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It’s not for everyone. It’s a serious, lifelong change. But for those who need weight-loss surgery, it’s one of the most effective ways of losing and maintaining weight loss. Make no mistake — this is not the easy way out. It usually requires months of preparation and massive lifestyle changes.

People who qualify for bariatric surgery usually have at least 100 pounds to lose. More recent studies show obese people with less to lose also benefit from surgery if they have complications like type 2 diabetes or high blood pressure.

The newest and fastest-growing surgery is the sleeve gastrectomy, usually referred to as the sleeve. With the sleeve, 70–85 percent of the stomach is removed. This includes the part that sends hunger signals to the brain. Many prefer this surgery over the traditional gastric bypass because it doesn’t involve re-routing the intestines. This means fewer problems with absorption and eliminates long-term issues like reactive hypoglycemia.

The sleeve also doesn’t cause what’s known as “dumping syndrome.” Dumping happens
in people who’ve had the bypass because sugars and carbs dump directly into the small intestines, often causing people to feel very sick. This is good and bad. Dumping helps stop people from eating high-calorie foods for fear of getting sick. On the other hand, re-routing the intestines often make it difficult to maintain nutritional requirements.

The bottom line is that whichever surgery is chosen, they both result in rapid and significant weight loss. People lose between 50 to 70 percent of excess weight within the first couple of years — most of it within the first year. In addition, long-term studies show most people recover from diabetes, improve cardiovascular risks, and see an increase in life expectancy that ranges from 20–40 percent.

Sounds good, but be prepared. Life as you know it will change dramatically. Most insurance companies require a doctor-monitored diet for 3–6 months before approving surgery. The average cost of a bypass is $24,000, while the average sleeve costs $19,000.

Long term, most meals are 2–4 ounces. In order to get enough protein, you’ll need to plan and track meals carefully, but, you will feel full and satisfied after a small amount of food. Liquids also need to be monitored daily to ensure you get enough.

It’s important to realize the surgery is only a tool. It will initially help you lose weight quickly, but exercise and a high-protein/low-carbohydrate diet need to become a lifelong habit. If you don’t accompany the surgery with lifestyle changes you will regain weight. However, very few people regain all of their pre-surgery weight. With a stomach the size of a walnut, it takes a lot of work to stretch it out enough to regain it all.

Unlike weight loss surgeries of the past, technology has dramatically improved the safety of each procedure. Most are now done laparoscopically. A recent study reported that most surgeries last less than two hours, with a mortality rate of less than one percent. Given that most patients are obese and often go in with health conditions, the numbers show the surgeries are now extremely safe.

Keep in mind, it is major surgery and with any surgery there are risks. The most common side-effects include nausea, diarrhea, and/or soreness during the first few months. Serious complications may include incisional hernia, infections, and pneumonia. These happen to less than seven percent of patients and are also possible side effects involved with most surgeries. For people who have the gastric bypass, malabsorption issues can lead to calcium, iron, B12, thiamine, folate, and other vitamin and mineral deficiencies.

Everyone needs to weigh the risks versus the benefits. With obesity rates skyrocketing, the surgical dangers often take a backseat to the risks of health problems from obesity. For many, it’s literally life-saving.