The bariatric nutritionist cited an NIH study (but couldn't give me enough information to track it down and I've thus far been unsuccessful) that looked at people that had lost at least 100 lb and then whether they had kept it off five years later. Overall, the number was depressing -- just 3%. But for bariatric surgery (all forms lumped together) it was about 70% worldwide and in the U.S. and a few other countries it was in the 90+% range. The reason for some countries being much higher than others is attributed to better pre-surgery screening and education and post-surgery follow-up and support. I had to attend a nutrition class specific to my particular surgery and I had to be evaluated by a psychologist whose goal was to determine if I was sufficiently likely to be able to follow the post-surgery guidelines for the long-term. Post-surgery they have monthly support group meetings that are free and I will have twelve monthly follow-up visits with the surgeon.

I would really like to find that paper.



There are certainly a lot of horror stories from a few decades back and many of them were well deserved. I was talking to the surgeon about this and he said that WLS has come so far in the last decade that he is still amazed (he's been doing it for over twenty-five years). He pointed out that not only are the underlying mechanisms much better understood, but so is the degree and type of nutritional support that is needed afterward in terms of supplements. The surgical procedures have also advanced to a point where the risks are comparable to things like having your gall bladder or appendix removed.

The expenses are a whole other issue. My insurance company covers a max of $15k and at the present time we are looking at about $14k in out-of-pocket costs. That about $100/lb of weight loss ($200/lb if you include what the insurance covered). Not trivial.