Indiana University

Media Relations

Tuesday, March 21, 2006

Weight-loss surgery: myths and realities

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Bariatric surgery is on the rise, with an estimated 177,000 surgeries performed last year compared to just 50,000 four years earlier. Yet this procedure is still widely misunderstood, say Indiana University health experts. Don Selzer, an assistant professor of surgery in the Indiana University School of Medicine, and Alice Lindeman, a professor of applied health science in IU Bloomington's School of Health, Physical Education and Recreation, separate fact from fiction regarding this treatment. In addition to their academic appointments, Selzer is a surgeon with the Clarian Bariatric Center and Lindeman is a dietician who has counseled bariatric surgery patients for more than 30 years.

Reality: "This surgical procedure can help patients lose up to 50 to 66 percent of excess body fat," Lindeman said. Patients who are 150 pounds overweight are likely to remain at least 50 pounds overweight at the end of the process. "We don't accept patients who have unrealistic expectations," she said. "We screen very carefully to find people who want to improve their quality of life and their overall mobility."

Reality: Patients have a lot of work to do post-surgery, Lindeman said. "You still have to overcome your old habits in order to maintain weight loss. It is possible to gain weight back after the initial loss that results from reducing the size of the stomach. Bariatric surgery is a tool, not a solution."

Reality: There are many different types of gastrointestinal procedures for weight loss, some of which reduce the functioning size of the stomach and others that bypass parts of the digestive tract, reducing absorption of calories and nutrients. Different types of surgeries offer different results, and some are more suitable for particular people than others, Selzer said.

Reality: Although potential complications such as pneumonia, blood clots and even death are real concerns, a number of recent advances have helped to minimize risks, Selzer said. In addition, having the procedure may assist patients in overcoming otherwise life-threatening conditions associated with obesity, including type 2 diabetes, hyperlipidemia, hypertension, high cholesterol and sleep apnea.

Reality: "It's a lifelong relationship between patient and doctor," Selzer said. Part of his role as a surgeon is to help patients manage their pre- and post-operative changes in diet and lifestyle. Most bariatric centers in the Indianapolis area, for example, take a multidisciplinary approach to the procedure, employing psychologists and nutritionists to help patients before and after the surgeries.

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