Many people find it challenging to reach and maintain a healthy weight through diet and exercise alone, but being overweight or obese will take a toll on your health, putting you at higher risk for health problems, such as Type 2 diabetes, heart disease, stroke, sleep apnea and certain cancers. Bariatric surgery, also called weight loss surgery, can be a successful treatment for obesity for people who are also committed to making healthy lifestyle changes.
How Does Bariatric Surgery Work?
Bariatric surgery helps you lose weight by making changes to your digestive system and altering the way your body absorbs nutrients. These changes help you to feel full faster, decreasing the amount of food you eat. The most common types of bariatric surgery include:
- Gastric bypass surgery involves the surgeon creating a small pouch using the top portion of your stomach. Next, the surgeon divides the small intestine into two parts, connecting the lower part to the new pouch. This adjustment allows you to eat less due to the small size of the pouch. Additionally, the food you eat bypasses the rest of the stomach and the first part of the small intestine, helping your body absorb fewer calories.
- Sleeve gastrectomy involves the surgeon removing about 80% of the stomach, dividing the stomach vertically to create a long pouch, or sleeve. This sleeve only holds a small amount of food, which means you will eat much less. In addition to helping you eat less due to smaller pouch size, both procedures lead to changes in gut hormone balance thereby suppressing your appetite. Hormonal changes also help keep blood sugar in check and make you feel full from eating sooner than you would have felt before the surgery.
Who Is a Candidate for Bariatric Surgery?
While weight loss surgery is a good choice for many people, it’s not right for everyone. To qualify for the procedure, you must meet one of the following requirements:
- Have a body mass index (BMI) of more than 40 and be at least 100 pounds overweight
- Have a BMI over 35, which is approximately 75 pounds overweight, and be diagnosed with a medical condition related to obesity, such as diabetes, heart disease, high blood pressure or sleep apnea
- Have been unsuccessful at losing weight through nonsurgical methods, including medical weight loss programs, diet programs and exercise
Keep in mind that some insurance companies require you to participate in at least one weight loss or nutrition program before bariatric surgery is covered.
Making Healthy Changes
Although bariatric surgery can be a good treatment plan for many people with obesity, it’s not a quick fix. For surgery to be successful, you must be willing to commit to making lifelong changes to your eating and exercise habits. You must also be mentally prepared for the surgery and the challenges and changes that may come with it.
For these reasons, you will likely need to complete several steps before scheduling bariatric surgery. These may include:
- Medical nutrition therapy: A nutrition therapy and education program led by a physician or registered dietitian can help you lose weight prior to surgery as well as prepare you for the lifestyle changes that come after surgery. This type of program will help you develop goals for healthy weight loss and teach you about nutrition, portion control and mindful eating practices. It will also teach you about healthy ways to exercise throughout every stage of your recovery and beyond.
- Psychological evaluation: Meeting with a psychologist or therapist before surgery can help ensure that you have realistic expectations for the outcome of the procedure and that you understand any potential risks. Your therapist will also determine whether you are fully committed to making the necessary changes to ensure long-term success and evaluate you for signs of depression, eating disorders and substance misuse. If you have an alcohol dependence, you may be required to complete a detox and rehab program and be in recovery for one year before qualifying for surgery.
- Pre-op evaluation and testing: Your doctor will complete a full health evaluation before clearing you to have weight loss surgery. This evaluation will include reviewing your health history, performing a physical exam and ordering comprehensive blood tests. Bloodwork will include:
- Metabolic panel, which tells your doctor important information about your metabolism
- Complete blood count, which checks red and white blood cells and other components of your blood
- Tests for iron and vitamin levels
- Hemoglobin A1C, which measures blood sugar levels
- Coagulation panel, which checks your blood’s ability to clot
Your doctor may also screen you for cardiac disease and obstructive sleep apnea, as well as perform imaging, such as an abdominal ultrasound.
If you smoke cigarettes, you may also be required to go through a smoking cessation program before having surgery. This is because people who don’t smoke or who quit smoking prior to the procedure have better outcomes and less risk of complications. Additionally, your healthcare team will make sure you have a support system to help you following surgery.
With a dedicated medical team, support from family and friends and a commitment to making lifelong changes, bariatric surgery can be a successful way to treat obesity and pave the way for a healthier future.
More to Read
- The Benefits of Bariatric Surgery Beyond Weight Loss
- 7 Tips for Healthy, Lasting Weight Loss
- Strength Training for Weight Loss: Gaining Muscle and Losing Fat
- GLP-1 Agonists for Diabetes: Can They Also Be Used for Weight Loss?
Medically reviewed by Rumbi Nzara Mukurazhizha, MD.
