|The Lounge | Champions | The Wire | Schedule | Audio | Arcade | The Top Ten | Historical | Email | Video|
Weight Loss Surgery: What are the options?
To understand how surgical procedures aid the grossly overweight person to reduce their body fat, it helps to first understand the digestive process that is responsible for handling the food we take in.
Once food is chewed and swallowed, it's on its way through the digestive tract, where enzymes and digestive juices will break it down and allow our systems to absorb the nutrients and calories. In the stomach, which can hold up to three pints of material, the breakdown continues with the help of strong acids. From there it moves into the duodenum, and the digestive process speeds up through the addition of bile and pancreatic juices. It's here, that our body absorbs the majority of iron and calcium in the foods we eat. The final part of the digestive process takes place in the 20 feet of small intestine, the jejunum and the ileum, where calorie and nutrient absorption is completed, and any unused particles of food are then shunted into the large intestine for elimination.
Weight loss procedures involve bypassing, or in some way circumventing the full digestive process. They range from simple reduction of the amount you can eat, to major bypasses in the digestive tract. To qualify for many of these surgeries, a person must be termed "morbidly obese", that is, weighing at least 100 lbs. over the appropriate weight for their height and general body structure.
In the mid 1960s, Dr. Edward E. Mason discovered that women who had undergone partial stomach removal as the result of peptic ulcers, failed to gain weight afterwards. From this observation, grew the trial use of stapling across the top of the stomach, to reduce its actual capacity to about three tablespoons. The stomach filled quickly, and eventually emptied into the lower portion, completing the digestive process in the normal way.Over the years, the surgery evolved into what is now known as the Roux-en-y Gastric Bypass. Instead of partitioning the stomach, it is divided and separated from the rest, with staples. The small intestine is then cut at approximately 18" below the stomach, and attached to the "new", small stomach. Smaller meals are then eaten, and the digested food moves directly into the lower part of the bowel. As weight loss surgeries are viewed overall, this is considered one of the safest, offering long-term management of obesity.
A procedure that produces basically the same results as the stomach stapling/bypass, and is also classed as a "restrictive" surgery. The first operations, involved a non-flexing band placed around the upper part of the stomach, below the esophagus, creating an hourglass shaped stomach, the upper portion being reduced to the same 3-6 ounce capacity. As technologies advanced, the band became more flexible, incorporating an inflatable balloon, which when triggered by a reservoir placed in the abdomen, was capable of inflating to cut down the size of the stoma, or deflating to enlarge it. Laparoscopic surgery means smaller scars, and less invasion of the digestive tract.
A combination of the gastric bypass, and Roux-en-y re-structuring, that bypasses a significant section of the small intestine, thereby creating the probability of malabsorption. The stomach is reduced in size, and an extended Roux-en-y anastomosis is attached to the smaller stomach, and lower down on the small intestine than is normal. This permits the patient to eat larger amounts, but still achieve weight loss through malabsorption. Professor Nicola Scopinaro, University of Genoa, Italy, developed the technique, and last year published the first long-term results. They showed an average 72% loss of excess body weight, maintained over 18 years, the best long-term results of any bariatric surgical procedure, to date. BPD patients require lifelong follow-ups to monitor calcium and vitamin intake. The advantages of being able to eat more and still lose weight, are countered by loose or foul smelling stools, flatus, stomal ulcers, and possible protein malnutrition.
One of the first weight loss procedures for the grossly obese, was developed in the 1960s, a strictly malabsorptive method of reducing weight, and preventing gain. The jejuno-ileal bypass reduced the lower digestive tract to a mere 18" of small intestine, from the natural 20 feet, a critical difference when it came to absorption of calories and nutrients. In the end-to-end method, the upper intestine was severed below the stomach, and re-attached to the small intestine much lower down, which had also been severed, thereby "cutting out", the majority of the intestine. Malabsorption of carbohydrate, protein, lipids, minerals and vitamins, led to a variation, the end-to-side bypass, which took the end of the upper portion, and attached it to the side of the lower portion, without severing at that point. Reflux of bowel contents into the non-functioning upper portion of small bowel, resulted in more absorption of essential nutrients, but also less weight loss, and increased weight gain, post-surgery. As a result of the bypass, fatty acids are dumped in the colon, producing an irritation that causes water and electrolytes to flood the bowel, ending in chronic diarrhea. The bile salt pool necessary to keeping cholesterol in solution is reduced by malabsorption and loss through stool. As a consequence, cholesterol concentration in the gall bladder rises, increasing the risk of stones. Multiple vitamin losses are a major concern, and may result in bone thinning, pain and fractures. Approximately one third of patients experience an adjustment in the size and thickness of the remaining active small intestine, which increases the absorption of nutrients, and balances out the weight loss. However, over the long term, all patients undergoing this bypass are susceptible to hepatic cirrhosis. In the early 1980s, one study showed that approximately 20% of those who had undergone JIB, required conversion to another bypass alternative. The procedure has since been largely abandoned, as having too many risk factors.
While surgical methods of reducing weight are valuable to the morbidly obese, they are not without risks. Patients may require more bed rest post-surgery, resulting in an increased chance of blood clots. Pain may also cause reduced depth of breathing, and complications such as pneumonia.
Before undergoing any fat/weight reduction surgery, a severely overweight person needs to thoroughly understand the benefits and risks, and must make a commitment to their future health. Having a smaller stomach is not going to stop the chronic sugar-snacker, from "grazing" on high calorie sweets. Nor does a steady supply of pop, concentrated sweet juices and milk shakes, reduce the calorie intake. With some bypass surgeries, certain foods can aggravate side-effects that need not be that severe, if common sense diets are adhered to. Surgery can be a "shortcut" to weight loss, but it can also reduce your enjoyment of life, if you are unable to adhere to the regimens that go with it.
