Weight loss surgery isn't just for the obese anymore

In order to qualify to have lap band surgery, Kim Byrd had to gain weight. "I gained 10 pounds just to have the surgery," she says. Byrd's scale read 239 when she had the surgery. "Now I weigh 159."

Her need to pack on even more weight in order to be labeled "obese" or "morbidly obese" has been a dilemma facing many Americans. That is, until weight loss surgery procedures got a face lift, making them safer for people hoping to trim down -- without first bulking up.
Typically thought of as a last-ditch effort for those needing to shed large amounts of weight, surgical procedures are becoming an option for overweight (not obese) people, and those suffering from diabetes.

Some say these changes can prevent Americans from needing to seek out potentially unsafe surgeries across the border.

In November 2004 Maeve MacSteves of Williston, N.D., went to Tijuana, Mexico for her lap band surgery because at 5 feet, 3 inches and 212 pounds, she didn't qualify for insurance-covered surgery.

"I wasn't big enough," she says. Luckily, MacSteves' surgery was both safe and successful and she's down to 165 pounds.

The surgery is expensive, with the average cost in the United States ranging from $13,000 to more than $30,000.

Supporters think lowering the weight requirement to "overweight" versus "obese" or heavier can also save Americans billions in medical costs related to obesity and its related diseases like diabetes and cardiovascular disease.

But opponents are pointing to the increased rate of bariatric surgeries as a sign Americans are getting soft -- literally.

"There's no quick fix to weight loss. And unless people modify their entire lifestyle, including implementing exercise and proper nutrition, these surgeries are a waste of time and unnecessary risks," says personal trainer Jason Brandolino of New York.

According to the American Society for Metabolic & Bariatric Surgery, the number of weight loss surgeries have doubled in the last six years, resulting in 220,000 procedures in 2008.

However, bariatric surgeon Ron Hekier, MD, in Texarkana, TX says there might not be cause for concern. "As the risks of bariatric surgery decrease there is more justification for 'lowering the bar' for the weight required to undergo bariatric surgery," Hekier said.

And a lower bar would justify the surge in weight loss surgeries.Hekier says it's a matter of examining the risk-benefit ratio.

"The death rate from laparoscopic gastric band surgery is as low as many common surgical procedures such as hip replacement surgery or gallbladder removal," he said. "If a person is not 'morbidly obese' but is 50 pounds overweight and suffers from Type II diabetes as a result, it might be better in the long term for them to undergo weight loss surgery to lose the weight and resolve their diabetes."
A recent New England Journal of Medicine study found obesity rates would soon negate life-span gains achieved through declining smoking rates. And a some reports claim Americans will cough up $344 billion in obesity-related health care costs by 2018.

Wondering if surgery is your key to sticking to a weight loss resolution?

Nick Nicholson, bariatric surgeon and founder of Nicholson Clinic, says individuals must evaluate if they are a candidate for surgery. And what might be a good option for one could be inappropriate for another.

"Talk with your doctor to ascertain if you've exhausted all other options, including diet and exercise, seeing a psychologist and dietician and gathering information from an unbiased source," Nicholson said.
Gina Roberts-Grey is a freelance journalist specializing in health, celebrity and consumer issues.
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