Decisions, Decisions… What Choice to Make?

You have been struggling to lose weight and keep it off for many years, and have recently been thinking that bariatric surgery may be your best hope for achieving a healthy weight that you will then be better able to maintain. How do you know if surgery is the right choice for you? Surgery is not the first choice for weight management if you have never tried to lose weight before. You must be an appropriate candidate for surgery. The criteria for surgery was standardized in 1991 by the National Institutes of Health and is as follows:

• Have a body mass index (BMI) of 35-40 with at least two obesity-related, serious medical conditions such as hypertension, diabetes, sleep apnea or hyperlipidemia to name a few. Calculate your BMI
• Have a BMI greater than 40 with no obesity-related medical conditions.
• Have tried to lose weight and keep it off for a period of time
• Have no untreated serious behavioral health problems
• Be able to understand and commit to the required lifestyle change

Surgery is not an easy fix, and does require the person be fully educated about the lifestyle change required, the risks of surgery and anticipated outcome. Surgical procedures are tools to help someone lose weight only work when the person is fully involved in the process. Surgical weight loss only works for the long term when the person works with the tool of surgery. I often tell my patients that they must be full participants in their plan of care- the surgery does not happen around them and won’t be successful for the long term unless the person is involved in the plan and following the guidelines provided.

How do you choose which surgery to have? If you are like most people, you talk to your friends and family (if any of them have had bariatric surgery) and/or go on line and Google “weight loss surgery”. I did that recently and got 15,300,000 results, and many were not helpful at all. Typing in “gastric bypass surgery” returned 2,260,000 results while “sleeve gastrectomy” then gave me only 1,050,000 results.

How can you get the information you need to make an informed decision about what to do with your body? Talk openly to your primary care provider about how your weight is affecting your health status and discuss obtaining a referral to a bariatric specialist in your area. One place to get reliable information on bariatric surgery, risks of surgery and qualified surgeons is to go the American Society for Metabolic and Bariatric Surgery website: asmbs.org/patients.