Q: I have been overweight all my life. My weight is now over 300 pounds and my blood sugar is high. I have managed to lose some weight with just about every possible type of treatment, but the pounds always come back. Years ago my doctor told me that surgical treatment for obesity was possible, but unsafe. What is the present story on surgery for obesity?
A: Recently, a panel sponsored by the National Institutes of Health concluded that certain types of surgery on the intestinal tract can be an effective choice for the treatment of severe obesity that has not responded to other forms of therapy.
The initial type of surgery for obesity, a partial bypass of the small intestine, was abandoned because of the high frequency of serious complications. Considerable experience has now been gained with two forms of surgery involving the stomach rather than the intestine. Both create a small stomach pouch that fills quickly and creates a feeling of fullness. Even with those newer types of surgery, about 10 percent of patients have complications in the immediate postoperative period. Most frequent are respiratory problems and wound infections. Most serious are blood clots in the legs and leaks of stomach contents from the gastrointestinal tract into the peritoneal (abdominal) cavity. The operative death rate is low -- about 0.1 percent. Some patients have complications that may require another operation.