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Quality of Life Interventions from the Columbia University Department of Surgery
Weight Loss Surgery: A Life-Saving Solution
Marc Bessler, MD
Director, Center for Metabolic and Weight Loss Surgery
Columbia University Medical Center
In Affiliation with NewYork-Presbyterian Hospital
Phone: 1-212-305-4000
The reasons why people become extremely overweight are not well understood, but there
are most likely many factors involved, including low metabolism due to low energy
expenditure and excessive calorie intake, as well as genetic, psychological, environmental,
social and cultural influences. One thing is certain, however: people who are severely
overweight are at increased risk for health problems that can be life-threatening.
About Weight Loss Surgery
Surgery has become an acceptable method of treatment because it appears to be the only
option that can provide long-term maintained weight loss in the majority of patients with
clinically severe obesity. Today, there are several surgical procedures used for achieving
weight loss. The most common are gastric bypass and adjustable gastric banding.
Gastric Bypass
The surgeon divides the top of the stomach to create a small pouch, and attaches the
pouch to the small intestine, bypassing the majority of the stomach and a short segment of
the intestine. The procedure achieves weight loss by decreasing the amount of food that
can be eaten at any one time and by causing the release of hormones that produce a
sense of satiety or lack of hunger. Appropriate candidates for this surgery are those who
are 80 pounds or more overweight. Almost everone can have a laparoscopic version of the
procedure performed through 5-6 small incisions.
Gastric Banding
Laparoscopically placed around the upper part of the stomach, the saline-filled gastric band
is removable and adjustable, and does not permanently alter the anatomy. The band
divides the stomach into a smaller pouch above the band and a larger pouch below. The
band is connected by a tube to a reservoir placed beneath the skin during surgery so that
the surgeon or nurse practitioner can later inject saline to adjust it. The procedure limits the
amount of solid food that a patient can eat at any one time.
Importance of a Comprehensive Approach to Weight Loss
Because of the multi-faceted nature of obesity, there is no single quick fix for the problem.
Nor is there a single way to achieve permanent weight loss for every individual. If you or
someone you know is considering weight loss surgery, our team recommends choosing a
program that takes a comprehensive approach, including modifications of diet and exercise
habits, as well as psychological support. The ideal weight loss program should have on-staff
dietitians and psychologists as well as surgical and nursing clinicians. It should offer patients
pre-operative evaluation and education, as well as extensive follow-up and support after
surgery to help patients settle into new routines and habits.
Quality of Life Interventions from the Columbia University Department of Surgery
"Weight Loss Surgery: A Life-Saving Solution"
"Weight Loss Surgery: A Life-Saving Solution"
