Gastric bypass creates metamorphosis

Gastric Bypass Surgery is credited with achieving impressive, potentially life-saving results in many patients. With global obesity rates spiraling around the world, people are signing up for the procedure in record numbers. But many still find the procedure difficult to stomach.

West Bay resident Sophia Forbes, who had gastric bypass surgery in 2003, bears little resemblance to her former self. Since undergoing the operation four years ago, she has lost an incredible 203 pounds.

Remarkably, she says the greatest changes have been on the inside.

‘Things are 100 per cent different now. My confidence level is higher, I’m much more vocal, I’m much more out there; I am a completely different person,’ she says.

Doctors first suggested Ms Forbes consider GBS in 1996, after a weight related back operation landed her in a Miami hospital. Although she had spent years unsuccessfully trying one diet and exercise regime after the other, she refused to concede defeat.

‘I had dieted my entire life; every new diet pill, every new type of exercise, every new exercise tape, I had tried it, and I still thought that I could lose this weight and succeed.’

Five year later, at 38 years of age, a spinal injury left her in a wheelchair. Unable to exercise and barely capable of looking after herself, she became scared she would not live to see her 40th birthday.

‘I could feel my body shutting down. I just had no quality of life at all.

‘When doctors are telling you that you will probably never walk again and you have to depend on someone else to do the most basic bodily functions for you; that is as low as a human being can go.

‘I knew there were some risks involved but I knew that if I didn’t have the surgery, death was not a possibility, it was a probability.’

The operation

Although there are variants of the procedure, GBS basically involves making the stomach smaller (about the size of a walnut) and diverting food around the small intestine. By reducing the size of the stomach, patients feel full quicker, reducing the amount of food they eat. Bypassing the small intestine also promotes weight loss as it results in fewer calories being absorbed.

Studies have found that GBS typically reduces a patient’s excess body weight by 65 – 80 per cent. However the procedure can give rise to unwanted side effects including stomach ulcers, and the development of nutritional deficiencies.

GBS has existed since 1967, but only in recent years has the operation become widely available. Since 1999, the number of GBS operations performed annually in the US has jumped from about 14,000 to about 150,000 today.

Surely, increasing rates of obesity are part of the reason for the spike. Dr. Juan Carlos-Verdeja, a bariatric surgeon from Baptist Hospital, Miami, says an increased understanding of the dangers associated with being obese is another contributing factor.

Speaking recently at the Cayman Islands Cancer Society’s Red Dress Affair at the Ritz Carlton, Dr. Verdeja said the mortality rate following GBS is about one-and-a-half per cent, usually due to risks common to all surgeries, such as infection and internal bleeding. This is slight, he cautioned, compared with the mortality rates of patients who stay obese for their whole lives. In time, patients that undergo the operation are estimated to be 90 per cent less likely to die from a condition associated with severe obesity.

‘The purpose of the operation is to reduce the co-morbidities of those diseases that come along with obesity, the most important of which are diabetes, hypertension and pulmonary problems. Those diseases are existent in about 80 to 90 per cent of all patients that have surgery for weight loss,’ he said.

By reducing those co-morbidities, the procedure can save over-burdened healthcare systems millions of dollars, he added.

Hard to stomach

Despite these impressive results and the potential healthcare savings, the mere mention of the procedure seems to incite controversy. Partly, this seems to stem from a misconception that this is cosmetic surgery gone too far.

‘This is not an appropriate operation for someone that is a little overweight,’ says Dr. Verdeja. ‘This is not an appropriate operation for someone unhappy with their looks. This is an operation for people that are at serious risk of medical diseases.’

The operation is generally only available to patients at least 100 pounds overweight. With studies indicating that only one per cent of morbidly obese patients ever succeed in losing weight through exercise and dieting, it is often an option of last resort.

His patients are subject to rigorous assessments that include consultations with psychiatrists, cardiologists and other health professionals. After the operation, patients need to stick to strict eating and exercise regimes and will be involved in regular follow ups with hospital staff.

“It is not an easy way out. It requires a very pro-active effort on the part of the patient … This is an operation about behavior, about lifestyle. What we do for them assists the patient and makes it easier for them but it doesn’t take the responsibility away from them.”

Few of those that castigate the procedure will ever understand what it is like to be morbidly obese according to Ms Forbes.

‘Unless you have lived it, you will never understand the nuances; you will never have experienced being stared at as if you were a freak in a circus show, never know how it feels to squeeze your too large body into a too small restaurant booth, never feel the humiliation of having to ask for seatbelt extensions of an airplane, and never have felt the desperation of being repeatedly denied health insurance coverage due to your weight.’

With those painful memories still fresh in her mind, Ms Forbes in now reaching out to others in Cayman that are considering the operation. By providing counselling and advice about the operation, she hopes others will come to enjoy a new chance at life like she has.

‘That is why I am so passionate about this,’ she says. ‘I have seen the other side; I know what it is like to go as low as you can go. This procedure saved my life.’

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