Gastric Bypass Candidates
Who's a candidate for gastric bypass surgery?
A patient who's overweight, their first choice should be to try to lose weight by dieting, whether it's diet pills, a program, or just their own diet method. Once that fails then bariatric surgery would be the next choice. There are a few exceptions to that. If somebody has never dieted and they're 600 pounds, the chances that they're going to lose weight by dieting is almost, if not, zero and their chances of losing weight is tremendous with the bariatric surgery although the risks are very high. But that would be their first choice.
Is gastric bypass surgery the first choice in obesity treatment?
A patient who is overweight, there first choice should be to try to lose weight by dieting, whether it is diet pills, a program or just their own diet method. Once that fails, then bariatric surgery would be the next choice. Now there are a few exceptions to that. If somebody has never dieted and they are 600 pounds, the chances that they are going to lose weight by dieting is almost if not zero. And their chances of losing weight is tremendous with the bariatric surgery, although the risks are very high but that would be their first choice.
Is gastric bypass surgery more suitable for men or women?
Gastric bypass surgery is suitable for both men and women. I would say ten years ago about 90% of my patients were women. Now it's probably about 80% who are women. More men are coming to see that their health risks are tremendous and they need to lose weight. If you look out in society an overweight woman is much less accepted than an overweight man. And I think that's what has influenced the rates of surgery that these patients want to have. I don't know what the percentage of men in the population are more than a hundred pounds overweight over women. I've never seen a study of that sort, but definitely the people who have the surgery are mostly women.
How obese do I have to be to get gastric bypass surgery?
To be a candidate for gastric bypass surgery, you need to have a BMI, which is body mass index, of about forty, which equates to being about a hundred pounds overweight. You can even have a BMI of thirty-five, which equates to about a weight of seventy-five pounds, if you have comorbid conditions, again, diabetes, hypertension, sleep apnoea. We have patients, obviously, who are very overweight, BMI's of fifty, sixty, seventy, even a hundred, maybe up to a weight of six hundred. The heaviest patient I've ever operated on was six hundred and seventy five pounds. But the complication rate goes up tremendously when you get over six hundred pounds, so we're very careful. We try to get those patients to lose weight, at least down to six hundred or under six hundred, before operating.
Can gastric bypass surgery treat illness aside from obesity?
One of the biggest benefits of gastric bypass surgery is the treatment of diabetes. They have found, with several research projects, that by bypassing the stomach into the duodenum, patients lose their diabetes, decrease the amount of medications they're taking, decrease the insulin they're having, almost immediately after surgery. And within 30 days after surgery, I would say up to 90% of the patients are cured of their diabetes. So gastric bypass surgery definitely treats other diseases. It also helps with joint problems. Because your joints are being worn out very quickly when you're overweight, by losing the weight you stop that process from going forward, although it doesn't cure the damage that was already there. Hypertension, high blood pressure caused by being overweight also is resolved once your weight comes down. And I've found patients, once they lose between 30 and 50 pounds and maybe be 100, 200 pounds overweight, don't need their hypertensive medications anymore, and their blood pressure is normalized.
Is it common for adolescents to have gastric bypass surgery?
It is not very common now. It's more common now than it was ten years ago. It is becoming more common. I just heard a recent commentary on the radio of the number of students in schools, high school, that are overweight. And it's increased, 50% over the last ten years. So it is becoming a much, much bigger problem in adolescents now.
