Americans are getting heavier. Much heavier. More people than ever are more than 100 pounds overweight – a condition called morbid obesity – and more of them are turning to surgery to drop the weight. Last year, about 140,000 Americans had bariatric procedures.

Weight loss surgery, or bariatric surgery, is an effective treatment for morbidly obese people who haven''t been able to lose weight in any other way, says Chris Eagon, MD, Washington University bariatric surgeon at Barnes-Jewish Hospital. Many insurance carriers cover bariatric surgery. Medicare will pay for bariatric surgeries done at hospitals certified as Centers of Excellence by the American Society for Bariatric Surgery, such as Barnes-Jewish.

The most common procedure for obesity is called the Roux-en Y gastric bypass. That operation involves separating the stomach into two compartments, a very small upper pouch which is about the about the size of an egg or a golf ball, and the lower 98 of the stomach, which is about football-size.

“We then take a limb of intestine and attach it to the upper pouch, so that the food the patients eat goes down their esophagus into the small stomach pouch and then empties directly into the small intestine,” Dr. Eagon said.  “The main reason people lose weight with that surgery is that the pouch fills up very quickly when they start to eat so they feel very full and their calorie intake drops way down.”

Patients notice the effects of surgery immediately, says Dr. Eagon. Typically, for the first three to six months after surgery, they don''t feel hungry. When they do begin to feel hunger again, that hunger is satisfied by a small amount of food, he says.

But more importantly, bariatric surgery can dramatically improve a patient''s overall health, lowering blood pressure and cholesterol, improving sleep and snoring, and especially, lowering blood sugar.

“In the case of these surgeries, about a third of the patients are diabetic and taking medications to control their blood sugar,” Dr. Eagon said.  “And oftentimes their blood sugar control, already by two or three days after the surgery is much better than it was before. They often go home on about half the dose of insulin they were on before the surgery. And in a matter of three weeks to three months after the operation about two thirds of the patients who were diabetic are off of all their diabetes medicines and have blood sugars in the normal range.”

The good news, says Dr. Eagon, is that these effects are long-lasting. Although patients typically regain five to 15 pounds after their first year post-surgery, on average patients keep off 55 percent of the excess weight for at least 15 years.

There is some risk to bariatric surgery, Dr. Eagon says. Complications can include infection, blood clots and breathing difficulties and in rare cases, death. But, he notes, the risk of undergoing bariatric surgery is smaller than the risk of remaining obese.

“There have been an increasing number of studies recently that compared the risk of dying of patient who had surgery to patients who couldn''t have the surgery for one reason or another. And it turns out that people who have the surgery have about one fifth the likelihood of dying compared to those people who don''t have the surgery. So in the long run, that five to 10 years out from surgery, your chance of the patient being alive is better than if you don''t. And that''s what''s on these people''s minds before the surgery. They want to be there for their children when they graduate from high school or when they graduate from college.”