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Bariatric Basics: What You Should Know About Weight Loss Surgery

Obesity is a growing health issue across the nation. Defined as excessive fat accumulation presenting a risk to health, obesity is most often tracked through the body mass index, or BMI. A BMI of 25+ is considered overweight, 30+ obese, 35+ severely obese and 40+ morbidly obese. 

There are a number of causes that have been observed to contribute to obesity, including genetic, behavioral, and environmental factors. Since so many elements have the ability to influence obesity, it can be difficult to find effective treatment that works universally. 

Bariatric surgery has been around for decades, and is a popular surgical option for long-term weight loss success. There are often misconceptions or just overall confusion about what bariatric surgery consists of, who it’s for, and what the process looks like from start to finish. 

To shed some light on the weight loss surgery that changes thousands of lives each year, read through some of the most important topics when it comes to bariatrics. 

Minimum Requirements

The National Institutes of Health (NIH) outlines several criteria that determine whether any given patient is a fit for bariatric surgery. Generally, someone needs to either have a BMI greater than 40 or have a BMI over 35 as well as an obesity-related health condition such as diabetes mellitus, high blood pressure or sleep apnea. 

Providers will often also look for the patient to demonstrate that they have tried traditional weight loss methods like diet and exercise with no success. To be assessed for bariatric surgery, candidates will need to first have a consultation where these and other health parameters are taken into consideration before a personalized recommendation is made.

Two Types of Surgery 

If a patient is deemed a good fit for bariatric surgery, they will usually be recommended one of two common procedures: the sleeve gastrectomy and the Roux-en-Y gastric bypass. Both have been used for years with long-term success and minimal risk associated with the surgery. 

During a sleeve gastrectomy, a surgical stapler is used to divide the stomach. As a result, approximately 80% of the stomach is removed. This leaves a much smaller stomach, which means patients will feel satiated after eating significantly less food. Because the part of the stomach that is removed also secretes hunger hormones, patients will also experience decreased hunger. 

The Roux-en-Y gastric bypass is the second most commonly performed weight loss surgery. It is the longest-standing bariatric procedure, with over 50 years of successful outcomes. It works by dividing the stomach into a smaller pouch while bypassing the larger part. The small intestine is then rerouted and connected to the small pouch, decreasing the number of calories absorbed by the body. The rerouting of the intestine also causes hormone changes that suppress appetite and make it easier to follow diet changes.

A Holistic Approach

While the bariatric surgery itself is undoubtedly the star of the show, a lot needs to happen in the preoperative and postoperative stages to help nurture long-term success. Before the surgery takes place, the preoperative pathway will often take between three and six months. This includes comprehensive education and mental health evaluation that take into account the complete wellbeing of the patient. 

Similarly, life after surgery consists of check-ins for all facets of life. Studies have shown that support and psychological wellness are big factors contributing to the long-term success of patients after bariatric surgery. For many programs, this also means a peer-to-peer support system where patients can lean on each other as they progress through the phases of the bariatric program. 

Long-Term Benefits 

While losing weight is undoubtedly the central focus of bariatric surgery, countless other benefits are associated with sustained weight loss. Since obesity is a contributing factor to a number of other conditions — like stroke, heart disease, arthritis, cancers, and lung disease — bariatric patients will have better odds of avoiding them post-surgery. 

Completing the surgery as early as possible will also bring about the best benefits for patients. Because things like degenerative joint pain can’t be cured once they start, only improved for treatment. By using bariatrics as a preventive practice, many patients can stop irreversible symptoms from starting in the first place. 

And bariatrics has the best track record of any weight loss method for those struggling with obesity — both in initial effectiveness and long-term success. The sleeve gastrectomy results in an average of 60-65% excess weight loss, with the Roux-en-Y gastric bypass offering an average of 65-75% excess weight loss. 

Interested in learning more? UM Charles Regional hosted a webinar covering additional details about its new Bariatrics program. You can watch the event video in full here:

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