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"PinterestFacebookpinching waist\nThe latest weight-loss frontier: surgery if you can pinch an inch\nAt 5&amp;#39;1&amp;quot; and 160 pounds, Michelle Mack didn&amp;#39;t want to lose a vast amount of weight. Her goal was to shed 25 to 30 pounds, and she&amp;#39;d tried everything to get there&amp;#8212;Atkins, Weight Watchers, Nutrisystem, Sugar Busters. &amp;quot;I&amp;#39;d lose five pounds, but it would come right back,&amp;quot; says the 42-year-old from Livingston, Louisiana, who owns an oil-field maintenance company with her husband. But then one day, while searching the Internet for other options, Mack stumbled across something she hadn&amp;#39;t tried: surgery.\nThe operation was called POSE, for Primary Obesity Surgery, Endoluminal, and it aimed to decrease stomach size and reduce cravings, all without the incisions or massive dietary changes more traditional weight-loss surgeries would require. Patients of one of the procedure&amp;#39;s pioneers, New Orleans-based bariatric surgeon Tom Lavin, M.D., had lost an average of 21.6 pounds, Mack learned. The price tag for the procedure: $11,600.\nSurgery? To lose only 20-some-odd pounds? It might sound extreme, but Mack felt desperate. She met with Dr. Lavin and, two weeks and one 45-minute dietary counseling seminar later, was on his operating table. Friends and family cautioned her that such a step seemed drastic, but she was resolute. &amp;quot;It&amp;#39;s easy for someone to sit on the other side of the table and say, Just lose 25 pounds with a diet,&amp;#39;&amp;quot; Mack says. &amp;quot;I&amp;#39;ve tried and failed to do that for years. This was my choice. When a woman wants to lose weight, she won&amp;#39;t take no for an answer.&amp;quot;\n&amp;quot;It might become as popular as plastic surgery&amp;quot;\nPOSE marks a seismic shift in the world of weight loss. Once considered a last-ditch resort for the morbidly obese, bariatric surgery may&amp;#8212;with the introduction of this new procedure and several others on its heels&amp;#8212;now be marketed to thinner women as what experts call a vanity procedure. And a surprising number are lining up. &amp;quot;Many people have been on dozens of diets and gotten nowhere, so they&amp;#39;re looking for options that are more long-term,&amp;quot; says Philip Schauer, M.D., director of the Bariatric and Metabolic Institute at the Cleveland Clinic and a top weight-loss-surgery expert. At the same time, &amp;quot;these surgeries, overall, are becoming safer and less invasive,&amp;quot; says Brian Quebbemann, M.D., a bariatric surgeon in Los Angeles. &amp;quot;As this happens, some surgeons will offer these treatments to people who want them for aesthetic reasons. They might become as popular as plastic surgery.&amp;quot;\nThere certainly is a clientele for it: According to the Centers for Disease Control and Prevention, one third of Americans are overweight but not obese. Prime POSE candidates have 25 to 75 pounds to lose, Dr. Lavin says. And POSE is less extreme than gastric bypass; though it does require full anesthesia, no scalpels are used. (Instead, a surgeon inserts an endoscope through the mouth to reach the stomach, then folds the stomach lining over and closes it with anchor stitches. The whole procedure takes about 45 minutes.) Patients of gastric bypass and Lap-Band must meticulously monitor their diet postsurgery for the rest of their life. (Typically, sweet and greasy foods are bad news for gastric bypass patients; bread and steak can be a problem for those with Lap-Band.) POSE patients, in contrast, can eat what they want, just less of it, says Dr. Lavin.\nThere are, however, big caveats: No one knows whether POSE lasts. And while the devices used in the surgery have been cleared for use by the FDA, the safety of the procedure itself has not been independently studied. Dr. Lavin first performed the surgery in 2009 on nine patients and saw them lose an average of 35 to 40 percent of their excess weight (roughly 18 to 20 pounds for someone who is 50 pounds overweight). After word of mouth spread, he started advertising online. Offering POSE is legal, but why not hold off until the FDA, or wider testing, finds it works? &amp;quot;In my hands, it is a safe procedure that benefits my patients,&amp;quot; Dr. Lavin says. He now receives an average of 30 to 40 inquiries per month and has performed POSE on 90 patients.