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Getting Thin Under the Knife Weight-loss doctor Carlos Carrasquilla, M.D. weighs in on the rise of obesity-related surgeries 
There isn't a magical weight-loss pill, but the way some people talk, there is a magic weight-loss knife. However, Carlos Carrasquilla, M.D., F.A.C.S., director of the Florida Center for Surgical Weight Loss Control in Fort Lauderdale, Fla., cautions that weight-loss surgery isn't an easy fix. It requires adopting new eating and exercise habits for life, as well as coping with the risks of surgery. Still, both bariatric and laparoscopic weight-loss surgery are increasingly common. One industry analyst predicts more than 120,000 Americans will have the procedures this year, with an average cost of $25,000 per surgery (an amount that is not always covered by health insurance). Body & More asked the man who brought the laparoscopic surgery procedure to South Florida for the low-down on the answers to the growing number of questions about weight-loss surgery. Body & More: Weight loss surgery isn't for everyone. Who is the ideal candidate? Dr. Carrasquilla: We go by Body Mass Index (BMI). People with a BMI of more than 40 are, on average, 100 pounds above average weight. Those people are considered "supermorbid obese." They have tried everything possible. But once you get above 100 pounds above your ideal weight, there is a 98 percent failure rate in [other] weight-loss treatments. Body & More: Why should patients in this category consider such a drastic treatment? Dr. Carrasquilla: It is a sad story. These people, 80 percent of whom are women, cannot go to a movie theater. Getting on an airplane is a disaster; they need to pay for two tickets so they can have the empty seat next to them. These things often lead to depression. After the surgery, they are less at risk for diabetes, hypertension and sleep apnea. Body & More: What is a typical day like after someone has had the surgery? Dr. Carrasquilla: There is a post-surgery transition. Most people feel great because they felt like they were carrying around a 200-pound bag and it is gone. But they still have to get used to having a new life. The great change that most people don't know about is that it takes about a year to lose all the weight. Most patients lose 75 percent of the weight they are going to lose in the first year. The weight keeps slowly coming down. We start heavy exercise six weeks after the surgery. Body & More: So, patients still have to exercise to keep the weight off, like any other weight-loss plan. Can patients eat whatever they want once they've had the surgery and had their stomach banded? Dr. Carrasquilla: No. The way we do gastric bypass, they are restricted. They cannot have any food with heavy sugars. If they eat food with a large amount of sugar, they will get awfully sick, with vomiting, diarrhea and nausea, and maybe even fall unconscious on the floor. A person may cheat the first time, but they will not cheat the second time. Body & More: That sounds very unpleasant. Are there any dietary benefits that patients experience after surgery? Dr. Carrasquilla: People who have the banding surgery have a restriction at the entrance of the stomach. They may feel satisfied with a smaller amount of food than before. If before they used to eat a whole pizza, they may now feel satisfied by just a slice. Body & More: Do you recommend patients have cosmetic surgery, if they want it, at the same time they have weight loss surgery, so that they only have to go under anesthesia once? Dr. Carrasquilla: No, we advise patients not to do anything for a year, so that they can see what happens with excess amounts of skin once they lose weight. |
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