More and more I've been hearing from people who have just about given up on losing weight and now are thinking seriously about having "the surgery."

Not so fast.

Gastric bypass is the most popular weight loss surgery in America, but it is a double-edged sword with very sharp edges. While it can reduce some of the risks associated with obesity, it also presents a whole new set of health challenges and is hardly without side effects or complications, including blood clots, leaking, hernia and a fairly high rate of death (1 per 200-300 surgeries). It's not a decision that should be made lightly.

Gastric bypass is the health equivalent of the "bail-out" option we're reading about in relationship to the auto industry. Wouldn't you like to have had a few minutes with those auto execs before things became so dire, to have grabbed them by the lapels and said, "What were you thinking?" Maybe something could have been done before we reached the dire straits we're in now.

If you haven't had the surgery yet, you're in that position. You can still do a lot before declaring "bankruptcy." Now, I'm not saying surgery is always a bad thing -- sometimes declaring chapter 11 is the only way to "restructure." But let's explore all options before going for the nuclear one.

In Kansas, Mary Vernon, M.D. -- a past president of the American Association of Bariatric Surgeons, no less -- has been quietly treating obese individuals with a very strict low-carb diet for years and has probably prevented the need for hundreds and hundreds of surgeries. It can be done.

A recent review of all the literature on bariatric surgery found that of all the surgical procedures used to reduce weight, gastric bypass resulted in the most serious nutritional deficiencies post-surgically. The authors conclude that nutritional supplementation is absolutely necessary. The most common micronutrients found to be deficient were: vitamin B12, calcium, vitamin D, thiamine (vitamin B1), folic acid, iron, zinc, and magnesium.

Since you'll have to eat very differently after the surgery, why not try eating that way first? Reduce calories to target weight times 10, trim your nutritional budget of all "non-essential" items (like processed carbs, sugar, soda, and junk foods) and fill your plate with protein and vegetables. The best results seem to be had with a really strict low-carb approach, circa Induction Phase of Atkins -- that's pretty much what Dr. Vernon uses. You might be surprised at the results!

If you do have the surgery-- or if you've already had it -- make sure you're supplementing with vitamins and omega-3 fats and that every calorie you do consume gives you the most nutritional bang for the buck.