Christie's Weight-Loss Surgery: Less Invasive but Slower Weight Loss

Christie's Lap-Band surgery, performed laparoscopically, was less-invasive.

ByABC News
May 7, 2013, 12:06 PM

May 7, 2013— -- New Jersey Gov. Chris Christie revealed earlier this week that he had secretly undergone Lap-Band surgery in February to bring his weight under control, a top Christie aide told ABC News.

Lap-Band surgery is among the less-invasive forms of gastric band surgery. According to the company's website, the procedure is performed laparoscopically, meaning the surgeon makes a few small incisions in the abdomen, then uses long, thin surgical instruments to encircle the stomach with a silicone and titanium band.

Although as with any weight-loss surgery, the goal is massive weight loss, Dr. Jaime Ponce, a bariatric surgeon and president of the American Society for Metabolic and Bariatric Surgery, explained that Lap-Band surgery differed from other types of weight-loss operations.

According to Ponce, the most popular type of bariatric surgery is gastric bypass. This involves cutting the stomach into smaller pouches, then rerouting the digestive tract to reduce the amount of food eaten and the amount of nutrients the body absorbs. Gastric bypass accounts for more than 50 percent of the 200,000 or so bariatric surgeries performed in the United States each year.

Another surgery, gastric sleeve, involves removing about 80 percent of the stomach, Ponce explained. He said this type of surgery also diminished the hunger-regulating hormones, so one of its benefits is that hunger is greatly reduced compared to other types of surgeries.

Dr. Richard Besser, ABC News' chief health and medical correspondent, said he believed the governor may have chosen Lap-Band because it restricts food intake without making any surgical alterations to the digestive tract.

"Lap-Band really has the fewest complications and is the least invasive," he said.

Unlike the more radical procedures, Lap-Band can be done as a same day, outpatient procedure, and carries minimal complications, said Ponce. Bypass and sleeves can carry a higher immediate risk of leakage or bleeding from the staples, and can cause an infection. In the long term, however, about 5 percent of the time, the band can slip out of place or erode from exposure to stomach acids.

One other disadvantage of Lap-Band is that it requires multiple follow-up surgical visits. The band must be gradually tightened in a series of adjustments as the patient learns to eat smaller portions and chew more slowly.

Also, weight loss is much slower with Lap-Band compared to gastric bypass and gastric sleeve surgeries. Ponce said most Lap-Band patients lose one to two pounds a week, and that it can take two or more years to reach a healthy weight.

Christie has gone public about his struggles to lose weight over the years. During an appearance on "The Late Show With David Letterman" last February, presumably right before he underwent his Lap-Band surgery, he pulled out a doughnut and told the host his weight was "fair game" for comedians, who frequently make his size the butt of their jokes.

Although Christie has gone public about his actual weight, he said he's lost about 30 pounds since his surgery three months ago. Ponce said that seems about right.

Regardless of the weight-loss surgery chosen, Besser said there's always a chance these efforts will fail.

"You can't look at bariatric surgery as a cure all. Only about half of patients will have long-term success," Besser said. "Christie still needs to practice good eating habits, exercise and seek a supportive environment to keep the weight off long term."

Besser also emphasized that the country cannot "operate" its way out of the obesity crisis, which affects more than one-third of Americans, according to the Centers for Disease Control and Prevention.

"Prevention is best. But for someone who is already struggling with obesity, they may be left with no other option than surgery. For many severely obese, surgery can improve sleep apnea and diabetes and long-term weight loss, though not without its own side effects," Besser said.