Any medical center who does these should have a comprehensive program which includes both pre-op and post-op assessment, counseling, exercise physiology or the like, and nutritional support. Pre-op issues which should be addressed include motivation for losing weight and keeping it off, eating behaviors, social support, history of exercise (or not), overall health, with particular attention to cardiovascular health, and what damage has already been done due to the obesity, such as severe knee arthritis or degenerative disk disease of the spine.

Proper patient selection, based on all these variables, helps to weed out those with a greater chance of death from the surgery, as well as those it won't benefit in the long run. On this latter topic, I read a newspaper account of a father and daughter who both got bariatric surgery and were in the "eating teeny amounts" post-op phase. All they could talk about was their eagerness to get back to the high-calorie foods they got fat on in the first place. And eventually they will gain back every pound.

Having said this, there are those who will benefit. Morbid obesity results in such devastated health, from orthopedic to cardiovascular, that if done early enough and if the patient is then able to maintain a reasonable weight, it will truly change their life.

The big issue is whether it should be covered by insurance. Not an easy question. Many conditions which people bring on themselves (50% of all medical care, it is estimated, is for conditions related to lifestyle) are covered as it is. But I would guess most of us would not be excited about funding the surgery for someone who afterwards can't control their diet and is back in the same mess in a matter of a few years.

posted by 66.170.4...

• Way, way OT: What do you think of stomach stapling?, Brian, Thu, 20 Nov 2003 10:13:00
  • my brother had this done, saabgirlie , Thu, 20 Nov 2003 17:12:29
  • Some thoughts, saabaru, Thu, 20 Nov 2003 12:46:44 <-- Viewing This Message
  • Re: Way, way OT: What do you think of stomach stapling?, JasonS, Thu, 20 Nov 2003 12:27:07
  • Depends on the patient, Leon, Thu, 20 Nov 2003 11:19:59
  • Doesn't address the problem..., FrozenSaab, Thu, 20 Nov 2003 10:35:00
    • That surgery can be deadly serious ->, michael p, Thu, 20 Nov 2003 10:42:06

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