Chris Christie’s weight-loss surgery: How does it work?

New Jersey Gov. Chris Christie revealed that he is one of the estimated 220,000 Americans who will have weight-loss surgery this year.
(Mel Evans / Associated Press)

An estimated 220,000 Americans undergo some type of bariatric surgery each year, and New Jersey Gov. Chris Christie has revealed that he is one of them.

The high-profile Republican – who hasn’t revealed his weight but is estimated to tip the scales at between 300 and 350 pounds – said he went under the knife for a 40-minute lap band procedure on a Saturday morning in February. In less than three months, he has lost about 40 pounds, according to sources cited in various reports.

A lap band procedure involves fitting an inflatable silicone ring around the stomach to reduce food intake. Christie joked this week that he went out to dinner recently and became full after eating only one-third of his steak.

Banding procedures are less invasive than other types of bariatric surgeries. All of them “foster rapid weight loss by surgically reshaping the intestinal tract,” as the Los Angeles Times reported in February. “To varying degrees, they aim to reduce the stomach’s capacity, decrease the calories and nutrients absorbed from food, and change the chemical signals of fullness that are passed between the brain, the gut and the endocrine system.”


In addition to banding, other options include:

-- Sleeve gastrectomy, which reshapes the stomach into a banana-shaped tube that can hold 20% to 30% of its former volume.

-- Roux-en-Y gastric bypass, a more elaborate surgery that involves stapling off a large portion of the stomach and routing food past a good portion of the lower intestine to prevent nutrients – and calories – from being absorbed.

-- Biliopancreatic diversion, or duodenal switch, is similar to Roux-en-Y but involves removing part of the stomach, not just stapling it off.


Generally speaking, the more involved the surgery, the more rapid the weight loss. The Times in 2011 detailed the pros and cons of weight-loss procedures.

With one in three Americans qualifying as obese, doctors and public health experts have increasingly embraced the procedures as a way to help fight obesity and rein in medical costs. Diabetes, heart disease, certain types of cancer and other obesity-related ailments cost the medical system $190 billion a year – a figure that’s projected to rise to $550 billion by 2030.

Two medical studies published last year in the New England Journal of Medicine found that Roux-en-Y gastric bypass, biliopancreatic diversion and sleeve gastrectomy helped people with Type 2 diabetes get off their medications far more rapidly than aggressive efforts at dieting and exercising. In an editorial that accompanied both studies, diabetes experts wrote that “the success of various types of bariatric surgery suggests that they should not be seen as a last resort. Such procedures might well be considered earlier in the treatment of obese patients with Type 2 diabetes.”

However, a study published this year in the journal JAMA Surgery threw some cold water on the widely embraced belief that bariatric surgery could play a major role in reducing the country’s medical expenses. The study found that people who got weight-loss surgery had roughly the same medical expenses over the next six years as obese people who did not try such invasive measures. Gastric banding, which includes the lap band procedure Christie had, was one of the methods that turned out to be a poor long-term investment, from a strictly financial point of view.


Christie, who turned 50 in September, told the New York Post that he was motivated to get the surgery for the sake of his four children. Political pundits have speculated that the stepped-up effort to slim down could presage a 2016 run for the White House.

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