Although acceptable weight reduction may occasionally be achieved through medically supervised dieting and intensive behavior modification, the panel noted that the majority of patients that undergo this therapy fail to remain at reduced weight. A surgeon performing a stomach bypass, the other recommended procedure, creates a small pouch at the upper portion of the stomach and attaches a Y-shaped section of small bowel to serve as the outlet from the stomach to the intestinal tract. Significant weight loss as a result of these procedures usually occurs, and a number of associated disorders often improve. These include diabetes, high blood pressure, arthritic symptoms in weight-bearing joints, and disturbances of heart and lung function.
Many patients also report improvements in mood and other psychosocial aspects of their lives.
Death rates from these procedures are low, but significant complications may occur, including leaks from staple or suture lines, diarrhea, persistent vomiting, ulcers, and gallstones. In addition, some patients fail to lose weight from these procedures and may require reoperation. Currently, nearly 80 percent of severely obese people who have surgery are women of childbearing age. Thus, the panel gave special caution to these patients. Women with reproductive potential would well be advised to avoid pregnancy until their weight has stabilized after surgery,' said panel chairman Dr. Scott Grundy, director of the Center for Human Nutrition at the University of Texas Southwestern Medical Center in Dallas.