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Weight Loss Surgery Has
Hefty Benefits
posted 05/29/04
New Orleans-- Obese patients who undergo weight loss surgery not only shed unwanted pounds, but also reduce their risk of a number of obesity-related illnesses, including heartburn, high cholesterol, hypertension, and diabetes, a new study shows.
In the study of more than 150 obese people who underwent a gastric reduction procedure in which an adjustable band was placed around the stomach to reduce it, 75% of those who suffered heartburn and chest pain caused by GERD no longer had symptoms after the procedure, researchers say. GERD -- gastroesophageal reflux disease -- happens when the valve between the stomach and the esophagus doesn't function properly, allowing stomach acids to escape and burn their way back up the esophagus.
Also, high cholesterol levels dropped to healthy levels in two-thirds of affected patients, while high blood pressure resolved in nearly half, says Hadar Spivak, MD, a laparoscopic surgery fellow at Emory University Hospital in Atlanta who also maintains a private practice in Houston and Baytown, Texas. One-third of the patients with diabetes were able to stop taking medication for their condition, he says.
Speaking in New Orleans at Digestive Disease Week, an annual medical conference, Spivak tells WebMD, "We knew the procedure helped patients to lose a significant amount of weight. Now we've confirmed it significantly improves overall health as well."
Patients Eat Less
The researchers studied 163 obese people who underwent gastric restriction using the adjustable Lap-Band system. The procedure involves inserting an inflatable silicone band around the upper stomach to create a new, tiny stomach pouch that can only hold a small amount of food.
"We don't really know exactly how it works, but you feel full on top of the band because food doesn't go down like before," Spivak says. "So you consume less food and for reasons I can't explain, people report less hunger, too."
Also, the narrowed opening between the stomach pouch and the rest of the stomach controls how quickly food passes from one to another, increasing the amount of time it takes for food to be digested.
Many patients prefer the procedure to traditional gastric bypass surgery because it's less invasive and reversible, Spivak says. The band is inserted laparoscopically through several tiny incisions in the abdomen, he explains.
The Lap-Band system is made by BioEnterics Corporation of Carpinteria, Calif., which helped pay for the study.
Patients Lose 45% of Excess Weight
By nearly two years after the procedure, the patients lost an average of 45% of their excess weight. Their average body mass index, or BMI -- a measure of obesity - dropped from 46 to 38. A BMI over 40 indicates a person is morbidly obese, increasing the risk of death from any cause by nearly double.
Other findings:
 | Of the 48 people with GERD, 73% were able to stop taking their medication, and 15% needed less than before. |
| Of the 40 people taking hypertension pills, 43% were able to stop taking their drugs and 5% needed less. |
| Of the 116 people with high cholesterol, 64% stopped needing their medication. |
| Of the four patients with insulin-dependent diabetes, 33% stopped needing insulin and another 33% needed less. |
"The question is whether a reduction in medication is the best way to measure comorbities [other illnesses]," Spivak says. "We think it is. If a doctor says, 'You don't need to take any more diabetes medication,' for example, that's a pretty good indication you're doing better. And if you need no medication -- well, then the disorder has resolved."
Every Pound Counts
William Scott Helton, MD, chief of surgery at the University of Chicago, agrees. "It's pretty well demonstrated that even a little weight loss -- 10 pounds -- results in an improvement in diabetes," he tells WebMD. This holds true for other obesity-related illnesses as well, he says.
"It doesn't matter how you achieve the weight loss -- with bypass surgery or the Lap-Band -- there seems to be a correlation between weight loss, less caloric intake, and fewer obesity-related illnesses," says Helton, whose own study shows the Lap-Band procedure can safely be performed in about an hour at specialized centers rather than in the hospital.
But the procedure alone won't achieve the best results, he cautions. "You must also have behavioral modification, intensive follow-up, and nutrition counseling. That's how you really keep the weight off and improve your health."
Source: WebMD: Digestive Disease Week 2004, New Orleans, May 16-20, 2004. Hadar Spivak, MD, laparoscopic surgery fellow, Emory University Hospital, Atlanta; private practice, Houston and Baytown, Texas. William Scott Helton, MD, chief of surgery, University of Chicago.
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