In May 2013, New Jersey Governor Chris Christie revealed that he had secretly undergone gastric band surgery in February of the same year. This decision brought bariatric surgery back into the spotlight and sparked a national conversation about weight loss, health, and political image. This article delves into the details of Christie's surgery, the implications of his choice, the various types of bariatric procedures, and the broader context of obesity and weight loss surgery in America.
Governor Christie's Decision
Chris Christie's decision to undergo weight-loss surgery was motivated by a desire to improve his health and be there for his children. As he approached his 50th birthday, he recognized the need to address his weight, which was estimated to be around 350 pounds before the surgery. Christie had struggled with obesity for two decades and had tried various weight loss programs with some initial success. However, he ultimately opted for a more drastic measure to achieve long-term results.
“For me, this is about turning 50 and looking at my children and wanting to be there for them,” Christie told the New York Post.
Christie chose to undergo laparoscopic gastric banding, also known as Lap-Band surgery. This procedure involves placing a silicone band around the upper part of the stomach, creating a small pouch that restricts the amount of food a person can eat. The band can be adjusted by injecting or withdrawing saline through a port implanted under the skin, allowing for personalized control over the rate of weight loss.
Christie's surgery was performed by Dr. George Fielding in New York, who had also performed the same procedure on NFL Coach Rex Ryan. Ryan, who had lost over 100 pounds, advised Christie during his decision-making process.
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Lap-Band Surgery: Procedure, Benefits, and Risks
Lap-Band surgery is considered one of the less invasive bariatric procedures. It works by restricting food intake without making any surgical alterations to the digestive tract. The surgeon wraps an adjustable silicone band about two inches in diameter around the upper part of the stomach. This creates a small pouch with a narrow opening that empties into the rest of the stomach. The small size of the upper stomach makes a person feel full much sooner than before.
Benefits
- Less Invasive: Lap-Band surgery is typically performed laparoscopically, requiring only small incisions.
- Reversible: The band can be removed if necessary, making the procedure entirely reversible.
- Adjustable: The band can be tightened or loosened as needed to control the rate of weight loss.
- Shorter Recovery Time: Patients usually experience a faster recovery compared to other bariatric surgeries.
Risks and Considerations
- Slower Weight Loss: Weight loss with Lap-Band surgery is more gradual compared to other procedures, with patients typically losing one to two pounds a week.
- Frequent Adjustments: The band requires frequent adjustments through needle injections, which can be inconvenient for some patients.
- Complications: There is a higher reoperation and complication rate in the long run, including band slippage or erosion.
- Less Effective for Super Morbidly Obese Patients: Patients with a BMI over 50 may not achieve optimal results with Lap-Band surgery.
Dr. Amir Mehran, Bariatric Surgeon and Medical Director of La Peer’s Bariatric Surgery Center of Excellence, noted that while the Lap-Band procedure is often presented as the least invasive with the shortest downtime, patients may not be fully aware of the potential complications and the need for frequent adjustments.
Other Types of Bariatric Surgery
While Governor Christie opted for Lap-Band surgery, other bariatric procedures are available, each with its own advantages and disadvantages. The most common types include gastric bypass and gastric sleeve surgery.
Gastric Bypass (Roux-en-Y)
Gastric bypass, also known as the Roux-en-Y procedure, is a more invasive surgery that involves shrinking the size of the stomach by more than 90%. The surgeon converts the upper part of the stomach into a small pouch about the size of an egg. The small intestine is then cut. One end is connected to the stomach pouch and the other is reattached to the small intestine, creating a Y shape. This allows food to bypass most of the stomach and the upper part of the small intestine, although both continue to produce the gastric juices, enzymes, and other secretions needed for digestion. This makes a person feel full after eating very small amounts of food. In addition, the body absorbs fewer calories because food bypasses most of the stomach and upper small intestine.
- Advantages: Significant weight loss, resolution of medical problems like type 2 diabetes, high blood pressure, and high cholesterol.
- Disadvantages: More invasive, higher risk of complications, potential for "dumping syndrome" (a reaction that causes flushing, sweating, severe fatigue, nausea, vomiting, diarrhea, and intestinal gas after a high-carbohydrate meal).
Gastric Sleeve
The gastric sleeve technique transforms the stomach into a small, narrow tube by removing the curved side of the organ creates a small pouch using the side of the stomach rather than the bottom. One advantage is that no rearrangement of the intestines is needed. The vertical pouch the sleeve procedure creates is less prone to stretching compared to the pouch left by a gastric bypass. This procedure also diminishes the hunger-regulating hormones, which helps to reduce hunger.
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- Advantages: Significant weight loss, reduced hunger, no rearrangement of the intestines.
- Disadvantages: Irreversible, potential for complications.
Weight Loss Expectations and Long-Term Success
Weight loss surgery can be a powerful tool for individuals struggling with obesity, but it is not a magic bullet. It requires a lifelong commitment to lifestyle changes, including healthy eating habits and regular exercise.
According to Dr. Jaime Ponce, a bariatric surgeon and president of the American Society for Metabolic and Bariatric Surgery, most Lap-Band patients lose one to two pounds a week, and it can take two or more years to reach a healthy weight. In comparison, gastric bypass surgery generally results in greater weight loss in the first year.
Dr. Richard Besser, ABC News' chief health and medical correspondent, emphasized that bariatric surgery is not a cure-all and that only about half of patients achieve long-term success. He stressed the importance of practicing good eating habits, exercising, and seeking a supportive environment to maintain weight loss.
The Broader Context of Obesity and Bariatric Surgery
Obesity is a significant public health issue in the United States, affecting more than one-third of Americans, according to the Centers for Disease Control and Prevention. While prevention is the best approach, bariatric surgery can be a viable option for individuals who have struggled with obesity and have not been successful with other weight loss methods.
Dr. Ninh T. Nguyen, president of the American Society for Metabolic and Bariatric Surgery, emphasized that the goal of bariatric surgery is to help individuals achieve a healthier lifestyle and reduce obesity-related conditions, not to make them skinny.
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Chris Christie's Progress and Public Scrutiny
Following his Lap-Band surgery in February 2013, Chris Christie reportedly lost at least 40 pounds. While he did not disclose his exact weight or goal, he stated in September 2013 that he was "more than halfway to my goal."
Dr. Nguyen estimated that Christie had lost 40% to 45% of his excess weight in the first year, which is typical for adjustable gastric band surgery.
Christie's weight loss journey has been subject to public scrutiny, with many speculating whether his decision to undergo surgery was motivated by political reasons or concerns about his health. Despite the public attention, Christie has remained relatively private about his procedure, focusing on his health and well-being.