What No One Tells You About Weight Loss Surgery

You’ve heard the amazing testimonials: Morbidly obese person has surgery, sheds 150 pounds, lives healthfully ever after. You’ve seen stars transform themselves: Carnie Wilson, Al Roker and, if you believe the rumors, Star Jones Reynolds. It’s no wonder the demand for weight loss operations has tripled since 2001 and that many women overlook the risks. But bariatric surgery is no quick fix; it requires major lifestyle changes and lifetime follow-up. “It should be a last resort,” says Louis Aronne, M.D., an obesity expert in New York City. Here, the truths about weight loss surgery you won’t read in celeb success stories:

Surgery is only for the very obese.

“We sometimes get inquiries from people who might be just 50 pounds overweight, or even 20 or 30,” says Daniel Herron, M.D., chief of bariatric surgery at Mount Sinai Hospital in New York City. Although some unscrupulous doctors may operate on such people, American Society for Bariatric Surgery guidelines say patients should have a body mass index (BMI) above 40 (which is about 100 pounds overweight), or a BMI above 35 plus serious obesity-related medical problems like type 2 diabetes.

Complications are likely.

One in 200 patients die after gastric bypass surgery, the most common weight loss operation, in which a surgeon seals off most of a person’s stomach, drastically reducing the amount of food she can eat. Although those considering surgery are counseled about such risks, complications may be more common than many women believe. A new study found that about 40 percent of patients had problems ranging from diarrhea after eating fatty foods to hernias and intestinal leaks. And because gastric bypass shrinks the areas of the digestive tract that absorb nutrients, patients can develop deficiencies and must take vitamins for life.

It won’t necessarily make you thin.

Bypass patients typically drop 50 to 75 percent of their excess pounds within a year of surgery. After that, weight loss levels off and some patients, while no longer morbidly obese, are still overweight. “Take someone who’s 200 pounds overweight,” says Dr. Herron. “After losing 75 percent of that, or 150 pounds, she would still need to lose 50 extra pounds to get to a healthy BMI.” What’s more, some patients gain back 10 to 20 percent of the lost weight within three to five years. While weight loss surgery has helped thousands, doctors agree cutting your stomach in half isn’t an ideal solution. “Some severely obese people simply can’t lose enough weight through diet and exercise alone,” says Joseph DeSimone, Ph.D, a New York City clinical psychologist who counsels bariatric patients. “But the goal is to lose weight without surgery, if possible.”