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Surgery is a widely accepted method of treatment for clinically severe obesity because it has been shown to be the only option that can provide long-term weight loss in patients with clinically severe obesity. In fact, the number of patients undergoing surgical treatment for obesity has steadily increased over the last several decades.
Bariatric Surgery Procedures
Currently, the two leading approaches to weight-loss surgery in the United States are sleeve gastrectomy and Roux-en-Y gastric bypass. Adjustable gastric banding, the duodenal switch and the single-loop duodenal switch are additional surgical options for the treatment of obesity.
Patients who undergo surgery can lose anywhere from 50 to 80 percent of their initial excess weight, depending on the selected procedure.
Weight-loss surgeons should be skilled in more than one surgical approach as the specific procedure needs to be carefully matched to the individual patient.
How Bariatric Surgery Causes Weight Loss
Procedures for weight loss are either restrictive and/or malabsorptive: they restrict the intake of food and/or cause some of the food to be poorly digested and absorbed, and, therefore, eliminated in the stool. Surgical treatments for obesity also lead to a change in the gut hormones that are released after eating a meal; therefore, patients no longer experience hunger in the same manner and are satisfied with much smaller food portions.
Weight loss varies widely, depending on many factors, such as the patient’s age, starting weight, ability to exercise and the type of operation used.
How Bariatric Surgery Improves Health
The degree of improvement of various obesity-related problems depends on the extent of the illness and how long the patient has had it. In general, more than half of surgical patients find an improvement of conditions such as hypertension, hyperlipidemia, diabetes mellitus and sleep apnea. In fact, up to 80 percent of non-insulin dependent diabetes is controlled without medication after surgery.
Obesity-related respiratory problems, including sleep apnea and shortness of breath with minimal exercise, will become asymptomatic, improve or completely resolve.
Weight-induced infertility can be reversed with significant weight loss and patients are able to have safer pregnancies with healthy babies. (Pregnancy should, however, be delayed for one to two years after surgery until weight becomes stable. Pregnancy is not recommended before that time due to the risk of malnutrition to both the mother and her fetus.)
Joint and back pain associated with obesity, urinary incontinence, venous problems in the legs, acid reflux, menstrual irregularities, and certain types of headaches can also improve with weight loss after surgery.
Do You Qualify for Bariatric Surgery?
Persons eligible for medications or bariatric surgery include:
- Persons who have a body mass index (BMI) greater than 40.
- Persons who have a BMI greater than 35 and have weight-related problems such as diabetes, hypertension, sleep apnea, etc.
- Above persons who have failed non-surgical attempts at weight loss, specifically a combined regimen of diet and exercise.