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WLS Fact Sheet
The desire for rapid weight loss, increased health, and a longer and fuller life can become reality with weight loss surgery. Weight loss surgery, or bariatric surgery, as the medical profession calls it, involves risks, and a life-long commitment to good nutrition and exercise. Before you or anyone you know considers this life-altering medical procedure, take time to understand the facts. How many weight loss surgeries have been performed in the There has been an exponential increase in the number of weight loss surgeries performed over the past three years. This is due to an increased awareness of the procedures, an increase in skilled surgeons, new surgical options, such as laparoscopic procedures, and a growing number of baby boomers electing surgical procedures under Medicare. Total operations performed according to the American Society for Bariatric Surgery are as follows: 2005 171,000 2004 140,000 2003 103,200 How many bariatric surgeons are there now in the Because surgeons are not required to register with any medical agency, there is no precise number. However, the American Society for Bariatric Surgery reports current 2006 membership at 1500.
According to the From 1998 to 2002, the majority of patients were female, with the numbers increasing from 81% to 84%. The proportion of patients living in the highest zip code income level (over $44,999 per year) increased from 32% in 1998 to 60% in 2002. And the proportion of patients with private insurance increased from 75% in 1998 to 83% in 2002. What is the expected weight loss for each type of surgical procedure? While there are no hard and fast statistics available on each surgical option, the Roux-en-Y gastric bypass (RGB), also considered the gold standard of procedures, is the most common. In 2002, 92% of all procedures were the Roux-en-Y. Like all weight loss programs and diets, individual weight loss will vary from person-to- person depending on starting weight, age, and sex. Patients generally lose about half of their excess body weight in the first year after restrictive procedures such as RGB. The The following numbers represent statistical percentages for monitored patient populations.
Roux-en-Y
According to a Rand Corporation study, patients who have had the Roux-en-Y bypass surgery lose an average of 20 pounds more than patients with vertical-banded gastroplasty. The National Institute of Diabetes and Digestive & Kidney Disease (NIDDK) report that many patients maintain a weight loss of 60 to 70 percent of their excess weight for 10 years or more. Vertical Banded Gastroplasty (VBG) According to the American Obesity Association, 80% of patients lose some weight and 30% reach normal weight with VBG procedures. The long-term weight loss success rate with VBG is 40% to 63% of excess body weight over a 3-year period and 50% to 60% after 5 years. The National Institute of Diabetes and Digestive & Kidney Disease (NIDDK) report that after 10 years, as few as 20% of patients have kept the weight off. They also state that there is also some evidence that weight loss results are better than with VBG. Adjustable Gastric Banding (AGB) or LapBand® According to an American Obesity Association 3-year study, 62% of patients lost at least 25% of their excess weight; 52% lost at least 33%; 22% lost at least 50% and 10% lost at least 75% of their excess weight. The American Society for Bariatric Surgery reports weight loss is 28%-65% of body weight after 2 years and 54% after 5 years. Biliopancreatic Diversion (BPD) or Scopinaro Procedure Vertical Banded Gastroplasty (VBG) According to the National Institute of Diabetes and Digestive & Kidney Disease (NIDDK) studies report an average weight loss of 75% to 80% of excess weight.
According to the Agency for Healthcare Research and Quality (AHRQ), approximately 20% of people who have weight-loss surgery experience complications. The National Institute of Diabetes and Digestive & Kidney Disease (NIDDK) reports that up to 20% of VBG patients may have to undergo a second operation for a problem related to the procedure. According to a medical report from researchers at The Agency for Healthcare Research and Quality (AHRQ) reports that advances in bariatric surgery, specifically laparoscopic procedures, result in fewer wound complications and incision hernias than traditional abdominal surgery.
The American Obesity Association reports the following complications due to weight loss surgery: Overall complications caused by the surgery may be 10% or more. Complications requiring a hospital stay of 7 days or more based on the IBSR patient database were 1.35%. Ø Complications involve the heart or liver, rupture of blood vessels in the lungs, infection surrounding the diaphragm area, leaking and bleeding of the stomach and intestines, blood clotting of veins, and blockage of the small intestine. Complications requiring a hospital stay of less than seven days were reported in 5.28% of patients from the IBSR patient database. Ø Complications include breathing difficulties, wound infections, and injury to the spleen. Ten to 20% of patients have been reported to need follow-up operations to correct complications such as abdominal hernias. Gallstones develop in more than one-third of patients as a result of losing a large amount of weight or from losing weight quickly. Anemia, osteoporosis and other bone disease are nutritional deficiencies that develop after the surgery due to long-term loss of absorptive function. Nutritional deficiencies, which occur in almost 30% of patients, can be prevented with proper attention to vitamin and mineral intake. Women of childbearing age should be aware that quick weight loss and nutritional deficiencies could harm a developing fetus. Rates of complications remain stable over time. The rate of unexpected re-operations ranged from 6% to 9%. Pulmonary complications (e.g., pneumonia, respiratory failure) occurred in 4% to 7% of patients. One to 2 patients per 1,000 patients died while in the hospital for bariatric surgery. How many people die each year from weight loss surgery? According to the National Institute of Diabetes and Digestive & Kidney Disease (NIDDK), less than 1% of all cases of bariatric surgery result in death. The VBG and RGB death rate is relatively low. Within 30 days of surgery, death occurred in less than a quarter of one percent (0.17%) of patients in the IBSR database. Pulmonary embolism was the most frequent cause of death.
