More than 72 million Americans were considered obese in 2006, and about 15 million of them classified as morbidly obese, according to the Centers for Disease Control.

Although diets and exercise are common ways for losing weight, more and more people are turning to medical procedures for help.

The America Society for Bariatric Surgery estimates roughly 220,000 gastric bypass surgeries were expected to be performed nationwide in 2008.

Gastric bypass, also known as bariatric surgery, manipulates the internal organs by creating a stomach pouch smaller than normal and rejoining it with the intestinal track roughly three-quarters of the original length to give the system less time to absorb food. The changes make the small intestine 40 centimeters in length and result in rapid weight loss.

Dr. Darla Mabery of the Optimal Weight and Wellness Medical Center contends surgery is not the only answer.

"There's a serious misconception that if you have a serious problem, besides Weight Watchers and Jenny Craig, there's no functional alternative," she said, "and that's just not true."

Mabery said the wellness center, which has offices in Yuba City, Folsom and Roseville, treats obesity by examining psychological issues rather than surgery.

A comprehensive psychological screening is conducted to examine how the person became obese and to change associated behaviors, Mabery said.

"If you don't get to the root of the problem and find out why (food) is treated the way it is, you're not going to fix it," she said.

Mabery said surgery patients could go back to their old eating habits if they are not taught how to change.

But doctors Mohammed Ali, director of minimally invasive surgery at the University of California, Davis Medical Center in Sacramento, and Deron Ludwig, surgeon and Successful Solutions program director at Enloe Medical Center in Chico, said their surgery programs are just as comprehensive. Surgery candidates must go through a number of medical tests and dietitian appointments as well as psychological exams to be sure surgery is the right option.

Ludwig said roughly 250 surgeries have been performed at Enloe since 2005. At UC Davis, Ali said, the bariatric team performs about 350 surgeries annually. Mabery said the wellness clinic is treating roughly 400 patients.

"It's a big operation," Ludwig said. "It is a tool for a patient and it is a part of changing the way of life, making a positive lifestyle change. We hope the surgery is a spark."

Health risks and benefits

With any major surgery there are health risks along with benefits: gastric bypass surgery is no exception. Complications with this surgery include bowel blockage, leaks, blood clots, heart attack, stroke, dehydration and ulcers.

"The list is long," Ali said. "But less than 1 percent of patients are at risk for life-threatening complications."

On average, patients lose 60 percent of their body weight after surgery, Ali said.

Ludwig said the weight loss is the primary benefit.

"Weight loss surgery is high-risk, but unchecked health problems because of obesity is worse than the natural risk," Ludwig said. "It is a lifestyle change that will improve survival and quality of life."

Though the Optimal Weight and Wellness Center does not manipulate the organs for rapid weight loss, Mabery said the techniques they use — monitoring food consumption and psychological monitoring — help patients lose weight as quickly as surgery candidates, without related risks.

"We want them to lose as quickly as they can in safe medical parameters so (it) doesn't take three years," Mabery said. "They can lose three to five pounds a week, if they are pushing as hard as they can."

Mabery said the clinic sees all types of patients and even some who have had weight loss surgery.

Candidates for medical help

Ludwig acknowledges there are patients who are too risky for the surgery, but his team at Enloe has performed the procedure on elderly, extremely overweight and patients on oxygen.

"What other option do they have?" Ludwig asked of those high-risk patients. "They know they can't (take off the weight) on their own. Natural history says morbid obesity is a killer. They know the disease could kill them. They deserve a chance."

Ali said high-risk patients, including the elderly, those with a higher BMI and men, could have more complications with the surgery. Men, on average, tend to be more centrally obese, Ali said.

"If the fat is more around the abdomen it is more challenging for (the) chance of a problem occurring," he said.

Women carry their weight in the more peripheral regions such as the buttocks and thighs.

Before surgery, the UC Davis program encourages patients to lose weight and position themselves at a better BMI going in to the procedure, Ali said.

"In our process the patient needs a significant amount of work," Ali said, referring to the number of tests, and labs done leading up to surgery.

"We want to make sure they understand what they are about to do and what it will take to do well," he said.

Mabery said her patients have often tried everything they can before entering the medical clinic.

Regardless of the method to lose weight, these doctors are hopeful they've given patients enough tools to change and live healthier.

"We don't want them to fall into their old behaviors," Mabery said. "But we also want them to have strategies to be able to eat in a way they feel comfortable and not deprived so they are willing to adopt a new lifestyle."

Contact Appeal-Democrat reporter Andrea Koskey at 749-4709 or akoskey@appealdemocrat.com