As the obesity epidemic continues to widen, more Americans are turning to gastric bypass surgery than ever before. Over 200,000 people elected to have the procedure done in 2007 alone. But do the benefits outweigh the risks? Long-term impacts on immune function may have a negative impact on the body which could be of greater concern than those of diabetes and cardiovascular disease.

For many in a lifelong battle with their weight, surgery may seem like a welcome relief from the daily struggle to eat right and increase activity. Gastric bypass is often presented as a simple, routine procedure with minimal recovery time that can help a person finally gain a foothold on weight loss. It is what may come afterward that people can find difficult to swallow.

For starters, the dietary restrictions imposed on patients post-surgery are often more stringent than what would ordinarily have to be followed to successfully lose weight without surgical intervention. Then, despite having a stomach roughly the size of a walnut, some people end up gaining more weight back than they originally lose in the months following surgery. Most concerning are the results of a 2005 study which found that 1 in 50 bypass patients died within a month of the surgery.

Yet beyond these more obvious issues are concerns that potential malnutrition resulting from severe caloric restriction can impair the immune system from functioning properly. Pam Fraker, professor of Biochemistry and Molecular Biology at Michigan State University, has been investigating these effects. Says Ms. Fraker, "A modest depletion in nutritional intake can have a significant impact on the immune system's ability to defend the body."

Her comments highlight a disturbing trend in weight management which places so much focus on caloric restriction that the value of nutrition often gets overlooked. Most bodily processes require the presence of a vitamin or mineral in order to function properly. In scientific terms, these are known as enzyme cofactors. When a cofactor is not present, the enzyme it is normally paired with does not function correctly. Over time this sets the stage for chronic health problems and disease.

While weight loss can greatly reduce the risk of diabetes, heart disease, and certain cancers, it is important to consider how the various methodologies involved impact the body as a whole. In many cases difficulty with weight loss stems from underlying hormone imbalances, chronic inflammation, or impaired detoxification pathways which in turn result from malnutrition. Therefore further caloric restriction in an attempt to accelerate weight loss is actually a step in the wrong direction.

Many weight loss programs do a great job in teaching participants to be more aware of the calories in their food, but do not make the grade when it comes to educating about nutrition. As a result people can become misled into believing that cutting calories is all that matters. Often times my clients are surprised to learn that they actually need to eat more in order to lose weight. While skeptical at first, the results speak for themselves.

Surgery can be a useful tool. It is important to take all of the options into consideration and to keep in mind that the most drastic methods also carry the most risk. Whether or not to have surgery is a decision that shouldn't be made quickly or out of desperation, but in full awareness of the possible side effects as well as the benefits.