Weight Loss Woes: What's The Secret?

By Roberta Jasina

What's the secret to quick (and healthy) weight loss?Is there a secret? Is it surgery?

Why so do many people who've had weight loss surgery gain their weight back?

I had a chance to chat for about an hour with Dr. Scott Laker, Director of Bariatric Surgery at Henry Ford West Bloomfield Hospital.

I had tons of questions.  Some of the answers surprised me, and some of the answers depressed me.

One of the more depressing tidbits:  Dr. Laker says "If you look at studies, as many as 99% of people who attempt diet and exercise will eventually regain their lost weight and most times, will gain more weight than they lost."

Can you be addicted to food?

Dr. Laker:  "I am not an addiction specialist but what's my hunch? YES food can certainly be an addiction, and sugar can be an addiction, and unless we change these addictive behaviors, no surgery, no diet is going to get you better."

What are the risks of bariatric surgery?

 Dr. Laker:  "I'll tell you there are more people dying because of NOT HAVING Bariatric surgery on an annual basis than those people dying as a result of a complication of Bariatrics.  The risk of dying for a laproscopic gastric band is estimated at one of every ten thousand.  It's that rare.  We generally quote people the risk of dying after a sleeve or gastric bypass is ... very low."  Bariatric surgery does increase longevity and it's got an incredible impact on diabetes."

 Is surgery the "easy" way out of a severe weight problem (as opposed to diet and exercise?)

 Dr. Laker:  "It's not the easy way, it's a different way.  In some people I think it is a reasonable thing to refer to it as a "shortcut." If you're in your sixties and you have 200 pounds to lose, you don't have a decade or even five years generally to get this off.  And if we can offer the ability to get off 100, 125, or 150 pounds in a period of one to two years you're changing that person's underlying medical issues very quickly."

When people have the surgery, why do so many patients gain their weight back--and why?

Dr. Laker: "It is possible to have all these operations and not lose weight.  And everybody knows of somebody, or knows somebody who knows of somebody who had bariatric surgery, did great, only two years later regain it back. Weight regain is frustrating."

What percentage of bariatric surgery patients gain their weight back?

Dr. Laker:  "An estimated 25%."

Why does that happen?

"I think the biggest issue is what we're putting in our mouths. It's human nature to desire things that are pleasurable.

And a lot of the foods that give us such great pleasure are high calorie, nutrient poor foods.  What MY belief is, is it's less of an issue with the operation, but more of an issue with the diet.  If you're not going to change your ways you should not entertain bariatric surgery.  It's extremely important for patients to understand that long-term success is absolutely predicated on changing dietary habits.  Cookies should not be in the diet.  We need to change our ways with or without surgery.  The only sustainable diet is a diet that people feel they can eat as much as they want.  And there is such a diet. But that diet is filled with vegetables and lean meats (in that order) and really minimizing the carbohydrates and even moderating fruits."

If you conquer your addiction to food...will you develop other "replacement" addictions?"

Dr. Laker: "We  have seen a transference of addiction.  People develop alcoholism, drug addictions. You're at risk for any type of addiction: gambling.  It is kind of a transference of something underlying that is being satiated with a new type of indulgence."

What role does depression play in the life of someone who is morbidly obese?

 Dr. Laker: "50% to 75% of patients we see are on antidepressants or an anti-anxiety (medication.)  It's very common.  And these things have to be continuously addressed."

If you lose a hundred pounds do you have to get plastic surgery to get rid of the wrinkly, excess skin?

Dr. Laker:  "Most people are not nearly as bothered by it, as much as they THINK they're going to be bothered by it.  If it is bothersome,  I will not allow my patients to seek consultation with the plastic surgery department until at least 18 months.  We want the weight loss to show that it is stopped before we undergo any of these procedures."

What do you see in the future?

Dr. Laker:   "What I don't see in the future is a medication that gives the same results (as surgery.) I see bariatric surgery continuing a long while."

Henry Ford West Bloomfield offers free seminars every month on weight loss surgery.

For more information, call (248) 661-7960 or visit this link.