Bariatric Surgery: Is it for you?

Patrika Tsai Health Guide
  • Despite the increased emphasis on healthy lifestyles with exercise and a balanced diet, many Americans continue to struggle with the problem of obesity. Some look for hope in the form of diet pills. When medications do not seem to be enough, others are turning to surgery to lose weight. Weight loss surgery or bariatric surgery is quickly becoming more popular every year thanks to "success" (and not so successful) stories that have appeared in the media. The surgery's cost varies, depending on factors such as the type of procedure and geographic region, and may be $12,000-$30,000.


    The two main bariatric procedures being performed now are adjustable gastric banding and the Roux-en-Y gastric bypass. With the adjustable gastric band, a band is placed around the top of the stomach. The band can be adjusted or tightened by a port which is connected to the band and placed under the skin of the abdomen. In the Roux-en-Y gastric bypass, a small pouch is created from the top of the stomach. The rest of the stomach and part of the small intestine is cut out. This portion is then used to create a "Y" shape by connecting the small intestine to another part of the small intestine further down that was not cut out.

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    Not everyone is a candidate for bariatric surgery. The National Institutes of Health have developed criteria for which patients should be considered for surgery. Criteria include a body mass index (BMI) greater than 40 or a BMI between 35 and 40 combined with health problems such as diabetes, high blood pressure, high cholesterol, or obstructive sleep apnea. BMI is an estimate of your body fat that is calculated by dividing your weight in kilograms by your height in meters twice. One kilogram is 2.2 pounds. One meter is 39.37 inches. A BMI between 20 and 25 is considered healthy while a BMI that is 25 or higher but less than 30 is overweight. A BMI that is 30 or higher is defined as obese and 40 or higher is severe or morbidly obese.


    In addition to the BMI requirement, all other methods of weight loss, including diet, exercise, lifestyle changes, and medications must have been tried and have failed. Candidates usually must demonstrate motivation and a commitment to a healthy diet and exercise, and most bariatric surgery programs also require a psychological evaluation. Another consideration is the weight limit based on medical equipment. For example, many CT scanners that may be needed for body imaging in the event of a complication after surgery cannot hold a person that weighs more than 450 pounds. Many programs also require candidates to quit smoking before surgery. These requirements are intended to provide the candidate the best chance of success for the procedure and sustained weight loss afterwards.


    The most successful patients are the ones that use bariatric surgery as part of their weight-loss regimen in combination with exercise and a balanced diet. In fact, patients may not lose any weight and may even continue to gain weight after surgery if they eat enough to overcome the effects of the surgery. Truly, bariatric surgery is only one tool in a comprehensive weight-loss program.


Published On: February 28, 2008