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Assessment & BMI :: Weight Loss Surgery

Weight Loss Surgery

This option is only for people diagnosed by a doctor to be morbidly obese. But that's not the only consideration. You may be a candidate for weight loss surgery if:

You have a body mass index (BMI) of 40 or higher.

You have a BMI of 35 to 39.9 and a serious obesity related medical condition. This may be high blood cholesterol, high blood pressure, heart disease, sleep apnea, and/or type 2 diabetes.

Nothing else has worked. You've changed your eating habits, changed your behavior, increased your physical activity, and/or tried drug therapy and you're still morbidly obese.

Your quality of life is seriously impacted and you can't do normal daily activities.

All these factors must be carefully discussed and reviewed by your doctor. But there's one other critical factor before you quality for weight loss surgery.

Can you change your lifestyle forever?

Weight loss surgery is successful ONLY IF you can permanently change your habits. You must be able to sustain healthy eating habits and regular exercise for the rest of your life.

Your greatest adjustments are in the first 12 weeks to 6 months. But realize you'll never be able to eat large meals again. And even if you eat small meals, if it's the wrong food you'll gain the weight back.

Your doctor will advise you on some additional changes you'll need to make. These will minimize your risk of developing post-surgery complications. Some of the serious risks associated with weight loss surgery include:

  • Death (less than 1 to about 5% depending on the type of surgery).
  • Vitamin and mineral deficiency. About 30% of the patients experience this resulting in anemia, osteoporosis, and metabolic bone disease.
  • Gallstones. About 1/3 of patients develop gallstones.
  • Bleeding stomach ulcers.
  • Hernia at incision sites. About 10-20% of weight loss surgery patients need follow-up operations to correct hernia and other surgery related complications.
  • Intolerance to certain foods.
  • "Dumping syndrome." This can occur after a meal high in simple carbohydrates. Stomach contents move too quickly through the small intestine and cause nausea, abdominal pain, and diarrhea after eating.
  • Blood clots in the legs.
  • All the normal risks of any major surgery but they are more likely with severely obese people - pneumonia, abscesses, and wound infections.

Types of weight loss surgery

There are four types: Gastric bypass, biliopancreatic diversion, adjustable gastric banding, and gastroplasty.

Gastric bypass (Roux-en-Y gastric bypass, RGB) - This is the most common and most successful weight loss surgery in the U.S. It's described in more detail in laparoscopic weight loss surgery. Essentially less than 5% of the stomach remains available for food digestion. This dramatically reduces the amount of food you can eat.

Biliopancreatic Diversion (BPD) - A variation of gastric bypass. About 1/2 of the intestine is bypassed before rejoining it to the lower segment of the small intestine forming a common channel. It's seldom used anymore because of the high risk of nutritional deficiencies.

Adjustable Gastric Banding (Lap Band) - This is covered in more detail in the article laparoscopic weight loss surgery. Basically the stomach is encircled with an inflatable, adjustable band. This restricts the stomach's capacity for holding food. Patients generally lose less weight than with other methods. And after 10 years, 80% have regained the weight.

Gastroplasty (Vertical Band Gastroplasty, VGB) - This weight loss surgery procedure uses both a band and staples to create a small stomach pouch. It's not often performed today.

Other surgery considerations

Weight loss surgery is a serious undertaking. There are no guarantees and there are very serious risks to consider. In addition, a rough cost estimate for weight loss surgery ranges from $20,000 to $35,000 or more.

Medical insurance coverage varies from state to state and by provider. But because morbidly obese people have shorter life spans and higher medical care costs, many insurance providers will cover weight loss surgery.

Remember: Success is only possible if you are seriously committed to . . .

Lifelong medical follow-up
Lifelong vitamin and mineral supplementation
Lifelong changes in how and what you eat; including the need to chew food very well and never able to eat large meals again
Lifelong commitment to exercise and lots of physical activity

Weight loss surgery may or may not be the right choice for you. Check with your doctor.

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