Who Should Consider Bariatric Surgery To Lose Weight?

Are you very obese and have more traditional attempts at weight loss not offered you the results you were looking for? You are not alone — once you are 100 lbs or so above a healthy weight, diet and exercise alone will often not be enough. An increased stomach size means you will constantly be feeling hungry, and exercise will soon result in shortness of breath and severe physical pain.

Bariatric surgery may make all the difference, giving you a fresh start to your weight loss journey. It's not for the faint-hearted and certainly no easy way out, though. If you have been toying with the idea of talking to your doctor about weight loss surgery, here is some food for thought.

What Is Bariatric Surgery?

Bariatric surgery, on the most basic level, is surgery designed to promote weight loss in morbidly obese people. This can be done by reducing the size of the stomach or by altering the small intestine in such a way as to interfere with the normal absorption of calories and nutrients. Both types of bariatric surgery change a person's physical interaction with food on a very basic level. 

Gastric band surgery, for instance, limits the amount of food the stomach can hold by putting a band controlled by an inflatable balloon in place around the stomach. Connected to a port right under the abdominal skin, this set-up can then be adjusted at a later date. This surgery neither alters digestive function by bypassing a portion of the small intestine, nor reduces the size of the stomach — it just makes the active, used part of the stomach smaller.

Roux-en-Y gastric bypass is a more radical surgery. Though this surgery doesn't physically remove any part of the digestive tract, it alters the usable portions of the stomach and small intestine. This surgery sections off a small portion of the stomach to create a "pouch", to which the small intestine is then attached. Because part of the small intestine remains with the original larger stomach, post-surgery patients can't absorb as many nutrients. With their new smaller stomach, they can also eat much less.

In a sleeve gastrectomy, the size of the stomach is reduced by completely removing part of it. The operation gets is name from the fact that the new stomach looks somewhat like a small sleeve. Though a sleeve gastrectomy doesn't impact the small intestine in any way, the much smaller stomach patients are left with also emits less of the hunger hormone grehlin, helping the patient control their eating patterns by reducing their appetite.

A biliopancreatic diversion with duodenal switch combines sleeve gastrectomy surgery with re-routing a portion of the small intestine to limit nutrient absorption. Because the relevant portion of the small intestine is re-routed rather than removed, however, bile and pancreatic digestive juices can still flow freely.

All types of bariatric surgery end with a smaller functional stomach, which means that you can eat much less and still feel satisfied. Bariatric surgery that also alters the digestive process results in faster weight loss, but this also means that you are at a greater risk of nutritional deficiencies. More about that later.

Risks Of Bariatric Surgery

Like all types of surgery, bariatric surgery carries risks. Some, such as pulmonary embolism, deep vein thrombosis, and internal hemorrhage can be fatal. Bariatric surgery is especially risky for people in the super-morbidly obese category, and few surgeons will work with people with BMIs exceeding 50 for this very reason. However, because remaining in that weight category carries very high risks in itself, some bariatric surgeons believe that the benefits of surgery outweigh the risks, and will perform weight loss surgery even on super-morbidly obese people. 

Before you undergo weight loss surgery, it is very important to understand both the short-term risks of the surgery and the impact it will have on the rest of your life.

Thinking About Bariatric Surgery?

Who Is  A Good Candidate For Weight Loss Surgery?

While different countries, clinics, and insurers are going to have varying qualifying criteria for bariatric surgery, you may be a candidate for it if your medical team determines a true clinical need. They need to believe that the benefits of surgery will outweigh the risk in your case, as well as that you will be able to cope well with the lifestyle alterations required of you after your operation.

In general, you may be a good candidate for bariatric surgery if:

• You have a BMI of over 40 but under 50.
• You have a BMI of over 35 in combination with at least one medical condition that is directly weight-related, such as hypertension, diabetes, or obstructive sleep apnea.
• You need to lose at least 100 lbs to reach a healthy weight.
• You are unable to lose sufficient weight without bariatric surgery, either because mobility restrictions prevent you from exercising or because diet and exercise plans simply did not yield the results you need to attain a healthy weight.
• You have shown that you are able to control your eating patterns prior to the surgery. Bariatric surgeons will often require you to lose some amount of weight by yourself before considering you a candidate for this reason.

Because the surgery itself will not change your emotional relationship with food, receiving counseling prior to undergoing the operation increases your chances of a successful outcome.

Life Beyond Bariatric Surgery

Some people see bariatric surgery as an "easy fix". They are, without exception, all people who have not undergone it themselves. Weight loss surgery can help people with life-threatening surgery live longer. More than that, it can help them turn their lives around completely. It is, however, not an easy path to take by any means.

At least initially, you will be on a very low calorie diet to promote weight loss. Those who have had portions of their stomachs surgically removed will need to eat smaller meals for the rest of their lives, both to prevent weight gain and surgery-related medical complications. Those who underwent resectioning of the small intestine will never again be able to receive all the nutrients they need from food alone, causing them to depend on nutritional supplements for the rest of their lives. 

While the weight will fly off in the initial post-surgery period, even people who have undergone bariatric surgery frequently find that their weight loss plateaus as they inch closer to their ideal weight and that they'll have to work increasingly hard to continue seeing results.