\nMany, like Mack, are thrilled with the results. For one thing, she claims her appetite has vanished. &amp;quot;I eat a cup of food per meal and I&amp;#39;m satisfied,&amp;quot; she says. &amp;quot;If my husband and I go out to eat, sometimes I&amp;#39;ll just eat off of his plate.&amp;quot; Once when she &amp;quot;overdid it&amp;quot;&amp;#8212;her words&amp;#8212;with just four chicken-and-cheese nachos, she says she felt so nauseatingly full she was miserable for hours. Since then,&amp;quot;I&amp;#39;ve learned how much I can eat and when to stop,&amp;quot; she says. Three fried shrimp? Sure. Baked potato, salad, or the rest of her plate? No way&amp;#8212;no room.\nToday, nearly six months after her surgery, Mack has dropped 32 pounds to reach 128. Once a size 12, she&amp;#39;s now a size 4, and she&amp;#39;s decided to up the ante: &amp;quot;I&amp;#39;ve changed my goal to 125 pounds,&amp;quot; she says.\n&amp;quot;What could go wrong? The patient could die&amp;quot;\nWhile patients may rave about POSE, some experts are sounding alarms. &amp;quot;POSE is still in its infancy,&amp;quot; says Scott Cunneen, M.D., director of bariatric surgery at Cedars-Sinai Medical Center in Los Angeles. &amp;quot;What could go wrong? The patient could die. General anesthesia always has risks; plus, this is an invasive procedure&amp;#8212;incisionless but invasive. You&amp;#39;re placing anchors through the wall of the stomach.&amp;quot; Those extra-strong stitches could tear and cause bleeding, or erode, or fall out, he says, which wouldn&amp;#39;t necessarily be dangerous but would negate any weight-loss benefits. &amp;quot;No one has done independent studies to prove it&amp;#39;s safe,&amp;quot; says Dr. Cunneen. &amp;quot;People will come running to try it. And if it isn&amp;#39;t safe, you&amp;#39;ve created a monster.&amp;quot;\nWhich has happened before. When the Lap-Band got FDA approval, in 2001, many initial reviews were effusive. But since then at least five patients have died. Similarly, Fen-Phen and Meridia diet pills were pulled from the market after early hype, and vertical band gastroplasty (better known as stomach stapling) didn&amp;#39;t prove as effective as originally thought and has dwindled in popularity. &amp;quot;Since everyone is looking for a magic bullet, many people see only the positive claims and ignore the negatives,&amp;quot; says Dr. Quebbemann. &amp;quot;It doesn&amp;#39;t help that unethical clinics may rely on this misleading hype to boost their business. Over time, the real story unfolds and makes it hard for charlatans to sell people artificial dreams. It happened with Lap-Band. The same is going to be true of POSE.&amp;quot;\nEven if POSE does prove safe and effective, other experts are still wary about offering surgery to women with so little weight to lose. &amp;quot;Losing an extra 25 pounds isn&amp;#39;t going to make a huge difference in terms of heart disease, stroke, and most forms of cancer if your habits remain unhealthy,&amp;quot; says JoAnn Manson, M.D., chief of preventive medicine at Brigham and Women&amp;#39;s Hospital in Boston. &amp;quot;And if the main reason to get POSE is for looks, that&amp;#39;s a slippery slope. What if people start thinking, Why not get this before my wedding or high school reunion? It could lead to complacency, in which people don&amp;#39;t even try exercise, which has huge health benefits.&amp;quot; For the $11,600 price of POSE, says Dr. Manson, &amp;quot;women could buy a top-notch treadmill, a membership to a great gym, and a fun, active vacation.