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Lifestyle change key for obesity surgery success

Anyone thinking about having weight loss surgery should be sure to do their homework beforehand, and must understand they need to dramatically change the way they eat for the surgery to be successful, advises the head of the U.S. government agency responsible for research on health care quality and patient safety.

"People who succeed and lose weight and keep it off eat very, very differently," Dr. Carolyn Clancy, director of the Agency for Healthcare Research and Quality (AHRQ) in Rockville, Maryland, told Reuters Health. "Essentially, you've got to eat a whole lot less."

Clancy has written about the realities of operations to promote weight loss, known as bariatric surgery, in the latest issues of Nursing for Women's Health and Health for Women, both published by the Association of Women's Health, Obstetric and Neonatal Nurses.

Bariatric surgery has skyrocketed in popularity, Clancy noted in an interview, but just a fraction of people who could benefit most from the surgery have gotten it. According to AHRQ, evidence for the procedure's benefits is strongest for people with body mass indexes (BMIs) of 40 or higher, or individuals with BMIs of 35 or greater who have a serious medical condition, such as diabetes or severe sleep apnea.

Nevertheless, she added, the surgery "is not risk free, and I think it's really important for all people, women and men, to know about the risks and to be very clear about what they're getting into."

For example, Clancy said, 7 percent of people who undergo the surgery need to be rehospitalized for complications. Four out of 10 will develop complications within 6 months of the surgery. These complications include nausea, cramps and vomiting due to overeating.

People should also seek out a surgeon and health care team they can communicate with effectively, because post-surgical follow-up care is just as important as the procedure itself, Clancy added. If you don't "click," or you feel your surgeon isn't hearing your concerns, she advised, look elsewhere.

People may want to seek out bariatric surgery programs designated as Centers of Excellence by the American Society for Metabolic and Bariatric Surgery (, Clancy suggested.

Finally, she said, people need to find out before having the surgery whether or not their insurer covers it. Some will require documentation that a person has made a serious effort to lose weight by other means before they will pay for the procedure.


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