Like many people dealing with weight problems I have looked into surgery as a way of losing weight. It seems so inviting to have a quick fix and I saw medical studies indicating that bariatric (weight loss) surgery was the only way to permanently lose weight. And yet all of my patients who had surgery, from a Roux en Y gastric bypass to Lap Bands have had complications. And all but one, whose Lap Band is too new to tell, are still obese.
One of my patients even had her gastric bypass redone, resulting in the loss of her spleen when it was accidentally cut during the surgery. And my 40-something pharmacist lost her life to a heart attack after a successful gastric bypass that allowed her to lose 100 pounds and recover from diabetes. But it gave her unpleasant gastric symptoms that interfered with her life and most likely the rapid weight loss caused loss of muscle including heart muscle, which killed her.
Gastric bypass conceptually creeps me out. You have a long stretch of the GI tract which is isolated, no longer carrying food and not cleaned by the friction of food going by. It is living, secretory tissue. Is it then colonized by undesirable bacteria, fungi or yeasts? You have a brain in your gut, a real brain. What happens to that? You make most of your serotonin in your gut- 85%. Is that impaired? And how do you manage when you can’t absorb essential fatty acids? Too many unanswered questions.
But lap bands often have tubes leading to a port by your belly button- do inform your acupuncturist where it is since silicone isn’t self-healing. The stomach can expand even after the operation, stopping or reversing weight loss. And port sites can be infected.
Recently I saw a paper that showed over a 50% complication rate of redone bariatric surgery, referred to as “revisions”. Apparently as bariatric surgery has rapidly expanded, reported revision rates of vary widely, from 5% to 56% of all procedures. Over a third of patients with revisions had complications within 30 days with over a quarter more having complications at 90 days.
Most of the patients who had a re-do (69.6%) had had unsatisfactory weight loss with the initial procedure. Another 26.8% had protein malnutrition. Two patients (3.6%) had stomal obstruction and stenosis.
In the group with unsatisfactory weight loss, 90% of original procedures were either stomach stapling or gastric banding. All of the patients with protein malnutrition had a Roux-en-Y gastric bypass. Of the last two patients, one had a standard Roux-en-Y gastric bypass and one had a biliopancreatic diversion with gastric bypass.
Mind you, weight loss even with uncomplicated surgery still requires dieting. I wasn’t delighted with the health quality of the foods they recommended or left out. And you face malabsorption of fats, which digest in the gut, including essential fatty acids. There is some concern that appetite is stimulated when the body does not absorb sufficient EFAs.
I think I’ll stick to the insulin resistance diet, Paleo version. And acupuncture and herbs to reverse Spleen Qi Deficiency and to drain Dampness, the technical terms used in Chinese medicine to refer to common patterns of obesity.Self Care
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