The following blog series will offer information on the types of surgery available for the treatment of the condition known as obesity. Obviously there is no one size fits all treatment plan for someone who is struggling with a diagnosis of "seriously overweight or obese," and depending on your personality, finances, past and current health history associated with the extra weight, you will need to determine the treatment that best fits your situation.
Bariatric surgery now includes several surgeries that somehow modify your digestive system so that the amount of food you can eat is markedly reduced. The basis for this approach is the reality that many people who struggle with obesity or with being morbidly overweight, do not have the ability to stop eating past the point of fullness, do not feel fullness or cannot stop eating with the kind of frequency that instigates dramatic weight gain over time. Gastric bypass surgery is still the most common form of bariatric surgery performed in the United States. Surgeons believe it has the fewest negative outcomes when performed by a licensed and experienced surgeon, and it has the best track record currently for providing long term sustained loss of weight, if the patient maintains a healthy diet and exercises. This surgery is a major medical procedure which has risks and side effects and requires permanent lifestyle changes in order to have the best possible long term outcome.
Most patients will turn to this surgery after they have exhausted all other possible treatments for obesity. That would include numerous attempts at dieting and exercise, possible use of oral medications and the development of co-morbidities like diabetes, accompanying a state of being overweight. Doctors still use a BMI guideline as a standard for justifying bariatric surgery:
- A BMI (body mass index) at or over 40
- A BMI of 35 or above, with concomitant weight-related health issues like diabetes, or significant hypertension.
- A BMI between 35 and 40 with concomitant obesity-induced physical problems that prevent or seriously compromise mobility, employment
It should be noted that you can always find a surgeon who may not be licensed or experienced who will perform weight reduction surgery, despite the patient not fitting the criteria. These surgeons are often times not certified or licensed or significantly experienced with performing bariatric surgery. That is why patients need to be extremely careful when selecting a surgeon who will evaluate them for the surgery and perform the surgery. The American Society for Metabolic and Bariatric Surgery is one good resource for finding a surgeon who meets important criteria. Another important aspect to consider before undergoing bariatric surgery is the fact that the surgery's success depends on your commitment to a sustained long term lifestyle change. That means a willingness to follow a healthy diet that includes strict portion control and a daily focus on calorie burning aerobic exercise. Lifestyle modification is required to maintain the weight loss. Otherwise a patient can stretch the new, small stomach pouch, and regain most if not all of the weight back.