Gastric bypass becomes increasingly popular for obese in Southwest Virginia.

Byline: Deirdre Conner

Aug. 8--Together, they have lost more than 150 pounds.

For one Roanoke woman, a surgery meant to free her from a life of pain caused by obesity has merely swapped one misery for another. Another woman who had the same procedure is shedding pounds, and, she said, gaining her life back.

Both underwent gastric bypass, a radical, controversial stomach operation whose safety and effectiveness are coming under closer scrutiny.

In Southwest Virginia and across the nation, the number of procedures performed more than tripled in the last five years as gastric bypass gains acceptance as a treatment for morbid obesity.

At the same time, an increasing number of health care and medical malpractice insurance providers are restricting coverage of gastric bypass, calling the surgery too high-risk.

"What has been shown is that short-term, it is extremely effective in controlling weight and the ravages of diabetes," said Dr. Elihu Ledesma, a surgeon at the Veterans Affairs Medical Center in Salem who does not do gastric bypass. "What nobody knows is what the long-term effects are going to be. It does not have, as of yet, a 20-year follow-up. How can you project 20 years down the line? You can't do that."

One thing is clear, medical professionals and patients say: The surgery causes a dramatic physical, and often psychological, change, and lifelong follow-up is required.

Success story Cynthia Andrews of Roanoke started researching gastric bypass in February 2003, after she saw a small clip on television -- just an ad for a daytime talk show about people who have weight-loss surgery. It planted the seed of an idea in her mind.

At age 25, she carried…