Considering Weight Loss Surgery? The What, When, and How of Bariatric Procedures
Sometimes, in spite of every effort, you may not be able to achieve long-term weight loss on your own. In cases of chronic or severe obesity, bariatric surgery can serve as a tool to reaching weight loss goals. It can also help with overall well-being by improving other diseases or disorders that may be present, such as diabetes or obstructive sleep apnea.
Weight-loss surgery is an option for most people who struggle with obesity and who have not achieved sustainable weight loss through diet and exercise programs. The American Society for Metabolic and Bariatric Surgery estimates that more than 225,000 people underwent bariatric surgery in 2017 alone to help them overcome their battle with obesity. The only way to really know if you are a good candidate, as well as which surgery may be best for you, is to have a conversation with a qualified bariatric surgeon. And, it’s important to have that conversation earlier rather than later.
It’s a common misperception that bariatric surgery should be considered only when all else fails. The reality is that it’s often more effective to have weight-loss surgery earlier in life before the comorbidities (other existing disorders) associated with obesity can cause additional health issues.
“Research suggests that waiting until a patient’s body mass index (BMI)―their weight to height ratio―is extremely high can actually hamper the benefits of bariatric surgery because these individuals will have a lower likelihood of achieving the type of weight loss that leads to a healthy and sustainable BMI,” says Michael Lee, M.D., a bariatric surgeon at Lee Bariatrics, a Texas Health Physicians Group practice. “What we have learned over time and through many studies is that patients and their physicians should consider bariatric surgery as a primary therapy for obesity rather than the option of last resort.”
According to JAMA Surgery, people who weren’t morbidly obese when they had surgery were over 12 times more likely to achieve their weight-loss goal within a year.
Are you a candidate for bariatric surgery?
The ideal candidate for weight-loss surgery is someone who is well-informed about the various procedures available and who has a good support system in place. Being psychologically stable and having a realistic expectation of the surgery are also extremely important. But even with the right mindset and information on hand, Lee advises that surgery may not be the best option for everyone.
“Bariatric surgery is not a quick fix; it’s a lifestyle change and a lifetime commitment,” he says. “When I meet with a patient, I try to assess their willingness to adjust their eating habits following the surgery and make sure they are knowledgeable of the risks and benefits of the procedure.”
Choosing the right bariatric procedure
Bariatric surgery is a surgical procedure that makes changes to the digestive system to help you lose weight. The various types of bariatric surgeries each accomplish weight reduction in different ways and can often be done through minimally invasive laparoscopic techniques.
Restrictive surgeries: Work by shrinking the size of the stomach and slowing down digestion to help reduce food intake and promote weight loss.
Malabsorptive/restrictive surgeries: Give you a smaller stomach and also remove or bypass part of your digestive tract to change how you take in food, making it harder for your body to absorb calories.
Revision bariatric surgeries: There are times when revision surgery may need to be performed to help address weight regain after initial bariatric surgery.
The type of weight-loss surgery you choose should be a well-thought-out decision between you and your bariatric surgeon based on your unique needs and goals. Laparoscopic surgical options for weight loss available through Texas Health include:
- Sleeve gastrectomy
- Adjustable gastric banding
- Duodenal switch
- Gastric bypass
- Revisional bariatric surgery
Qualifying for weight-loss surgery
Qualifying for surgery is largely about your BMI and whether you suffer from obesity-related health conditions. If your BMI is under 40, some insurance providers require you to have an obesity-related health condition in order to qualify. This may include high blood pressure, heart disease, sleep apnea, or type 2 diabetes.
If your BMI isn’t high enough and you don’t have other health-related conditions, you may have other options. Start by contacting a qualified bariatric surgeon to discuss your situation. They can work with your insurance company on your behalf. Once you are medically approved for surgery, a dedicated bariatric program coordinator can also help guide you through insurance matters, the necessary medical appointments, psychological and nutritional counseling, and other requirements.