Dear Dr. Eva,
In your column about weight loss, you didn’t discuss surgery. I can tell you from experience that there are some of us for whom no diet works and surgery is the only answer. I lost 120 lbs after my gastric bypass and while there are some limitations from the surgery, it has been well worth it to me. My diabetes, which had gotten to the point I was on the verge of needing insulin, is now under control with no medicine. Please give some space to this important option.
I’m glad the surgery worked for you and that you don’t mind the limitations resulting from it. However, most people can lose weight without having surgery and without risking the complications of surgery. The most common complications of gastric bypass surgery are chronic diarrhea and malabsorption.
Malabsorption means inability to absorb essential vitamins and minerals, especially calcium, iron, and vitamin B12. The lack of these minerals and vitamins leads to other complications, including anemia, kidney stones, osteoporosis, and abnormal nerve function.
Even when there is no malabsorption, after bypass surgery many people feel tired, achy, and cold much of the time. Many also experience dry skin, hair loss, and mood changes.
There are also medical risks associated with any major surgery, and the risks are higher for seriously overweight people. These risks include death during or after surgery, heart attacks, and blood clots in the legs and lungs.
Weight loss surgery is not magic. The surgery causes weight loss by greatly decreasing the size of the stomach so a person feels full after eating a small amount of food. If the person tries to eat more, they will vomit.
After gastric bypass surgery or gastric banding, a person can eat only a very small quantity of food. Many healthy foods that are more bulky, like raw fruits and vegetables, cannot be eaten at all or can be eaten only in very small amounts.
Weight reduction surgery works by forcing behavior changes – forcing a person to limit their food intake. If that person can make the same behavior changes without having surgery, they can achieve equal, and equally lasting, weight loss without the financial cost and medical risks of surgery.
Weight loss surgery is most appropriate in cases like yours, when a person has major medical problems such as diabetes that are directly linked to weight, and has been unable to lose weight after working with a dietician. If there are no serious weight-related medical problems, I encourage people to work on changing eating habits as a simpler, safer, cheaper and healthier way to lose weight.
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