Challenging Misperceptions: Bariatric Surgery

A friend shared a story about a recent doctor’s visit, when she was seeking help with her weight. “Why do you think you can’t lose weight?” her doctor asked. Her answer: “I can — I just can’t lose enough and I can’t keep it off.”

Obesity is a complicated problem and is caused by more than just eating too much. For many, there are psychological and biological factors that lead to significant weight gain and prevent sustainable weight loss. According to the World Health Organization, obesity has more than doubled across the globe since 1980. In the United States, more than 66 percent of adults are currently overweight.

But while the number of people struggling with obesity is increasing, so are the options available to help people with this condition. Weight-loss, or bariatric, surgery is one potential solution for adults suffering with severe obesity. I receive many questions from patients who want to learn more about bariatric surgery, including: “Is bariatric surgery risky?”, “Is the surgery a quick-fix?”, “How does the surgery work?” and “Why should I consider a surgical procedure over diet and exercise alone?” To understand the effects of surgery for weight loss, it is important to understand some facts about this option.

1. Surgery is the most effective way for severely obese patients to lose a significant amount of weight and keep it off, for good.

Surgery is proven to help maintain weight loss over time, with better results than diet and exercise alone. Obesity is recognized as a chronic disease, and when severely obese people attempt to lose weight through diet and exercise without surgery, maintaining any weight lost can be exceedingly difficult. When a person loses weight through dieting, the amount of calories the body burns is reduced. This means that in order to maintain weight loss, a person who has been on a diet will have to eat fewer calories than someone who naturally weighs the same. In contrast to diet, weight loss following bariatric surgery does not reduce the amount of calories burned. Bariatric surgery actually increases the production of certain gut hormones that interact with the brain to reduce hunger and enhance feelings of fullness. Through these complex metabolic and hormonal changes, bariatric surgery, unlike dieting, produces long-term weight loss.

2. There are different kinds of bariatric surgical procedures.

The most common procedures are laparoscopic gastric bypass and the laparoscopic sleeve gastrectomy. These procedures can cause weight loss in severely obese patients by restricting the amount of food the stomach can hold, which translates into fewer calories consumed. It could also cause weight loss with a combination of restricting and a process called malabsorption (“bypassing,” which limits the absorption of foods in the intestinal tract). Ask a specialist with expertise in bariatric surgery which option fits your needs best.

3. Risk is lower than many other common surgeries.

Recent statistics show that the risk of death within the 30 days following bariatric surgery is considerably less than most other operations, including gallbladder removal and hip replacement surgery. In fact, large studies have found that over time, risk of death in those with severe obesity is higher when they do not have surgery. Like any surgical procedure, there is risk. The long-term benefit of surgery outweighs this risk for most patients.

4. Obesity related medical conditions, such as diabetes, often improve after bariatric surgery.

Most diabetic patients are able to stop taking insulin and diabetes medications. After surgery, the have normal blood sugars and less risk of long-term diabetes complications than obese diabetic patients who do not undergo bariatric surgery. Bariatric surgery is also proven to help combat serious diseases caused by obesity such as coronary artery disease and obstructive sleep apnea.

5. Bariatric surgery is not “the easy way out.”

To be successful, patients must make significant changes to their diet and lifestyle, both before and after surgery. It is a lifetime commitment that takes a lot of work and requires a dedicated support team. Strictly following the prescribed diet, sometimes enhanced with supplements, means patients will have a healthier life than they could have hoped for otherwise. Not everyone who seeks surgery is approved or deemed to be a suitable candidate.

The decision to pursue bariatric surgery is a proactive and personal one. It is a declaration that the time to take matters into ones own hands in the struggle against obesity (a chronic disease) has come. If you are considering this journey, find a program that offers social, nutritional and psychological support alongside you as you go through your journey. Improved health and a better quality of life is the payoff.

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