European Stars and Stripes (Newspaper) - October 31, 1993, Darmstadt, Hesse                                J slim reaction to cutting through the fat weight loss surgery carries with it Anasty list of possible Side effects. Still Many severely obese people see it a their Only escape from physical an emotional anguish. They undergo surgery to reduce their stomach size through stapling or banding. Others try gastric by pass surgery which channels food from a reduced stomach Pouch directly to the Small intestines. Surgery patients have a relatively Good record in maintaining their lowered weight but they often pay a Price in such chronic Side effects As diarrhoea Ane Mia and vomiting. Or. John Krai surgery professor at the state University of new York in Brooklyn says obese patients find such Side effects generally acceptable because of the significant improvement in Quality of  people unable to work or ashamed to leave their Homes can live Normal lives As a result of surgery. Sweden s health care program even pays for such operations because of benefits from reduced Absentee ism and health costs related to obesity. Not All surgery patients find the weight loss gains Worth the discomfort. Krai says drawbacks occur most often when doctors fail to explain All the Side effects. Leila Haegh Counselor with a weight reduction Agency in Norway told participants in a recent con Gress on the subject of obesity that most of the 12 surgery recipients whom she informally interviewed were bitter about their experiences. The operation that promised to solve All their problems. In Many cases caused ill health disability and actually made their lives even More difficult Haegh says. She told of one woman who after stomach band ing vomited eight to 10 times a Day until gastric acids ate the enamel off her Teeth. She lost 220 of her original 352 pounds in 12 months but developed an insatiable craving for sugar eventually eating it straight from the bag. When doctors determined a liquid coming out her nose was brain fluid she was granted 100 percent disability Haegh said. She  band removed her vomiting stopped and she now weighs nearly 400 pounds. Another woman whom Haegh interviewed had a slightly better experience with gastric bypass surgery. Ana weighed 300 pounds before the operation. Following surgery she experienced the Normal Side effects of diarrhoea a metabolic imbalance and Leth Argy. She slimmed to 153 pounds Over two years. Now she cats everyday food and is Content with her 170 Pound weight. However Shell require regular Hospital checkups and injections of Vitamin b Theresa of her life. Ana never would have undergone the operation if she d known what she knows now Haegh recounts from their talk. On a balance the health benefits of obesity sur Gery outweigh its Side effects Krai says noting that even modest weight loss reduces risks such As diabetes and heart failure. He stresses that some Side effects can be prevented and All can be treated. Weight loss also relieves patients psychological and social suffering he says. Effective alternatives to surgery do not seem to be available Krai says. Unlike obese people who have been treated with. Is Rosemary Sawyer or. John Krai of Brooklyn effective alternatives to surgery do not seem to be  drugs or diets patients who undergo surgery appear to keep most of the pounds off. After five years patients who have had their stomachs reduced main Tain a loss of 40 percent to 45 percent of excess weight he says. Gastric bypass recipients keep about 60 percent of excess weight off after five or 10 years. Krai endorses a staged approach in considering surgery. Obese people who fail at conventional treat ments should first consider having the stomach reduction surgery which can be done extremely safely in experienced  if this fails and it does in 30 percent of cases be cause sugars and other High density caloric foods can pass through the system then the patient can consider More aggressive treatment including gastric by pass he says. The gastric surgeries should not be confused with procedures such As liposuction or Lipe Tomy that re move fat deposits for cosmetic reasons. Cosmetic and plastic surgery have no role in the actual treatment of the metabolic disease obesity Krai says. The procedures will not remove enough fat tissues to make any difference in the patient prognosis. When considering surgery it s ultimately up to the obese patients themselves to decide what is moral just or  but they must be Given sufficient facts Krai says. Rosemary Sawyer. Is Dave casey1 his Ivor Kout Lent on display at Atu Trp s seminar provides additional heat to the body during exercise. Advice for children before shipping Junior off to a fat farm at age 6, consider the following suggestions from childhood obesity expert or. Elizabeth Poskitt from England s University of Liverpool try to schedule family Mealtimes which Combine socialization with eating and May in crease mealtime satisfaction. Regulate snacks to specific times. Limit television watching. Encourage sports or activities. Even a sedentary activity such As stamp collection can occupy a child and reduce his eating out of boredom. Encourage a helpful attitude so when something needs to be fetched from upstairs it s the child who runs to get it rather than the Mother. Page 6 sunday Qto bar 31. 1933