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After Dominick Basso struggled throughout his life with high blood pressure, high cholesterol, high triglycerides, and eventually type II diabetes, he decided he wanted to be rid of the cost and medications of his health problems.
Basso weighed 280 pounds, was easily winded and didn’t sleep well. In early 2011, he started learning about bariatric surgery, known as weight loss surgery, and decided to meet with doctors at NorthShore University HealthSystem in Gurnee, to see if the surgery could help him eliminate his health issues.
The Mundelein resident lost 80 pounds in the last two years, after having a gastric bypass at Highland Park Hospital in December 2011. Before the surgery, he went through months of physical and psychiatric evaluation.
“[The surgery] improved my life greatly. My sleep is better, although I didn’t have sleep apnea like many [bariatric surgery] patients do. Before the surgery, I was in fairly good shape but was lugging around so much extra weight.”
But Basso added bariatric surgery is “a tool, not a magic pill.”
Dr. Woody Denham, Basso’s bariatric surgeon and director of NorthShore University HealthSystem’s bariatric program, specified that bariatric surgery is not cosmetic in nature, like liposuction or tummy tucks.
“Morbidly obese people have a shorter life expectancy, and higher rates of blood pressure and diabetes,” he said. “They can’t ride public transportation, they can’t clip their own toenails, they fight depression and social stigma. Their self-esteem is very low. When people lose weight down to a normal BMI [body mass index], their life expectancy goes up to where it should be. People who have the surgery live longer than other morbidly obese people.”
Most people who opt for bariatric surgery have lost weight by other methods throughout their lives, Denham said. “They’ve been in fat camps since they were 12, done Weight Watchers or Atkins and lost 40-60 pounds before, and struggled to keep it off for many years,” he said.
“There comes a point where there’s a straw that broke the camel’s back. ‘I can’t ride my bike on family camping trips,’ or ‘I tried to chase my grandkids the other day and couldn’t, so someone else had to do it.’”
What some view as the answer to a life-long struggle seems extreme to others. “Some people think it’s crazy to rearrange organs, but it’s not quite as drastic as they think,” Denham said. “It’s safer than colon surgery.”
Denham said of the three types of surgery available, the laparoscopic gastric bypass has become the most popular. In a bypass, the stomach is stapled into a smaller pouch, and the small intestines are attached to the new pouch that was created.
The second most popular is the lap band, which restricts the size of the stomach by blocking it off near the entrance. The third option, sleeve gastrectomy, consists of removing part of the stomach.
According to Denham, the bypass is the strongest weight loss tool with 80 percent chance of long-term success, followed by sleeves with a 60 percent success rate, and bands with a 40 to 50 percent success rate.
Candidates are selected based on their body mass index, along with other weight-related health issues that may affect their quality of life, such as high blood pressure, sleep apnea and diabetes, Denham said.
“Eighty percent of our patients are women,” Denham said. “Women are more willing to seek and accept help for their weight. Guys are culturally allowed to be big.”
Basso said he lost about 20 pounds during the pre-diet before surgery, a pre-cursor to the change in eating habits he’ll maintain for life after surgery.
However, it’s not an easy ride for surgery patients – they have to maintain lifestyle and diet changes for the rest of their lives.
Basso said, “I’ve known people who had the surgery and re-gained the weight because they didn’t stay with the program,” checking in with doctors annually and maintaining a nutritional plan.
One of the most intense post-surgery challenges can be a new attitude toward food.
Basso said, "Once I had the surgery, the hunger just went away. That was the major change. I feel the physical prevention from eating too fast. I used to be a big gulper of liquids and I can't do that anymore – it's painful. I can't tolerate greasy fast food at all."
“A lot of people, in the first eight months post-surgery, are apathetic toward food,” Denham said. “Things taste different or not as good. Within six months to a year, they start getting hungry again. Some people used to love fried chicken, but it doesn’t taste good to them anymore.
They really have to pay attention to what they eat. If they eat too quickly, they may throw up or get dizzy, or feel like passing out. Nausea is pretty miserable, and it’s strong enough that they quit eating like they used to and start to be more careful.”
Denham said the best part of the process is when he sees his patients when they come in for their six-month and year visits after surgery.
“You don’t recognize them. Many of them bring pictures showing their monthly weight loss. They bring photos of themselves being active – kayaking, riding bikes. It’s amazing to see a totally transformed person.”
Five years ago, he operated on a man who weighed 250 pounds. “He couldn’t exercise, had sleep apnea and diabetes. Since the surgery, he’s started doing bike rides for charity and recently did a 100-mile bike ride outside of Tahoe [Nevada]. He’s been doing great.”