NEW YORK (Reuters Health) -
Anyone thinking about having
weight loss surgery should be sure to do their homework
beforehand, and must understand they need to dramatically
change the way they eat for the surgery to be successful,
advises the head of the U.S. government agency responsible for
research on health care quality and patient safety.
"People who succeed and lose weight and keep it off eat
very, very differently," Dr. Carolyn Clancy, director of the
Agency for Healthcare Research and Quality (AHRQ) in Rockville,
Maryland, told Reuters Health. "Essentially, you've got to eat
a whole lot less."
Clancy has written about the realities of operations to
promote weight loss, known as bariatric surgery, in the latest
issues of Nursing for Women's Health and Health for Women, both
published by the Association of Women's Health, Obstetric and
Neonatal Nurses.
Bariatric surgery has skyrocketed in popularity, Clancy
noted in an interview, but just a fraction of people who could
benefit most from the surgery have gotten it. According to
AHRQ, evidence for the procedure's benefits is strongest for
people with body mass indexes (BMIs) of 40 or higher, or
individuals with BMIs of 35 or greater who have a serious
medical condition, such as diabetes or severe sleep apnea.
Nevertheless, she added, the surgery "is not risk free, and
I think it's really important for all people, women and men, to
know about the risks and to be very clear about what they're
getting into."
For example, Clancy said, 7 percent of people who undergo
the surgery need to be rehospitalized for complications. Four
out of 10 will develop complications within 6 months of the
surgery. These complications include nausea, cramps and
vomiting due to overeating.
People should also seek out a surgeon and health care team
they can communicate with effectively, because post-surgical
follow-up care is just as important as the procedure itself,
Clancy added. If you don't "click," or you feel your surgeon
isn't hearing your concerns, she advised, look elsewhere.
People may want to seek out bariatric surgery programs
designated as Centers of Excellence by the American Society for
Metabolic and Bariatric Surgery (http://www.asbs.org/), Clancy
suggested.
Finally, she said, people need to find out before having
the surgery whether or not their insurer covers it. Some will
require documentation that a person has made a serious effort
to lose weight by other means before they will pay for the
procedure.
SOURCE: Nursing for Women's Health, February/March 2008.
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