Half of Obese Patients Opt Out of Bariatric Surgery
I Bailed on Bariatric Surgery
In March of 2003 I was raring to go into my bariatric surgery. All the paperwork was complete, all the evaluations were complete, my insurance carrier had given approval for the gastric bypass surgery, and the surgeon I had selected was ready to nip and tuck. I would finally be addressing the health conditions caused by my obesity as well as the obesity itself. New life here I come… and then I didn’t do it.
It turns out I had an unanticipated concern about being anesthetized. That is to say I was relatively certain that once I was put under I wouldn’t be coming back. Given that thought, obesity wasn’t so bad after all. What’s the big deal about a little diabetes anyhow?
In August of that same year I gathered my senses, came to a shaky compromise with my fear, and moved forward with the procedure. As it turns out, I am not alone in my start and stop approach to bariatric surgery.
That All Sounds Great, But My Answer Is No
Bariatric surgery can be life-changing for people suffering from obesity. Studies have shown that weight-loss operations can successfully alleviate chronic illnesses such as diabetes and arthritis. Kicking osteoarthritis to the curb can be especially satisfying because the pain from the disease can make exercise difficult.
A primary care physician can refer patients for bariatric surgery if they have a body mass index of 35 or higher, and have one or more chronic conditions.
Then comes the process: There will be an orientation, a nursing consultation, a nutrition class, a dietician assessment, and an evaluation by a social worker. A psychologist will have a final consultation with the surgeon and then - finally - the green light shines and better days are just ahead.
Unless the patient won’t do it.
Who Is Less Likely to Proceed
Researchers analyzed data on 1,644 patients who were referred to the bariatric surgery program at the University of Toronto’s Rotman School of Management between June of 2008 and July of 2011. Only 45 percent became bariatric surgery patients, and among those who did not 30 percent did not even make it as far as the orientation session.
Men were half as likely as women to complete the assessments that proceed the operation even if they completed the orientation.
Patients with a body mass index of 35 to 40 also were more likely to leave the program especially after the orientation or the nutritional assessment. Those with a BMI of 40 to 49 were 1.5 times more likely to have the surgery than those with a lower BMI.
Those who smoke were 10 percent more likely to leave the program after the social work assessment and 26 percent more likely to leave after the nutrition evaluation than were non-smokers.
Those patients who were 60 years old or older were 54 percent less likely to undergo the procedure than younger patients.
What needs to be done now is to discover why more than half of obese patients choose to not complete the program. At this point, the answer is not known although measures are being taken to identify patients who are risk for not having the surgery.
As for me, bariatric surgery saved my life. And I am ever so glad that I went through with it.
Living larger than ever,
My Bariatric Life