Bariatric Surgery

Bariatric surgery is for patients who are seriously obese or obese with additional dangerous medical conditions.

Reasons for Bariatric Surgery

Morbid obesity can lead to early mortality and often interferes with the patient’s quality of life, so those who are unable to lose weight through diet and exercise may decide, with the medical advice of their doctor, that bariatric surgery is a good course of treatment. Morbid obesity is usually defined as having a body mass index, or BMI, of 40 or more. In male patients, this translates into being 100 pounds or more over ideal body weight. In female patients, it means the patient is carrying an excess of 80 pounds or more.

Serious medical conditions that morbid obesity contributes to include:

• Type 2 diabetes
• High blood pressure
• Heart disease
• Severe sleep apnea
• Cancer

Candidates for Bariatric Surgery

Bariatric surgery is a last resort for weight loss and is never undertaken on a whim or without serious consideration. Patients are carefully examined and screened to determine if they are good candidates for the bariatric procedure. Insurance will only cover the procedure if it is deemed “medically necessary.” Patient must meet certain guidelines to be considered a good candidate – these could include:

• History of inability to lose weight with diet, exercise or medication
• BMI of 40 or higher, indicating morbid obesity
• BMI of 35 to 39.9 combined with a serious weight-related medical problem
• Slightly lower BMI if combined with an extremely serious weight-related medical condition

Candidates for bariatric surgery must possess great motivation to make permanent lifestyle changes since the surgery alone does not guarantee sustainable weight loss. In the screening for patients for whom bariatric surgery is fitting, physicians inspect the following:

• Medical conditions
• Nutrition and weight history
• Psychological status
• Personal motivation
• Age

There is potential for patients who do not follow directives about diet and exercise to regain weight after the procedure.

Risks of Bariatric Surgery

Short term surgical risks of bariatric surgery may include excessive bleeding, blood clots, damage to adjacent organs and an adverse reaction to anesthesia. Longer term risks and complications of weight-loss surgery vary with the type of surgery done and may include:

• Bowel obstruction
• Gastric dumping syndrome, including vomiting and diarrhea
• Gallstones
• Incisional hernia
• Hypoglycemia, low blood sugar
• Malnutrition
• Ulcers

While there are several risks associated with bariatric surgery, there is often greater risk to the patient in remaining morbidly obese. The mortality rate for bariatric surgeries is very low in spite of these risks.

Recovery from Bariatric Surgery

Following surgery, patients may remain in the hospital for a period of time. Many patients are able to return to work after 2 weeks or earlier. Patients are usually able to manage at home without assistance if they follow the instructions and restrictions given by their doctor.

Results of Bariatric Surgery

Patients can anticipate being in much better health after bariatric surgery. In almost all cases, obesity-related illnesses improve after surgery, and some will disappear completely. During a standard recovery, weight loss occurs rapidly during the first months and may continue for as long as 24 months. Patients who have gastric bypass can expect to lose about 60 percent of their body weight. After bariatric surgery, patients must adjust to a different body and be prepared to adopt sustainable lifestyle modifications in order to secure the full benefits of the procedure.

Additional Resources

• MedlinePlus
• National Institutes of Health
• Centers for Disease Control and Prevention
• Eunice Kennedy Shriver National Institute of Child Health and Human Development
• U.S. Department of Health & Human Services
• U.S. National Library of Medicine
• WebMD

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