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What Should You Know About Weight-Loss Surgery?

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Losing weight can improve your health in numerous ways, but sometimes, even your best diet and exercise efforts may not be enough to reach the results you're looking for. If that's the case, you might consider exploring weight-loss surgery — also called bariatric surgery — as a treatment option to help you shed pounds and potentially improve other health conditions you're experiencing as a result of obesity. Bariatric surgery is an involved treatment that'll require you to make some lifelong changes, however, so it's important to learn more about what to expect before you pursue this procedure.

What Is Weight-loss Surgery?

Although there are different types of weight-loss surgeries, they all make surgical changes to your stomach and to other parts of your digestive system. The main reason for doing this is to make your stomach smaller, which restricts the amount of food you can eat. When you eat less food, you consume fewer calories, and this leads to weight loss over time. Bariatric surgery can cause your digestive system to absorb fewer nutrients, which also helps you lose weight. Eventually, your gut hormones, which are responsible for making you feel hungry or full, begin to shift, helping your body adapt to functioning at your new, lower weight.

Weight-loss surgery isn't an option for people who only have a few pounds to lose. It's intended for people who are obese, which means they weigh more than what the medical community considers healthy for their heights. Doctors sometimes assess obesity using a screening tool called body mass index, or BMI. Your physician can calculate your BMI to determine whether you're obese; according to the CDC, having a BMI of 30 or higher classifies you as obese. Weight-loss surgery is intended for people with BMIs of 40 or higher.

According to the Mayo Clinic, weight-loss surgeries can help improve your quality of life by reducing your risk of developing weight-related health conditions such as heart disease and sleep apnea, but these surgeries also have some risks and potential complications of their own. It's important to remember that you'll have a road to recovery following surgery — it isn't an instant cure — and you'll need to create some new nutrition and other lifestyle habits to apply for the rest of your life.

Types of Weight-loss Surgery

You may have heard about gastric bypass surgery before, but this is only one type of weight-loss procedure. There are several others to consider for this treatment.

The Roux-en-Y gastric bypass surgery is perhaps the most well-known weight-loss surgery. During this procedure, the surgeon separates the top section of your stomach from the bottom, creating a 1-ounce-sized pouch with the top. The surgeon then disconnects your small intestine from your stomach, bringing the intestine up to connect to the new pouch. The remaining large section of your stomach is reconnected to your intestine at a lower point. The small pouch restricts the amount of food this new stomach can hold.

Sleeve gastrectomy — instead of leaving a large, unused section of your stomach in your abdomen — removes about 80% of the organ. This leaves behind a tube-shaped section of stomach that's about the size of a banana, according to the American Society for Metabolic and Bariatric Surgery. Again, this limits the amount of food you can eat.

Gastric band surgery is a little different from the options above. This procedure places an inflatable band device around a small upper portion of your stomach, leaving a small hole for food to move into and get processed by the larger, lower stomach section. The small pouch above the band functions as your new stomach and helps you feel fuller faster.

Are You a Candidate for Weight-loss Surgery?

Ultimately, your doctor will work with you to determine whether bariatric surgery is a suitable option for you. However, there are some general criteria and medical guidelines that people typically need to meet before they're able to pursue weight-loss surgery. It's important to remember that these surgeries aren't without their own risks even though they can improve your health in the long run when they're successful. This is why you'll undergo a screening process before your doctor determines it's safe to move forward with one of the options.

Being obese with a BMI over 30 doesn't necessarily qualify you for weight-loss surgery. You'll likely need to have a BMI of 40 or higher, and you'll have to have had difficulty losing weight through changing your diet, exercising and making other efforts to lower your BMI. You may need to demonstrate these efforts to your doctor, and they may want to work with you to create new diet and exercise habits before considering bariatric surgery.

In some cases, people with BMIs under 40 are candidates for weight-loss surgery. People who have serious health complications related to their weight, such as high blood pressure, type 2 diabetes or sleep apnea — but who have BMIs of 39–39 — may be approved for these procedures. Most patients who are good candidates for weight-loss surgery are adults, but if you're a teenager who's gone through puberty, have a BMI over 35 and have health complications related to obesity, you may also be a candidate.

Preparing for Weight-loss Surgery

Once your physician has determined you're a good candidate for weight-loss surgery, you'll begin a new health journey before you even have the procedure. There's a lot that goes into preparing for weight-loss surgery once you and your doctor have determined that you're eligible, and you'll have other medical guidelines and requirements to meet, along with seminars to attend and health assessments to participate in. The time to complete these elements of your surgery program will vary depending on the hospital where you're having the operation, but it can take 6 months of careful planning and preparation before you have the procedure.

Initially, a team of health professionals that typically consists of a surgeon, your doctor, a dietitian and a psychologist evaluates whether bariatric surgery will have more benefits than downsides for you. They'll look at your current eating and exercise habits, and they'll review things like how you handle stress and how motivated you are to work towards your desired outcome with the surgery.

Your team will review your medical condition and any health issues you may be living with to determine whether you're physically healthy enough to have surgery. If you have any mental health conditions — which can make it more difficult to stick with your new lifestyle after surgery — that aren't being treated, the team will help you work on managing these conditions before deeming you ready for surgery. Even in the months and weeks leading up to your bariatric surgery, your team will continue to evaluate you. If they see signs that you're not following guidelines or may not be physically or mentally ready for the surgery, they may opt to postpone the procedure until you make changes.

Your doctor may also require you to take some classes before your weight-loss surgery. These may include seminars that teach you what happens during the surgery and what you can expect during your hospital stay afterward. Nutrition counseling can help prepare you for the new ways you'll be eating after surgery, and you may visit with a nutritionist individually or in a group setting. You may also be asked to lose weight before the procedure. Not only does this demonstrate your commitment to the lifestyle changes you're making, but it can also make the procedure easier for your surgeon to perform.

Resource Links:

https://www.mayoclinic.org/healthy-lifestyle/weight-loss/in-depth/gastric-bypass-surgery/art-20046318

https://asmbs.org/patients/bariatric-surgery-procedures

https://www.cdc.gov/obesity/adult/defining.html

https://www.cdc.gov/healthyweight/assessing/bmi/adult_bmi/index.html

https://wa.kaiserpermanente.org/static/pdf/public/bariatric/bariatric-booklet.pdf

https://www.mayoclinic.org/tests-procedures/gastric-bypass-surgery/in-depth/weight-loss-surgery/art-20045334

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