See MasterChef Graham Elliot’s Dramatic Weight Loss!

MasterChef judge Graham Elliot is showing off his new physique. The 37-year-old underwent weight loss surgery, specifically a gastric sleeve procedure, in July 2013, and has lost 150 pounds!

Elliot had struggled with weight his whole life, but when he reached nearly 400 pounds and couldn’t easily get in and out of a car or tie his shoes or play with his kids, he knew it was time to take action, telling People: “This is what I need to do for my family.”

As part of his new lifestyle Elliot has taken to eating healthier. As he told People:

“In the past I would get stressed and ask craft services for cookies and candy. But now I know my stomach is the size of a banana and I need to have food that just gives me energy.”

Now his dressing room has almonds, dried fruit and seaweed chips instead.

He’s also added regular exercise to his routine. He started slowly and was able to run a mile without stopping by Sept. In November, along with his wife Allie, he ran his first 5K. Now he runs 5 miles at least every other day!

What is bariatric surgery?

Bariatric surgery, commonly known as weight loss surgery, is an operation on the stomach and/or intestines that helps patients with extreme obesity to lose weight. This surgery is an option for people who cannot lose weight by other means or who suffer from serious health problems related to obesity. The surgery restricts food intake, which promotes weight loss and reduces the risk of type 2 diabetes.

The best results occur when patients follow surgery with healthy eating patterns and regular exercise.

Currently, bariatric surgery may be an option for adults with severe obesity. Body mass index (BMI), a measure of height in relation to weight, is used to define levels of obesity. Clinically severe obesity is a BMI > 40 or a BMI > 35 with a serious health problem linked to obesity. Such health problems could be type 2 diabetes, heart disease, or severe sleep apnea (when breathing stops for short periods during sleep).

Recently, the Food and Drug Administration (FDA) has approved use of an adjustable gastric band (or AGB) for patients with BMI > 30 who also have at least one condition linked to obesity, such as heart disease or diabetes.

Who is a good candidate for bariatric surgery?

Candidates should meet the following criteria:

• Have extreme obesity (BMI > 40 )
• Be their adult height (usually at age 13 or older for girls and 15 or older for boys)
• Have serious health problems linked to weight, such as type 2 diabetes or sleep apnea, that may improve with bariatric surgery

In addition, health care providers should assess potential patients and their parents to see how emotionally prepared they are for the surgery and the lifestyle changes they will need to make.

What are the surgical options?

There are four types of operations that are commonly offered in the United States: AGB, Roux-en-Y gastric bypass (RYGB), biliopancreatic diversion with a duodenal switch (BPD-DS), and vertical sleeve gastrectomy (VSG). Each surgery has its own benefits and risks.

Adjustable Gastric Band

AGB works mainly by decreasing food intake. Food intake is reduced by placing a small bracelet-like band around the top of the stomach to restrict the size of the opening from the throat to the stomach. The surgeon can then control the size of the opening with a circular balloon inside the band. This balloon can be inflated or deflated with saline solution to meet the needs of the patient.

Roux-en-Y Gastric Bypass

RYGB restricts food intake. RYGB also decreases how food is absorbed. Food intake is limited by a small pouch that is similar in size to the pouch created with AGB. Also, sending food directly from the pouch into the small intestine affects how the digestive tract absorbs food. The food is absorbed differently because the stomach, duodenum, and upper intestine no longer have contact with food.

Biliopancreatic Diversion with a Duodenal Switch

BPD-DS, usually referred to as a “duodenal switch,” is a complex bariatric surgery that includes three features. One feature is to remove a large part of the stomach. This step makes patients feel full sooner when eating than they did before surgery. Feeling full sooner encourages patients to eat less. Another feature is re-routing food away from much of the small intestine to limit how the body absorbs food. The third feature changes how bile and other digestive juices affect the body’s ability to digest food and absorb calories. This step also helps lead to weight loss.

In removing a large part of the stomach, the surgeon creates a more tubular “gastric sleeve” (also known as a VSG, discussed later). The smaller stomach sleeve remains linked to a very short part of the duodenum, which is then directly linked to a lower part of the small intestine. This surgery leaves a small part of the duodenum available to absorb food and some vitamins and minerals.

However, when the patient eats food, it bypasses most of the duodenum. The distance between the stomach and colon becomes much shorter after this operation, thus limiting how food is absorbed. BPD-DS produces significant weight loss. However, a decrease in the amount of food, vitamins, and minerals absorbed creates chances for long-term problems.

Some of these problems are anemia (lower than normal count for red blood cells) or osteoporosis (loss of bone mass that can make bones brittle).

Vertical Sleeve Gastrectomy

VSG surgery restricts food intake and decreases the amount of food used. Most of the stomach is removed during this surgery, which may decrease ghrelin, a hormone that prompts appetite. Lower amounts of ghrelin may reduce hunger more than other purely restrictive surgeries, such as AGB.

Since this procedure does not re-route the passage of food, it is less likely to cause complications such as the malabsorption of vitamins.

VSG has been performed in the past mainly as the first stage of BPD-DS (discussed earlier) in patients who may be at high risk for problems from more extensive types of surgery. These patients’ high risk levels are due to body weight or medical issues. However, more recent research indicates that some patients who have VSG can lose a lot of weight with VSG alone and avoid a second procedure.

What are the side effects of these surgeries?

Some side effects may include bleeding, infection, leaks from the site where the intestines are sewn together, diarrhea, and blood clots in the legs that can move to the lungs and heart.

Examples of side effects that may occur later include nutrients being poorly absorbed, especially in patients who do not take their prescribed vitamins and minerals. In some cases, if patients do not address this problem promptly, diseases may occur along with permanent damage to the nervous system. These diseases include pellagra (caused by lack of vitamin B3—niacin), beri beri (caused by lack of vitamin B1—thiamine) and kwashiorkor (caused by lack of protein).

Other late problems include strictures (narrowing of the sites where the intestine is joined) and hernias (part of an organ bulging through a weak area of muscle).

Some patients may also require emotional support to help them through the changes in body image and personal relationships that occur after the surgery.

Source: Weight-control Information Network