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8641Surgery becomes popular option to battle obesity

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  • Robert J. Matter
    Dec 1 4:00 AM
      http://www.chicagotribune.com/news/printedition/chi-0312010143dec01,1,5088752.story?coll=chi-printnews-hed

      Surgery becomes popular option to battle obesity
      Many say benefits are worth the risks

      By Karen Testa
      Associated Press
      Published December 1, 2003

      BOSTON -- Ken Powers knew the potential dangers of having his stomach stapled, but to a man who had tipped the scales at 475 pounds, those risks didn't much matter.

      "I had this thought: If I die on the operating table, having the surgery to try to better my life, I thought it was a better thing to do than to live the way I was living, which, in my opinion, I was kind of waiting to die anyway," he said.

      By the tens of thousands, morbidly obese people who have failed at diets, support groups and exercise programs are turning to surgery to lose weight.

      In 1998 there were 25,800 obesity-related operations, most of them gastric-bypass procedures commonly known as stomach stapling. This year, the American Society for Bariatric Surgery estimates there will be 103,200 operations.

      Questions about the risks and growing use of the procedures surfaced in recent weeks after two patients in New England died during stomach-stapling surgeries. However, obesity specialists say the procedure is safer than it ever has been, and that that is contributing to the growing popularity.

      And for most patients, the risk of not having the surgery is greater.

      "It's an operation that helps cure people of this disease, which is life-threatening," said Dr. Janey Pratt, a surgeon at the Massachusetts General Hospital Weight Center in Boston, which does about 300 gastric bypasses a year. "People see it as some type of cosmetic surgery, when it's not. More patients die waiting for surgery than die after surgery."

      The operation involves using staples or stitches to close off part of the stomach to form a pouch about the size of an egg, which limits how much food the person can eat. A part of the small intestine also is bypassed to reduce nutrient absorption.

      Risks include wound infections, stomach leaks and occasionally life-threatening blood clots.

      The International Bariatric Surgery Registry estimates that 1 in 1,000 patients will die within four weeks of the surgery, and 3 in 1,000 will die within three months.

      Powers, 42, was lucky. Even carrying more than 400 pounds on his 5-foot-11-inch frame, the Worcester man had not developed many of the common ailments associated with obesity. Still, his sleep was fitful, and walking was exhausting.

      Powers underwent laparoscopic gastric-bypass surgery in May 2001 and now weighs 280 pounds. He believes the surgery staved off the onset of diabetes, and he has had no complications.

      Surgery is not used to treat minor obesity. Candidates must be 100 pounds above their ideal body weight and have failed at other attempts at weight loss.

      Still, an estimated 15 million people would qualify for the surgery, said Dr. Scott Shikora, head of bariatric surgery at Tufts-New England Medical Center in Boston. Tufts did not take new patients for nearly six months earlier this year so it could deal with its backlog of patients. At one point, there was a 500-person waiting list, Shikora said.

      Many insurers have started to cover the procedures, finding it cheaper to pay for the surgery than treating obesity-related health problems such as diabetes and high blood pressure.

      But Powers worries that some may perceive stomach stapling as a simple, convenient option.

      "I don't think you see all the pain involved," he said. "You eat half an English muffin and you throw up. You have to be ready to abandon the way that you've lived with food for the rest of your life."

      Copyright © 2003, Chicago Tribune
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