Bariatric Surgery Considerations

Posted: July 1, 2005

Numerous studies have shown that obesity treatments using behavioral therapy to improve diet and physical activity levels can lead to weight losses of approximately 5% to 10% over four to six months. With such weight losses come improvement in obesity-related medical conditions such as high blood pressure and Type 2 diabetes.

However, these improvements are not maintained if weight is regained, and rebound in weight gain above the pre-intervention weight is the ultimate outcome in a majority of cases. Therefore, better methods to induce substantial weight loss when a person develops morbid obesity, as well as to maintain weight loss over the long-term, are ultimate goals.

The most effective means currently available to induce substantial weight loss, with long-term maintenance of that weight loss, is through bariatric surgery.

Am I a good candidate for the surgery?
Gastric bypass is major surgery, and it is not appropriate for everyone who wants to lose weight. Candidates for gastric bypass surgery include:

- People with a body mass index (BMI) of 40 or greater.
- People with a BMI of 35-40 who also have health problems associated with obesity. These problems can include diabetes, sleep apnea, hypertension, heart disease and degenerative joint disease.

Before being considered for this operation, you must be evaluated by an experienced surgeon and be considered a good risk for this surgery. You also must have tried other weight loss programs, and be motivated and committed to the overall bariatric surgery program, which includes certain lifestyle changes.

Outcomes
Most people who have Roux-en-Y gastric bypass surgery lose 60% to 80% of their excess weight and they keep it off. It is not uncommon for this surgery to result in a loss of 100 or more pounds. Follow-up studies have shown that people have maintained that loss for 10 years.

In addition to losing weight, people also reduce or eliminate many health problems associated with obesity such as hypertension, degenerative joint disease, and diabetes. Some people who take medications for their obesity-related diseases can reduce their intake or eliminate their medicines completely.

There are psychological and social benefits as well. Many people gain a more positive outlook on life. They finally are able to "fit in" to a world that had not adapted to their larger size. It’s a whole new way of life!

Following your surgery, you should have a personal consultation with a physical therapist to develop an exercise plan for your specific needs. In addition, before and after your surgery, a dietitian will talk to you about nutrition and diet modification.

Source: Columbia St. Mary’s Bariatric Center

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