According to the National Institutes of Health, nearly 1 in 3 adults are overweight and about 1 in 11 are struggling with severe obesity. For people who have tried a variety of weight loss and dieting tactics to no avail, or people who suffer from chronic conditions that contribute to weight gain, bariatric surgery can provide incredible benefits.
We spoke with Aimee Hymel, MD, a bariatric and general surgeon with Our Lady of Lourdes Health, about the positive outcomes of the procedure and ways patients prepare for surgery.
What Is Bariatric Surgery and Who Can Benefit from It?
Bariatric surgery typically involves making surgical changes to your digestive system to help your body lose weight. There are different types, including:
- Sleeve gastrectomy, which uses laparoscopy to remove parts of the stomach, making it smaller to restrict the amount of food consumed
- Gastric bypass, which reroutes most of the food entering your stomach to your small intestines, decreasing the amount that’s absorbed and stored
- Biliopancreatic diversion with duodenal switch, which involves both a sleeve gastrectomy and a bypass to limit food intake and absorption
There isn’t one official guideline for who is considered overweight or obese. As times have changed, doctors have taken a more nuanced approach to diagnosing whether a patient’s weight is healthy or not.
A referral isn’t needed to consult with a bariatric surgeon. The main barrier, though, is insurance and cost. Most insurance companies will require a certain body mass index (BMI) and consider other factors like height, weight and any medical problems connected to being obese.
Fortunately, Dr. Hymel’s team includes a patient coordinator to help navigate all the insurance paperwork.
“The most common patients we are seeing, they are at the point where they are tired of being overweight and tried a variety of things, yo-yo dieting for many years,” Dr. Hymel says. “They have come to the decision to take this more aggressive and more final step to achieve the health and fitness they need.”
What Kind of Preparation is Involved?
Patients are expected to participate in several weeks to sometimes several months of preparation before bariatric surgery.
Because it’s an elective procedure, bariatric surgeons want to make sure their patients are medically optimized for surgery, so their experience is as safe as possible. That includes getting things like the patient’s blood pressure, heart health, lung capacity and more in check, as well as any medical clearances needed for an existing condition — things doctors might not have a chance to address ahead of an emergency procedure.
“This decreases the complication rate and absolutely improves patient outcomes,” Dr. Hymel says.
Most importantly, patients begin working toward better dietary and physical activity habits ahead of surgery. Dr. Hymel and a registered dietitian on her team regularly meet with patients to guide them through this process so those healthy habits are more likely to continue after surgery.
“Research shows that patients who lose weight before surgery have less complications and better outcomes,” she says.
Note: This is part one of a two-part series about bariatric surgery. To learn more about what to expect after surgery and its long-term benefits, read part two here.
