Scott Shikora, Surgical Director of the Tufts-NEMC Obesity Consult Center.

On average, American adults have become 10 pounds heavier over the last 20 years, doubling obesity rates from 15 to 30 percent. At the same time, the number of extremely obese--those with a body mass index (BMI) of 40 or more--has increased five-fold. In the face of such daunting numbers, more and more people are choosing gastric bypass surgery to help them lose weight.

Gastric bypass is generally recommended only for patients with a BMI of 35 or higher. People who have gastric bypass lose more weight than those who stick to non-surgical approaches like dieting or medication--about 35 percent of their body weight as opposed to 10 percent. They're also more likely to keep it off.

Two of our participants--Amy and Rodney--opt for gastric bypass at Tufts-New England Medical Center in Boston.

Amy Battles before her gastric bypass surgery.

At the Tufts-NEMC Obesity Consult Center, Medical Director Edward Saltzman, M.D.,and his staff have found that patients who are prepared not only for surgery but also for life after surgery have greater success losing and keeping off weight. So Tufts-NEMC offers support groups and "basic skills" classes in which patients can discuss their attitudes toward food and weight loss and get practical advice. One example of such advice is how to break habitual "behavior chains" that automatically lead to over-eating.

Alan accompanies Scott Shikora, M.D., Surgical Director of the Tufts-NEMC Obesity Consult Center, to the operating room to observe Amy's surgery. During the 90-minute procedure, the size of Amy's stomach is dramatically reduced--in her case from about a half-gallon to one ounce. Amy's natural stomach remains in place to produce digestive fluids.

Alan watches as Scott Shikora performs gastric bypass surgery on Amy.

Shikora explains to Alan that although gastric bypass can be surgically reversed, it's very difficult. But nationally about 25 percent of gastric bypass surgery patients reverse the operation behaviorally, by eating enough to stretch out the new small stomach. At Tufts-NEMC, the emphasis on patient education and support reduces the failure rate--patients who regain their initial weight loss after five years--to about 15 percent.

For more on this topic, see the web feature:
Battling the Bulge
Science Hotline - Ed Saltzman
Compute Your BMI (Shockwave required)