Introduction
Thank you for your interest in the Duke University Health
System Weight Loss Surgery Center.
Let us begin by stating that serious obesity is a disease.
It is not due to any weakness or laziness on your part. Medical
research is showing that obesity is a genetic abnormality that
is expressed to variable degrees -- even between individuals of
the same family. When the genetic abnormality is weakly
expressed and obesity is only a mild problem, medical risks are
minimal and the multitude of diet programs available are
usually effective and satisfactory.
When, however, the genetic abnormality is strongly expressed
and weight increases in excess of 100 pounds above one's ideal
weight, medical implications become very important with
increased risk for cardiac and pulmonary diseases, diabetes
mellitus, and most importantly, a 10- to 20-fold increased risk
of early death.
For this population of patients, structured dietary programs
have universally been unsuccessful. Patients report whatever
weight loss occurs to be only followed by weight regain and all
efforts are associated with guilt feelings and depression. It
is this population of seriously obese patients that weight loss
surgery is intended to help.
The currently applied surgical procedures of Roux-en-Y
gastric bypass and Lap-Band® have consistently resulted in 80
to 140 pound weight loss in properly selected patients. As you
might expect, such significant weight reduction has a
tremendous impact on all aspects of life. As you begin to lose
weight, the way you feel about yourself, your family, and
friends will all change.
Weight loss surgery, however, cannot accomplish or
maintain the necessary weight loss without your
cooperation. To accomplish and maintain weight loss
after surgery, you must eat less food, change the types of food
you eat, and increase your exercise. The operations will create
a very small stomach.
Although you might continue to get hungry, one or two bites
will satisfy your appetite and make you feel full. You must
accept this fact and overcome the urge (habit) to overeat. Once
you have recovered from surgery, liquids will not be as
effective in satisfying your appetite and you must avoid large
amounts of liquid calories.
We currently offer two surgical approaches for the
management of obesity: the laparoscopic Roux-en-Y gastric
bypass procedure and the laparoscopic Lap-Band procedure.
The Roux-en-Y gastric bypass is recognized as the “gold
standard” surgical procedure and is the only procedure to have
demonstrated long-term (124 year) maintenance of weight
loss.
The Lap-Band procedure results in less weight loss, requires
more frequent office visits for adjustment, and has not yet had
long-term follow up. The Lap-Band procedure, however, is a less
invasive surgical procedure and is associated with fewer major
complications.
It is therefore very important for you to carefully consider
the two surgical options and for us to conduct a complete
evaluation before surgery to make sure surgery is right for
you. This evaluation will include completion of the attached
questionnaire, a physical exam, an evaluation by our eating
disorder psychologist, and a nutritional evaluation.
It is important for you to read and understand the
information in this Web site before you make an application to
our surgery program. We also encourage you to have your family
read this information.
Note: To qualify for insurance coverage, you must have a
body mass index of 40 or more. Calculate your
body mass index before you consult with your physician or
insurance company.
Patient Manual Index