Fitness Consultant Anthony Ellis has helped thousands of individuals lose fat and build more muscle. To read more about his fat loss recommendations please check out his site at http://www.fatlosstips.com
Willowbrook's Orangetheory Fitness announces winners of weight-loss challenge - The Doings La Grange
Its All In The Numbers
Offer a woman the choice between a dress she likes a lot, that fits well but is size 12, and a dress she likes, which also fits well but is labeled size 8, and she'll take the lesser preferred every time.Why are we so hung up on sizes? Men don't care.
Diet Preparaton -- The Impact of Sleep and Stress
When you have started a diet in the past, how much sincere and attentive focus did you give to preparing for your diet? Isn't it true that usually you are getting the food together a particular diet requires, buying yet another tread mill (or hauling out the old one covered in dust from the last diet), getting another gym membership, planning that last big blowout gluttonous meal you're going to eat because you are going to have to starve for the next eight weeks. The above really isn't an exaggeration.
The Low Carb Craze and Other Dieting Mistakes
Dear BMTers,Low carb this and low carb that?that's all you hear nowadays. Kinda reminds me of something that was the craze a few years ago?The Low or No Fat Craze?Can you remember where that got us? Still Fat!!!Well my friends this Low Carb Craze is going to bring us to the same exact place?Yep?Still Fat!Listen, anyone who tries Low carb dieting will experience some Short Term success?but it's only short term.
Why Do You Say You Want To Lose Weight?
How many of your New Year's resolution start out with "I want to lose x amount of pounds" as if just saying it were some kind of magic mantra.As if the weight would just fall off, in response to the spoken words!Why do we not want to pay the price for anything? Gaining weight is not an overnight effect and it will NOT be reversed overnight.
Do You Make These South Beach Diet Mistakes?
The South Beach Diet works, for most people. Its low fat, low carb approach helps you lose weight quickly and easily.
Wellness Coach Reveals Celebrity Diet
We think we know everything there is to know about them. After all, faithful paparazzi hunt them down just so we can get a picture or a glimpse of their lives.
Burning Fat vs. Burning Calories
To lose weight and get in shape you must have a good diet and exercise regularly to burn fat. The first thing you must understand about exercise is that just because you are burning calories does not mean you are burning fat.
Body Composition And Weight Loss: They Are Related!
The world today has more obese and overweight people than any other time in history. The reasons are simple too much bad foods and not enough exercise and weight training.
Find the Right New Year's Resolution to Get into Your Best Shape Ever!
Yep, it is that time of year again! Time to moan and groan about the weight we gained over the holidays as we resolve to lose it all in the New Year! If memories of failed New Year's resolutions are haunting you, it is time you found the right resolution for 2005.The reason that most New Year's Resolutions fail is that they are too extreme or time consuming.
Lose Weight NOW! - Do or Die Time!
Some of you will not like what I'm going to say, even though it is the truth. That may be where the issue of America's health problems lies.
I learned about gaining weight when I heard the question of a skinny girl asking, "how does someone gain weight." First I came to surprise because gaining weight is not something that people want to have around you.
Want To Lose Fat? Eat More of This
If you've been working out with weights for any length of time, you know the importance of supplying your body with frequent feedings of quality protein so that your body will be able to have the necessary building blocks to build muscle in the shortest amount of time possible.How much protein should you be consuming each day? Well, that debate has been raging for many years.
The Secret to Reaching Your Ideal Weight
There are many books and internet articles written about weight control. However, if you already know the stuff you should be doing, you might want to skip past the next section of this article.
Can Writing Actually Improve Your Health?
According to the Journal of the American Medical Association, writing about stressful life events helped reduce symptoms of asthma and rheumatoid arthritis in patients with these chronic illnesses. The effects of the writing exercise were still evident four months later and resulted in clinically meaningful improvements in patient symptoms.
Weight Loss Program: Do Your Expectations Sabotage Your Success?
When women talk about their biggest obstacles to successful weight and health management, we often hear about hurdles like not enough time or knowledge to prepare healthy meals. Or frequent social occasions that involve food.
5 Easy Steps to Help You Lose Weight
When losing weight, most of us don't have the time to drastically change our lifestyles. We need a practical and convenient way to integrate effective habits into our daily lives.
Obesity Acceptance and Fat Acceptance: Different Labels; Same Dangerous Message
Obesity acceptance, also known as fat acceptance, has a simple, appealing message..
Throw Out the Scale
Do you know someone that is obsessed with the scale? Someone who hops on the scale morning, noon and night? And stepping off each time with feelings of frustration or disappointment? With obesity on the rise and weight loss a common household topic, its easy to become obsessed with weight, diets and the scale. This multi-billion dollar industry brings about constant marketing and advertisement on the next solution or quick fix that hits sixty five percent of American's weight issues.
How Many Calories Are Too Many
In today's bustling world we are constantly surrounded by media hype about "Weight Loss" and "Calorie Controlled Diets". As a Nutritional Therapist, I am often asked "How many calories are too many?" The simple answer to this question is that we are all individuals, and we all require a different amount of calories per day.
Dieters : Put MORE Focus on Food
If you're always on a diet you probably spend half your lifethinking about food - what you can eat and what you can't,what you'd like to eat if only it was allowed, what you'llhave for your next meal, what you shouldn't have eaten atthe last one..
Section Site Map - Submit News - Feedback - Comments - Advertise with Us
Copyright © 2006 Luminati Inc. All rights reserved.