Other Treatments
Surgical procedures for obesity may be appropriate for some dangerously obese people and may reduce heart problems and many of their risk factors, including high blood pressure, sleep apnea, and diabetes. In fact, some evidence suggests that surgery may provide much greater control of weight and diabetes than nonsurgical weight-loss methods. Studies are reporting significant reductions in diabetes and need for diabetic medications. Other medical conditions that often improve after surgery include heartburn, arthritis, and other joint and circulation problems.
Bariatric surgeries produce weight loss through one of two approaches:
- Restrictive Banding Procedure. These procedures restrict the amount of food by closing off parts of the stomach with bands.
- Malabsorptive Bypass Procedures. This approach restricts the amount of food and also reduces absorption by using a bypass of parts of the intestine.
The malabsorptive procedures are more successful in achieving weight loss than the banding approach, but they carry a greater risk for nutritional deficiencies.
Benefits of Bariatric Surgery
Most people who have bariatric surgery lose about two-thirds of excess weight within 2 years. In addition, diseases associated with obesity (such as diabetes, high blood pressure, sleep apnea, joint pain, and incontinence) often improve.
Researchers at the Mayo Clinic looked at records from patients who had the surgery between 1990 and 2003. They found that those who had bariatric surgery reduced their risk of cardiovascular events such as a heart attack much more than those who lost weight without surgery. The findings were published the September 2005 Mayo Clinic Proceedings.
Other studies have shown that even though most patients maintain significant weight loss, the majority regain about to 10% of their weight. Patients must still develop a healthy life style and be calorie conscious after the operation. Follow-up must be life long.
Candidates for Bariatric Surgery
Any surgical candidate must have failed consistently in losing weight through less invasive methods. Experts recommend bariatric surgery only for the following:
- Those whose BMI is above 40 (about 100 pounds overweight), and or
- Those with BMIs of over 35 who have type 2 diabetes or serious obesity-related medical problems at least 35 or more or whose weight is about 85 to 100 lb. more than ideal, and or
- Those with severe obesity that interfered with employment, normal physical activity (e.g., walking), and important relationship.
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