Weight Loss Surgery (Bariatric Surgery) | Medical-Weight-Loss-Guide.com

People who have had bariatric (stomach) surgery started out with an average BMI of 50 and dropped their BMIs to 32.6 after 10 years. In general, the malabsorptive surgeries caused more weight loss than the restrictive surgeries.

As people lose weight after these surgeries, they show improvement in the diseases that are related to obesity. These improvements are larger in the first 2 years after surgery than 10 years later.

A common misconception is that people think they will lose more weight than they actually do with these surgeries. Notice that although the BMIs dropped significantly, the average was still in the obese range.

There are recommendations on who should be evaluated for weight loss surgery. A person should have a BMI of 40 or more or have a BMI of 35 or more along with one of a list of certain medical conditions that are related to obesity. Surgery is a big deal and does have risks. Before undergoing surgery, people need to have tried other weight loss methods before and been unsuccessful on them. Even with the surgery, a person must still put effort into losing weight. You need to be motivated and committed to losing weight. It is recommended that everyone who is considering weight loss surgery undergo a psychological evaluation. This is so that doctors can be sure that people have realistic expectations of their weight loss, assess motivation, and rule out any psychiatric illness that will interfere with diet after surgery. Some people can have other medical conditions that make the surgery too risky, and they should not have these procedures done.

Of course there is weight loss. However, these surgeries are not promises to automatically turn you into a supermodel. You should have a full discussion with your doctor and surgeon about how much you can expect to lose.

Along with weight loss, there come several benefits. There are fewer deaths in the long run for people who need the surgery and get it, and fewer people die of diabetes, heart artery disease, and cancer. The improvement in diabetes lasts for a long time. In the gastric banding procedures, there is a short term improvement in high blood pressure, but in people who had gastric bypass and lost more weight, there was a sustained improvement in high blood pressure. Sleep apnea, shortness of breath, chest pain, and quality of life showed more improvement in people who lost more weight.

Around 90% of people who have Roux-en-Y gastric bypass surgery see improvement of cure of their diabetes, high blood pressure, and cholesterol levels. Those who had lap banding also saw a significant amount of improvement in these conditions.

People who needed and had either Roux-en-Y gastric bypass or the lap band surgeries have about a 30% less chance of dying within the next 10 years.

For more on the risks and benefits of bariatric surgery concerning pregnancy, click here.

Weight loss surgery is becoming more popular and several celebrities have undergone these procedures, making them seem like easy miracle cures. They often do not mention the risks. There are risks of complications with any surgery and these are best discussed with your doctor and a bariatric surgeon. The risk of death is somewhere between 0.1% and 2%. Malabsorptive procedures have the most risk for death, while gastric banding seems to have the least. Some other complications after surgery are: blood clots, leaks where intestines were joined, bleeding, hernias, gallstones, ulcers, dehydration, intestine blockage, and others. A return stay in the hospital or secondary surgery may be needed to address these issues.

When going back to eating after the surgery, a condition called dumping syndrome can occur in up to 70% of people after Roux-en-Y gastric bypass. In this syndrome, body chemicals normally released during digestion become out of balance when people start eating again. The effects can include facial flushing, lightheadedness, fast heart beats, fatigue, and diarrhea.

A long term complication of some of these procedures is a deficiency of certain nutrients because the intestines cannot absorb as many of them. Iron, calcium, folate, vitamin B12, and others may be deficient in people who get the malabsorption procedures. Some more involved surgeries can also lead to deficiencies in protein absorption and vitamins A, D, E, and K.

Who Should Perform My Surgery?

It has been shown that the more experience that a surgeon and the hospital has, the lower the risk of complications. A study found that the lowest risks came with surgeons who performed more than 100 of these surgeries per year and the hospitals hosted more than 150 surgeries per year.

There is a learning curve, so be sure your surgeon and hospital are experienced. Also, to make sure long term progress is made and any complications can be managed, you should be set up with a well coordinated team of experts in medicine, surgery, psychology, and nutrition.

The American Society of Bariatric Surgery (now the American Society for Metabolic and Bariatric Surgery), the American College of Surgeons, and several insurance providers have developed criteria for Bariatric Centers of Excellence. This new but may be something to look for when considering a facility for your surgery. The criteria include:
     - Institutional requirements for bariatric equipment
     - A registry to monitor patient outcomes
     - Designated bariatric surgical wards
     - Immediate availability of critical care and other specialists
     - Surgical leadership
     - Clinical pathways
     - Continued nursing education
     - Minimum volume requirements

It is important you discuss any weight loss or exercise plan with your doctor. Only you and your physician can decide what is best for you. Some people have certain conditions that prevent them from doing all exercises, and goal body weights may be different for different people. You need to discuss all these things with your physician before starting any weight loss or exercise program. Dr. Vickery is not a surgeon. For more specifics on surgical procedures, contact a board certified bariatric surgeon.

Weight Loss Surgery

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