoing the procedure is essentially a guinea pig. Will teen patients get enough nutrition to stay healthy throughout their lives? Will they regain the lost weight over time? "We don't have any long-term studies on teenagers--none," Ikeda said. "We can't predict what's going to happen in the long term."

Ikeda believes surgery can benefit teens who weigh more than 400 pounds and show evidence of obesity-related diseases. They carry a very real risk of dying from obesity. But most teens, she believes, can learn healthful behaviors. "I don't think this surgery is equivalent to helping to change a lifestyle," she said.

Lawrence Capici admits that weight-loss surgery is no quick fix. "It's a major step and really a last resort," he said. "You're confronting a whole new set of problems and emotions." Today Lawrence is a freshman at Hunter College in Manhattan. He's still learning how to deal with his smaller size, but he's thankful for the opportunity. "Absolutely no regrets," he said.

Fat Chance

Multiple Choice

Choose the word or words that best complete each statement or answer each question. Write the letter in the blank before each number.

--1. Weight-loss surgery is known as (A) bariatric surgery. (B) barometric surgery. (C) obstetric surgery.

--2. Gastric bypass surgery (A) reduces the size of the stomach. (B) shortens the intestines. (C) both A and B.

--3. Which is not a section of the small intestine? (A) duodenum, (B) jejunum, (C) stomach

--4. According to the U.S. surgeon general, which percentage of teenagers are overweight? (A) 8 percent, (B) 14 percent, (C) 61 percent

--5. People who stop breathing for short periods during sleep suffer from (A) sleep paralysis. (B) sleepwalking. (C) sleep apnea.

--6. When part of the intestine slips through a small hole in the abdominal wall, the result is (A) an ulcer. (B) a gastric bypass. (C) a hernia.

--7. A bowel obstruction is a blockage in the (A) esophagus. (B) intestines. (C) stomach.

--8. What percentage of people develop nutritional deficiencies after weight-loss surgery? (A) 1 to 2 percent, (B) 10 to 20 percent, (C) nearly 30 percent

--9. A recent study found that in a majority of patients, weight-loss surgery reversed (A) high blood pressure. (B) diabetes. (C) both A and B.

--10. Which is not a risk of obesity? (A) heart disease, (B) Parkinson's disease, (C) stroke

Fat Chance

1. A, 2. C, 3. C, 4. B, 5.C, 6. C, 7. B, 8. C 9. C, 10. B