 After
bariatric surgery, the amount of weight you lose will depend
on a variety of factors -- your weight before surgery, your
willingness and ability to follow the nutritional programs
postoperatively and the activity level you maintain. Continuing
exercise is a major factor in your postoperative plan. The
medical literature reports that the average weight loss
is 40 to 75 percent of excess body weight.
Immediately following surgery, most patients lose weight
rapidly and continue to do so until 18 to 24 months after
the procedure. Although some patients may then start to
regain some of their lost weight, few regain it all. Strict
adherence to your surgeon's instructions after surgery will
help you maintain your weight loss. Weight reduction
surgery has been reported to improve, or even cure, many
of the comorbid conditions produced or aggravated by obesity,
such as diabetes mellitus.(1) Sugar levels of most obese
patients with diabetes returns to normal after surgery.
Nearly all patients whose blood sugar levels do not return
to normal are older or have had diabetes for a long time.
A recent study showed that Type II diabetics treated medically
had a mortality rate three times that of a comparable
group who underwent gastric bypass surgery.(7)
Improvement, and more often, resolution is seen in sleep
apnea and obesity associated hypoventilation.(2, 3) hypertension,(4)
and serum lipid abnormalities.(5, 6) Preliminary data
show heart function improved by the sustained weight loss,
with decreased ventricular wall thickness and decreased
chamber size. Other benefits seen in some patients after
obesity surgery include improved mobility and stamina.
Many patients find themselves in a better mood, with increased
self-esteem, improved interpersonal relationships, and
a much improved quality of life. They are less self-conscious.(8)
They are able to improve social activities, find jobs
and participate in activities formerly inaccessible to
them. Contemptuous body image decreases. Marital satisfaction
increases, but usually only if a measure of satisfaction
existed before surgery. If marital problems existed before
the surgery, the improved self-image may lead to divorce
after the surgery and the weight loss it brings.
More long term follow up data will prove what magnitude
of weight loss is necessary to achieve the greatest benefit
in terms of longevity. Data from medical weight reduction
studies suggest that a small weight loss will favorably
affect obesity comorbid conditions. Data for patients
over 55 years old at the time of surgery, followed for
six or more years after gastric bypass, reflect significant
sustained improvement in morbidity(9)
YOU will play the major role in your eventual weight
loss. You will need to make adjustments in your present
lifestyle, but the pride and feeling of accomplishment
as you lose weight will be yours.
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1. Pories WJ, Swanson MS, MacDonald KG, et al. Who
would have thought it? An operation proves to be the most effective
therapy for adult-onset diabetes mellitus. Ann Surg 1995; 222(3):339-50;
discussion 350-2.
2. Charuzi I, Lavie P, Peiser J, Peled R. Bariatric surgery
in morbidly obese sleep-apnea patients: short- and long-term
follow-up. Am J Clin Nutr 1992; 55(2 Suppl):594S-596S.
3. Sugerman HJ, Fairman RP, Sood RK, et al. Long-term effects
of gastric surgery for treating respiratory insufficiency of
obesity. Am J Clin Nutr 1992; 55(2 Suppl):597S-601S.
4. Benotti PN, Bistrain B, Benotti JR, et al. Heart disease
and hypertension in morbid obesity: the benefits of weight reduction.
Am J Clin Nutr 1992; 55(2 Suppl):586S-590S.
5. Brolin RE. Results of obesity surgery. Gastroenterol Clin
North Am 1987; 16(2):317-38.
6. Glysteen JJ. Results of surgery: long term effects on hyperlipidemia.
Am J Clin Nutr 1992; 55:591S-594S.
7. MacDonald KG, Long DS, Swanson MS, et.al. The gastric bypass
operation reduces the progression and mortality of non-insulin
dependent diabetes mellitus. J Gastrointest Surg 1997; 1:213-220.
8. Rand CS, Macgregor A, Hankins G. Gastric bypass surgery
for obesity: weight loss, psychosocial outcome, and morbidity
one and three years later. South Med J 1986; 79(12):1511-4.
9. Macgregor AM, Rand CS. Gastric surgery in morbid obesity.
Outcome in patients aged 55 years and older. Arch Surg 1993;
128(10):1153-7.
