What Are the Benefits of Bariatric Weight-Loss Surgery?
Procedure helps improve obesity-related conditions
Procedure helps improve obesity-related conditions
People struggling with severe obesity may be familiar with bariatric weight-loss surgery. They may wonder if they are good candidates for this type of surgery. Knowing the requirements as well as the risks and benefits is helpful.
Doctors often recommend weight-loss surgery for patients with severe obesity who cannot lose significant weight with diet, exercise and medications and have obesity-related health conditions.
“Bariatric procedures are usually considered only when other efforts to lose excess weight, have failed,” says William Fuller, MD, a bariatric surgeon at Scripps Clinic. “Generally, the patient has severe obesity and obesity-related conditions, such as type 2 diabetes and heart disease, or is at risk of these conditions.”
Bariatric surgery helps people lose weight by changing how their digestive system works. It is one of the best treatments for severe obesity.
The surgery can also help improve high blood pressure, high cholesterol, sleep apnea, joint and other body pain and urinary incontinence. Studies show that people with type 2 diabetes improve their blood sugar levels after weight-loss surgery. For some patients, combining weight-loss medications with bariatric surgery leads to the best results.
If you are considering this procedure, learn as much as you can. Weight-loss surgery is not a quick fix. It requires long-term commitment to healthy living. After surgery, patients must follow a special diet and exercise plan to keep the weight off and stay healthy.
How does bariatric surgery work?
Bariatric surgery helps with weight loss by making the stomach smaller, limiting how much food it can hold, and reducing appetite.
Most surgeries are done using minimally invasive techniques where small incisions, instead of long ones, are made. This often results in shorter hospital stays, fewer complications, quicker recovery and better cosmetic results.
“Your surgeon will recommend the proper weight-loss surgery based upon your medical condition, prior operations, weight history and other factors,” Dr. Fuller says.
There are different types of weight-loss surgeries, including:
- Gastric sleeve, or sleeve gastrectomy, removes a large part of the stomach and creates a smaller, tube-shaped stomach. The smaller stomach helps limit calorie intake. It is the most common weight loss surgery today.
- Gastric bypass surgery makes a small pouch in the stomach and reroutes part of the small intestine to this pouch. This procedure helps reduce calorie and nutrient absorption.
- Biliopancreatic diversion with duodenal switch (BPD/DS) is a more complex surgery that combines gastric sleeve with an intestinal bypass. It reduces stomach size and reroutes part of the small intestine, leading to significant reduction in calorie and nutrient absorption. Single Anastomosis Duodenal-Ileal bypass is a simpler, modified version of BPD/DS involving only one intestinal connection.
- Gastric banding, or adjustable gastric band, places a band around the upper stomach and creates a small pouch that limits food intake and helps you feel full. This procedure is less popular now. More effective options, like gastric sleeve and gastric bypass, are preferred by patients and surgeons.
Scripps offers various types of bariatric surgery. It also offers nonsurgical weight-loss services for patients who don’t qualify for surgery.
Who is a candidate for bariatric surgery?
A body mass index (BMI) above 30 is classified as obese. However, this alone does not make one a candidate for bariatric surgery.
Surgery is usually considered only after diet, exercise and medication have not led to significant weight loss. “Even then, careful selection is critical for successful outcomes,” Dr. Fuller says.
To be a candidate for the procedure, a patient must:
- Have a BMI of 35 or higher
- Have a BMI between 30 and 34.9 and a serious health problem related to obesity, such as type 2 diabetes, coronary heart disease or severe sleep apnea
- Get medical, psychological and nutritional evaluations to make sure they are ready for surgery and can make the needed lifestyle changes
What are risks and side effects of bariatric surgery?
Like any surgery, bariatric surgery has risks, including:
- Bleeding
- Infection
- Leaking from site of operation
- Diarrhea
- Blood clots
Patients often need regular checkups to see how they are recovering and address any problems.
Follow-up care for surgery-related problems is not uncommon. While there are risks, bariatric surgery is rarely fatal. Candidates should understand that the risk of remaining in their condition is far greater than the risks of this surgery.
Who performs bariatric surgery?
Bariatric experts recommend patients select only board-certified surgeons and accredited centers for bariatric surgery.
Bariatric surgery is expensive. Health insurance coverage and criteria for the procedure can vary depending on the insurance plan. Medicare, for example, pays for some weight-loss procedures.
Check with your insurance provider to learn their policy and requirements. You may also want to call the office of a local bariatric surgeon and ask for help in checking whether you have coverage.
The American Society for Metabolic and Bariatric Surgery cautions against medical tourism or going to another country for weight-loss procedures. Some people do this to save money or get treatment faster.
Medical tourism has risks, including lower medical standards and problems with follow-up care or managing complications.
Commitment to lifestyle changes
Bariatric surgery is not a quick fix. It requires lifelong changes in diet, exercise and behavior.
Patients can lose a lot of weight, but they may regain some if they do not stick to lifestyle changes.
Smokers should quit smoking before the surgery. Patients must also avoid alcohol for six months after surgery to prevent issues. If they choose to drink, they should be careful. It is best to pick low-sugar, non-carbonated drinks to lessen negative effects.
Some patients may have extra loose skin after surgery and want it removed. Exercise can help make the skin more elastic. Cosmetic surgery is another option and is usually done as an outpatient procedure.