You can’t help but see them on infomercials, in magazines and in pop-ups on the Web. Ads and testimonials for weight-loss surgery are everywhere–touted by celebrities from Al Roker to Carnie Wilson–and the number of procedures has skyrocketed.
Weight-loss surgeries have soared to 140,600 in 2004 from 28,800 in 1999, according to the American Society for Bariatric Surgery.
But beware: It’s not as easy as it looks.
Surgeons and patients alike say many people are unaware of the potential risks and lifelong commitments required for a successful outcome.
“If you don’t stick by the rules, you can actually kill yourself,” said John Berghofer, a 32-year-old Streamwood resident who underwent gastric bypass surgery, the same procedure that Roker and Wilson underwent.
Before the procedure, Berghofer said he missed out on activities like prom and was unable to visit amusement parks with his friends because of his weight. Some of his friends even made fun of his weight.
“Here I am at 32, and I’ve got my life back,” said Berghofer, who is now a regular at Six Flags.
“It’s like I’m reliving my youth and doing things that were impossible for me before.”
Berghofer, who weighed 288 pounds on surgery day 18 months ago, today weighs 201 pounds.
The average weight loss for gastric bypass patients is 100 pounds, according to the Weight Interventions and Surgical Healthcare Center (WISH). The surgery involves sealing off most of the stomach to limit food intake and rearranging the small intestines to reduce the amount of calories the body can absorb.
The final result: A patient’s stomach goes from the size of a football size to the size of a golf ball.
Berghofer says if he eats more than the allotted amount, he throws up almost immediately.
“You can literally eat yourself to death,” said Berghofer, emphasizing the point by pulling out the half-cup that he uses to measure out his three main meals. He is also allowed a few small snacks–such as M&Ms or peanut butter cups–in moderate amounts.
“If you eat too much or too fast, you can blow your staples,” Berghofer said.
“By the time you notice the pain and dial 911, it could be too late for you.”
Having your surgery go smoothly is just the first step, surgeons say.
Gastric bypass surgery can leave patients with complications from absorbing too few vitamins and minerals to stomach ruptures if they eat too much, said Jeff Rosen, lead surgeon and president of WISH Center.
After surgery, Berghofer had his own problems. Immediately after, his downsized stomach pushed food back into his esophagus.
It was a temporary setback, but he had to quit his liquid diet and suck ice chips to avoid dehydration. Luckily, the problem remedied itself after a day.
Julie Frueh, also a WISH Center patient, said people thought she was copping out when she underwent gastric bypass surgery more than three years ago.
In reality, she said, “this surgery is by far the hardest thing I’ve ever done,” said 33-year-old Frueh, a district manager at plus-size retailer Lane Bryant.
“As a young woman, you want a certain quality of life, and I just didn’t have it,” Frueh said. “I’d walk into a bar and not get
served. I’d sit in a restaurant and not get waited on. People don’t acknowledge you when you’re overweight. You get treated pretty poorly.”
Frueh, who is 5 feet 4, dropped more than half her weight–from 311 pounds to 150–since her procedure.
“You can no longer sit down in front of a Thanksgiving meal and pile up a plate of food and inhale,” said Frueh, who now dines mostly off the kids’ menu at restaurants.
“This is a lifestyle adjustment, and it’s very permanent.”
It’s also not an excuse to become a couch potato.
“Don’t think this surgery keeps you from having to exercise,” said Berghofer, who recently regained and “relost” 12 pounds. “You have to work at it constantly to keep the results.”
Beyond the medical risks, the procedure is not cheap.
Without insurance picking up part of the tab, costs run from $15,000 for LAP-BAND–a less-invasive weight-loss procedure–to $25,000 for gastric bypass.
Making matters more complicated, some Chicago surgeons say many Illinois insurance carriers are turning down candidates if they don’t meet stringent criteria.
Blue Cross Blue Shield, for example, does not bar patients from the procedures but said patients must meet specific requirements–including a BMI of 40 or above and other conditions–in order to qualify.
“Compared to any other kind of surgery I do, this is the operation that is most difficult for patients seeking insurance coverage,” said Jay Prystowsky, director of bariatric surgery at Northwestern Memorial Hospital.
The high costs can force desperate patients to turn to the Internet and infomercials to find an affordable surgeon, said April Hochstrasser, author of “The Patient’s Guide to Weight Loss Surgery.”
Hochstrasser went to Mexico to have the LAP-BAND procedure performed for less. LAP-BAND involves a doctor placing a silicone band around the patient’s stomach to separate it into two pouches. When the smaller stomach fills up, a patient feels full.
“I have only lost about 60 pounds from the surgery in five years,” said Hochstrasser who weighed 270 pounds before surgery. “Personally, I would have preferred gastric bypass. I wish I’d had more information in front of me.”
That’s why she wrote her book: to get that information to potential patients and to de-glamorize weight-loss surgery.
“In the 1980s, news of gastric bypass spread through word-of-mouth, but the news was mostly negative because there were a lot of complications and even death,” Hochstrasser said.
“Now, companies will send you videotapes and brochures telling you they’ll help qualify you for the surgery.”
She advises a simple test before patients sign up for weight loss surgery.
“Try eating a fourth-cup or half-cup of food three times a day,” Hochstrasser suggests. “If you are not committed to eating like this for the rest of your life, you should probably look elsewhere for a solution.”
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kkyles@tribune.com
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Are you a candidate?
Typically, patients must have a body-mass index (BMI) of 35 or greater and associated problems such as high blood pressure, sleep apnea or diabetes to qualify for surgery, according to Mark Holterman, chief of pediatric surgery at University of Illinois Medical Center at Chicago. Patients with a BMI of 40 or over with no other health problems also can qualify for weight-loss surgery, Holterman said. For prospective patients who think they qualify for weight-loss surgery, visit www.asbs.org and click on the “Patients” tab. The Web page contains a BMI calculator and information about different types of weight-loss surgical procedures.
— RedEye
