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Bariatric, or weight loss surgery, continues to be on the rise with a large portion of the U.S. population officially defined as obese. Gastric bypass surgery, also known as Roux-en-Y, is the most popular surgical method in the U.S. to obtain massive weight loss. While many gastric bypass patients are desirous of plastic surgery to improve their residual body deformities left after the weight loss, less than half actually ever do priamrily due to economic considerations. One very interesting question is that in those patients who do undergo body contouring surgery, after all the effort and expense, is their weight loss maintained?

Attempts to answer this question appeared in the June 2008  issue of the journal Plastic and Reconstructive Surgery. Over four years, the authors collected data on 70 patients who lost an average of around 140 lbs and had body contouring surgery after with an average removal of skin and fat of near 13 lbs. Their data showed that gastric bypass patients susbsequently gained around 2 lbs whereas those patients who lost the weight without gastric bypass surgery (diet) gained close to 22 lbs. It should be pointed out that the patient numbers for the diet group were quite low (6) compared to the gastric bypass group. (64) Statistically, however, the difference was still significant.

This paper concludes that gastric bypass surgery patients maintain their weight loss better than those patients who lost it by diet alone. I don’t think that this finding is that surprising. The ‘why’ of it undoubtably has to do with ther permanent alteration of nutrient absorption by the bypass. Diet weight loss patients must maintain their weight loss by the mental restriction of food intake, they simply can relape back faster as their ability to absorb nutrients is unaltered. In either case, bariatric plastic surgery produces successful results. Gastric bypass patients are just better at maintaining their investment due to their altered gastrointestinal anatomy.

Dr. Barry Eppley

Indianapolis, Indiana

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