The American Society of Bariatric Surgery reports that studies show non-expert centers have higher rate of mortality. The death risk for the first month post surgery is 0.2-0.5% in expert centers. In a recent study (October 19, 2005) published in the Journal of the American Medical Association (JAMA) states that an important factor linked to early postoperative death and adverse outcomes following bariatric surgery is the surgeon and hospital procedural volume. Among a large, multi-state collaborative of teaching hospitals, institutions where fewer than 50 procedures were performed per year had the highest rates of in-hospital mortality (1.2% compared with 0.3% in higher-volume [>100 cases] hospitals). In the state of Vol. 294 No. 15, October 19, 2005 V According to the National Institute of Diabetes and Digestive &Kidney Disease (NIDDK) obese individuals, people with a body mass index greater than 30% have a 50% to 100% increased risk of death from all causes, compared with normal-weight individuals. Most of the increased risk is due to cardiovascular causes. Life expectancy of a moderately obese person could be shortened by 2 to 5 years. White men between 20 and 30 years old with a body mass index greater than 45% could shorten their life expectancy by 13 years; white women in the same category could lose up to 8 years of life. Young African American men with a body mass index of 45% could lose up to 20 years of life; African American women, up to 5 years. What are the common causes of weight regain for people after they have weight loss surgery?
According to Structure House, a private weight management clinic in According to the National Institute of Diabetes and Digestive & Kidney Disease (NIDDK), weight regain happens when patients eat high-calorie soft foods that easily pass through the opening to the stomach. Others gain weight because they do not change their eating habits and do not lose much weight to begin with. Successful results depend on the patients willingness to adopt a long-term plan of healthy eating and regular physical activity.
The American Obesity Association reports that approximately 127 million American adults are overweight, 60 million are categorized as obese, and 9 million are severely obese. National Institute of Diabetes and Digestive &Kidney Disease (NIDDK) data from the 2000 U.S. Census breaks down the numbers to: Women (20+ years old): 64.5 million (61.9%) Data from the Weight Control Information Network provides information on obesity by ethnic groups age 20 years and older. Mexican American women: 71.9% How successful is dieting without weight loss surgery? Drug therapy, calorie restrictive diets, and exercise, are used to promote weight loss with varying degrees of success. A drug therapy study presented by the Agency for Healthcare Research and Quality (AHRQ) showed that prescription diet drugs, Sibutramine, Orlistat, Phentermine, Diethylpropion, Bupropion, Fluoxetine, and Topiramate all promote weight loss when given along with recommendations for diet. Sibutramine and Orlistat were the 2 most studied drugs and had provided additional, though modest weight loss of less than 5 kg a year. The agency reports that there is no evidence indicating that any particular drug promotes more weight loss than another drug. All of these drugs have side effects. The choice of drug may be made on an individual with the average weight loss of 11 pounds. A 2004 report on weight loss strategies from American Sports Data, Inc. (ASD) found that 80% of people wanting to lose weight changed their eating habits. Nearly half, 46%, worked out at home, 38% exercised outdoors, and 20% followed a formal diet. Nineteen percent or 24.2 million went to a health club to exercise as their weight loss tool. Health club members report higher success rates. Twenty-five percent of all health club members who attempted to lose weight were "very" or "extremely" successful, compared with only 19% of weight reducers who did not attend a club. For members who exercised at their club at least 100 times throughout the year, the success rate soared to 30%. The study also found dieting an effective weight loss strategy: 26% of those who embraced a formal diet were very or extremely successful. Outdoors and Home Exercise were not quite as effective, earning success rates of 21% and 19% respectively. When evaluating the non-surgical weight loss options, keep in mind, again, 95% of all dieters will regain their lost weight in 1-5 years (Grodstein, et al., 1996). NAWLS has put together this fact sheet in an attempt to answer some of the most frequently asked questions about weight loss surgery. We have compiled our information from the most reliable public and private resources available. This fact sheet is for informational purposes only and should not substitute for the care or advice of a trained bariatric physician. All information included is under the copyrights held by the individual sources cited. This fact sheet was last updated February 2006. · Agency for Health Care Research and Quality · American Obesity Association · American Society for Bariatric Surgery · American Sports Data, Inc. (ASD) · Christopher Huang, et al., · National · The · Structure House, · · Weight Control Information Network (WIN) · Grodstein, F., Levine, R., Spencer, T., Colditz, G.A., Stampfer, M. J. (1996). Three-year follow-up of participants in a commercial weight loss program: can you keep it off? Archives of Internal Medicine. 156 (12), 1302.
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