A guide to NJ Gov. Christie's weight-loss surgery

New Jersey Gov. Chris Christie, a Republican who is seen as a possible presidential candidate for 2016, said Tuesday that he underwent a procedure in February to have a band implanted around his stomach in February in an effort to lose weight.

A look at the procedure, his decision, and what it might mean:

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THE SURGERY

Christie says he decided around the time he turned 50 on Sept. 6 that he wanted to have the procedure. It was originally scheduled for November but pushed back to February after Superstorm Sandy hit his state.

The procedure is the least invasive of the major weight-loss surgeries, and it's reversible. An adjustable band is placed around the stomach to restrict how much food someone can eat at once.

Compared to other procedures, weight loss is relatively slow — no more than 1 or 2 pounds per week. Patients still have to eat healthy foods and get exercise for the procedure to be successful, doctors say.

Christie says he underwent the 40-minute procedure on Feb. 16, went home later that day and was back at work after two more days of rest.

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THE REASON

Christie has struggled with his weight throughout his adult life, though he has never said publicly how much he weighs. He says that he has no other major health problems but knows that obesity is a risk for a variety of conditions.

"It's not a career issue for me. It's a long-term health issue for me. That's the basis on which I made the decision."

He said he wants to make sure he's there for his family and denied that he decided to have the surgery to advance his re-election campaign this year or a future run for president, if he decides to embark on one.

He said he presented the idea of the surgery to his wife and four children and they encouraged him to do it.

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THE SECRECY

Christie says he told only a few staff members about the operation and did not intend to make a public announcement. "It's not anybody else's business but mine," he said.

But when he was asked directly by a New York Post reporter on Monday, he said he decided to acknowledge he had had the operation. He said the revelation was news to practically everybody, including his communications office and campaign staff.

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THE TIMING

Though Christie says he intended to keep his procedure a personal matter, The Post's article came out the same day as MSNBC personality Mika Brzezinski's book, "Obsessed: America's Food Addiction — And My Own," was released. The book features an interview with Christie about his struggles with his weight. It's a topic he has discussed in many national television interviews with questioners from Oprah Winfrey to David Letterman, and for years he has both joked about his size and said it's a serious problem that he's been working on.

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THE POLITICS

While Christie says the surgery was a personal decision about his health — something he called "a hell of a lot more important to me than running for president," there could be political implications.

Some critics have suggested that Christie's weight could be a political hindrance.

"Gov. Christie's weight is an issue the same way that any candidate or official's health is an issue," said Michael Dennehy, a New Hampshire-based Republican strategist and veteran of presidential politics. "Anyone running for president will need to comfort Americans with an overall healthy picture for their future."

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THE ROUTINE

Christie says he's been working with a personal trainer four times a week for years, and is continuing now.

He says he has not been as hungry since the surgery and has eaten less.

While he appears to be a bit thinner, Christie would not say Thursday how much weight he as lost.

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NJ governor: Weight-loss surgery was for my family

NEWARK, N.J. (AP) — Gov. Chris Christie, who has both joked about his weight and said that it's a real concern, secretly underwent a weight-loss surgery in February that experts say could help him if he gets exercise and watches what he eats.

He said Tuesday that he decided to have a band placed around his stomach to restrict how much food he can eat for his long-term health and for his family, not to lay the groundwork for running for president in 2016.

"This is a hell of a lot more important to me than running for president," Christie, a father of four, said at a news conference in Newark. "This is about my family's future."

Christie, who appears thinner than he did earlier this year, said he decided to have the surgery around the time he turned 50 in September and initially planned to have it done in November. But Superstorm Sandy's destruction in New Jersey pushed back the procedure until February, after the governor's weight made news multiple times.

He said he suggested the idea and his family supported it.

Two of Christie's children are still in elementary school.

"I'm in this father business for a while," he said. "And I hope one day dear God to be in grandfather business."

He told only a few top staffers — not his communications office or campaign staff. He said his communications director was caught by surprise on Monday when a New York Post reporter asked directly if he'd had the procedure. The spokeswoman, he said, did not know. The Post first reported the surgery on Tuesday.

Christie said he never intended to make a public announcement and that he's "not going to be the guy who writes a book" about losing weight. The Republican, who has been a fixture of the national media spotlight, said the scrum of reporters at his news conference was "silly" and "ridiculous" at a time when there are other things going on.

