With one third or 23 million Americans obese, the medical profession is looking for ways to treat the problem. Surgical intervention has been found to be very effective weight loss method but it is not without risk.
Who is a Candidate for Weight Loss Surgery
Weight loss surgery is appropriate and most effective for people who have a BMI of greater than 40 (Men who are at least 100 pounds overweight or women who are 80 pounds overweight) or those who have a BMI of 35 and have an obesity related disease such as Type 2 diabetes, heart disease or obstructive sleep apnea.
Because of the lifestyle changes that must be made after the surgery a person must first complete a screening process. He is evaluated by a doctor, psychiatrist and a dietitian. This is to make sure the person was unsuccessful in losing weight through diet and exercise and understands the commitment that comes with having the surgery.
Types of Weight Loss Surgery
There are three types of bariatric (weight loss) operations. The first is restrictive, or procedures that promote weight loss by limiting intake. An example of a restrictive surgery is gastric banding. This limits the amount of food an individual can eat at one time. The second type of bariatric surgery is malabsorptive. This procedure interferes with digestion and absorption. An example of this is the intestinal bypass. The third type is mixed, it limits intake and produces malabsorption. An example of the mixed procedure is the gastric bypass.
Benefits
Significant weight loss can occur very quickly. Data suggest that a person can lose between 47-80% of excessive weight depending on type of weight loss surgery, starting BMI, age, gender, body composition and level of activity.
After bariatric surgery many patients have a remission of type 2 diabetes. In many patients there is also an improvement in obesity related diseases such as reflux disease, obstructive pulmonary disease, cardiac failure, arthritis, infertility and skin breakdown.
Risks
Bariatric surgery is considered safe with a low mortality rates. Most complications occur after the surgery. Acute complications appear in 5-10% of patients and include side effects such as hemorrhage, obstructions, anastomatic leaks, infection, arrhythmia and pulmonary emboli. Long term complications are mainly neuropathies (nerve disorders) due to nutritional deficiencies, internal hernias and emotional disorders.
Diet after Weight Loss Surgery
Having weight loss surgery requires significant changes to the diet and eating habits. For the first few days post surgery only small amounts of liquid and soft foods will be allowed. After about 2 weeks post surgery regular foods can be added back to the diet but a person will only be able to eat about 2-4 tablespoons of food at meals.
While weight loss surgery is seen as a very effective method of weight loss, a person should understand all the risks, benefits and the lifestyle changes that come with the surgery.
Reference:
- Smith. “Bariatric surgery: it's no easy fix.” RN. 2005; 68(6): 58-64
- Pories. “Bariatric surgery: Risk and Rewards.” Journal of Clinical Endocrinology and Metabolism. 2008; 93(1); S89-96
 |
