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The challenges of dieting and the promises of bariatric surgery

Today, an estimated 15 million people in the United States are morbidly obese — that is, 50 to 100 percent, or 100 pounds, above their ideal body weight. And though obesity-prevention programs are starting to take root, it will be roughly two decades for these efforts to begin yielding results, John Morton, MD, MPH, told me recently. “You end up losing a generation,” he said. “What do you do for people right here, right now?”

During a recent interview, Morton, one of the nation’s top weight-loss surgeons, reflected on the challenges of obesity in America and how bariatric surgery may be part of the solution for some. You can read what he had to say in my Q&A on the Stanford Hospital & Clinics website.

What especially struck me was his discussion of the body's natural resistance to losing weight:

Look at the levels of ghrelin, the so-called hunger hormone, in a person who lost weight on a diet, and you’ll see they are much higher than before. Levels of another hormone, leptin, which suppresses hunger and speeds up metabolism, are lower. Your body’s not stupid. It knows you have lost weight and will do everything in its power to get that weight back.

He also highlighted how bariatric surgery can cut down on obesity-related disease, saying that "the real eye-opener is the improvements to diabetes":

 A 2001 study showed an 82 percent resolution rate of diabetes in morbidly obese patients who underwent laparoscopic gastric bypass surgery. They were able to stop taking medications — no Metformin, no Actos, no insulin, no Byetta — and that happened very quickly. This is where bariatric surgery certainly can make a difference.

Morton added that weight-loss surgery is now very safe, “especially compared to the risks of extreme obesity.”

Previously: Stanford expert weighs in on study comparing gastric bypass and banding, Study finds family members of weight-loss-surgery patients also shed pounds, Study hints at benefits of weight-loss surgery for less obese patients, Study: Outpatient bariatric surgery appears risky and Bariatric surgery may help protect teen patients’ hearts
Photo by -Paul H-

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