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28 Are surgical procedures like liposuction or stomach stapling a good way to lose weight?


This article is from the Diet FAQ, by Claudia McCreary cookignnewsletter@chef.net with numerous contributions by others.

28 Are surgical procedures like liposuction or stomach stapling a good way to lose weight?

Liposuction (also known as lipolysis or suction lipectomy) is a surgical
procedure in which localized deposits of fat tissue are suctioned out of the
body through a long, thin metal tube known as a cannula in order to improve
body proportions (e.g., to reduce "saddlebag thighs," oversized buttocks, or
double chins). Liposuction is not appropriate as a weight loss method;
because of the large amounts of blood and body fluids that are suctioned out
along with the fat, only about 2-5 pounds of tissue can be removed during
the procedure. Most reputable plastic surgeons recommend that liposuction be
used only on patients who are already at or near their ideal body weights
and whose unsightly bulges fail to respond tosensible diet and exercise
plans. [Since liposuction is not a weight loss procedure, it will not be
described in detail here. For those interested inthe details of the surgery,
check your local library or bookstore for references on plastic surgery,
such as Dr. Paula Moynahan's Cosmetic Surgery for Women by Paula A.
Moynahan, M.D., or The Complete Book of Cosmetic Surgery by Elizabeth

Surgical procedures that are used to treat obesity include gastric bypass
and gastric reduction or partitioning (a.k.a. stomach stapling). These are
both drastic measures that are normally used only when more conventional
weight loss methods have failed and the patient's health is compromised by
his/her weight. The gastric bypass procedure involves stitching or stapling
across the entire width of the stomach, closing off the bottom portion of
the stomach and leaving only a fraction of the upper part of the stomach
open to receive food. A small opening is made in this remaining "pouch" of
stomach; the jejunum (a part of the small intestine) is brought up and
ttached to this small opening. As a result, all food and fluids ingested by
the patient must now pass through this small opening in the top of the
stomach and then directly to the attached small intestine. The stomach
stapling surgery also uses staples or stitches to close off part of the
stomach, but in this procedure, the staples or stitches are not placed
across the entire width of the stomach. A small opening, about 1/8 to 1/4
inch (.3-.7 cm) in diameter, is left through which food can pass into the
lower portion of the stomach and then into the small intestine as usual.
Both of these procedures reduce the size of the stomach so that only very
small amounts of food can be stored in it at any given time; the patient
feels full after eating tiny portions of food. Because the opening into the
remainder of the digestive tract is also reduced in size, food must be
chewed very thoroughly (or pureed) so that it will pass through the opening.
Attempting to eat too much at one sitting, or failure to chew food slowly
and thoroughly can result in upset stomach and vomiting. Weight loss
following surgery is dramatic: 26-44 lb. (12-20 kg.) in the first month,
with total weight losses of 50 lb. (23 kg.) or more being quite common.
However, neither of these surgical procedures should be viewed as a quick or
easy fix to a lifetime of obesity. Because the surgery drastically decreases
the amount of food that the patient can eat, special care must be taken
following the surgery to ensure that the patient consumes a nutritious diet
which is low in fat and has adequate amounts of vitamins, minerals, and
fiber. The patient must also accept the necessity of eating small meals and
chewing food completely to prevent regurgitation. Some patients find
themselves unable to tolerate the discomfort created by gas-producing foods
such as carbonated beverages.

Neither procedure is without risks. As in any major surgery, bleeding,
infection, and anesthesia-related complications are possible. Increased
occurrence of gallstones, vitamin deficiencies, and occasional stomach
ulcers have also been reported, although patients who have undergone the
stomach stapling procedure seem to be affected by these complications less
often than are gastric bypass patients. Neither operation is foolproof,
either--the size of the upper "pouch" of stomach can increase with time, as
can the size of the opening left following stomach stapling. Either of these
occurrences can allow the patient to eat more without feeling bloated or
experiencing vomiting, and can result in gradual weight regain. It is also
possible for patients to regain weight by consuming high-calorie foods such
as milkshakes which will pass through the opening. The long-term success
rate of these procedures is estimated to be around70-80%.


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