&amp;quot;\nBut patients like Cori and Erin Caimi, 32-year-old twins from Kenner, Louisiana, dispute the idea that overweight women are simply not logging enough hours at the gym. For more than a decade, they exercised daily in an attempt to shrink their 220-pound, 5&amp;#39;5&amp;quot; and 5&amp;#39;4&amp;quot; frames, respectively. Even with the help of a nutritionist, the weight stayed on. They started considering surgery but found they didn&amp;#39;t weigh enough for gastric bypass. Then, in 2010, the women heard about POSE. Their father agreed to split the cost, and they were operated on about three months later. Afterward, if they ate more than a cup of food per meal, they experienced severe, &amp;quot;painful&amp;quot; stomach cramps. But nearly 19 months post-op, Cori has dropped 43 pounds; Erin, 45. And, says Cori, &amp;quot;I&amp;#39;ve lost my cravings. Sometimes I have to force myself to eat.&amp;quot;\nExperts concede that for certain women, diet and exercise don&amp;#39;t always produce weight loss. &amp;quot;There&amp;#39;s no question that some people have a harder time losing than others,&amp;quot; says Louis Aronne, M.D., director of the Comprehensive Weight Control Program at New York-Presbyterian Hospital/Weill Cornell Medical Center. &amp;quot;Some are born with systems that don&amp;#39;t regulate hunger very well, which makes it difficult to comply with a diet.&amp;quot; Nonetheless, Dr. Aronne doesn&amp;#39;t recommend POSE. After all, &amp;quot;surgery is typically not the answer for someone with so little weight to lose,&amp;quot; he says.\n&amp;quot;Women will get a second mortgage for this&amp;quot;\nDr. Lavin says that of the 90 patients he&amp;#39;s treated, just four have suffered mild complications, and 80 percent are satisfied. Those who aren&amp;#39;t &amp;quot;say they don&amp;#39;t notice a big difference in hunger or cravings, or that they notice, but it goes away quickly,&amp;quot; he told Glamour. Though he&amp;#39;s careful not to guarantee more long-term results, Dr. Lavin says most patients have maintained their weight loss in the three years that he&amp;#39;s been performing POSE. &amp;quot;This is not the case of the pseudo doctor in Miami who was injecting cement into the buttocks of patients,&amp;quot; he says. &amp;quot;If a procedure is safe and effective and the patient is fully informed about the risks and benefits, I feel great about doing it.&amp;quot;\nSo do two other surgeons who are joining Dr. Lavin in offering POSE. (A fourth surgeon involved in early testing, Chris Thompson, M.D., director of therapeutic endoscopy at Brigham and Women&amp;#39;s Hospital, has yet to decide. &amp;quot;I&amp;#39;m waiting to see the longer-term outcomes before performing it outside a study setting,&amp;quot; he says.) The manufacturer of the suturing device Dr. Lavin uses for POSE is submitting a proposal to the FDA to begin clinical trials; if the procedure gets FDA approval, more doctors will probably offer it, even if others remain dubious.\nMegan Duplain of Phoenix believes that people will be won over. At 5&amp;#39;7&amp;quot;, Duplain, who is also Dr. Lavin&amp;#39;s sister, weighed 176 pounds when she turned to POSE at age 39. &amp;quot;My friends were skeptical at first. They said, Gastric surgery is for obese people, not people like you,&amp;#39;&amp;quot; she recalls. &amp;quot;With this procedure I hope I never have to worry about my weight again.&amp;quot; In 17 months she&amp;#39;s dropped 33 pounds. That&amp;#39;s all the proof her friends need, she says: &amp;quot;Now five or six of them are talking about doing this too.&amp;quot;\nPamela Peeke, M.D., author of Body for Life for Women, isn&amp;#39;t surprised: &amp;quot;Some women will do anything to lose weight easily.&amp;#39; They&amp;#39;ll do what some have done for bariatric surgery in the past: get a second mortgage on their home, get a loan, dip into their savings, anything. I&amp;#39;d warn women to wait before getting POSE, as there&amp;#39;s a big need for credible research examining its effectiveness and safety. In fact, I caution against anything&amp;#8212;pill, potion, surgery&amp;#8212;that promises a quick and easy fix to a weight problem, because that, quite frankly, doesn&amp;#39;t exist.&amp;quot;\nJudy Dutton is the author of Secrets From the Sex Lab."^^<http://www.w3.org/2001/XMLSchema#string>
<http://www.glamour.com/story/weight-loss-would-you-have-shocking-new-surgery-to-lose-just-25-pounds>