Several studies have shown that, for most obese people, weight loss surgery results in long-term weight loss. But until now, there was no scientific evidence that weight loss surgery also promotes longer life.

In the first report of its kind, the result s of an 11-year Swedish study, published in the August, 2007 issue of the New England Journal of Medicine, show that weight loss surgeries reduce death rates. The results of this study are important because, with even though it is an established fact that obesity is associated with decreased life expectancy, the long-term results of weight loss surgeries were unknown. Weight loss itself carries risks, and surgeries introduce further risks. But now we know that for most obese people, the gain seems to outweigh the risks (no pun intended).

Swedish investigators followed 4047 obese individuals (1180 men and 2867 women) for an average of 11 years after surgical and/or non-surgical obesity treatments. After 10 years of follow-up, individuals who had bariatric surgery lost 14% to 25% of their original weight, and there were 101 deaths. In the group that did not have surgery, weight remained fairly constant during the 11-year study. In that group, there were 129 deaths.

The Swedish study included two kinds of weight loss surgery. Nineteen percent underwent gastric bypass surgery and 87% had some form of banding surgery.

Gastric bypass is a procedure that reroutes the digestive system. This surgery is usually very effective at producing significant weight loss. It requires a lengthy incision and a hospital stay of three to four days, and often produces side effects that include nausea, cramping, sweating and diarrhea. Risks included nutritional deficiencies that can lead to a variety of serious medical conditions and diseases. In fact, the potential risks and complications of gastric bypass are often enough to scare many morbidly obese patients away from what is often a life-saving surgery that results in weight loss and lowers the patient's risk of heart disease, diabetes, and other potentially life threatening diseases.

Fortunately, there is now another option available. Banding procedures - commonly referred to as the Lap Band - are a newer option with fewer major risks. These procedures reduce the available space in the stomach to a small pouch that holds only two ounces of food. Lap band surgery can usually be performed laproscopically, with tiny incisions (as opposed to the long incisions required by gastric bypass). Essentially, a small incision is made, and then a flexible tube is inserted and wrapped around the stomach.

Filling the little pouch in the upper portion of the stomach leads to a feeling of fullness after eating just a very small amount of food. The band further works by slowing the progress of food into the lower stomach and intestines. Attached to the band is a tube that ends with a port attached to abdominal muscles just below the ribs. Through this port, doctors can add saline to the hollow band, causing increased restriction of the stomach as needed.

Weight loss surgery is an option for most people who:
* are 100 pounds overweight, or more.
* have a BMI (body mass index) is 40 or greater. [link to
* have co-morbidities such as hypertension, diabetes, or sleep apnea.
* have tried and failed with other methods.
* are willing and motivated to follow the prescribed diet and exercise regimen.
Certain patients, although they meet the weight guidelines, may not be suitable candidates for successful weight loss surgery.

The cost of Lap Band surgery varies from about $17,000 to $30,000, depending on where you live. In the past, insurance companies did not cover this procedure, but increasingly they are paying for all or part of it if your doctor states that it is medically necessary, or if you meet certain conditions.

Frequent office visits are required to inject saline solution into the port, and adjust the band. On average, patients require six to eight adjustments of the band during the first 18 months following Lap-Band surgery.

Patients typically lose 50% to 60% of their excess body weight within two years after the procedure. Additional plastic surgery may be indicated, depending on how much weight is lost.

People often think of weight loss surgery as taking the easy way out, that instead of changing eating habits and exercising, these people just go get a surgery to do the hard work for them. But if you get to know someone who has had this surgery, you soon find out that this is far from the truth. Weight loss surgery is a huge commitment. Life is never the same again. It's better socially, of course, since the staring and ridicule is gone. Clothes fit. It's easier to move. Energy is resumed. But despite all these benefits, weight loss surgery is hard work, requiring constant attention to the body's new needs.

There are some serious daily - and even hourly - adaptations. For the first five days or so, patients need to follow a clear liquid diet to prevent additional surgery. No coffee, tea or soda is permitted for the first three months. Even pills can be too large to digest and must be replaced with liquid medications or be crushed and stirred into a liquid. For about six weeks, patients have to eat every hour, for 10 - 12 hours a day. Each "meal" is two ounces of protein shake, with an occasional substitute of baby food or sugar-free gelatin.

During the next six weeks, patients may eat food that is shredded in a food processor prior to eating - but no bread, potatoes or starchy vegetables. Eventually, patients get to eat - but more like a baby than an adult: small amounts, small bites, and a somewhat bland diet. Tough meats, citrus fruits, fiber, spicy foods, fried foods, cinnamon, and pepper are most often on the "no" list.

After weight loss surgery, patients often find that after a year or so, they've lost so much weight that they require plastic surgery to remove excess skin. While the weight issue may be solved, breasts and butts may be flat, and loose arm, leg, and tummy skin may sag significantly. A lower body lift or full body lift may be required to solve the problem. Sometimes just a breast lift and/or an arm lift are enough. Whatever their choice, patients are usually advised to wait until they have reached their desired weight - or at least until their weight is stable.

While it's quite an extensive process to go through, all this sounds like a pretty good trade-off for getting your body back after becoming morbidly obese. And now that we know it can also extend life, there is an even more compelling reason to consider this option - or at least get some more information from a trusted doc about whether or not this might be beneficial.