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Losing weight is an uphill battle_______especially for the morbidly obese. Diet and exercise often fail. Drugs are not very effective. And in the end, many people suffer for years only to be left with one last and very expensive (1)resort: surgery

In the last decade, bariatric surgeries like gastric bypass have become an acceptable method for treating the 15 million people in the U.S. who suffer from morbid obesity.(I) "Obesity can be life threatening," says Dr, Philip Schauer , president of the American Society for Bariatric Surgery(ASBS). "And surgery is the next best step." Despite this, only 1% of patients who are eligible for surgery actually get it. Sometimes, people just don't want to undergo a surgical procedure, but more often than not, obese patients are dissuaded by difficult insurance companies and are sometimes (2)__________by doctors who feel they may not be the right age for the procedure.

Researchers from the University of Texas Southwestern Medical Center in Dallas have found that teenagers handle bariatric surgery even better than adults. The study of 309 adolescents and 55,192 adults found that only 5.5% of teenagers had complications after surgery compared with 9.8% in adults. "There had always been a lot of concern that doing surgery in a young person, howerer extreme the case is, will carry a lot of complications," says Dr. Esteban Varela, lead author of the study "But it is even safer." (II) Between 2000 and 2003, the number of teenagers who had bariatric surgery-triplde. While the number is growing, with 771 adolescents signing up in 2003, teenagers still represent less than 1% of all bariatric surgeries --- a number that will begin to increase as more doctors view the practice as safe.

(III)However, a small preliminary study presented at the comference could change some of this thinking. Researchers found that the average cost of bariatric surery is often completely recouped by the patient after three years, after which time the medical expenses of patients who did not have surgery are twice as high. "Patients who come in for surgery have a lot of medical problems," says Dr.Anita Courcoulas, lead author of the study. "It makes sense that it would end up costing less." A larger study still needs to be done, but this new research shows that surgery may actually be the cheaper option in the long term.

Most insurance companies will make patients jump through hoops before they will actually pick up the tap for bariatric surgery. providers often require that patients lose a specified amount of weight by staying on a medically enforced diet plan. However, a new study from Duke University Medical Center found that 62% of bariatric surgery patients trimmed the excess fat regardless of whether they lost or gained 10 pounds before surgery. "There is no value in policies like this." says Dr.Eric DeMaria, the study's lead author. "If there is no value, we shouldn't use it as a requiement."(IV)