by liquidstayce » Wed May 04, 2005 2:10 am
Hi Belfy~
Actually most are dedicated just after. To go through something this drastic you have to be. It is NOT the easy way out as you can see if you read through even some of the info I posted. However, when the honeymoon is gone and when the big weight loss stops and you are only getting a lb here and there that is when problems can happen. People come down from that inital high which lasts about 12-18 months. The problem arises if they have not taken advantage of that inital window of opportunity to make the behavioral changes along with the weight loss.
Your comment about that it works sometimes can be somewhat quantified..
What is the success rate (statistic) of persons undergoing bariatric surgery? These are NOT easy statistics to come by, as many patients fail mostly at following up with their surgeon's group so that accurate statistics can be compiled. However, from what is available, this is what "I" have concluded (you're conclusions from the same data, may vary - which is what makes science so interesting to me :-) ):
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It seems that about 85 - 90% of diets fail the morbidly (MO) and super-morbidly obese (SMO). The average dieter is considered a 'success' if they lose 10% of their excess weight. In the MO/SMO, that amounts to a paltry 25 to 40 pounds (on average), which is not enough to alleviate the health concerns created by being MO/SMO.
Bariatric surgery is considered successful if the patient loses between 50 and 75% of their excess weight, depending on the surgery performed, surgical group performing, the patient's mental health AND their starting weight. It is further considered a success if the patient maintains a loss of at least 48% over the long term (5+ years), even with a weight regain of 5 to 10 percent over that time.
"With gastric bypass, as well as the biliopancreatic diversion and duodenal switch, weight loss is rapid and substantial. Excess weight loss one year after surgery is generally 70% or more. Studies have found that 5 years after gastric bypass surgery most individuals will have maintained 48 to 74% of their excess weight loss. One study found that even 14 years after surgery, average excess weight loss for over 600 gastric bypass patients exceeded 50%." [beyondchange-obesity.com/obResearch/surgeryATool.html]
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Bariatric surgery remains the only durable treatment for extreme overweight and can dramatically improve health and quality of life for morbidly obese individuals, says UAB bariatric surgeon John J. Gleysteen, MD, who notes that at 5-year follow up, medically supervised weight-loss programs report a 96% failure rate.
For patients undergoing bariatric surgery, mean excess weight lost ranges from 50% to 75%. After 14 years, excess weight loss still exceeds 50% in many patients, reports the American Society for Bariatric Surgery.
With United States obesity rates reaching epidemic proportions — currently, more than 14 million Americans are morbidly obese — national demand for surgery is soaring. In 2002, the number of bariatric procedures jumped 40%, to 80,000. According to the National Institutes of Health (NIH), the number of surgeries topped 120,000 in 2003.....Peak weight loss occurs about 1 year postprocedure; after 5 years, many patients regain some weight, with most maintaining about 50% of excess weight lost" [health.uab.edu/4docs/show.asp?durki=64602]
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With the Roux-en-Y gastric bypass, 70% or more of patients achieve success, as defined by a loss of 50% of excess weight maintained at 1 year. The mean weight loss is 60% to 85% of excess body weight at 3 years of follow-up. A small amount of weight regain can be expected after the weight nadir, but at least one study has shown maintained success at 3 years in 72% of patients (11,13)." [postgradmed.com/issues/2004/01_04/mattison.htm]
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Mayo Clin Proc. 2000 Jul;75(7):673-80
Prospective evaluation of Roux-en-Y gastric bypass as primary operation for medically complicated obesity.
Balsiger BM, Kennedy FP, Abu-Lebdeh HS, Collazo-Clavell M, Jensen MD, O'Brien T, Hensrud DD, Dinneen SF, Thompson GB, Que FG, Williams DE, Clark MM, Grant JE, Frick MS, Mueller RA, Mai JL, Sarr MG.
Division of Gastroenterologic and General Surgery, Mayo Clinic, Rochester, Minn. 55905, USA.
OBJECTIVE: To determine prospectively the results of Roux-en-Y gastric bypass (RYGB) used as the primary weight-reducing operation in patients with medically complicated ("morbid") obesity. The RYGB procedure combines the advantages of a restrictive physiology (pouch of 10 mL) and a "dumping physiology" for high-energy liquids without requiring an externally reinforced (banded) stoma. PATIENTS AND METHODS: Between April 1987 and December 1998, a total of 191 consecutive patients with morbid obesity (median weight, 138 kg [range, 91-240 kg]; median body mass index, 49 kg/m2 [range, 36-74 kg/m2]), all of whom had directly weight-related morbidity, underwent RYGB and prospective follow-up. RESULTS: Hospital mortality was 0.5% (1/191), and hospital morbidity occurred in 10.5% (20/191). Good long-term weight loss was achieved, and patients adapted well to the required new eating habits. The mean +/- SD weight loss at 1 year after operation (113 patients) was 52 +/- 1 kg or 68% +/- 2% of initial excess body weight. By 3 years postoperatively (74 patients), weight loss was still 66% +/- 2% of excess body weight. Overall, 53 (72%) of 74 patients had achieved and maintained a weight loss of 50% or more of their preoperative excess body weight 3 years after the operation. In addition, only 1 (1%) of 98 patients had persistent postoperative vomiting 1 or more times per week. CONCLUSION: We believe that RYGB is a safe, effective procedure for most patients with morbid obesity and thus may be the current procedure of choice in patients requiring bariatrics++ surgery for morbid obesity."
MID: 10907381 [PubMed - indexed for MEDLINE] [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=10907381]
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A couple of interesting studies I ran across, but am not posting showed that oddly enough, people who suffered from depression often had more significant weight-loss the first year, though without treatment, had the highest incidences of regain over the long term. And those with more friends and confidants, a greater history of diet attempts, and greater sexual satisfaction tended towards greater success at weight loss. Whereas, those who reported sexual abuse in childhood, poor current sexual satisfaction, and those who shied away from follow-ups with healthcare professionals tended towards a higher failure rate with weight loss surgery.
~stacy