Christie has never disclosed his weight, but it's been an issue throughout his political career. He said four years ago that then-Gov. Jon Corzine was bringing it up in a campaign commercial that accused Christie of "throwing his weight around" to get out of traffic tickets.

Comics including Jimmy Kimmel and David Letterman also have made fun of it. In interviews with Letterman, Oprah Winfrey, Barbara Walters and others, Christie has both joked about the issue and said solemnly that he's trying to shed pounds.

During a February appearance on "The Late Show with David Letterman," the governor pulled out a doughnut and said his girth was "fair game" for comedians.

Over his appearances the next few days, he was asked repeatedly about his weight. At one point, he said he had a plan for shedding some pounds: "Whether it's successful or not," he said, "you'll all be able to notice."

The next day, he responded angrily to comments from a former White House physician who said she hoped he would run for president but worried about him dying in office. The governor said Dr. Connie Mariano should "shut up."

Ten days after that, on Feb. 16, Christie had the surgery. He said the operation lasted 40 minutes and he was home the same afternoon. He was back at work on Feb. 19 for a full day of events.

Christie, who is in the midst of a re-election campaign, declined to say how much weight he has lost since the surgery. But he said he has been eating less because he hasn't been as hungry and he has been working out with a personal trainer four times a week.

The revelation about Christie's surgery came the same day that MSNBC host Mika Brzezinski's book featuring comments from Christie hit bookstores.

In the book, "Obsessed: America's Food Addiction — And My Own," Christie describes working out four times a week but not seeing major weight drops and hearing critics say that his weight shows he's undisciplined. He also talks about what others have said on Twitter, such as: "HEY GOVERNOR, WHAT DID YOU HAVE FOR BREAKFAST TODAY, ONE STICK OF BUTTER OR TWO?"

"For somebody like me who's had so much success in my life, and really been successful at everything I've tried, to not be able to be successful at this is incredibly discouraging," he said.

Approximately 160,000 stomach-reducing procedures of various types are performed each year. Gastric bypass, sometimes called stomach stapling, where surgeons shrink the stomach's size and reroute food to the small intestine, is the most common.

Gastric band surgery, best known by the brand name Lap-Band, is a less invasive and reversible alternative, in which an adjustable ring is placed over the top of the stomach and tightened to restrict how much food can enter.

Candidates for gastric banding must have a body mass index of between 30 and 40 — plus a weight-related medical condition, such as diabetes or high blood pressure — or a BMI of 40 and higher. They also must have previously attempted to lose weight through diet and exercise.

Christie, who says he does not have any other significant health problems, has talked about working with a personal trainer since he first ran for governor four years ago.

"If you eat appropriately and chew your food, it works nicely," said Dr. Christina Li, a bariatric doctor at Sinai Hospital of Baltimore.

She said Christie has the resources to have people help him eat right and get exercise. While the band is removable, she said patients are told to adjust to having it for the rest of their lives.

Li said risks include infection, and that it does not work for all patients.

Dr. Jaime Ponce, who practices in Dalton, Ga., and is president of the American Society for Metabolic & Bariatric Surgery, said people who have the procedure Christie had often lose 1 to 2 pounds per week.

Christie's procedure was performed by Dr. George Fielding, head of NYU Medical Center's Weight Management Program, who did the same procedure for New York Jets coach Rex Ryan three years ago.

"It basically teaches you how to eat like a human," Ryan said of the device in an interview last week with The Associated Press.

"I'd go to McDonald's or whatever and have a Big Mac, a quarter-pounder, a 20-piece (McNuggets) and some French fries and I never realized that was out of control. The Lap-Band goes: 'No, no. You're only going to eat this or that, and it trains your body how to eat right," said Ryan, who said he has lost 115 pounds from his pre-surgery weight of 348.

Christie said Ryan once urged him during a phone conversation to have the surgery, but the two men never spoke about it again.

The adjustable Lap-Band has been available in the U.S. since 2001 for the most obese patients. In 2011, the Food and Drug Administration expanded approval to somewhat less obese patients.

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Mulvihill reported from Haddonfield, N.J. AP Medical Writer Lauran Neergaard in Washington and AP Sports Writer Dennis Waszak in New York contributed to this report.

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