Bariatric surgery includes a number of different weight-loss procedures that will change the anatomy of the GI system. These include a Gastric Sleeve, Duodenal Switch, Gastric Bypass, Gastric Band, and Band to Gastric Sleeve to reduce appetite and cause a person to feel full faster. These are approved, surgical procedures for weight loss in persons that have trouble losing weight or maintaining weight loss by other means. Bariatric surgery can also work to modify your energy balance, meaning that your metabolism increases to burn fat more effectively.
Bariatric surgery is more than a physical reduction of stomach volume. Some of these procedures can change a person's intestinal hormone production resulting in less hunger and increased satiety (the feeling of a full stomach). The NIH considers bariatric (weight-loss) surgery as the only effective treatment for severe obesity and in many cases, the only way to maintain long term weight loss. For these individuals, bariatric surgery is only one part of a total weight loss plan which may also include counseling for behavior modification, partnering with a nutritionist, and committing to a program of activity or exercise.
According to the American Society for Metabolic and Bariatric Surgery, the risks and effects of obesity in the U.S. are very serious. Obesity affects around 78 million Americans, and is linked to a 50 to 100 percent risk of premature death. Obesity is also linked to a range of other diseases, including type 2 diabetes, cardiovascular disease, stroke, and cancer.
Who Should Consider Bariatric Surgery?
Bariatric surgery may not be the right weight-loss treatment for everyone. Like any other surgical procedure, weight-loss surgery will have medical risks, side effects to consider, and for some, the likelihood of long-term success should be examined. Anyone considering these surgeries will have to complete medical screening to make sure current health problems will not disqualify them from the procedures. For this reason, there are established medical guidelines to determine if a person qualifies for bariatric surgery.
According to the Mayo Clinic, weight loss surgery is generally recommended for patients who:
- Have failed to lose enough weight through diet and lifestyle changes
- Have a BMI of over 40, OR
- Have a BMI of over 35 combined with serious health problems due to their weight
Many types of cancer, heart disease, stroke, high blood pressure, type 2 diabetes, and severe sleep apnea are associated with obesity. If a person is at risk with these medical conditions, bariatric surgery may be approved to reduce the contribution of symptoms due to weight. But, these same medical conditions may pose a risk that outweighs the potential benefit.
For these reasons, the patient consults with a medical team that may include doctors, a dietitian, surgeon, and psychologist to evaluate if a surgical weight-loss procedure is appropriate. In one study, patients who underwent bariatric surgery reduced their risk of obesity-related diseases by 48 percent up to 10 years after the procedure. Patients with diabetes and older patients (over 60) saw the greatest benefits after bariatric surgery in that study. On average, bariatric surgery patients see an average of 50 percent loss of excess body weight in the long term (5 years after surgery).
Other Factors to Consider
Prospective bariatric surgery candidates are not only evaluated based on their medical history and potential health complications, the medical team will also assess the patient's psychological risk factors, and their ability to follow recommended lifestyle changes after the surgery. Bariatric surgeries are highly successful in part due to the pre-surgical and psychological assessments.
Following weight-loss surgery, a patient will have altered physical sensations, permanent changes in their dietary experiences, a new body image and an extensive self-care program, along with initial dietary restrictions. To ensure continued success, a psychological exam will identify if the patient has the psychological resources and sound coping strategies to overcome these initial challenges.
Most of these psychosocial factors are not a reason to disqualify a person from bariatric surgery, but they are indicators of what additional services the patient may need. The goal is to ensure long-term, weight-loss success with a sustained change in eating habits and lifestyle changes. Your medical team may recommend medications, mental health education, individual psychotherapy, bariatric surgery support group attendance, dietary consultations, and/or aftercare monitoring.
What to Expect After Bariatric Surgery
The good news is that even a modest amount of weight loss can improve the outcomes for people with obesity. Bariatric surgery is considered an extremely effective and long-lasting method of weight control for patients with severe obesity. Everyone's weight-loss and health goals will be different, but people lose about 60% of their excess weight (on average) after gastric bypass surgery.
Following your procedure, you will not be allowed to eat for a few days to give your digestive system the time it needs to heal. Afterward, your medical team will have designed a specific diet that must be followed for up to 3 months.
Your diet will progress from liquids only, to soft foods, and finally, you will be eating regular foods with restrictions on how much and what type of foods and drinks to include in your new diet. The months immediately after surgery, you will stay in contact with your medical team to monitor your health and recovery from the surgical procedure. Blood work, lab testing, and other after-care exams are necessary to insure you’re achieving a healthy and successful weight loss.
As your body changes and reacts to the rapid weight loss during the first six months, you may experience body aches, chills, mood changes, tiredness, and sometimes hair thinning. But, you can expect to be back to your typical activities in 3 to 5 weeks. This is an exciting time for many people, because of the immediate benefits in their quality of life including a reduction in medical symptoms, increased energy and a zest for life, a positive attitude, and the ability to do more - even exercise and other activities that were unachievable before.