Gastric bypass patient lost too much weight 

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BY JIM RITTER Health Reporter Sun Times - May 27, 2007

Weight-loss surgery often is the most effective way for extremely obese people to lose weight.

But what if it works too well?

Sherilyn Herkey of Streamwood was delighted when she lost 125 pounds in six months. But her gastric bypass surgery left her unable to adequately digest food, causing severe malnutrition.

Since her 2003 surgery, Herkey has been hospitalized 11 times for malnutrition. She suffers from fainting spells, osteoporosis and severe vitamin and protein deficiencies.

'I feel like I've aged 2 decades' Herkey, 44, is so weak she's had to quit her information technology job. Her muscles have atrophied, and she lacks the strength even to play competitive darts with her husband. "I feel like I've aged two decades in four years," she said. Herkey is preparing for a revision surgery at Northwestern Memorial Hospital. The operation will partially reverse the gastric bypass Herkey had at a hospital in Downstate Belvidere.

Weight-loss surgery is a last resort for people who generally are at least 100 pounds overweight. Patients typically lose 60 percent to 70 percent of excess body weight the first year. While many gain some of the weight back, they still see big improvements in diabetes, cholesterol, high blood pressure, sleep apnea, etc.

But various studies have found a risk of dying can range from 1 percent during the first 30 days to nearly 5 percent within a year of surgery. Possible nonfatal complications include blood clots, bleeding, leaks and infections.

'Potentially dangerous' Malnutrition is "pretty rare, but it can be potentially dangerous," said University of Chicago weight-loss surgeon Dr. Vivek Prachand. The most common weight-loss surgery is a gastric bypass. The surgeon creates a golf ball-size pouch at the top of the stomach, severely limiting food intake. Also, part of the intestine is bypassed, so less food is absorbed.

In an attempt to maximize weight loss, a few surgeons have bypassed too much intestine, resulting in malnutrition. Such surgeons understand the technical aspects of the operation, but not nutrition, said Northwestern gastroenterologist Dr. Alan Buchman. "We're seeing more disasters than we should be seeing," he said.

Herkey went on her first diet in the sixth grade. She tried Weight Watchers, Jenny Craig, a liquid diet, a high protein diet, even a cabbage soup diet. But the weight always came back.

She was an emotional eater. She ate when she was happy. She ate when she was sad. And she always ate a lot. A typical lunch was a quarter pounder with cheese, fish filet sandwich and large fries.

Still craved food In April 2003, Herkey decided to have surgery after seeing one of those dramatic before-and-after ads on TV. The pounds melted away. But Herkey found it enormously frustrating not to be able to eat more than half a sandwich. She would pass her favorite drive-through and break down in tears. "I had stomach surgery, I didn't have brain surgery," she explained. "You still think the same way. My first thought was still about food."

Herkey is at home now, getting tube-fed 24 hours a day to build strength for the revision surgery. Afterward, Herkey still will have a small stomach pouch. But food will pass through a longer section of intestine, allowing better absorption, said Northwestern weight-loss surgeon Dr. Alex Nagle.

Herkey said if she could turn the clock back, she would have gone to a nutritionist, personal trainer and psychologist who specializes in eating disorders.

"I rue the day I climbed up onto that operating table," she said.

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