Before and After Weight-Loss Surgery

Celebrities such as Al Roker, Roseanne Barr and Star Jones have used bariatric surgery to battle obesity.

En español | After years of struggling to lose weight, Julie Hartje, 58, decided it was time for desperate measures. Almost 100 pounds too heavy, she knew that being obese put her at increased risk of heart disease, which runs in her family. And she'd already been diagnosed with type 2 diabetes, almost certainly a consequence of being too fat.

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Last fall, Hartje underwent gastric bypass surgery. "I didn't feel like I had a choice," says Hartje, who lives in Beloit, Wis.

One of several forms of bariatric (weight-loss) surgery, gastric bypass is the most complicated. Surgeons create an egg-size pouch out of the stomach, reconnecting it to the small intestine. The operation restricts how much food people can eat and also bypasses portions of the intestine that absorb food, so some fats and sugars pass through without being digested. The surgery reduces the size of the stomach — so people feel full on much less food — and changes the way the body absorbs nutrients.

Better health, longer life

Some 220,000 bariatric surgeries were performed in the United States last year. And while surgery may appear to be an extreme method for addressing America's growing weight problem, three decades after researchers began to track an epidemic of obesity and type 2 diabetes, many experts say that it is the only reliable treatment. Dieting and exercise may work for a small percentage of people. "But studies show that most people long-term lose only a few pounds," says Nestor Villamizar, M.D., a bariatric surgeon at Duke University Medical Center in Durham, N.C.

Gastric bypass surgery, on the other hand, can cause people to lose 80 percent or more of their excess weight. And to the surprise of many researchers, this surgery reverses type 2 diabetes in many patients — often immediately after surgery, before they begin to lose weight. Among obese patients with type 2 diabetes who undergo gastric bypass surgery, studies show that 86 percent see significant improvements in blood sugar control. In 78 percent, the signs of diabetes vanish entirely. No other treatment for this potentially deadly disease has been shown to work as well.

The operation also has been shown to lower blood pressure, improve cholesterol levels and relieve obstructive sleep apnea, a common breathing problem associated with obesity. It can even help the heart. A recent report from researchers at the Medical College of Georgia showed that, after gastric bypass surgery, enlarged hearts often return to more normal shape and function.

Next: Who should be considered for bariatric surgery? >>

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