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new balance tennis shoes uk A bariatric boom Paul Ernsberger, an associate professor of nutrition at Case Western Reserve University School of Medicine in Cleveland, has studied the longterm complications of weightloss surgery. While the surgical procedure has become quite safe, he said, too many patients have problems later, such as nutritional deficiencies, diarrhea, regurgitation and bowel obstructions. Agency for Healthcare Research and Quality, 19 percent of patients experience involuntary vomiting or defecation. Complication rates involving ulcers, wound problems, hemorrhage, deepvein thrombosis, heart attacks and strokes are as high as 2.4 percent.LOS ANGELES After spending most of her 48 years trying, and failing, to slim down, Veronica Mahaffey was still 50 pounds overweight not morbidly obese by a long shot, but still far from the size she wanted.Worried about her health, she called a San Diego weightloss surgery clinic last spring and asked for help.She was told no.At 185 pounds and with a body mass index of 28, the Ramona, Calif., mother of four was not heavy enough to meet the medical guidelines or insurance company qualifications for weightloss surgery. Those standards require a BMI of 40 or higher, or 35 or higher for people with a medical problem such as diabetes or sleep apnea."People would say, 'You look fine.' But I couldn't get into normalsize clothing. That's not fine," Mahaffey said. "And then I was told I was going to have to gain weight to qualify for surgery. That doesn't make sense."Ultimately, she got the surgery through a clinical trial for one of several new weightloss procedures. Now 10 pounds from her goal weight of 135, she says she looks better, feels better and is confident she'll no longer have to fight her weight.Her experience could soon be shared by thousands of Americans.Usually reserved for the most obese people, weightloss surgery is unlikely to be a lastditch option much longer. Technological advancements are turning it into a onehour, incisionless procedure making it more attractive to moderately overweight adults, overweight and obese teenagers; and normalweight people with difficulttocontrol diabetes. Several new procedures are in human clinical trials."I see surgery playing a bigger role," said Judith Stern, a professor of nutrition and internal medical at University of California Davis, "because the weightloss drugs we have now are lousy."The need for new treatments is hard to ignore.A report from the American Public Health Association projected that healthcare costs related to obesity would quadruple in 10 years, accounting for 21 percent of healthcare spending.Bariatric surgery, many doctors say, should be a bigger part of the solution."We're seeing increased disability due to obesity among a younger population," said John Baker, president of the American Society for Metabolic and Bariatric Surgery. "We can't afford to wait. As a tool to bring down costs and the burden of disease, bariatric surgeons have the most effective tool in medicine today."Other health professionals are aghast at the idea of more Americans undergoing the surgery.Bariatric surgery rates have already doubled in the last six years, resulting in 220,000 procedures in 2008. Depending on the type of surgery, patients lose 50 percent or more of their body weight and maintain that loss for as long as 10 years after surgery. In comparison, the most recent studies on longterm use of weightloss medications show a typical weight loss of 5 to 22 pounds over one year, with some side effects.Other research has found that bariatric surgery cures Type 2 diabetes in a majority of patients studied, as well as improving symptoms related to sleep apnea and heart disease, such as high cholesterol and blood pressure.