Weight-Loss Surgery Spreads; So Does Debate
MICHELE NORRIS, host:
From NPR News, this is ALL THINGS CONSIDERED. I'm Michele Norris.
ROBERT SIEGEL, host:
And I'm Robert Siegel.
As the number of obese people in the United States grows, so does the number of people having weight-loss surgery. During the procedure, part of the patient's stomach is stapled shut, forcing the person to limit the calories they take in. The surgery has helped many obese people lose tens or even hundreds of pounds, but the procedure has risks. And some critics say the long-term benefits of the surgery have not been proven. NPR's Joe Palca reports.
JOE PALCA reporting:
Maureen Bayer has been overweight for as long as she can remember. She's counted carbs and watched her calories, but nothing kept the weight off.
Ms. MAUREEN BAYER: And then I found out I was diabetic. I lost 50 pounds then, but then it suddenly just started coming back on.
PALCA: This spring Maureen celebrated her birthday at her heaviest weight ever, 315 pounds.
Ms. BAYER: I've been heavy all my life, ever since I was a little kid. So I turned 40, and I said, `I have to do something.'
PALCA: That something was surgery. In July, a portion of Maureen's stomach was stapled shut. Instead of being the size of a large melon, her stomach is now the size of a golf ball. And the surgery made other changes. Her stomach now empties lower in her intestinal tract. The net effect: She ingests fewer calories, and less of what she does take in is absorbed. Two weeks after the surgery, Maureen was on a liquid diet.
Ms. BAYER: I have to eat at least six meals a day, small meals. I have to take medicine every day. I take Pepcid twice a day, and I take this stuff so I don't get gallstones 'cause people who lose weight rapidly tend to get gallstones.
PALCA: Maureen's surgery is becoming very popular. Last year an estimated 140,000 Americans had the procedure; that's twice as many as 2002. But Paul Ernsberger thinks the surgery is too popular. Ernsberger is an associate professor of nutrition at Case Western Reserve University. He says surgeons are promoting it as a cure for morbid obesity, and it's not.
Professor PAUL ERNSBERGER (Associate Professor, Case Western Reserve University): There's a honeymoon period for about the first 12 to 18 months, during which things look pretty good. You're losing weight rapidly. Then you start to regain.
PALCA: Ernsberger says you regain because your body adjusts.
Prof. ERNSBERGER: The stomach pouch stretches. It's no longer just the size of a golf ball. You can eat a normal-sized meal, and also the intestine gets better at absorbing calories, and people put the weight back on.
PALCA: And Ernsberger says there are other problems. Even patients who keep the weight off frequently have lifelong digestive problems and don't absorb enough vitamins and minerals from their diet. He also worries surgeons are downplaying the risks of surgery. Myriam Curet tells her patients the risks of dying from the procedure is about one in 200. Curet is a surgeon at Stanford University. She says the surgery is difficult, and the risks can be greater depending on a surgeon's skill and experience. And she says the surgery is not for everyone. Only people who are severely overweight should even consider it. Still, Curet says there are some long-term studies that show people can keep off an average of half the weight they lose initially.
Ms. MYRIAM CURET (Surgeon, Stanford University): And, more importantly, it really corrects a lot of the medical problems that come with obesity: diabetes, hypertension, sleep apnea. So it's really treatment for a major problem that Americans have.
PALCA: Curet has just completed a study showing that a surgical robot may make the procedure safer and easier.
It's been five weeks now, and Maureen Bayer is feeling pretty good about her decision to have the surgery. She's lost 35 pounds, and she has fewer aches and pains in her joints. But she still thinks about food. She thinks about food a lot.
Ms. BAYER: And I watch the Food channel all day, so I'm sitting there looking at the food, and I'm just, like, getting ideas of stuff that I can have after, when I can start having real food.
PALCA: Maureen is off her liquid diet now. Her first solid food was Tex-Mex: ground beef, cheese and salsa. It was somewhat solid. She had to puree the concoction in a blender before she ate it. Joe Palca, NPR News, Washington.