Healthwatch 16: Gastric Bypass Study Finds Keys to Long-Term Weight Loss

GEISINGER MEDICAL CENTER -- A study done here in northeastern and central Pennsylvania was published last month by Jama Surgery. JAMA is Journal of the American Medical Association, a peer-reviewed national medical journal.

The topic was gastric bypass surgery, specifically which patients had greater long-term weight loss.

It was done by a team at Geisinger Medical Center.

"I got all the way up to 330 pounds," recalled Stephanie Ranck.  "I was miserable. If you saw a picture of me, you wouldn't even recognize me."

Stephanie Ranck of Watsontown struggled with her weight for years but in 2004, she was on the verge of being a Type 2 diabetic had a family history of cardiovascular disease and worried she wouldn't be around for her daughter.

"I decided I was ready to go the surgery route because nothing else was working."

Stephanie had gastric bypass surgery, a procedure that creates a small pouch from the existing stomach, restricting the volume of food that can be eaten. The surgery is becoming fairly common, but doctors noted that some patients lost more weight as a result of it than others.

The factors behind that are what Dr. Michelle Lent and her team studied.

Dr. Lent is a clinical psychologist at Geisinger Medical Center near Danville who works in obesity research. She calls bariatric surgery, of which gastric bypass is one type, the most effective long-term treatment of obesity.

"The study sought to determine which patients lost more weight after surgery and which lost less after surgery," Dr. Lent explained.

It looked at more than 700 patients in the Geisinger system for up to 12 years after their gastric bypass surgeries.

She calls what her team found surprising.

"We found that patients who used insulin, patients who had a history of smoking cessation, and patients who used a high number of medications before surgery lost the most weight."

Those are factors they previously would have thought may have hindered weight loss, not helped it along.

Dr. Lent says the study wasn't designed to answer the why, and could only speculate about the reasons behind the results.

"Perhaps the history of behavior change gave them motivation or experience necessary to also change their eating behavior."

Stephanie didn't deal with those factors, but she knows all about behavior modification after surgery. In less than a year, she lost 140 pounds. She has since gained back some, but is healthy and feeling great. And she now works at Geisinger near Danville in obesity research counseling others.

If you'd like more specifics on the study, it was published last month in Jama Surgery.

Dr. Lent says she hopes the findings will help them, and other doctors, better tailor post-surgical plans for each of their patients.