Bariatric Journal

Understanding Weight-Loss Surgery: Is it for you?

Weight loss surgery or bariatric surgery affects not only the shape but also the function of your digestive system. The surgery can help obese patients in losing weight and managing related medical conditions. The conditions include risk of heart disease, stroke, obstructive sleep apnea, and diabetes. Weight-loss surgery or bariatric surgery can become a necessity in severely obese patients. There are different procedures for bariatric surgery. Yet, all of their help in weight loss by limiting the food and calorie intake. Some procedures may limit nutrient absorption by the body as well. Sleeve gastrectomy or gastric sleeve surgery is the most common procedure in the US. In this procedure, the surgeon creates a tube-like structure by removing a large portion of the stomach. Other types of bariatric procedures include adjustable lap-band surgery and gastric bypass. While weight-loss surgery is effective, it is only a small part of the complete treatment plan. Post-surgery, patients need to include exercise, diet, and nutrition guidelines, as well as mental health care. The patient must be willing to follow and commit to a long-term treatment plan to achieve weight loss and healthy lifestyle goals. If you feel you might need weight-loss surgery, you’ll have to consult several specialists to determine whether it is an option for you or not.

Medical Fitness and Guidelines

Weight-loss surgery has some general medical guidelines, which focus on BMI or the body mass index. BMI estimates body fat on the basis of the weight and height of an individual. For adults with BMI 40 or higher, weight-loss surgery can be a feasible option. The surgery is also apt for individuals who meet the three conditions stated below –
  • 35 or higher BMI
  • A minimum of one medical condition related to obesity
  • Supervised weight loss attempts spanning over a minimum period of six months
In specific cases, doctors recommend bariatric surgery even for adolescents. The medical guidelines in this case include –
  • A medical condition related to obesity, in addition to 40 or higher BMI
  • A severe medical condition related to obesity, in addition to 35 or higher BMI
In the case of adolescents, surgeons may also use growth charts instead of BMI, as a guideline for the surgery. For each age, these charts display the standard BMI. Based on the difference between the standard BMI and the adolescent’s BMI, the surgeon may recommend the procedure. Surgeons also recommend bariatric surgery for some adolescents and adults with lower BMIs, depending on the severity of the obesity-related illness they might be suffering from.

Determining Whether You’re Ready For Surgery or Not

If you’re considering bariatric surgery and wish to learn more about it, you’ll have to meet with a complete team of healthcare professionals including –
  • Primary Care Physician
  • Surgeon
  • Dietician
  • Anesthesiologist
  • Psychiatrist or Psychologist
  • Nurse with a specialty in weight management
  • Any specific specialists on the basis of your medical conditions
Every member on this team will explain to you, what you can and can not expect before or after the procedure. These professionals evaluate your readiness for the surgery and help you determine whether you should go for it or not. Before you’re ready for the surgery, meeting with professionals can help to identify psychological, behavioral, or medical concerns.

Obesity-Related Medical Conditions

Before recommending a bariatric surgery procedure, primary care physicians or surgeons can recommend medical exams to diagnose obesity-related medical concerns. You may not be aware of these either. Doctors also test for issues that may lead to complications during or post-surgery. The following tests are very common –
  • Liver Disease
  • Kidney Disease
  • Cardiovascular Disease
  • Sleep Apnea
If you suffer from any of the following conditions, you’ll not be able to undergo surgery –
  • Any conditions which increase the risk of using anesthesia
  • Severe heart diseases prohibiting the safe use of anesthesia
  • Disorders leading to clotting of blood

Mental Health and Behavior

Post-surgery weight loss depends highly on behavioral changes. You’ll have to commit to a healthy lifestyle, diet, and exercising. For following the treatment plan, you must have a good mental health condition. The team of professionals who’ll guide you through the procedure must identify any behavioral or psychological risk factors. They need to address the problems before you undergo the surgery. Following are some things you’ll have to discuss with your healthcare team –
  • Motivation: Do you have enough motivation to educate yourself about healthy eating, set goals, and make necessary lifestyle changes? Your team might have to track your ability to follow an exercise routine or a recommended diet.
  • Mood Disorders: Many mood disorders are associated with obesity, including bipolar disorder, anxiety, and depression. It becomes difficult to manage weight when suffering from any of these conditions. If the mood disorders remain untreated, it can become difficult to follow exercise and diet habits post-surgery as well.
  • Use of Alcohol and Drugs: Poor weight loss can cause people to abuse drugs or alcohol. Even after surgery, the substance use may continue. Not managing or treating these issues can prohibit the surgeon from clearing you for weight-loss surgery.
  • History of Weight Loss: You might have tried diet and exercise plans in the past. Alternatively, you may have lost and regained weight. Such patterns in your weight-loss history help professionals understand the challenges you face and recommend post-surgery care accordingly.
  • Eating Behavior: Eating disorders and irregular eating behaviors are common causes of obesity. These include unplanned snacking between meals, nighttime eating or binge eating. Some disorders also find root in mental health conditions or other mood disorders.
  • Suicidal Tendencies: People who undergo weight loss surgery are at an increased risk of suicide. The risk increases significantly in patients suffering from schizophrenia, substance use disorder, bipolar disorder, anxiety, depression, and other mental health conditions.

Is bariatric surgery the best option for you?

As long as you clear the medical guidelines and find an approved surgeon, healthcare insurance covers the cost of the surgery. Yet, you must consult with your team of doctors and other specialists to determine whether it is the best route for you. You can make an informed decision once you’re aware of the pros and cons of the surgery. You also need to realize that post-surgery care is much more taxing than the surgery itself. You need to commit to a lifelong nutrition and exercise plan. So, before you decide, think about all the risks and changes you’ll have to make.