left-arrow right-arrow Twitter Twitter Facebook Facebook Google Plus LinkedIn YouTube Email

Is Weight Loss Surgery Right for You?

Today's Medicine
Published: May 22, 2019

 

When it comes to weight, I like to explain it using a bell curve. On the left side, you’ve got those who cannot gain weight no matter what or how much they eat.

In the middle? I call them shifters. Depending on their diet and activity level, they’re able to shift their weight to some degree.

And then on the far right side, are those who can’t lose weight no matter how hard they try. They were likely heavy as third-graders and as teenagers, and they’ll likely be heavy their whole lives … unless there’s an intervention. Generally speaking, these are the people weight loss surgery could really benefit.

 

Obesity’s impact on mental and physical health

If you would categorize yourself as a “far right” on the bell curve, perhaps you’ve experienced one or more of the following:

  • Low self-esteem
  • Depression
  • Discrimination
  • Difficulty being social, making friends or finding a partner
  • Thoughts of suicide
  • Bullying
  • Emotional eating

It’s no secret that being overweight can take a toll on your emotional and psychological well-being. And physically, it can put you at greater risk for:

  • Joint pain and orthopedic injuries
  • High blood pressure
  • Heart disease
  • Stroke
  • Type 2 diabetes
  • Certain types of cancer (breast, colon, endometrial, kidney, liver and gallbladder)

To people elsewhere the curve, the answer seems simple: Just lose the weight! But it really isn’t always so simple.
 

Candidates for weight loss surgery

Many people might assume that someone hundreds of pounds overweight would benefit from weight loss surgery, but it’s not only for those who 400 pounds or more. Society as a whole has gotten heavier over the years, and as a result, more forgiving.

Someone with a BMI of 35 to 40 is considered morbidly obese, but they may not stand out in a crowd as much as they would have 30 or 40 years ago.

Despite what society thinks, a person is considered a weight loss surgery candidate if they have:

  • A BMI of 40 or higher (at least 100 pounds heavier than their ideal weight ) with no weight-related health conditions
  • A BMI of 35 or higher (at least 60 to 70 pounds heavier than their ideal weight) with one or more significant weight-related health conditions (see physical risks above)

Bottom line: If you’ve been consistent with a proper diet and exercise, and if your BMI is still between 35 and 40 (or higher), it’s time to talk to your doctor.

Keep in mind, though, that it’s possible you’re not healthy enough for surgery. It’s also possible you’re not ready to commit to the lifestyle changes required after surgery. No matter how good the surgeon is, no matter what the surgery is, if you don’t make a conscious effort to eat healthier and eat less postoperatively, you could easily sabotage your and your surgeon’s efforts.
 

Weight loss procedures

Depending on your weight loss goals, there are a few procedures to choose from. Here are the most popular:

Gastric bypass

A small pouch is created at the top of the stomach. This pouch is the only part of the stomach that holds food, so the amount a person can comfortably eat decreases. Food then bypasses part of the small intestine, so less calories (and nutrients) are absorbed.

Expected excess weight loss: 70 percent in 12-18 months

Sleeve gastrectomy

A portion of the stomach is removed. The remaining smaller part of the stomach is formed into what looks like a tube. The new tube-shaped stomach holds less food and eventually decreases a person’s desire to eat.

Expected excess weight loss: 60 percent in 12-18 months

Intragastric balloon

A softball-sized balloon or pouch is placed into the stomach (through the throat) and filled with saline. Because it, too, decreases the amount of food a person can comfortably eat, they feel fuller quicker. The balloon is removed after six months.

Expected excess weight loss: 30 percent in six months
 

Risks and complications

All procedures carry risks. Some short- and long-term concerns of bariatric procedures include:

  • Bleeding
  • Infection
  • Internal disruption or leak
  • Nausea
  • Small bowel obstruction

It’s important to listen to your body. If you’re experiencing any kind of pain, call your doctor.


Before you commit …

There’s a lot to consider before undergoing surgery. The most important thing to reflect on is whether you’ve given everything else a valiant effort. If you can lose weight without any procedure, that is always your safest and cheapest option.

But if you have tried everything, I encourage you to fight those feelings of defeat, hopelessness and fear of “failing” at surgery.

Only about 5 percent of people 100 or more pounds overweight can lose the weight and keep it off without a procedure. You don’t have to do this alone. And if you follow your doctor’s recommendations, it’s extremely likely that you will succeed and become a healthier you. What are you waiting for?

More resources

Thomas White

About the Author:

In over 20 years as a surgeon, Dr. Tom White has been involved with about 4,000 laparoscopic weight loss procedures. While a surgery might take only 30 minutes, he said, “you can make a pronounced effect on people’s lives.”

See More Articles by Thomas White