Weight Loss Surgery: Facts For an Informed Decision

If you're one of the estimated 78.6 million Americans who suffer from obesity, you have a medical condition, and weight loss surgery could be your medical solution. Not only do gastric bypass and other bariatric surgeries help many patients lose significant weight, they can also kick-start big improvements in health conditions that often accompany obesity, such as high blood pressure, acid reflux and sleep apnea. However, there are risks as well, and long-term success rides on a firm, lasting commitment to total lifestyle change. Some basic facts will help get you started on making the right choice for you.

Eligibility

You may be a candidate for weight loss surgery if:

• Other efforts at losing weight, such as medication, diet and exercise, have failed
• Your body mass index (BMI) is 40 or above
• Your BMI is at least 35 but less than 40, and you have one or more weight-related health condition

You might also qualify for weight loss surgery if you have a BMI of 30-34 and more than one obesity-related health problem. Your doctor, hospital and insurance provider may have other requirements.

Types

Two of the most common weight loss surgery procedures are:

• Gastric bypass. The most popular type of bariatric surgery, a gastric bypass reduces your stomach to a small pouch, making it impossible to eat more than tiny amounts of food. The food you do eat goes directly from the pouch to your small intestine. Surgery is performed with a laparoscope, a tiny camera inserted into your abdominal area so surgeons can see exactly they're doing.
• Vertical sleeve gastrectomy (VSG or “the sleeve"). The name may sound extreme, since “gastrectomy" means “stomach removal" -- and indeed, VSG does remove most of the stomach. But the procedure has turned out to be easier and safer than some other surgeries, and since there is no bowel rearrangement, there may be fewer long-term complications.

Complications

Some of the same things that make weight loss surgery so effective also make it risky. Bariatric surgeries work in one or both of two ways: restriction and malabsorption. Restriction means your stomach capacity is smaller, and malabsorption means your body cannot absorb nutrients in the same way it did before. You may have difficulty meeting your nutritional needs. You will need to follow a strict diet and take supplements.

There are other risks too, including infection, blood clots, bowel obstruction, hemorrhage and organ injury. Ask your doctor about ways to minimize risks.